March 2017

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MARCH <strong>2017</strong><br />

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2 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>


You asked us to help stop the loss of valuable sales and profits to online retailers.<br />

We created Sparkle!<br />

Register your patients on it now. Call our team on 0800 658 386.<br />

<strong>March</strong> <strong>2017</strong><br />

by Radiant Health<br />



The sad, the bad and the beautiful<br />


<strong>March</strong> sees us welcome the wonderfully<br />

talented Cait Sykes to our pages. A<br />

mum, an editor, a long-time business<br />

journalist and friend, Cait has penned the first of<br />

a series of more general business features we’re<br />

planning that are crafted and tailored specifically<br />

for our industry.<br />

Sadly, the first one couldn’t be more timely as it<br />

tackles theft, which some of you are still reeling<br />

from in what, anecdotally at least, seems to be a<br />

spate of break-ins as thieves focus on brandedsunwear<br />

ranges (see p18). And it’s not just those<br />

in retail hotspots who are being targeted, BTP’s<br />

Jill Stackhouse had her car broken into in a central<br />

city carpark (see story this page).<br />

But enough of the bad, there’s still plenty<br />

to smile about like the amazing group of<br />

young ophthalmologists and researchers<br />

celebrated at this year’s wonderful Excellence<br />

in Ophthalmology awards (p22). It was great to<br />

catch up with all the folk from the ophthalmology<br />

department again and I even managed to capture<br />

my predecessor, Maryanne Dransfield on film<br />

which, after being snapped by her for years, I<br />

thought some of you might appreciate! This year’s<br />

awards evening was a particularly warm occasion<br />

as the Calvin Ring Award was won by Dr Charlotte<br />

Jordan, who’s well-known to many of you having<br />

obtained a first in optometry before moving onto<br />

ophthalmology. What made it so warm, however,<br />

was the close friendship Charlotte has with the<br />

Ring family and department head Professor<br />

Charles McGhee, who stayed with the Rings when<br />

he first arrived in New Zealand so has known<br />

Charlotte (or ‘Charlie J’ as the family call her) since<br />

she was 15. The speech made by Dr Peter Ring’s<br />

daughter, also Charlotte, in honour of her friend<br />

brought a tear to the eye.<br />

For more heart-warming, beautiful behaviour<br />

check out the Christchurch care home initiative<br />

devised by optometrist Tianyuan Qu and his<br />

engineer wife Irene Kong (p8). And if you’re still<br />

debating whether to attend the CCLS conference<br />

in beautiful, sunny Nelson this year, our feature<br />

on p11-15, which includes a revealing look into<br />

what drives some of this year’s keynotes, should<br />

have you rushing to register. Plus, for even more<br />

beauty, we’ve got all the latest on the world of<br />

beautiful frames: check out Kylie’s Minogue’s<br />

photoshoot, this page; General Optical’s MCM<br />

brand on p8; Groovy Glasses stunning refit on<br />

p17; and of course our now regular fashion<br />

update on p26). If you’re in the OIG, make sure<br />

we’re getting all the news from all your frame<br />

brands, so we can include it in our updates!<br />

But if frames aren’t your thing, how about<br />

technology and the latest clinical advances. There’s<br />

the world’s first eye operation by robot (p6) and the<br />

latest thinking on glaucoma from ANZGIG (now<br />

ANZGS) on p23 and the cornea on p25, penned by<br />

our own Dr Graham Reeves and Professor Charles<br />

McGhee, respectively. Thanks guys.<br />

Enjoy.<br />

Lesley Springall, publisher, NZ Optics<br />

Are you a World Master?<br />

Word on the ophthalmic street is<br />

this year’s World Masters Games is<br />

going to be peppered with a heavy<br />

dose of ophthalmic industry representatives.<br />

NZ Optics’ own Nick Griffiths has entered the<br />

squash tournament, there’s a well-known Kiwi<br />

ophthalmologist in the 400m, and apparently<br />

there’s a host of<br />

others both from New<br />

Zealand and Australia<br />

entering. If you are,<br />

we’d love to hear from<br />

you. Just drop us a line<br />

at lesley@nzoptics.co.nz ▀<br />


Cardinal Eyewear at www.cardinal.co.nz<br />

Zeiss hits our slopes<br />

Zeiss is introducing<br />

snow goggles to<br />

New Zealand and<br />

Australia for the first time.<br />

The international lens<br />

company has been making<br />

and supplying high<br />

quality snow googles to<br />

the European market for<br />

a number of years, but<br />

this year will be the first<br />

time they are available in<br />

Australasia.<br />

Pamela Andrews,<br />

marketing<br />

manager-consumer<br />

products at Zeiss<br />

in Australia, says<br />

they are “incredibly<br />

popular” in Europe,<br />

but haven’t been<br />

introduced into<br />

Australasia until now<br />

because Australia wasn’t<br />

a particularly strong snow market. “But New<br />

Zealand certainly is. They are a great product and<br />

a new range has just been released so we thought<br />

it was the perfect opportunity to bring them to<br />

market here.”<br />

Zeiss Snow Goggles are created especially for<br />

the challenges posed by alpine sports, says the<br />

company, they are robust and light, with 100%<br />

UV protection, a large visual field and improved<br />

contrast vision in both bright sunlight and diffuse<br />

light. “Zeiss Snow Goggles feature many different<br />

models… and are available with easy-to-change<br />

lenses. Several types of mirror coatings and a large<br />

selection of high-performance tints don’t just give<br />

your goggles a fashionable, unique look: they also<br />

Watch out for stolen goods<br />

Trish Orr, from New Zealand high-end frames<br />

distributor BTP International Designz is<br />

asking industry colleagues to keep an eye<br />

out for a significant amount of stock stolen<br />

from her colleague Jill Stackhouse’s car in early<br />

February.<br />

The thieves broke a rear<br />

window in Stackhouse’s car<br />

in a central city carpark in<br />

Auckland during the day and<br />

made off with thousands of<br />

dollars’ worth of stock, despite<br />

the car being alarmed and the<br />

stock being covered with an<br />

old, dark blanket. “Luckily Jill,<br />

wasn’t there, so she was fine,”<br />

says Orr adding, however, that<br />

she was understandably upset,<br />

and even more so when she<br />

discovered the police had little<br />

interest in helping and the<br />

Wilson Carpark team wouldn’t<br />

even look at the security tape<br />

unless the police requested it.<br />

“It’s not been a good start<br />

Jill Stackhouse’s smashed car window<br />

ensure ideal vision in all weather,” says Zeiss. The<br />

goggles also cater for spectacle wearers with a clip<br />

insert for prescription lenses.<br />

There will be point-of-sale material and though<br />

there are no specific trade promotions available<br />

currently, the company is likely to launch<br />

something in the near future, says Andrews.<br />

“The ski season is June through to October, so<br />

we wanted to give people plenty of notice prior to<br />

the season coming into play.”<br />

The goggles will be available for order from 6<br />

<strong>March</strong> and will be on display at Silmo Sydney<br />

from 9-11 <strong>March</strong> at the International Convention<br />

Centre in Sydney’s Darling Harbour. For more, see<br />

the ad on p17. ▀<br />

Queen of Pop eyewear<br />

Kylie Minogue has<br />

launched her<br />

first collection of<br />

eyewear on Valentine’s<br />

Day, complete with<br />

sexy photoshoot<br />

showing the collection<br />

from morning to night.<br />

The new range, which<br />

will be sold exclusively<br />

in Specsavers, draws<br />

inspiration from her<br />

glamorous lifestyle,<br />

says the self-styled<br />

Queen of Pop and<br />

international megastar.<br />

The collection is<br />

designed around<br />

three key themes:<br />

modern classics, subtle<br />

bling and reinvented<br />

vintage and includes<br />

several petite styles at<br />

Minogue’s own request. Though the collection has<br />

been designed with women in mind, many can be<br />

worn by men too, say Specsavers. ▀<br />

to the New Year,” admits Orr, who’s now fighting<br />

through the insurance paperwork.<br />

Product taken includes: Porsche, sunglasses and<br />

optical; Vera Wang, sunglasses and optical; Kaos,<br />

optical; Olivier Contini, optical; and Rodenstock,<br />

sunglasses and optical.<br />

BTP is not the only company<br />

to have been hit by the bad<br />

guys, with media reports that<br />

Bell Neuhauser & Matthews<br />

Optometrists in Hamilton<br />

was burgled in late January<br />

after two thieves threw a rock<br />

through the door (it took four<br />

attempts to break it) and made<br />

off with thousands of dollars’<br />

worth of sunglasses. One thief<br />

has already been apprehended<br />

with the help of the company’s<br />

CCTV footage, however, but<br />

police are still looking for the<br />

second man. ▀<br />

For more about theft and<br />

protecting your practice<br />

against shoplifting, see p18.<br />

4 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>

<strong>March</strong> <strong>2017</strong> NEW ZEALAND OPTICS<br />


News<br />

in brief<br />


Marijuana has been given the<br />

thumbs down for treating<br />

glaucoma, reports Optometry<br />

Australia. A new report from the<br />

US National Academies of Sciences,<br />

Engineering and Medicine, ‘The<br />

Health Effects of Cannabis and<br />

Cannabinoids: The Current State<br />

of Evidence and Recommendations<br />

for Research’, which reviewed<br />

more than 10,000 scientific papers, concluded there was no<br />

real evidence to support cannabis as an effective treatment for<br />

glaucoma. “Non-randomised studies in healthy volunteers and<br />

glaucoma patients have shown short-term reductions in intraocular<br />

pressure with oral, topical eye-drops and intravenous cannabinoids,<br />

suggesting the potential for therapeutic benefit,” said researchers,<br />

but “a good-quality systemic review identified a single small trial<br />

that found no effect of two cannabinoids, given as an oromucosal<br />

spray, on intraocular pressure…suggesting a limited potential for<br />

cannabinoids in the treatment of glaucoma.”<br />


Second Sight Medical Products has announced encouraging results<br />

from its initial clinical safety and feasibility trial of its FDA-approved<br />

retinal prosthesis, Orion I. The company’s goal is to develop a visual<br />

cortical prosthesis that can provide artificial vision for individuals<br />

affected by virtually all forms of blindness by using an electrode<br />

array implanted on the surface of the brain over the visual cortex. A<br />

full clinical trial is still to come.<br />


Hoya Vision Care has expanded its capabilities by acquiring 3M’s<br />

safety prescription eyewear business. 3M has been supplying<br />

safety prescription eyewear for more than 90 years and has a<br />

strong foothold in the North American market as well as sales in<br />

Latin America, Europe and Asia. “The safety prescription eyewear<br />

business strongly complements Hoya’s existing portfolio, offering<br />

our customers a broader range of products while continuing to<br />

focus on high quality and service,” said Barney Dougher, president<br />

Hoya Vision Care, Americas.<br />


The latest figures from Organ<br />

Donation New Zealand (ODNZ) show<br />

there were a total of 61 deceased<br />

organ donors in 2016, a 69%<br />

increase over the past four years.<br />

From these donors, 181 organs were<br />

transplanted, representing a 57%<br />

increase over the same time period,<br />

though only 46% of deceased organ donors donated eye tissue.<br />

ODNZ, however, facilitated a further 60 eye tissue donations from<br />

donors who could not donate organs.<br />


Supported by RANZCO, the Australian Ophthalmic Nursing<br />

Association are in the process of formalising an Australian<br />

Ophthalmic Nurses Association National Council (AONANC). The<br />

new, national body will represent the whole Australian ophthalmic<br />

nursing community. RANZCO says it believes having a main-pointof-contact<br />

in the ophthalmic nursing community will enable greater<br />

collaboration and engagement between the profession and the<br />

wider eye healthcare community.<br />


The Ministry of Health released new data showing 148,000 more<br />

Kiwis have received a first specialist assessment (FSA) since 2008,<br />

a rise of 37%. Acceptance rates for FSA assessments are also higher<br />

with data showing there were 177,400 FSA referrals between April<br />

and June 2016, of which 87% were accepted.<br />


A US study has uncovered “large inconsistencies” when comparing<br />

symptoms reported in an electronic medical record (EMR)<br />

compared with patient reports on Eye Symptom Questionnaires<br />

(ESQs). Researchers compared symptoms checked off by 162<br />

patients on paper-based questionnaires with information entered<br />

in their electronic clinic charts. Between a quarter and a half of<br />

patients’ data on blurry vision, glare, pain and redness from the<br />

questionnaires didn’t match the EMR. The data suggests that<br />

symptom reporting varies between methods, with patients tending<br />

to report more symptoms on self-reported questionnaires, said<br />

researchers in JAMA Ophthalmology. “These results suggest that<br />

documentation of symptoms based on EMR data may not provide a<br />

comprehensive resource for clinical practice or ‘big data’ research.”<br />


Sun Pharma has launched BromSite (bromfenac ophthalmic<br />

solution) 0.075% in the US following several clinical studies<br />

demonstrating a strong safety and efficacy profile in cataract<br />

surgery patients. Approved by the FDA in April 2016, BromSite is<br />

the first nonsteroidal anti-inflammatory drug (NSAID) approved to<br />

prevent ocular pain and treat inflammation in the eye following<br />

cataract surgery.<br />

First by robot<br />

Eye surgeons at University Hospitals Leuven in Belgium have<br />

successfully used a surgical robot to operate on a patient with<br />

retinal vein occlusion. The robot, developed specifically for<br />

purpose by Leuven University (KU Leuven), uses a needle, barely<br />

0.03mm in diameter, to inject a thrombolytic drug into the patient’s<br />

retinal vein to remove blood clots.<br />

Current treatment for retinal vein occlusion, which can lead to<br />

blindness, consists of monthly eye injections that only reduce the<br />

side effects of thrombosis. But researchers from University Hospitals<br />

Leuven and KU Leuven are studying retinal vein cannulation (RVC),<br />

a revolutionary treatment that addresses the cause of retinal vein<br />

occlusion by removing the blood clot in the retinal vein.<br />

RVC is a promising method, say researchers, that requires the<br />

eye surgeon to insert an ultrathin needle into the vein and inject<br />

medicine to dissolve the blood clot. This is challenging as a retinal<br />

vein is only 0.1 mm wide, similar to a human hair. No surgeon can<br />

manually inject a drug into such a thin vein while holding the needle<br />

perfectly still for 10 minutes, they say. “The danger of damaging<br />

the vein or the retina would simply be too high.” Which is why<br />

researchers from KU Leuven’s Department of Mechanical Engineering<br />

embarked on developing a robotic device to allow a surgeon to insert<br />

the needle in a very precise and stable way and, once inserted, can be<br />

held perfectly still by the robot for as long as required.<br />

Thinking eyewear launched<br />

The world of wearable technology reached<br />

another milestone with the launch of<br />

brain-sensing eyewear, designed to<br />

improve cognitive function and concentration.<br />

The rather clumsily-named ‘Smith Lowdown<br />

Mpowered by Muse’ combines Canadian tech<br />

company Interaxon’s Muse brain-sensing technology with Italian<br />

eyewear manufacturer Safilo Group’s Smith Lowdown frames.<br />

Designed for athletes and outdoor enthusiasts, the new “smart”<br />

Smith sunglasses were unveiled at the <strong>2017</strong> Consumer Electronics<br />

Show in Las Vegas in January. The Smith frames integrate<br />

brainwave-sensing technology measuring electroencephalogram,<br />

electrooculography and electromyography technologies as well as<br />

other sensors like three-axis accelerometer, gyro and magnetometer,<br />

a UV and pressure sensor and a temperature gauge.<br />

The brain is central to athletic development and outcomes, not to<br />

mention the quality and value of those outcomes, said the companies<br />

in a joint statement. “By implementing the Muse technology<br />

into Smith glasses [we] have advanced a brain-first approach to<br />

maintaining brain health and performance.”<br />

Interaxon’s Muse brain-sensing technology has been in use for two<br />

years in the company’s Muse meditation headband. The technology<br />

measures brainwave activity during meditation and provides users<br />

with feedback and guidance to help them relax and focus. Interaxon<br />

describes the experience as listening to the sound of waves lapping<br />

against the beach: the more focused you are, the quieter and lighter<br />

the waves sound; the less focused, the more thunderous and stormy.<br />

At the end of each brain-training session, the accompanying app<br />

provides users with feedback and a performance score.<br />

“We’ve been providing superior vision and safety through our<br />

market-leading goggles and helmets for more than 50 years and are<br />

excited to add cognitive training and conditioning to our offering,”<br />

said Thorsten Brandt, general manager of Safilo’s sports and outdoor<br />

lifestyle brands. “Active consumers at all levels intuitively understand<br />

the importance of finding their focus, yet up until now, there<br />

CLs differ in myopia battle<br />

The results of a new study, presented<br />

at the American Academy of<br />

Optometry’s annual meeting late<br />

last year, indicate that certain contact<br />

lenses may be better for treating myopic<br />

patients, particularly children.<br />

CooperVision shared its two-year<br />

interim results from a clinical trial<br />

evaluating its MiSight dual-focus myopia<br />

control 1-day soft contact lens. The<br />

dual-focus lens demonstrated a slowing<br />

in myopia development in children by<br />

59% over two years when compared to<br />

children in the control group wearing a<br />

single vision 1-day contact lens.<br />

www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand<br />

Initial concerns from parents were<br />

also quickly overcome in the study, with<br />

82% of parents rating their children<br />

as ‘extremely happy’ with the overall<br />

experience. Nearly 80% of participating<br />

children, in both the test and control<br />

groups, also said they preferred wearing<br />

contact lenses to glasses.<br />

A Brien Holden Institute study projects<br />

the prevalence of myopia to increase<br />

from approximately two billion people<br />

worldwide in 2010 to almost five billion<br />

people in 2050. (See also p20-21) ▀<br />

“We are extremely proud our robot enables us to perform eye<br />

surgery that was previously impossible to perform safely,” says KU<br />

Leuven Professor Dominiek Reynaerts. “This brings us one step closer<br />

to commercialising this ground-breaking technology.”<br />

The robot is the result of seven years of collaborative research<br />

between the Hospitals’ ophthalmologists and KU Leuven. The current<br />

phase I trial aims to demonstrate it is technically feasible to use a<br />

robotic device to insert a microneedle into the retinal vein and inject<br />

ocriplasmin to dissolve the clot, while a planned phase II trial will<br />

research the clinical impact for patients. ▀<br />

hasn’t been a lot of products that help you up your mental game.<br />

We believe our collaboration with Interaxon is truly unique and<br />

something our customers will love. This is a first in bringing together<br />

innovative products that beautifully blend technology, form and<br />

style.”<br />

Derek Luke, CEO of Interaxon, said the company was excited by<br />

the launch. “Wearers of Lowdown Focus Mpowered by Muse will<br />

be supported to develop a consistent mental training practice,<br />

leading to greater levels of performance and focus whether they’re<br />

competing, studying, parenting or working. Our collaboration with<br />

Safilo has resulted in the first mental performance-enhancing<br />

eyewear on the market and the first device users will wear<br />

throughout the day, increasing the likelihood they will engage in<br />

beneficial exercises more often and consistently.”<br />

The new smart Smiths should be available for purchase later this<br />

year. The Muse technology will eventually be available with Safilo<br />

brands Smith, Carrera and Polaroid. ▀<br />

For general enquiries or classifieds please email info@nzoptics.co.nz<br />

For editorial, please contact Lesley Springall at lesley@nzoptics.co.nz or +64 27 445 3543 or Jai Breitnauer at editor@nzoptics.co.nz or +64 22 424 9322<br />

For all advertising and marketing enquiries, please contact Susanne Bradley<br />

at susanne@nzoptics.co.nz or +64 27 545 4357 in the first instance, or Lesley Springall at lesley@nzoptics.co.nz<br />

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

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

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

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

those of NZ Optics 2015 Ltd or the editorial team.<br />

6 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>


REMAINS.<br />


In early 2007, our original Port Melbourne lens laboratory and fledgling support office<br />

opened for business, igniting the first sparks of the Specsavers optical revolution.<br />

One year later, we unveiled our very first stores, heralding the opening of an<br />

incredible 150 Australian stores in just nine months and our first six New Zealand<br />

stores. Consumers in both countries were quick to embrace our simple offer of<br />

high quality eye care and affordable, stylish eyewear – allowing our stores not just<br />

to grow but to thrive.<br />

Fast forward to <strong>2017</strong> and we now have 370 Specsavers stores operating across the<br />

two countries with annual sales approaching $800 million in Australia and over<br />

$100 million in New Zealand. Our customer database has grown to over six million<br />

individuals and we dispensed more than 4 million pairs of glasses over the past 12<br />

months alone, at an average of 80,000 pairs every week.<br />

Partnership – underpinning our success<br />

At the very beginning, we set out our stall to optometrists and dispensers<br />

under the banner ‘A Passion for Partnership’. We presented a new, inclusive<br />

business model that was open to all those with ambition and a passion for<br />

service excellence.<br />

Ten years on our passion for partnership remains undimmed. The Partnership<br />

model that pairs an optometrist and an optical dispenser as partners in their own<br />

store has propelled hundreds of optical professionals into business ownership,<br />

creating hundreds of successful, profitable, community practices and thousands<br />

of current jobs. And the Partnership between the Store Partners and Specsavers<br />

grows ever-stronger, underpinned by an unrivalled business support structure.<br />

Back in 2007, we talked to optometrists and dispensers the length and breadth<br />

of Australia and New Zealand about the Specsavers Partnership – and we are still<br />

doing so today. To gain an insight into our plans for the years ahead and to find out<br />

if you are ready for Partnership in a store of your own, talk to us now in confidence<br />

– and spark your very own optical revolution.<br />

To get the conversation started, contact Sinead Convery on<br />

+61 427 754 076 or sinead.convery@specsavers.com<br />

Millward Brown<br />

Research<br />

No.1 for eye tests<br />

2016<br />

Excellence in<br />

Marketing<br />

Award<br />

2016<br />

Retail<br />

Store Design<br />

Award<br />

2016<br />

Retail<br />

Employer<br />

of the Year<br />

2015<br />

Overall<br />

National<br />

Supreme Winner<br />

2015<br />

Franchise<br />

Innovation<br />

Award<br />

2015<br />

NZ Franchise<br />

System of<br />

the Year<br />

2014<br />

Retail<br />

Innovator<br />

of the Year<br />

2014<br />

Roy Morgan<br />

Research<br />

No. 1 for eye tests<br />

2014<br />

FCA Social<br />

Responsibility<br />

Award<br />

2014<br />

<strong>March</strong> <strong>2017</strong><br />



A respectful vision<br />

Optometrist Tianyuan Qu is a naturally<br />

chatty individual, but he makes an extra<br />

effort when his elderly patients arrive at<br />

his Christchurch practice, especially if they come<br />

from a care home, he says. “In Chinese culture, we<br />

believe you should cherish every single moment<br />

with parents and grandparents.”<br />

Good eye care is a key enabler to living an<br />

independent life, but isn’t always readily accessible<br />

to the older segment of the population, says Qu,<br />

quoting studies showing one in every two elderly<br />

people has a vision problem.<br />

Since the February 2011 earthquake, the<br />

population of Christchurch has shifted to the<br />

Visiting a patient at Summerset retirement home<br />

Biof inity Energys <br />

With Digital Zone Optics lens design<br />

A breakthrough for sphere lens wearers<br />

Digital Zone Optics <br />

lens design<br />

• Helps ease the accommodative burden without<br />

impacting distance visual acuity<br />

• Multiple front-surface aspheric curves<br />

- across the entire optical zone<br />

- distribute power evenly to simulate more<br />

positive power in the centre of the lens<br />

8 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong><br />

3<br />

3<br />

suburbs yet most optometry<br />

businesses remain relatively central.<br />

That can mean a drive of 35 minutes<br />

to see an optometrist, with many<br />

patients brought in by a family<br />

member who may only visit once a<br />

week or once a month.<br />

“There are 77,400 elderly people<br />

living in Christchurch, 28% of them<br />

outside the central city. Many local<br />

care home residents have family in<br />

Auckland or Melbourne, and they<br />

don’t have transport to get to a local<br />

practice,” says Qu, emphasising care<br />

home staff do a great job but are stretched<br />

thin. “They cherish their visits from children<br />

and don’t want to fill them in with routine<br />

appointments. They want to have fun.”<br />

Many patients report the same experience<br />

of retirement, he says, “that it really sucks.”<br />

So Qu and his wife, structural engineer Irene<br />

Kong, felt there had to be something they<br />

could do to make the life of their elderly<br />

patients a little better. The result was to bring<br />

eye care services to retirement villages and<br />

care homes to help lift some of the strain.<br />

Qu and Kong joined ‘Live the Dream’, a<br />

nine-week intensive accelerator programme<br />

for social enterprise. With a tool box of<br />

necessary skills, they began contacting the<br />

Tianyuan Qu and Irene Kong<br />

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organisations that could support their endeavour,<br />

including the care homes themselves.<br />

“It was difficult to organise. Care homes are<br />

very busy places and at first it was hard for them<br />

to find the time to accommodate us,” says Qu.<br />

“But now they understand we are taking away a<br />

burden, relieving staff to focus their time on other<br />

activities around the care home.”<br />

Qu and Kong have been to three care homes<br />

in Christchurch since January, Summerset at<br />

Wigram, Anthony Wilding (Ryman Healthcare)<br />

and Woodcote (Ryman), and have seen around 40<br />

patients, as well as operating a service out of the<br />

BizDojo premises in the city. This wouldn’t have<br />

been possible without the support of the local<br />

optometry community, says Qu.<br />

© CooperVision <strong>2017</strong><br />

The Christchurch care home team: (back row) Natasha Louise, Sephy Ming Cheng,<br />

Tianyuan Qu, (front) Shannon Pope, Katarina Marijcarz and Douglas Mullan<br />

“Our team consists of optometrists Douglas<br />

Mullan, Jasmine Seok, Jasmine Zoest, Sephy<br />

Ming Cheng and Katarina Marcijasz, a part IV<br />

optometry student and NZOSS educational<br />

rep., and optical assistants Natasha Louise and<br />

Shannon Pope. Everyone has volunteered their<br />

time. We also have to acknowledge Specsavers<br />

Hornby, Riccarton and Shirley for providing<br />

optometry equipment, and ACG Yoobee design<br />

school for video recording.”<br />

Qu and Kong are really just starting out with<br />

their endeavour, raising awareness and seeking<br />

further help, but they feel this project has a lot of<br />

potential filling a gap in post-quake healthcare<br />

services. ▀<br />

For more, email mobileye.nz@gmail.com<br />

GenOp: a focus<br />

on luxury<br />

Australasia frames distributor General Optical, owned by<br />

VSP Global, has grouped together its luxury frames brands,<br />

some old, some new, into a new luxury frames portfolio. This<br />

means they can be marketed together direct to practices who have<br />

a focus on the finer things.<br />

“Our focus with the luxury brands is to partner exclusively with<br />

stockists who<br />

understand<br />

these brands and<br />

merchandise<br />

them in a way<br />

that is consistent<br />

with each of the<br />

brand’s values,”<br />

says Brad Saffin,<br />

managing<br />

director of VSP<br />

Global Australia.<br />

“Luxury brands<br />

are and have<br />

always been a bit<br />

more exclusive<br />

than traditional<br />

fashion and<br />

lifestyle brands.<br />

To be effective,<br />

it’s important<br />

to merchandise<br />

them consistently<br />

with their brand<br />

values, and in<br />

locations that<br />

are marketing<br />

to their target<br />

audiences.”<br />

Currently the<br />

luxury side of<br />

General Optical’s<br />

range includes Calvin<br />

Klein Collection, Chloé, Etro, Salvatore Ferragamo and, relative<br />

newcomer, MCM.<br />

MCM is about unique luxury, youthful luxury, says Saffin. “Many<br />

old school European houses have great craftsmanship and heritage,<br />

but the results are too conservative for emerging consumers in<br />

Asia. In Asia today it’s all about the young professionals who are the<br />

next generation of consumers. They have different needs and a new<br />

perception of luxury. That’s what MCM is feeding on.”<br />

According to Sung Joo Kim, founder, chair and “chief visionary<br />

officer” of the Korean-based retail group Sungjoo Group, which<br />

bought MCM in 2005, the German-based accessories company’s<br />

success so far has hinged on the understanding of major<br />

developments in the luxury market. “Millennials are ‘born with<br />

computers’, so they have a completely different approach to life and<br />

expect brands to be interactive, luxurious, and functional,” she’s<br />

reported as saying.<br />

Saffin stresses however, this focus on luxury brands is not to the<br />

detriment of the company’s other brands. “We have always had a<br />

robust portfolio of brands to represent all segments of the market,<br />

luxury brands included. It’s important that we maintain diversity in<br />

our portfolio to serve every customer at every price point.”<br />

See associated story on Nike Vision’s latest innovation<br />

collaboration with Zeiss p16. ▀

OPSM appoints NZ head<br />

OPSM has appointed<br />

Samantha Payne<br />

as country director<br />

for New Zealand.<br />

Payne, originally from<br />

the UK, has a corporate<br />

retail background,<br />

including head of<br />

operational excellence,<br />

joint ventures, for Mitre<br />

10 and national sales<br />

and project manager<br />

for Masters Home<br />

Improvement in Australia.<br />

The daughter of an army<br />

father, Payne started her<br />

career as a senior aircraft<br />

Samantha Payne<br />

engineer in the UK Royal<br />

Airforce, which she says taught her a great<br />

deal about how people work and gave her a<br />

real sense of perspective. Working in a tent,<br />

in rough conditions during pressured times<br />

on a Chinook helicopter, you learn quickly<br />

not to sweat the small stuff, she says.<br />

A working mother of four young children,<br />

Payne was interviewed for the OPSM NZ<br />

position just a few days before her fourth<br />

child was born. She began training at<br />

OPSM’s parent company, Luxottica’s head<br />

Epsom: new owner offers CPD<br />

Auckland’s Epsom Eyecare has been bought<br />

by dispensing optician Andy Willmott,<br />

formerly director of Specsavers in Botany.<br />

Willmott has a 30-year background in optometry<br />

and started off in independent practice. He’d<br />

already decided to sell his Specsavers store to<br />

pursue other avenues and hadn’t been considering<br />

buying an independent optometrist when he<br />

discovered the Epsom practice was for sale<br />

following an ad in NZ Optics. “The Epsom Eyecare<br />

practice presented an opportunity to take on a<br />

new challenge.”<br />

The challenge of growing the business was the<br />

office just two months<br />

after the birth, before<br />

moving to New Zealand at<br />

the beginning of January.<br />

A keen amateur artist,<br />

her interest in optics stems<br />

from a late diagnosis<br />

of astigmatism, which<br />

caused her to panic about<br />

her sight, she says. “I can<br />

relate to how life changing<br />

a sight problem can be<br />

and I remember going to<br />

the optometrist in tears<br />

thinking that I wouldn’t be<br />

able to continue with my<br />

art, but the optometrist<br />

was amazing the way she<br />

explained things for me. If we can give our<br />

customers that kind of experience, I would<br />

be really happy”.<br />

Payne says she’s excited about her new<br />

role and about setting a strong direction for<br />

the company in New Zealand focused on<br />

OPSM’s tagline, ‘OPSM loves eyes’.<br />

“I believe OPSM is a real powerhouse,<br />

combining the best technology available<br />

and highly skilled optometrists with an<br />

amazing brand.” ▀<br />

main attraction, he says, adding he’s been going<br />

at full steam since taking over the practice at the<br />

end of last year: installing an OCT; introducing<br />

on-site glazing; re-introducing ortho-k and<br />

myopia control; and kicking off a new marketing<br />

plan. “There isn’t going to be a re-brand, but we<br />

have opened up the window and brightened the<br />

interior.<br />

“This is most definitely a challenge, but it was<br />

the same at Specsavers and in the UK where<br />

I successfully turned an independent practice<br />

around. It will be a long haul to achieve growth,<br />

but plans are already in action.”<br />

Cardinal introduces Jensen,<br />

Rock*Star<br />

New Zealand frame distributor<br />

Cardinal Eyewear has added another<br />

string to its bow with the addition of<br />

Eyespace Eyewear’s brands to its portfolio.<br />

The award-winning British eyewear<br />

company approached Cardinal directly<br />

last year, says Cardinal’s John Wedlake.<br />

“Eyespace have been selling their optical<br />

frame products in the UK and Europe for a<br />

number of years and in 2016 they created<br />

an Export Team with a view to entering<br />

several overseas markets. They identified<br />

Cardinal Eyewear through NZ Optics’<br />

website and, after reviewing Cardinal’s<br />

own website decided we were a very good<br />

match. Both companies are family-run businesses<br />

and we both strongly believe these create the most<br />

positive long-term relationships.”<br />

Cardinal has initially agreed to distribute two of<br />

Eyespace’s brands, its Rock*Star range and its Jensen<br />

range.<br />

Rock*Star are a “funky” range of frames, aimed at<br />

young people, 10 years and up, says Wedlake. “The<br />

modern shapes and small sizes also lend themselves<br />

very well to women with small faces.” Whereas<br />

men’s range Jensen are “instinctively modern…with<br />

In Botany, Wilmott grew his Specsavers’ business<br />

to an 18-strong team, with four consulting<br />

rooms providing up to 1000 eye examinations<br />

each month. He was also heavily involved with<br />

Specsavers’ professional development side,<br />

running bi-annual CPD conferences for dispensing<br />

opticians, optical assistants and optometrists – a<br />

practice he’s going to continue at Epsom. His first<br />

free Epsom CPD event was held on the 20 February<br />

on ortho-k and his next, on 20 <strong>March</strong>, is on<br />

glaucoma. He says he’s hoping to run monthly CPD<br />

events, offering 12 points a year to local DO’s.<br />

Former owner Jyotika Lal says she sold the<br />

Rock*Star frames now in New Zealand<br />

a European feel and quality.” Wedlake says both<br />

him and his business partner Rose Wedlake were<br />

especially attracted by Jensen’s very light weight<br />

titanium models in its “Jensen Black” range, which<br />

also includes some larger models, up to 60mm in size.<br />

“We have been very impressed because Jensen and<br />

Rock*Star are excellent quality products, priced at a<br />

level to provide good value to the end user.”<br />

Both Rock*Star and Jensen are available now and<br />

the Cardinal team will be showing them to customers<br />

over the next few months. For more, see ad on p4. ▀<br />

business so she could spend more time with her<br />

family. Epsom Eyecare doubled in size under her<br />

management and this was from the company’s<br />

total focus on good old-fashioned service, she says.<br />

“Epsom has the most loyal customer base, one<br />

I will miss, but my family’s needs have to come<br />

first.”<br />

Lal says she’s been surprised by the number of<br />

people who have approached her since learning of<br />

her decision to sell and says she’s now weighing<br />

up several new, exciting opportunities that will<br />

also give her the time she needs to spend with her<br />

family. ▀<br />

Education Series <strong>2017</strong><br />

Seminars<br />

are FREE!<br />


Tuesday 23rd May <strong>2017</strong><br />

6.30pm - 8.45pm<br />

Theme:<br />

Diagnostics and<br />

Therapeutics in<br />

Everyday Practice<br />

Venue:<br />

Ellerslie Event Centre<br />

Racecourse, 80 Ascot Ave<br />

Ellerslie, Auckland<br />

Registration:<br />

5.45pm - 6.30pm<br />

Light Meal & Beverages<br />

provided<br />

Eye Institute’s Education Series continues to offer an opportunity for the Optometry Profession to gain exposure<br />

to the latest advances in therapeutics, shared-care management and surgical advances in New Zealand.<br />

You are invited to join us on one or more of the following Seminars and Conferences for the <strong>2017</strong> year.<br />

2nd Seminar<br />

Tuesday 22nd August<br />

6.30pm - 8.45pm<br />

Ellerslie Event Centre<br />

Racecourse, 80 Ascot Ave<br />

Ellerslie, Auckland<br />


BOOK NOW!<br />

for your <strong>2017</strong> CPD Credits<br />

(including Therapeutics)<br />

Optometry Conference<br />

Sunday 5th November<br />

8am - 5pm<br />

Waipuna Hotel & Conference<br />

Centre, 58 Waipuna Road,<br />

Mt Wellington, Auckland<br />

PLUS 1/2 day workshops<br />

Saturday PM 4th November<br />

www.eyeinstitute.co.nz/optometry<br />

Or register by contacting...<br />

Amber Pio<br />

Ph 09 522 2125 | Fax 09 529 1814<br />

professionaleducation@eyeinstitute.co.nz<br />

Dispensing Optician Conference<br />

Sunday 5th November<br />

8am - 5pm<br />

Waipuna Hotel & Conference<br />

Centre, 58 Waipuna Road,<br />

Mt Wellington, Auckland<br />

<strong>March</strong> <strong>2017</strong><br />



Meet the … bio-engineer<br />

Dr Ehsan Vaghefi is known by friends and family as ‘the eye guy’, a<br />

name given to him by his dad, who is also his inspiration. Jai Breitnauer<br />

discovers the man behind the research<br />

Dr Ehsan Vaghefi is a quietly spoken, very private, but<br />

exceptionally passionate man. You get that from<br />

the handshake alone. His office, tucked into a quiet<br />

corner in the School of Optometry and Vision Science at the<br />

University of Auckland, is well-ordered and punctuated with<br />

personal photos – people are clearly important to him.<br />

“My background is in bioengineering and I wanted to use a<br />

novel, bioengineering approach to working with degenerative<br />

eye diseases,” he explains, when asked about his research.<br />

“I began imaging the eye using different modalities during<br />

my PhD and became very passionate about this. It’s an area<br />

where there is little research.”<br />

The central tenant underpinning Dr Vaghefi’s work is the<br />

idea of pre-diagnosis – that if you can find markers or model<br />

the behaviour of parts of the eye under certain conditions, you<br />

will be able to predict the likelihood of a patient developing<br />

a particular eye problem and ultimately prevent potential<br />

blindness.<br />

“My dad went blind when he was five-years old,” explains Dr<br />

Vaghefi. “He had congenital glaucoma, an ultimately treatable<br />

disease that went undiagnosed. He’s a successful man in<br />

his own right and a great dad – but my childhood was very<br />

different from my friends. While they were play fighting with<br />

their dads, I was helping mine with basic tasks like walking<br />

around. It drives me mad that his blindness was preventable.”<br />

When Dr Vaghefi went to university, his parents – both<br />

lawyers – were surprised he chose bio-engineering.<br />

“I said, ‘I want to help people like you, Dad.’ I knew he was<br />

proud of me for wanting to make a difference in this area. He<br />

calls me ‘the eye guy’.”<br />

After he finished his PhD, Dr Vaghefi says the school of<br />

Optometry and Vision Science was the natural place to go.<br />

He felt there was a lot to be done from a bio-engineering<br />

perspective. Clinicians, he says, are doing amazing work, but<br />

there is room for a fresh look at the eye.<br />

“We are seeing similar approaches for other systems in the<br />

body, like cardiovascular. Medicine in this area is predictive<br />

and preventative, but we can’t do this for vision right now.”<br />

Using up-to-the-minute MRI technology, using the<br />

University’s state-of-the-art MRI machine, Dr Vaghefi is<br />

imaging the blood flood in patient’s eyes to find predictive<br />

trends.<br />

“MRI has many benefits. It’s non-invasive and has no depth<br />

limitations, whereas most optical devices are limited to<br />

looking at the surface. MRI can be fine-tuned to image the<br />

same tissue in different ways looking at, for example, water<br />

content then oxygen content.”<br />

Looking at blood flow is a new area of development, which<br />

has opened up MRI’s usefulness for the eye.<br />

“Currently, ophthalmologists use angiography to look at<br />

blood flow, but this has two problems,” explains Dr Vaghefi.<br />

“Firstly, you have to inject a tracer into the blood stream, which<br />

Dr Ehsan Vaghefi<br />

makes this treatment invasive and perhaps not suitable for all.<br />

Secondly, all you can see from this is one moment in the blood<br />

flow, where the tracer enters that tissue. So, for example, you<br />

can see if a leak is present, but you can’t see the quantity of the<br />

leak or the speed of the blood flow.”<br />

Dr Vaghefi has designed a system that solves these<br />

problems. Using iron naturally present in the patient’s own<br />

red blood cells as a marker, he tags them using a neutral<br />

magnetic setup around the patient’s jaw bone area. The<br />

magnetic tag lasts for just a few seconds and doesn’t interfere<br />

with the patient at all, but it does allow Dr Vaghefi and his<br />

team to monitor the blood flow for a few seconds using the<br />

MRI machine, measuring the speed and quantity of the flow<br />

and getting a really good look at where that blood is, and isn’t,<br />

going in the eye. The full scan takes just seven minutes.<br />

“It’s quite simple science really,” he says noting that the<br />

possibility was always there, it just needed a sensitive enough<br />

MRI machine and someone, like himself, to have the idea in<br />

the first place.<br />

“When people think of MRI, they always think of the brain.<br />

But there’s a lot of applications for MRI technology if you think<br />

broadly and from a bio-engineering perspective.”<br />

So what’s the future for his research? Its potential knows<br />

no bounds, says Dr Vaghefi. But for now the team are<br />

concentrating on developing a model for pre-diagnosis of agerelated<br />

macular degeneration (AMD) and have applied for an<br />

HRC grant on the back of a successful pilot study to run a bigger<br />

clinical study on people newly-diagnosed with AMD and in the<br />

later stages of AMD. This study will<br />

look at blood flow patterns to see what<br />

the early warning signs of AMD could<br />

be and also what the blood flow looks<br />

like in later stages when patients are<br />

receiving treatment. It will run for more<br />

than three years.<br />

“It’s very exciting,” says Dr Vaghefi,<br />

who is aiming to launch the research<br />

trial later this year. “I believe the<br />

outcome of this trial will be informative<br />

and unique. As far as I know, we are<br />

the only research group in the world<br />

who has this perspective on AMD. We<br />

are aiming to get in a couple of steps<br />

before vision starts to degrade and if<br />

we can spot AMD here, then maybe we<br />

can prevent it.”<br />

This pre-diagnosis would involve a<br />

simple scan of people with certain risk<br />

factors and allow ophthalmologists to<br />

prescribe preventative lifestyle changes<br />

and medication before AMD damage<br />

has set in. The research will also look<br />

at the relationship between AMD<br />

progression, treatment and blood flow,<br />

giving medical practitioners the ability<br />

to fine tune the way they prescribe and<br />

treat patients suffering AMD related<br />

vision loss.<br />

The same technology can be applied<br />

to other vision damaging conditions as<br />

well, Dr Vasghefi adds. “Imagine going<br />

to a clinic and being told a couple of<br />

years beforehand that you were at risk<br />

of losing your sight for some reason<br />

and then being told what you can do<br />

now to prevent that from becoming a<br />

reality rather than just what they will<br />

do once the symptoms set in. If you<br />

can predict you can prevent. Predicting<br />

pathologies is my big drive. Preventing<br />

eye disease, not just managing it, is the<br />

next big thing.” ▀<br />

It’s green for<br />

glaucoma<br />

World Glaucoma Week (WGW) from 12-18<br />

<strong>March</strong> kicks off this year with an all-day event<br />

in Times Square, New York, which will be followed<br />

by a host of other inventive events around the globe.<br />

Across Japan, 34 landmark buildings will be illuminated in green with the<br />

‘Light Up in Green for Glaucoma’ campaign to help spread awareness. This will<br />

be complemented by special lectures in Tajimi by Dr Tadahi Nakano and a host<br />

of screening events.<br />

Closer to home, Glaucoma Australia is inviting everyone to ‘Beat Invisible<br />

Glaucoma’ (BIG) by hosting a BIG breakfast to raise funds for glaucoma<br />

awareness and education; the Department of Ophthalmology at the University<br />

of Auckland is hosting a fundraising morning tea; and Glaucoma New Zealand<br />

has been contacting numerous organisations to help drum up awareness.<br />

Thousands of glaucoma awareness initiatives have been held since the first<br />

World Glaucoma Week in 2010. The World Health Organization has identified<br />

glaucoma as the second<br />

leading cause of blindness<br />

in the world with 79.6<br />

million people expected<br />

to have lost their sight<br />

from glaucoma by 2020.<br />

“Enormous efforts will<br />

be needed in the next<br />

decade to overcome<br />

the impact of glaucoma<br />

around the world. New<br />

strategies concerning<br />

glaucoma screening,<br />

diagnosis, treatment<br />

and rehabilitation are<br />

mandatory,” said Maria<br />

Carrasco, WGW managing<br />

director.<br />

In other glaucoma news,<br />

registrations are now<br />

open for the 7th World<br />

Glaucoma Congress<br />

from 28 June to 1 July in<br />

Helsinki, Finland. In 2019<br />

the event will be held<br />

in Melbourne. For more<br />

information, visit: www.<br />

worldglaucoma.org. ▀<br />

For more on the latest<br />

research on glaucoma, see<br />

our story on ANZGIG <strong>2017</strong><br />

on p23.<br />

Light Up in Green for glaucoma in Japan<br />

Partnership reduces<br />

cataract costs<br />

Eye Institute has partnered with Southern Cross to reduce the cost of<br />

cataract procedures.<br />

The Auckland-based Eye Institute has committed to incrementally<br />

decrease the cost of a cataract procedure for Southern Cross members by almost<br />

30% to help make cataract surgery more affordable, both organisations said in a<br />

joint statement at the end of January.<br />

“With a significantly ageing population and stretched health dollars, we have<br />

entered into a long-term agreement with Southern Cross Health Society,” said<br />

Dr David Fitzpatrick-Cockram, Eye Institute CEO. “They wanted to ensure great<br />

value with the best possible outcomes and treatment experiences for their<br />

825,000 plus members. This marries with our commitments to provide high<br />

quality clinical care and exceptional patient service and in doing so maintain a<br />

sustainable sector.”<br />

Southern Cross’ main vehicle for providing members with cost certainty is its<br />

Affiliated Provider programme, where specialists provide procedures at agreed<br />

prices and streamline prior approval and claims processes for members. But this<br />

is contracting, said Geoff<br />

Searle, Southern Cross’<br />

head of provider networks.<br />

“With our increasing<br />

senior population, the<br />

number of cataract<br />

operations is increasing<br />

each year, [so] we need<br />

to be getting the best<br />

possible deal for our<br />

members. Eye Institute<br />

are definitely supporting<br />

us in this by providing<br />

exceptional patient<br />

experience at lower cost<br />

to the patient and in doing<br />

so, helping to keep the<br />

private healthcare sector<br />

affordable for a significant<br />

number of Kiwis.”<br />

Southern Cross Health<br />

Society currently funds<br />

around 9,000 cataract<br />

procedures each year. ▀<br />

Eye Institute CEO, Dr David Fitzpatrick-Cockram and Southern Cross’<br />

Geoff Searle<br />

10 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>

SPECIAL FEATURE: CCLS <strong>2017</strong><br />

CCLS: A little bit<br />

legendary<br />


Welcome to CCLS <strong>2017</strong>, with a new format and some exciting<br />

new speakers.<br />

In 2016, the CCLS Council changed the one-day conference<br />

format with the introduction of an optional workshop the day prior.<br />

The change was well received and paved the way for the Council to<br />

make changes to the format of the traditional three-day conference.<br />

In the past, our larger conference opened on the Thursday evening<br />

and was followed by a full-day on Friday, a half-day on Saturday and<br />

a half-day on Sunday, so attendees could enjoy the city they were<br />

visiting. The downside, however, was people had more time away<br />

from families and costs were higher.<br />

So we’ve revisited the timing for this conference. The opening<br />

function is still on the Thursday night, the 23 <strong>March</strong>, but now we<br />

have a full-day of conferencing on Friday 24 and Saturday 25 <strong>March</strong>,<br />

ending at 4.30 pm. So delegates can choose whether to fly home on<br />

Saturday evening or stay an extra night to explore. With about half the<br />

delegates returning home on Saturday and the other half staying on to<br />

enjoy Nelson, I’m delighted to say it’s clear giving people the option of<br />

an extra night has worked.<br />

This year we have a very exciting conference line-up in a very<br />

beautiful place – sunny Nelson. I’m particularly looking forward<br />

to hearing from Dr Marc Bloomenstein from Southern California<br />

who will be discussing inflammation and contact lens intolerance.<br />

I saw him at the Southern Regional Conference (SRC) in Melbourne<br />

a couple of years ago and his delivery is entertaining as well as<br />

educational. I’m also looking forward to hearing from our own<br />

Professor Charles McGhee and his take on Acanthamoeba, because<br />

it’s something we all need on our optometric radars, and Alex Petty<br />

on myopia control because it’s a personal interest. Then of course<br />

we’re very lucky to have Professor Fiona Stapleton join us again from<br />

Australia and Professor Ken Nischal from the Children’s Hospital in<br />

Pittsburg, as well as a host of great local speakers too.<br />

The conference wouldn’t be complete without our legendary<br />

dinner, which is being held on Friday night. In past years, we’ve seen<br />

some amazing costumes and we think the theme “Best-of-British”<br />

gives people lots of scope to have some fun this year too.<br />

So please join us. There are still a few spaces left. CPD points have<br />

been applied for. And I for one look forward to seeing you in Nelson.<br />

To register visit www.contactlens.org.nz for full details.<br />

Renowned speakers’ line-up for <strong>2017</strong><br />

This year promises an exceptional line of up international<br />

and home-grown speakers. International names Dr Marc<br />

Bloomenstein and Professors Ken Nischal and Fiona<br />

Stapleton, back by popular demand, join our own Professors<br />

Charles McGhee and Trevor Sherwin and a host of other local talent<br />

including Dr Trevor Gray, Alex Petty, Grant Watters, Robert Ng, Peter<br />

Walker and Eleisha Dudson, promising to make this CCLS two-day<br />

conference something special.<br />

NZ Optics asked some of the keynotes how they came to be<br />

involved in eye health and what they’re most looking forward to at<br />

this year’s CCLS conference in Nelson.<br />

Professor Charles<br />

McGhee<br />

Professor Charles McGhee<br />

heads up the Ophthalmology<br />

Department at the University of<br />

Auckland, is foundation director<br />

of NZ National Eye Centre and<br />

chair of the ANZ Cornea Society<br />

(see story p23.) At CCLS <strong>2017</strong><br />

he will be presenting on trends<br />

in corneal transplantation,<br />

Acanthamoeba keratitis, iris<br />

abnormalities and keratoconus<br />

management.<br />

Professor Charles McGhee<br />

Why eye health?<br />

It was entirely by serendipity. I was a medical student and I’d taken<br />

a couple of years out to do pathology during a time when I was<br />

thinking of giving up medicine and “going on the road” as part of<br />

a blues-rock band. However, my parents persuaded me to finish<br />

at least the pathology degree. Unfortunately, the professor of<br />

pathology thought I was ‘a bad example to other students’ and had<br />

suggested I should do something else, so when serendipitously the<br />

professor of eye pathology asked me to come and work for him, I<br />

did. He then arranged for me to pursue research at Harvard, after<br />

which I decided to finish both my pathology and medical degrees…<br />

and move into ophthalmology and eye research.<br />

What keeps you interested in eye health?<br />

It’s about trying to address the demand, because the demand<br />

always exceeds the supply. So I’m always looking at better ways or<br />

safer ways to meet demand. But what drives me generally in life,<br />

what wakes me up in the morning and gets me to work after 31<br />

years of doing ophthalmology, is curiosity. I’m always intrigued<br />

by ‘what if’, and so every day I like to think of something new<br />

and I surround myself with young, enthusiastic optometrists,<br />

ophthalmologists and scientists who always challenge the dogma<br />

of what we think we know.<br />

Why not dedicate yourself full-time to research?<br />

I spend about 50% of my week seeing patients and doing surgery<br />

and 50% of my week on research, so I do a very enjoyable, busy,<br />

six-day week. But there’s nothing like seeing someone who has<br />

a complex eye problem, working out what that problem is and<br />

solving it either medically or surgically. I’m very fortunate that<br />

my clinical practice is based around tertiary referrals, so most of<br />

my patients have already seen a number of ophthalmologists and<br />

optometrists, so I typically see the ‘weird and wonderful’ or ‘rare’<br />

cases. That complexity and patient interaction stimulates my<br />

clinical curiosity… and so I’m also fortunate that this challenging<br />

patient base often leads onto clinical research projects.<br />

What are you looking forward to most from CCLS <strong>2017</strong><br />

It always has excellent speakers you can learn from. I believe if<br />

you ever think you’ve ‘learned the lot’, you’re kidding yourself. Also<br />

one of the fantastic things about New Zealand is the networking.<br />

There isn’t a big hierarchy, everyone is happy to be approached<br />

about cases or interests. So one of the things I most enjoy is<br />

people bringing up interesting cases or questions; sometimes even<br />

posing questions that might be worth developing into a research<br />

project. So the personal exchange of ideas and discussion of cases<br />

and problems is probably the biggest thing I get from CCLS.<br />

What’s the one thing you’d like people to take away<br />

from your time at CCLS?<br />

We are still investigating keratoconus. We certainly don’t know<br />

the full story. We have a much better grasp of the aetiology and<br />

the prognosis and the outcomes of corneal transplants, but each<br />

year we chip away at the enigma of keratoconus. It’s 160 years<br />

since it was first described and we still actually don’t know what<br />

is the best management to recommend for every individual. So<br />

it’s worth always considering that there will be other discoveries<br />

and major developments, which may completely change the we<br />

manage keratoconus in the next 20 years.<br />



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8/04/16 5:22 PM<br />


SPECIAL FEATURE: CCLS <strong>2017</strong><br />

Dr Marc Bloomenstein<br />

American practitioner Dr<br />

Marc Bloomenstein is adjunct<br />

assistant professor at the<br />

Southern California College of<br />

Optometry and Arizona College<br />

of Optometry and director<br />

of optometric services at the<br />

Schwartz Laser Eye Center<br />

in Scottsdale, Arizona. He<br />

will be covering a number of<br />

different topics at CCLS <strong>2017</strong><br />

including inflammation and CL<br />

intolerance, povidone iodine<br />

vs topical ganciclovir for EKC,<br />

advanced corneal cross-linking,<br />

LASIK surgery and Restasis vs<br />

Xiidra for dry eye.<br />

Marc Bloomenstein<br />

What drew you into to eye health and influenced your<br />

journey?<br />

I always knew I wanted to work in the health industry; I wanted to<br />

help people. But I didn’t want to be in a hospital setting. I liked the<br />

idea of working with one organ and the ocular system has always<br />

fascinated me, so optometry seemed a good fit.<br />

I didn’t wear glasses as kid or have a squint and my parents weren’t<br />

in eye care, but I didn’t have great eye exam experiences. I remember<br />

my doctor sitting behind me in the examining room and using<br />

automated eye charts. We didn’t have much interaction. I wanted<br />

more of a relationship with my patients. I also found the surgical side<br />

of things fascinating in optometry school, which has influenced my<br />

practice to be more medically orientated. The anterior segment is<br />

something of a speciality for me.<br />

What are you most looking forward to at CCLS?<br />

First and foremost, the people. I was lucky enough to go to Australia<br />

and everyone was amazing; so engaged and interactive. I’m also<br />

interested in how different people across the globe perceive the<br />

same profession. In Trinidad, for example, I learned that access<br />

to healthcare and treatments we take for granted in the US, like<br />

drops or artificial tears, are not that accessible for doctors and<br />

optometrists there. That informs the way they practise.<br />

What do you hope delegates will take away from your<br />

sessions at CCLS?<br />

I hope they stay awake! A long time ago someone said to me that<br />

if you can have everybody walk out of the room knowing just<br />

one more thing than before they came, then that’s a win. I hope<br />

everyone will be engaged and my talks will feed into their daily<br />

practice, allowing them to approach something differently or be a<br />

little more pro-active for the benefit of their patients.<br />

Professor Ken Nischal<br />

Professor Ken Nischal heads up Paediatric Ophthalmology,<br />

Strabismus and Adult Motility at the Children’s Hospital of<br />

Pittsburgh and is professor of ophthalmology at Pittsburgh<br />

University’s School of Medicine. At CCLS <strong>2017</strong> he will<br />

be tackling blepharokeratoconjunctivitis, penetrating<br />

keratoplasty, acute corneal melt and alternatives to PKP in<br />

children, and congenital corneal opacification.<br />

What inspired you about eye health?<br />

I was a lazy medical student and found it easy to look at the<br />

eye – that’s the truth! However, early on in my training I saw<br />

a child with a tumour in one eye and that really inspired me<br />

to become involved in paediatrics.<br />

Later, during a placement in Oxford, I saw a child with Peters’<br />

anomaly, a clouding of the cornea that results in blindness. I<br />

was told by a senior colleague there was nothing that could be<br />

done. In the UK in 1998, it was deemed that the failure rate of<br />

infant corneal transplants was too high to justrify the trauma.<br />

Months later in Toronto, I saw a five-year-old who’d been born<br />

with the same condition and had a corneal transplant. He<br />

had a level of sight that meant he could lead an indpendent<br />

life. When I got back to the UK, I championed infant corneal<br />

transplants at Great Ormond Street Hospital and by the time I<br />

left in 2011, it was standard practice.<br />

What are you looking forward to at CCLS?<br />

Exchanging ideas and discussing what people are doing<br />

for adults and children. I always learn something at these<br />

events.<br />

What do you hope people will take from your talks?<br />

I am giving several, varied sessions, including a talk about<br />

acute corneal melt in children and how if you wait for the<br />

eye to go quiet, the<br />

damage will have been<br />

done. I recommend<br />

you operate when hot<br />

– that should generate<br />

some good discussion!<br />

I will also be talking<br />

about alternatives<br />

to full thickness<br />

corneal transplants<br />

in children and<br />

blepharoconjunctivitis<br />

– a condition many<br />

wrongly believe children<br />

can’t get. Paediatric<br />

approaches are often<br />

Professor Ken Nishal<br />

very different.<br />

Corneal Lens Corporation (CLC)<br />

<strong>2017</strong> is going to be an exciting year for Corneal Lens Corporation. A<br />

new distribution will be announced at the CCLS conference and Paul<br />

Rose has released the Rose K2 Soft lens for irregular corneas, now<br />

available in New Zealand through CLC.<br />

The SMap mapping system has had a number of developments<br />

that enhance the fitting of specialty lenses, the new benchmark in<br />

data collection of the cornea and sclera. Plus, we’ve got a number of<br />

new accessories for the management of dry eye. We look forward to<br />

seeing you at CCLS <strong>2017</strong> on stand 8.<br />

Abbott<br />

Abbott is a proud sponsor of CCLS and will be stationed at booth 7<br />

where Damien Liuzzo and Rachel Haynes will be representing Abbott<br />

ANZ Consumer Eye Health. They will showcase Blink Intensive<br />

Tears Plus gel drop 10ml, which is designed for enhanced ocular<br />

comfort and relief of the symptoms of severe dry eye. Blink Intensive<br />

Tears Plus gel drop’s visco-elastic technology provides maximum<br />

lubrication with minimal blurring. While some eye ointments and<br />

gels are messy and inhibit your vision, Blink Intensive Tears Plus gel<br />

drop’s synergistic action of sodium hyaluronate and polyethylene<br />

glycol formulation adapts to the eye’s natural blinking function and<br />

provides hypotonic long lasting relief and vision acuity. Preservative<br />

free in the eye. Free from Benzalkonium chloride.<br />

Alcon Vision Care<br />

Alcon’s Dailies Total1 water gradient contact lenses provide<br />

outstanding breathability and comfort 1 to meet the demanding<br />

needs of today’s contact lens wearers. Patients can now experience<br />

both the benefits of high oxygen transmissibility and a lubricious<br />

surface gel 2 with the world’s first and only water gradient contact<br />

lens 2 . The unique chemistry of the lens material allows the water<br />

content to increase from 33% at the core to almost 100% at the<br />

outermost surface 2-4 . Dailies Total1 also feature phosphatidylcholine,<br />

which is eluded into the tear film when needed through lipid layer<br />

stabilisation 5 . A modulus of 0.01MPa at the outermost surface allows<br />

the lens to mimic the softness of the corneal epithelial cells 6 . With<br />

exceptional comfort ratings 7 , let your patients experience the lens<br />

that feels like nothing 7 !<br />

References available on request.<br />




Single: up to 17mm diameter<br />

Stitched: up to 22mm diameter<br />


Single: H22mm x V17mm<br />

Stitched: H22mm x V22mm<br />


32,400<br />


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Manipulator: 14” x 13.5” x 7.5”<br />

(36cm x 34cm x 19 cm)<br />

12lb. (5.44kg)<br />

Chinrest: 21” x 10.5” x 3”<br />

(53cm x 27cm x 8cm)<br />

5lb. (2.26kg)<br />

Base: 20” x 14” x 3”<br />

(51cm x 36cm x 8cm)<br />

7lb. (3.2kg)<br />


Width: 9.5” x 13.5” x 6”<br />

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varied width from patient to doctor<br />

Depth: 17” (43cm)<br />

Height: 19”-21” (48cm - 53cm)<br />

[with head fully lowered and fully raised]<br />

WEIGHT<br />

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• Fluorescence based structured light<br />

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• Under the eyelid scleral measurements<br />

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• Polar display<br />

• Full 3D display<br />

TOOLS<br />

• Principle toricity display at varying diameters<br />

• Distance measurement<br />

• Mean sagittal height at varying diameters<br />

• Lens and sagittal height cross-section display<br />

• Customizable Data tips<br />

• Customizable color scales<br />

• Brightness and contrast adjustments<br />

• Customizable for multiple users<br />

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• Scleral Lenses<br />

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• Customized Soft Lenses<br />

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12 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>







CORE<br />

THIS IS WHY patients<br />

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DAILIES TOTAL1 ® contact lenses have an ultrasoft surface,<br />

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*Dk/t = 156 @ -3.00D. **Based on wearers agreeing with the statement, “while wearing my lenses, I sometimes forget I have them on”. †In vitro measurement of unworn lenses.<br />

References: 1. Perez-Gomez I, Giles T. Clin Optom 2014;6:17–23. 2. Angelini TE et al. Invest Oph & Vis Sci 2013;54:E-Abstract 500. 3. Angelini T. Hydrogel surface viscoelasticity and<br />

mesh-size characterized with microrheology. ARVO, 2013:E-abstract 1614872. 4. Dunn AC et al. Tribol Lett 2013;49(2):371–378. 5. Straehla JP et al. Tribol Lett 2010;38:107–113.<br />

6. Thekveli S et al. Cont Lens Anterior Eye 2012;35(Supp1):e14.<br />

See product instructions for wear, care, and safety information.<br />

© 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<br />

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<strong>March</strong> <strong>2017</strong> NEW ZEALAND OPTICS<br />


SPECIAL FEATURE: CCLS <strong>2017</strong><br />

CCLS boosts workshop numbers<br />

This year there will be four workshops at the<br />

CCLS conference in Nelson to ensure every<br />

delegate with a special interest is take care<br />

of, but places are limited so you need to sign up<br />

fast, say organisers.<br />

Workshop 1: Choosing and fitting the<br />

right Rose K design for the irregular<br />

cornea<br />

Time: Friday 24 <strong>March</strong> 2.10 - 3.10pm<br />

Host: Paul Rose, CNZM<br />

Ever taken a history and a topography, diagnosed<br />

an irregular cornea, and then been confused<br />

about which design you should fit? This workshop<br />

will cover how to<br />

choose the correct<br />

Rose K design from<br />

the six different Rose K<br />

designs available, with<br />

particular emphasis<br />

on live fittings of the<br />

corneo-scleral Rose K2XL<br />

design.<br />

Designs for Vision (DFV)<br />

The Rose K workshop will be<br />

given by none other than Paul<br />

Rose himself<br />

Workshop 2: Dry eye<br />

Time: Friday 24 <strong>March</strong> 2.10 - 3.10pm<br />

Host: Ally Xue<br />

This workshop offers a hands-on approach to dry<br />

eye, with opportunities to discuss diagnoses and<br />

treatment of the condition.<br />

Workshop 3: OCT – front to back<br />

Time: Saturday 25 <strong>March</strong> 8.00 - 8.45am<br />

Host: Richard Johnson and Dr Chris Murphy<br />

This workshop will cover the use of an OCT in<br />

everyday practice including cornea, anterior<br />

chamber assessment, macular and other retinal<br />

conditions.<br />

Workshop 4: Scleral Lenses – from start<br />

to finish<br />

Time: Saturday 25 <strong>March</strong> 8.00 - 8.45am<br />

Host: Eleisha Dudson and Andrew Sangster<br />

This scleral workshop will be a detailed and<br />

hands-on discussion on the fitting protocol of<br />

scleral lenses, using case examples and hands on<br />

practical fitting.<br />

For more speciality CLs and myopia control see<br />

p16 and p20.<br />

Designs for Vision (DFV) are looking forward to a big year in <strong>2017</strong>, and particularly to making<br />

contact at the CCLS conference where we will be demonstrating the versatile Oculus Easygraph<br />

combination corneal topographer/keratometer, as well as consulting room equipment specials.<br />

The highly successful Icare ic100 tonometer continues to draw interest, along with the Icare<br />

Home for at-home monitoring of IOP. Keeler provides a high quality Symphony slit lamp, while a<br />

more affordable retinal camera is now available in the Volk INview.<br />

We are also anxiously awaiting the newly-upgraded Vistavision digital eye chart system, which<br />

will soon be joining the vast range of DFV’s other ophthalmic products, and should be available on<br />

stand to view. See you in Nelson!<br />

Ophthalmic Instrument Company (OIC)<br />

We look forward to welcoming you onto the OIC stand at the CCLS meeting in Nelson. Among items<br />

on display we will have the Nidek RS-330 DUO, which combines high resolution retinal photography<br />

with optical coherence tomography (OCT); and the Nidek RS-3000 Advanced SLO (scanning laser<br />

ophthalmoscope) OCT, which includes non-invasive OCT angiography.<br />

The latest release from Nidek is the TONOREF3, which is a four-in-one unit that combines<br />

autorefraction and keratometry with IOP and CCT measurement, all in one compact unit. The new<br />

tear film analysis software for the Medmont E300 Corneal Topographer will be being demonstrated,<br />

which perfectly complements our Tearlab Tear Osmolarity Test, which provides objective and<br />

quantitative point-of-care testing to help diagnose dry eye disease. See you in Nelson.<br />

Discover Nelson<br />

Sunny Nelson has a wealth of experiences to<br />

offer the CCLS conference delegate.<br />

Stroll along Wakefield Quay to appreciate<br />

the stunning scenery and take in the Nelson<br />

harbour, which is sheltered from the Tasman<br />

Bay by a natural 13km boulder bank crowned<br />

by Nelson’s historic lighthouse. Or you could<br />

head into the nearby city centre and discover the<br />

impressive Nelson Christ Church Cathedral with<br />

its 35m high tower.<br />

Renowned for its arts scene,<br />

Nelson is home to more than<br />

300 working artists. One<br />

gallery well worth a visit is the<br />

internationally-commended<br />

Hoglund Art Glass studio.<br />

World of WearableArt was<br />

also born in Nelson and you’ll<br />

find the WOW museum just<br />

10 minutes south of the city,<br />

on the way to the airport. The<br />

museum is also host to the<br />

Nelson classic cars gallery.<br />

If you’ve got time to head<br />

out of the city, experience the<br />

scenic Tasman’s Great Taste<br />

Trail, winding beside beaches<br />

and estuaries, past vineyards<br />

and restaurants such as Petite<br />

Fleur at Siefried Estate, art<br />

galleries, craft breweries and delightful cafés.<br />

Drive or join a tour following the wine trail<br />

through historic Moutere village where you can<br />

chat with winemakers or viticulturists at their<br />

cellar door.<br />

For those seeking something more adventurous,<br />

you can enjoy unparalleled views of Abel Tasman<br />

National Park skydiving with Skydive Abel<br />

Tasman.<br />

Enjoy.<br />


Nelson Seifried<br />


Distributed by:<br />

phone: 09 443 0072<br />

email: tim@oic.co.nz<br />

Precision Contact Lenses<br />

Precision Contact Lenses is pleased to<br />

once again attend the CCLS conference<br />

in Nelson. Kathryn Steeman, director,<br />

is looking forward to catching up with<br />

clients old and new. Kathryn will be on<br />

hand to share her knowledge of 37 years<br />

of contact lens manufacturing and help<br />

optometrists obtain the best contact lens<br />

fit for their clients. If optometrists have<br />

any tricky design fits you wish to discuss,<br />

Kathryn will be more than glad to talk<br />

over the best options for your clients.<br />

Be it the range of free contact lens trial<br />

lenses available, the variety of contact<br />

lens materials on offer or the need to use<br />

one of many different designs that PCL<br />

supplies. We look forward to seeing you at<br />

stand 16!<br />

Device Technologies<br />

Device Technologies is proudly supporting<br />

CCLS <strong>2017</strong> and will be exhibiting at stand<br />

15. While the Topcon Triton Swept Source<br />

OCTs have become highly ranked in retinal<br />

specialist clinics and exclusive optometry<br />

practices around the world, the demand<br />

for the affordable and space saving<br />

Maestro OCT is ever increasing.<br />

Come and see the Maestro, featuring a<br />

‘one-click wide scan’ including macular-,<br />

RNFL-, GCL- and real-colour fundus photo,<br />

all presented in a single report. The<br />

Maestro’s ‘one minute learning curve’ will<br />

also help staff in today’s busy practice<br />

(anterior scan and networking available).<br />

Plus, discover the Frey VA chart’s great<br />

flexibility, durability and great value.<br />

14 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>

<strong>March</strong> <strong>2017</strong> NEW ZEALAND OPTICS<br />


Nike & Zeiss: a new<br />

innovation<br />



As the guest writer for this<br />

issue’s speciality contact lens<br />

forum, I thought I would<br />

tackle a problem I have encountered<br />

a few times and feel may become<br />

more common as we test an aging<br />

population.<br />

First we have to go back, way back,<br />

to my penultimate year at university.<br />

Sitting in a lecture about the history<br />

of contact lenses, I learned all about<br />

dental technician Eugene Hirst<br />

who brought rigid contact lenses<br />

to New Zealand around the Second<br />

World War. We heard how these<br />

lenses, made of PMMA and other<br />

old materials, took off and soon<br />

became common place. We talked<br />

about the challenges of fitting and looking after<br />

patients with hard contact lenses and how more<br />

modern materials had replaced them. Despite<br />

this, we were warned, we would still occasionally<br />

see patients who had been in hard contact lenses<br />

for several decades. They might even be PMMA or<br />

other old materials. These patients were known<br />

affectionately as ‘dinosaurs’.<br />

This leads me today’s patient, a 70-year-old<br />

female – ‘LS’ – who has been in hard contact<br />

lenses for at least 40 years. LS presented to my<br />

practice as a new patient and is a true ‘dinosaur’<br />

– not only is she a full-time wearer but she is<br />

still in PMMA. LS had noticed a reduction in<br />

vision over the past few months particularly in<br />

her right eye, and felt her contact lenses needed<br />

an update or a polish. On examination it was<br />

revealed a cataract was the underlying cause.<br />

It makes sense that these patients who have<br />

been in contact lenses for thirty or forty years<br />

may be coming in with blurry vision more often.<br />

Even if they started lens wear in their twenties<br />

they will at least be getting into their sixties<br />

now, increasing the chance of cataract, macular<br />

degeneration and other pathologies. I discussed<br />

with LS that the cataract was blurring her vision<br />

not the contact lenses and she wanted to have<br />

this dealt with. Having been short-sighted her<br />

whole life she was keen following cataract<br />

surgery to still be slightly short-sighted for<br />

the convenience of reading unaided. This got<br />

me thinking about the effect PMMA has had<br />

on her cornea and the potential effect on her<br />

prescription and final cataract outcome.<br />

PMMA and its effects on the eyes are well<br />

known to optometrists with lack of oxygen<br />

leading to oedema and corneal warpage among<br />

other things. A topography following PMMA wear<br />

shows this warpage (fig 1.) with irregular mires<br />

and an irregular surface. This is immediately<br />

noticeable to patients who switch from their<br />

lenses into spectacles and notice blurry vision.<br />

This patient has spent every waking moment<br />

in PMMA lenses for the past 40 years with no<br />

spectacle wear and hence no obvious blur. Of<br />

course older, less oxygen permeable materials<br />

have been dying off for more cornea-friendly<br />

options such as Boston XO. But even these newer<br />

materials can affect the cornea if the lens is<br />

poorly fitting or if it flexes as it ages. This change<br />

in corneal shape is of course not always bad and<br />

with new designs and materials have started the<br />

orthokeratology revolution.<br />

Back to LS then. After removing the contact<br />

lenses my initial refraction was R -7.50/ -1.50<br />

x 45 (6/12-) and L -5.75/ -2.00 x 155 (6/7.5-). I<br />

advised LS that for the best cataract outcome she<br />

will need to cease contact lens wear and wear<br />

spectacles until her corneas stabilise. I got her<br />

back after one week without contact lenses and<br />

the prescription was now quite different, at R<br />

-7.50/ -4.50 x 80 (6/21) and L -4.50/ -3.00 x 160<br />

(6/9.5+).<br />

At this stage I wasn’t happy to prescribe<br />

spectacles so I got LS back once more a week<br />

later and things were quite similar to the week<br />

before so I gave her a pair of single vision<br />

distance spectacles. This got me thinking about<br />

when was an appropriate time to review LS and<br />

when do we expect her corneas to stabilise?<br />

Fig 1: A topography showing corneal warpage<br />

Further reading made me realise the answer<br />

to this was really ‘how long is a piece of string’.<br />

A study by Wang et al 1 found the average<br />

resolution time of corneal warpage was eight<br />

weeks but this had a standard deviation of<br />

nearly seven weeks! Based on this I got LS back<br />

two months later and her prescription was now<br />

R -4.00/ -4.00 x 80 (6/12) and L -4.50/ -1.00 x 80<br />

(6/7.5-).<br />

The end was in sight! Vision was stabilising,<br />

retinoscopy reflex was good and corneas were<br />

clear on slit lamp. To be safe I got LS back<br />

once more one month later and found the<br />

prescription was stable. Success! I have since<br />

referred LS for private right cataract surgery to<br />

be followed with left cataract surgery to balance<br />

any anisometropia.<br />

There may be nothing too startling about what<br />

occurred with LS, but I think it may be a more<br />

common scenario as long-time PMMA contact<br />

lens patients (dinosaurs) develop age-related<br />

pathologies. To give the best surgical outcome<br />

we, as the optometrists, should be considering<br />

the stability of prescriptions and the stability of<br />

the cornea.<br />

The options for these patients will vary with the<br />

patients’ needs. The first step which will help in<br />

the long-term will be to change these patients<br />

to well-fitting newer materials before problems<br />

occur. The patient may not be keen to change<br />

from a winning formula but just as we change<br />

soft contact lens wearers into silicon hydrogel<br />

it seems sensible to change PMMA wearers<br />

into more modern materials. If you do end up<br />

with a patient like LS though, it is worthwhile<br />

discussing with them that they will have a few<br />

months of potentially average vision to give them<br />

a long-term positive outcome. Once out of rigid<br />

lenses patients, may decide to pursue spectacles<br />

(although we must warn them the prescription<br />

may change quickly) or soft contact lenses but<br />

these of course can be difficult with rigid wearers.<br />

I would be intrigued to find out how other<br />

optometrists deal with this problem particularly<br />

for a patient concerned with the cost of this<br />

process. There doesn’t seem to be any universal<br />

answer but it does seem certain that the<br />

number of patients in rigid lenses whether it be<br />

PMMA or modern materials are increasing in age<br />

and therefore increasing in pathology. Cataracts<br />

can affect these patients and it is our job to deal<br />

with it to give them the best vision. ▀<br />

References<br />

1. Time to Resolution of Contact Lens-Induced Corneal<br />

Warpage Prior to Refractive Surgery1 Wang, Xiaohong<br />

M.D.; McCulley, James P. M.D.; Bowman, R. Wayne M.D.;<br />

Cavanagh, H. Dwight M.D., Ph.D. CLAO Journal: October<br />

2002 - Volume 28 - Issue 4 - pp 169-171<br />


* Guest columnist Jacob Benefield stepped in to help while our<br />

regular speciality lens contributor<br />

Alex Petty focused on establishing<br />

his new practice in Tauranga.<br />

Benefield, an optometrist based in<br />

Palmerston North, splits his time<br />

between Visique Naylor Palmer,<br />

Bruce Little Optometrists and the<br />

glaucoma clinic at Palmerston<br />

North hospital. He too has a special<br />

interest in ortho-k and fitting hard<br />

contact lenses.<br />

For those who missed it, General Optical’s stand<br />

at last year’s Visionz conference was proudly<br />

displaying the latest partnership innovation<br />

between Nike and lens company Zeiss for Nike’s<br />

most recent Vision Running Collection.<br />

Though the companies have been working<br />

together since 1998, last year saw the development<br />

of a completely new construction method which<br />

seamlessly fuses the lens material with the frame to<br />

increase coverage and offer eyewear that is lighter<br />

than the average performance product on the market<br />

today, said the companies in a statement. The new<br />

Nike Vapourwing, Tailwind and Bandit designs were<br />

the result of two-years of collaborative development<br />

between Nike Vision, Zeiss and The Shop, VSP Global’s<br />

innovation lab, which develops technologies for the<br />

physical and digital aspects of eyewear and eye care.<br />

US-based VSP Global is the licensee owner for Nike<br />

Vision, through its global design manufacturer and<br />

distributor, <strong>March</strong>on Eyewear.<br />

“The partnership started from scratch to<br />

manufacture a new lens from a custom mould,”<br />

said Stephen Tripi, <strong>March</strong>on’s marketing director.<br />

“Once developed, the mould was refined using<br />

ultra-precise machinery with diamond-polishing<br />

technology to polish the complex lens shape down<br />

to the nanometer. The end result is a lightweight,<br />

state-of-the-art lens that maximizes coverage<br />

and provides optimum clarity to allow athletes to<br />

perform at the highest level.<br />

“To better serve our athletes, we looked to the<br />

future of sunglass design to incorporate new lens<br />

geometry and materials, as well as fit technology<br />

and design elements that haven’t been used in<br />

the performance eyewear industry before. We<br />

really wanted to elevate athletic performance by<br />

developing a better system of eyewear.”<br />

Leslie Muller, co-lead of The Shop and vice<br />

president, design for <strong>March</strong>on said his team worked<br />

side-by-side with Nike athletes to first understand<br />

the unique eyewear demands of runners. The team<br />

drew design inspiration from nature—known as<br />

biomimicry—and looked at factors like the lattice<br />

structure of bones and tendons as strong, but<br />

lightweight interactions of materials. Collaboration<br />

with Zeiss then led to breakthroughs in lens design<br />

by fusing lens materials into frames, he said.<br />


The Retinal Atlas, 2nd Edition<br />

by Bailey Freund, David Sarraf, William Mieler and Lawrence Yannuzzi.<br />

Published by Elsevier <strong>2017</strong>.<br />


It has been a long time since I have been seduced<br />

by a text book. But a quick flick through the pages<br />

of The Retinal Atlas quickly became an absorbing<br />

two hours.<br />

Blame it on our busy lives and the digital<br />

revolution, but we are rapidly becoming attuned<br />

to 30 second soundbites, 140 characters and<br />

e-tocs. Rapid advances in technology are<br />

constantly changing our understanding of eye<br />

diseases and the way in which we perceive and<br />

manage them, so many textbooks have a short<br />

shelf-life. The Retinal Atlas, 2nd Edition, however,<br />

is a textbook which challenges and revolts against<br />

this. As a reference textbook predominantly<br />

consisting of images of retinal disease (and<br />

optic nerve disorders for good measure), this is a<br />

diagnostician’s dream.<br />

The stellar cast of editors and contributors have<br />

ably updated Lawrence Yannuzzi’s 1st Edition.<br />

Short synopses of clinical features, epidemiology<br />

and aetiology (longer than a tweet, but succinct<br />

and concisely written) accompany a feast of<br />

images. All imaging modalities are covered, with<br />

colour codes for image type and fundus photos,<br />

including wide-field, autofluorescence, fluorescein<br />

angiography (FFA), OCT (often with a histological<br />

correlate), ICG, and occasional ancillary images of<br />

ocular or systemic associations. Post-treatment<br />

images are present where relevant. Two pages<br />

describe and illustrate OCT angiography, but FFA<br />

images predominate, with only occasional OCT-A<br />

images – notably in MacTel2 and age-related<br />

macular degeneration (AMD) - present throughout<br />

the book.<br />

Often the ‘art of medicine’ is as simple as<br />

experience and pattern recognition; that gestalt<br />

that allows us to categorise the underlying cause,<br />

eg. vascular vs inflammatory, genetic vs toxicity.<br />

Armed with a book like this, the very clearly<br />

indexed and delineated chapters enable the<br />

Nike Vision Vapourwing sports sunglasses<br />

All styles include responsive comfort, that grips<br />

when the athlete sweats, and flexible arms that<br />

conform to the shape of the wearer’s face for<br />

stability and fit. The eyewear also features advanced<br />

ventilation with an auto-adjusting nose pad that<br />

is said to eliminate fog. Each style also includes an<br />

expanded lens for increased coverage that acts as a<br />

protection barrier and minimises stress-causing light<br />

leaks, allowing the runner’s eyes to stay relaxed and<br />

focused, said the companies.<br />

“For decades, the strict optical 0.09D standards for<br />

sunglasses have constrained designers to use only<br />

simple spheres and torics for the optical surfaces in<br />

their premium products. Zeiss has adapted advanced<br />

freeform design and manufacturing techniques<br />

developed for ophthalmic and precision optics to<br />

achieve 0.06D optical performance for general,<br />

complex-shaped surfaces. This extra freedom has<br />

been exploited by the creative team at Nike and<br />

frame-manufacturer <strong>March</strong>on to simultaneously<br />

optimise the fit, the aerodynamics and the aesthetics<br />

of their new line of premium athletic eyewear<br />

without compromising optical performance,” said<br />

Steve Sprat, lens designer for the project. ▀<br />

See associated story on GenOp’s luxury focus p8.<br />

observer to target<br />

and peruse relevant<br />

images for many<br />

diagnostic dilemmas.<br />

Any eye professional<br />

who looks at the<br />

retina; from the<br />

student, the resident<br />

studying for finals, and the generalist, to the rare<br />

diseases guru can find solace amongst these pages.<br />

Comprehensive sections cover common conditions<br />

such as diabetic retinopathy and AMD. There are<br />

detailed chapters on paediatrics, oncology and<br />

surgical retina and complications. The nematode<br />

section is truly fascinating and indicative of coverage<br />

of more singular entities. One omission, however,<br />

was manifestations of the Zika virus, demonstrating<br />

the speed at which our knowledge grows. Each<br />

chapter ends with a ‘suggested reading’ list, which<br />

is predominantly journal-based and necessary for<br />

further insight into aetiology, diagnostic tests or<br />

management plans.<br />

For those not wholly ready for a complete digital<br />

detox, the book includes an online companion,<br />

which can be viewed on your mobile. The Retinal<br />

Atlas website follows exactly the same format<br />

as the book, with a useful search function, and<br />

is easily navigated. The instructional blurb states<br />

you can view enhanced images, but a quick review<br />

of some topics showed the content to be near<br />

identical. The images are high quality resulting in<br />

some lag downloading them.<br />

The book, however, is truly desirable, (albeit<br />

large at 1173 pages long and weighing 3.5kg), and<br />

likely to develop a patina acquired from regular<br />

perusal from students to experts alike. ▀<br />

*Associate Professor Andrea Vincent heads a team researching the<br />

genetics of retinal and corneal dystrophies, keratoconus, glaucoma<br />

and lid abnormalities at the Department of Ophthalmology at the<br />

University of Auckland. She is also a consultant ophthalmologist<br />

at Greenlane Eye Clinic and Retina Specialists in Auckland, a<br />

section editor for Clinical and Experimental Ophthalmology and a<br />

board member of the Ophthalmic Research Institute of Australia.<br />

16 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>

Groovy re-fit in Christchurch<br />

Groovy Glasses have been a Christchurch<br />

institution since 1994, but when the<br />

September 2010 earthquake destroyed<br />

their Manchester Street premises, it put their<br />

future in jeopardy. Trudy McBeath and her team<br />

managed to find a temporary location to rent in<br />

High Street, but that was levelled by the February<br />

2011 earthquake. Perhaps a weaker business<br />

owner might have cashed in the insurance policy,<br />

but passionate optometrist Trudy and antiques<br />

dealer husband Dirk McBeath were determined to<br />

re-establish, re-opening in rented premises in Bath<br />

Street six-months later while they searched for a<br />

permanent new home.<br />

“We finally secured a character building in New<br />

Regent Street in 2013 that had been earthquake<br />

strengthened, and have been waiting for a suitable<br />

time to move in,” says Trudy, noting much of the<br />

city centre was, until recently, still a ghost town.<br />

“Christchurch is still very much disrupted by<br />

blocked streets, demolition and construction, so<br />

it has been hard to know when a location will be<br />

disruption-free.”<br />

The beautiful art-deco inspired buildings on<br />

Regent Street offered Trudy the perfect canvas<br />

for her quirky stock. Recently renovated, there<br />

wasn’t much to do to the exterior, but inside Trudy<br />

designed and styled the store herself.<br />

“I’d designed three other interiors for my<br />

business previously and have gained confidence<br />

that I know pretty much what I want and know the<br />

tradesmen who can help me achieve it. I have an<br />

artistic bent and a passion for retro and art deco<br />

design, so I guess things came naturally when<br />

thinking about the fit out.”<br />

The theme to the design is retro with a feminine<br />

twist on one side of the showroom including<br />

dressing tables and Axminster floral carpet, and<br />

a masculine industrial feel to the other side with<br />

pre-loved wooden cabinets and workbenches.<br />

“The general idea was to emulate an optician’s<br />

showroom from the 1920’s with all that lovely old<br />

patina on the furniture and that vintage vibe,”<br />

says Trudy, who describes herself as a child of the<br />

‘60s and says many of her patients are too. “Our<br />

aim is to use genuine vintage pieces of furniture<br />

whenever possible or re-purpose something<br />

vintage to become useful. Too much is thrown<br />

away by our society so a devotion to valuing things<br />

from the past has been a driving force in all my<br />

shop fit-outs.”<br />

This passion for vintage doesn’t extend to<br />

technology, however, as all the company’s optical<br />

equipment and POS systems have been recently<br />

updated.<br />

As well as sticking to her upcycling principles,<br />

Trudy incorporated sensory design into her fit out.<br />

“I wanted not just visual stimulation, but good<br />

music in the showroom (aural stimulation), good<br />

smells like fresh flowers and wood polish, and<br />

tactile stimulation from handling those battered<br />

old wooden surfaces when putting frames down<br />

after trying them on.”<br />

She admits though she’s never heard of sensory<br />

design principles, preferring to put her trust in<br />

instinct, adding that she’s even allowed for a<br />

positive taste sensation by providing mackintosh<br />

toffees for customers to enjoy! ▀<br />

Trudy’s showroom is like stepping back in time<br />

When you experience<br />

snow without limits<br />

ZEISS Snow Goggles<br />



ZEISS Snow Goggles are created especially<br />

for the challenges posed by alpine sports.<br />

Enjoy 100% UV protection, an optimum fit,<br />

a large field of view and improved contrast<br />

vision in both bright sunlight and diffused<br />

light. ZEISS Snow Goggles are extremely<br />

robust and lightweight – with a large<br />

selection of styles and tints to choose from.<br />

www.zeiss.com.au/vision<br />

<strong>March</strong> <strong>2017</strong><br />



Tackling that shrinking feeling<br />

Shrinkage is a given in the retail game, but by taking a proactive<br />

approach to minimising theft, businesses can reduce both their<br />

stress levels and financial losses. By Caitlin Sykes<br />

It’s a crime estimated to cost the country<br />

more than a billion dollars annually, and is<br />

increasingly perpetrated by criminal groups<br />

that are well organised and intimidating in their<br />

methods. But it’s not headline-grabbing offences<br />

such as methamphetamine dealing or cybercrime,<br />

it’s shoplifting.<br />

While it may have once been the domain of<br />

bored, opportunistic teenagers up for a lark,<br />

shoplifting today is often a more organised and<br />

menacing business.<br />

Chris Wilkinson, managing director of Wellingtonbased<br />

retail strategy firm First Retail Group,<br />

has spied a number of growing trends among<br />

shoplifters, including increased incidences of<br />

shoplifters travelling to several similar stores to fulfil<br />

specific orders.<br />

“There’s also an increasing incidence of threats<br />

made against staff and this is something that’s a<br />

major concern to businesses,” he says. “We’ve got<br />

people coming into stores and saying things like,<br />

‘you’re all going to stand in the corner while I take<br />

this, and none of you are going to call the police’...<br />

it’s very scary.”<br />

Phil Thomson<br />

heads up Auror, a<br />

crime-intelligence<br />

and prevention<br />

software<br />

platform that<br />

helps retailers<br />

and police work<br />

together to fight<br />

crime. Thomson<br />

says businesses<br />

in the eyecare<br />

and ophthalmic<br />

industries are<br />

facing similar<br />

issues to many<br />

other retailers<br />

Chris Wilkinson<br />

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18 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong><br />

with respect to shop theft and shrinkage - a<br />

progression toward more organised offending with<br />

groups that are selectively targeting goods, based on<br />

instructions from others, that can be easily on-sold.<br />

“In particular, sunglasses are a known item<br />

targeted by thieves as they are readily convertible,”<br />

he says. “Just last year, one specialty sunglass retailer<br />

in Dunedin had $30,000 worth of stock stolen<br />

overnight from a kiosk in a shopping mall. That’s<br />

not the type of theft conducted out of opportunity<br />

because someone liked a pair of sunnies; it’s because<br />

sunglasses can be easily sold through markets,<br />

online or in person for money or drugs.”<br />

To put this in an international context, according<br />

to the Global Retail Theft Barometer survey last<br />

year, sunglasses were the number four loss category<br />

within apparel and fashion accessories, says<br />

Thomson.<br />

The cost of shoplifting<br />

Greg Harford, general manager of public affairs<br />

at retail trade association Retail NZ, notes these<br />

trends impact businesses in a number of ways.<br />

“We’re seeing an increasing perception among<br />

some in the community – and it’s an incorrect<br />

perception – that shoplifting is a victimless crime<br />

and there are no consequences. Whereas actually<br />

there are very real victims of it.”<br />

Ultimately, as consumers, we’re all victims as losses<br />

wrought by shrinkage impact the price we pay for<br />

goods, he says. “Retail crime is a big issue. There is<br />

some analysis that suggests it costs the economy<br />

about $1.2 billion a year nationally, so that’s a driver<br />

for every retailer to take it pretty seriously.”<br />

At a firm level, the material cost associated with<br />

shrinkage is more keenly felt. Professional retail<br />

businesses such as optometrists are often small,<br />

privately-owned firms that are particularly impacted<br />

by the financial cost of theft, says Harford, and the<br />

violence and intimidation that are increasingly<br />

being associated with theft can be traumatic<br />

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for staff and<br />

members of<br />

the public, and<br />

present a health<br />

and safety risk.<br />

The emotional<br />

impact of theft<br />

on staff may<br />

be even greater<br />

in healthcarerelated<br />

businesses such<br />

as optometrists,<br />

where<br />

relationships with<br />

clients tend to be<br />

Greg Harford<br />

closer than those<br />

in purely transactional retail environments, notes<br />

Wilkinson. “With that intimacy comes an implicit<br />

trust, so it can be very unexpected when you see<br />

that trust violated.”<br />

It’s a sentiment echoed by therapeutic optometrist<br />

Hadyn Treanor, who is co-owner of Auckland-based<br />

Frith & Laird Optometrists.<br />

“We see ourselves more as a community<br />

optometrist, and that people are coming in because<br />

they’re genuinely seeking help and not wanting<br />

to be ‘sold’ to. So to then find out that that person<br />

wasn’t looking for your help and they were actually<br />

after something to take from you, I think that hurts<br />

more than if it was in a purely retail environment.”<br />

Tackling the shoplifting problem<br />

Frith & Laird’s Manurewa-based premises are<br />

located on the first floor of a medical centre, which<br />

Treanor says makes the practice less vulnerable to<br />

shoplifting, although he says the business is still<br />

not exempt. Prior to joining Frith & Laird seven<br />

years ago, however, Treanor worked in a number of<br />

different practice environments, including in a city<br />

centre location with a large sunglass offering where<br />

shoplifters were very much on the radar of staff.<br />

“One of the little things we always did was ensure<br />

the frame and sunglass racks were kept full, so<br />

if something<br />

was taken it<br />

was obvious,”<br />

he says. “But<br />

sometimes the<br />

more organised<br />

[shoplifters]<br />

would have a<br />

dummy frame<br />

they would swap.<br />

So they’d take<br />

the designer<br />

sunglasses down<br />

and the cheap<br />

service station<br />

sunglasses would<br />

Hadyn Treanor<br />

go into the rack<br />

in their place. So you do need to be very vigilant<br />

because when they’re good, they’re very good.”<br />

Dispensing optician and optometry practice<br />

designer Elaine Silk agrees keeping displays tidy<br />

and fully stocked – affording a quick visual check<br />

that nothing’s missing – is one tactic to help fight<br />

shrinkage.<br />

Silk says thinking about preventing shrinkage<br />

when planning a practice layout ultimately<br />

benefits the overall experience for both clients and<br />

employees. She prefers practice designs that are as<br />

open plan as possible, and says a well-considered<br />

layout can eliminate blind spots that staff can’t<br />

manage or watch.<br />

“Stand at your reception and survey your practice.<br />

Then do the same at your dispensing desks. Are<br />

there areas you cannot see? Consider moving any<br />

freestanding frame displays that impede your line-ofsight<br />

through the practice, and create a clear view for<br />

your employees and clients. The potential shoplifter<br />

will know they are far more likely to be seen.”<br />

Mirrors are also a great theft deterrent, she says.<br />

“One bonus when it comes to optometry practice<br />

design is the ability to use lots of mirrors – both for<br />

your clients to appreciate the great eyewear you have<br />

and for the added perk that when consumers can see<br />

A right mess<br />

A good Samaritan who came to investigate a<br />

disturbance at optometrist Peter O’Hagan’s<br />

Paeroa practice late one night got hit in the head<br />

with a brick for his trouble by a burglar fleeing<br />

the scene.<br />

While the incident made news headlines when<br />

it happened in April 2015, thankfully O’Hagan<br />

says the man who was struck made a quick<br />

recovery. But other annoyances linger.<br />

“There’s a bit of evidence that they’d cased<br />

the joint a few days before. They’d come in,<br />

wandered around, made an excuse and left,” he<br />

recalls.<br />

“The stupid thing was they broke in to steal the<br />

$20 that was in the charity box on the counter –<br />

that’s all they took. For all that, we had glass all<br />

through the front [of the practice], and I was up<br />

in the middle of the night taping it up.”<br />

Despite the experience, O’Hagan – who with<br />

his wife, optometrist Heather O’Hagan, also has<br />

practices in Whangamata, Waihi and Te Aroha<br />

– feels his businesses are not an obvious target<br />

for thieves and their security measures have<br />

remained unchanged.<br />

“It was just our turn. We’ve had three robberies<br />

in 34 years, and for us the cost has been in the<br />

mess, not in what they take.”

themselves, they tend to behave more appropriately.”<br />

Wilkinson’s company delivers a crime-prevention<br />

initiative called Eyes On, which helps businesses<br />

in the Capital work with each other and police to<br />

proactively reduce theft. Empowering staff with the<br />

skills to deal effectively with shoplifters is crucial,<br />

he says. The Eyes On initiative includes staff training<br />

programmes such as ‘verbal judo’, which teaches<br />

staff how to diffuse tricky situations using words<br />

and body language.<br />

Auror’s Thomson says taking a proactive approach<br />

to shoplifting prevention through customer<br />

service is also a good tactic. “The very best way<br />

to discourage an offender from stealing is to<br />

shower them<br />

with customer<br />

service. If you<br />

spot someone in a<br />

store that seems<br />

suspicious, they<br />

should become<br />

your number one<br />

service priority<br />

while in the shop.<br />

Ask for their<br />

name, be helpful,<br />

point out specific<br />

glasses, offer to<br />

hold bags, and do<br />

anything else you Elaine Silk<br />

can think of to let<br />

them know that they have your full attention. Often<br />

thieves will leave rather than try to press ahead with<br />

a theft if they know they are being watched.”<br />

Another key is to keep communicating with<br />

the public about the efforts you’re taking with<br />

security; with other retailers to share any shoplifting<br />

intelligence, as well as advice and support; and with<br />

police, says Harford. “There’s sometimes, perhaps,<br />

been the perception that the police won’t come<br />

[when shoplifting is reported], or it’s not worth the<br />

effort. Well it absolutely is because the police can’t<br />

do anything about it if they don’t know about it.<br />

Particularly with today’s software tools, you can now<br />

track patterns of activity and piece them together<br />

and build up potentially quite a dossier against<br />

individuals.”<br />

Theft from inside<br />

When it comes to preventing theft from staff, many<br />

of the same principles apply, says Harford. “It’s<br />

around making sure you’ve got security systems in<br />

place, thoroughly vetting your people, and making<br />

sure they’re aware you are watching what’s going<br />

on – in a positive way, in that you’re keeping an eye<br />

on the store.<br />

“Ideally its about having people working together<br />

so there’s good communication within the store,<br />

and again communicating with police and nearby<br />

retailers because if you find there are a lot of<br />

problems in your store and it’s only in your store<br />

then that might be telling you something.”<br />

Frith & Laird’s Treanor says combating internal theft<br />

can be particularly challenging in small businesses<br />

where responsibilities still inevitably need to be<br />

delegated, but there’s not always the luxury of<br />

having them overseen by a number of staff. Then<br />

again relationships between staff in small firms tend<br />

to be closer so it can be easier to pick up on clues that<br />

theft is occurring, such as staff displaying spending<br />

that’s out of sync with their earnings.<br />

“It’s difficult as a store owner in that you can’t<br />

do everything all the time. You have to give people<br />

responsibility and inevitably it’s the front of house<br />

staff who are handling the money. There has to be<br />

an element of trust but at the same time you have<br />

to be vigilant – things like keeping an eye on how<br />

many bank runs you’re doing to deposit cash, or<br />

looking at how many refunds you’re doing.”<br />

Treanor also says that when hiring, practice<br />

owners should check to see if there are any gaps<br />

in the applicant’s CV. “More often than not, it’s the<br />

employees who you’d almost least expect because<br />

they’ve worked hard to earn your trust so you<br />

start giving them more and more responsibility.<br />

Unfortunately, that’s sometimes when it’s<br />

betrayed.” ▀<br />

A corporate take on shrinkage?<br />

Peter Papatheodorou, loss prevention manager at<br />

Specsavers for Australia and New Zealand, shared<br />

his five top tips for securing your business:<br />

1. Position a designated ‘meet-and-greet’ staff<br />

member close to your store entrance. Not only<br />

does this improve the ‘welcome’ factor for<br />

patients and help capture browsers, it also acts as<br />

a deterrent for external theft<br />

2. Installing a CCTV camera and alarm system<br />

will deter potential theft and provide valuable<br />

evidence to assist police when a theft has been<br />

committed. Make sure the CCTV camera is<br />

highly visible<br />

3. Undertake regular stocktakes. This will<br />

identify missing stock very quickly and alert you<br />

and all staff to what could be either internal or<br />

external risks<br />

4. Establish a clear process for staff to report<br />

shoplifting or theft concerns to management<br />

5. Always do a complete end-of-day reconciliation<br />

and run all available reports, ensuring any card or<br />

cash variances are fully understood<br />

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NZOptics_halfpage_DynamicSync_18x28cm_MAr17.indd 1<br />

<strong>March</strong> <strong>2017</strong><br />

8/02/<strong>2017</strong> 12:39:03 PM<br />



Focus<br />

on Business<br />

BDO: Protecting business<br />

secrets from cyber threats<br />

A<br />

company was busily preparing<br />

its tender document for a<br />

major project – unaware<br />

spying eyes from a foreign country<br />

were watching through a cybersecurity<br />

infiltration of their network.<br />

Leon Fouche, BDO’s Australasian<br />

leader in cyber-security, says this<br />

does not only happen in movies. This<br />

is a real cyber threat happening to<br />

New Zealand companies – a threat<br />

to which no entity – even small scale<br />

clinical practices – is immune.<br />

According to Leon, BDO has<br />

been involved in cyber intrusion<br />

investigations similar to this. In one of<br />

these investigations, a BDO client was<br />

going through a large merger and<br />

acquisition process when they alerted<br />

BDO that a foreign body had been in<br />

their network for a number of months<br />

before they became aware of it.<br />

The company was able to clean the<br />

intruder – which had been looking<br />

for information to advantage its own<br />

tender – out of the network.<br />

The potential disaster was<br />

contained, but this and other forms of<br />

cyber-crime are already costing New<br />

Zealand millions of dollars.<br />

Internet security company Netsafe,<br />

in its 2015 report, estimated cybercrime<br />

as totalling between $250m<br />

and $400m annually. New Zealand<br />

law does not require companies to<br />

report cyber-crime, so many don’t.<br />

Few admit to a breach that could<br />

damage their brand, business and<br />

customer trust.<br />

Netsafe reported 8,570 cyber<br />

attacks in New Zealand last year,<br />

costing $13.4m – with the biggest<br />

attack costing the target just over<br />

$2m. But that only covers known<br />

breaches. Netsafe estimates that’s<br />

only about 4% of all cyber-crime.<br />

I take Fouche’s warnings very<br />

seriously. His long list of cybersecurity<br />

credentials includes<br />

establishing and running a cybersecurity<br />

programme for the<br />

Australian Government’s hosting of<br />

the G20 summit in 2014. His view<br />

of cyber-crime is that there are only<br />

two kinds of companies in the world<br />

– those who have experienced a data<br />

breach and those who don’t know<br />

they’ve already been breached.<br />

But most alarming is that whilst<br />

this is a big problem, so many<br />

companies just accept it as a fact of<br />

life and don’t do much about it. Yet<br />

a cyber breach can not only damage<br />

a business – it can close it. This point<br />

is most pertinent to optometrists as<br />

you are in a business that is founded<br />

on trust, and if you lose the trust of<br />

your customers because your data<br />

and their privacy has been breached,<br />

it can be fatal.<br />

It may be easy to be lulled into a<br />

false sense of security because you<br />

don’t think optometry is a line of<br />

business that one of the four main<br />

kinds of hackers would target –<br />

activists making a political or social<br />

point; cyber-criminals for whom<br />

money is the motivation; statesponsored<br />

hackers seeking a political<br />

or commercial edge; and those who<br />

use disgruntled employees or human<br />

error to gain access to a company’s<br />

network and data.<br />

Yet, as Fouche warns, it is not<br />

only large multinational companies<br />

that are at risk. Indeed, two recent<br />


examples prove that any New<br />

Zealand entity is susceptible to these<br />

attacks. In July 2016, Fairfax Media<br />

reported that Hunting and Fishing’s<br />

website had been targeted by<br />

hackers who were seeking customer<br />

information. As a result their website<br />

was shutdown including all online<br />

trading activity. As of the end of<br />

September, they were still offline as<br />

they have been unable to guarantee<br />

the security of customer details,<br />

including payment information. At<br />

the other end of the scale, a small<br />

Wairarapa business was the target of<br />

a crypto-ransomware attack, where<br />

the hacker attempts to encrypt<br />

valuable files and demand a ransom<br />

in return for decrypting them.<br />

One of the best defences against<br />

crypto-ransomware attacks is<br />

ensuring your staff are vigilant when<br />

receiving unsolicited emails with<br />

suspicious attachments. This is the<br />

most common method of infiltrating<br />

a business and antivirus software<br />

won’t always keep pace with the<br />

latest methods used by the hackers.<br />

An employee who opens a suspicious<br />

attachment can unknowingly<br />

release one of these viruses into the<br />

company’s network.<br />

BDO had a specific incidence of this,<br />

where one of our optometry clients<br />

had exactly that happen to them.<br />

Luckily BDO’s in-house IT specialist<br />

was able to recover their data with<br />

minimal disruption to the business. A<br />

potentially destructive event became<br />

nothing more than a minor headache.<br />

This was largely due to the ongoing<br />

relationship we have with the client<br />

and the backup processes that we<br />

had previously implemented for them<br />

in case of this type of event occurring.<br />

The threat is now at the point<br />

where cyber insurance is just as<br />

important as building, general<br />

liability or professional indemnity<br />

insurance. Equally important is the<br />

implementation of robust backup<br />

procedures, appropriate malware<br />

and antivirus protection and keeping<br />

network infrastructure up-to-date. As<br />

noted above, staff are an important<br />

line of defence and password<br />

strength is also key to this. The more<br />

complex the password, including<br />

upper and lowercase letters, numbers<br />

and symbols, the more exponentially<br />

difficult it becomes for a hacker to<br />

crack. Finally, the maintenance of<br />

current software protection versions<br />

is essential as with all technologies,<br />

the pace of change is significant. ▀<br />

Written in conjunction with Leon<br />

Fouche – National Leader of Cyber<br />

Security, Brisbane.<br />


* David Pearson is managing partner with<br />

BDO Central and has a speciality interest in<br />

advisory services to the optometry sector.<br />

For more<br />

information<br />

contact David at<br />

david.pearson@<br />

bdo.co.nz or visit<br />

www.bdo.nz<br />

Myopia Control – is it the new<br />

standard of care?<br />

One measure of how significant the discussion around<br />

myopia control has become was illustrated by the<br />

American Academy of Optometry holding a joint<br />

AAO/ARVO symposium on the first morning of its November<br />

2016 annual conference titled ‘Control vs Correction of<br />

Early Myopia: Has the Standard of Care Changed?’. This<br />

question reflects the current state of evidence supporting<br />

the use of optical<br />

and pharmacological<br />

interventions to<br />

reduce the progression<br />

of myopia and<br />

environmental<br />

interventions to reduce<br />

the incidence of new<br />

cases of myopia. It<br />

challenges practitioners<br />

to consider whether<br />

simply correcting myopia<br />

by prescribing glasses<br />

or contact lenses for<br />

children and adolescents<br />

showing progression is a<br />

sufficient management<br />

option or should advice<br />

regarding myopia<br />

control also be provided<br />

to the patients and their<br />

caregivers from the<br />

onset.<br />

High myopia, often<br />

taken as a refraction<br />

greater than -6DS, has<br />

long been recognised<br />

as being associated with sight-threatening conditions<br />

including myopic maculopathy, retinal detachment, cataract<br />

and glaucoma. However, this threshold is arbitrary and even<br />

low to moderate degrees of myopia increase the risk of such<br />

conditions developing. Furthermore, while high myopia has<br />

been considered to be more genetic than environmental in<br />

origin, the rapid increase in prevalence of myopia in East<br />

and Southeast Asia over the last few decades has revealed a<br />

new pattern of development of high myopia 1 . In this pattern,<br />

high myopia develops at around 11 years of age, due to the<br />

onset of common (or school) myopia at 6-7 years of age,<br />

associated with a relatively high progression rate of -1D per<br />

year or greater. This form of rapidly progressing common<br />

myopia appears to be associated with the adoption of an<br />

intensive and prolonged education system. While the current<br />

“epidemic” of myopia is commonly associated with Asian<br />

countries and states, a similar association between extensive<br />

academic education and myopia was also noted over 150<br />

years ago in Germany by the ophthalmologist, Hermann<br />

Cohn 2 .<br />

While a few dioptres of myopic refractive error may even<br />

be considered quite useful once presbyopia has developed,<br />

the aim of myopia control is to identify early signs of myopic<br />

progression in children and adolescent patients and offer an<br />

appropriate myopia control option with the aim of reducing<br />

the rate of progression, and hence the final degree of myopia<br />

developed in adulthood. The overall aim is to reduce the<br />

future risk of loss of sight due to myopic maculopathy and<br />

associated conditions. Current evidence-based myopia<br />

control options, which have been shown in controlled studies<br />

to reduce myopia progression, can be divided into optical<br />

(orthokeratology, peripheral/dual focus modifying soft contact<br />

lenses, progressive addition spectacles lens and executivestyle<br />

bifocals) and pharmacological (low concentration/dose<br />

atropine) methods.<br />

Optical control<br />


Myopia is now considered an “epidemic” by many commentators<br />

Optical interventions for myopia were traditionally based on<br />

the concept of managing accommodative demand and/or lag<br />

associated with near work and so under-correction of myopia<br />

was often promoted. However, when tested in a randomised<br />

clinical trial (RCT) under-correction actually resulted in a<br />

small, but significant increase in myopia progression relative<br />

to the control group who wore their full refractive correction.<br />

Conversely, myopia correction with progressive addition<br />

lenses (PAL) has been shown to slow myopia progression<br />

by 11-13% in a number of RCT studies, although the clinical<br />

benefit has been considered to be too small to promote as<br />

a clinical intervention. Interestingly, a larger reduction in<br />

myopia progression (39-51%) has been demonstrated in a<br />

RCT using executive-style bifocal spectacle wear, either with<br />

or without base-in prism incorporated in the near segments.<br />

In fact, the observation has been made across a number of<br />

spectacle-based myopia control studies that there appears to<br />

be a positive relationship between the size of near segment<br />

or zone, and the magnitude of the treatment effect. This<br />

observation has led to an alternative hypothesis that such<br />

spectacle lenses may be producing their reduction in myopia<br />

progression by the near segment altering peripheral retinal<br />

defocus when the wearer is looking through the distance<br />

portion of the lens.<br />

The role of peripheral retinal defocus in the control<br />

of refractive development is supported by a number of<br />

experiments in animal models of myopia. In these models,<br />

manipulation of the retinal focal plane so that it lies behind<br />

the retina (hyperopic defocus) promotes a compensatory<br />

axial elongation of the eye, resulting in the development<br />

of a myopic refractive error. Conversely, relative peripheral<br />

myopic defocus (image plane in front of the retina) slows axial<br />

elongation and myopia development, even when the foveal<br />

region is experiencing hyperopic defocus.<br />

These findings have led to a number of optical solutions,<br />

including novel spectacle lens designs, intended to produce<br />

relative peripheral myopic defocus with the aim of reducing<br />

myopia progression. A one-year trial of peripheral defocuscontrolling<br />

spectacle lenses demonstrated that a sub-group of<br />

6 to 12-year-old children with a parental history of myopia did<br />

display significantly less progression (0.29D less) with one lens<br />

design, however, the effect was not statistically significant<br />

across all participants. One possible explanation for the overall<br />

lack of a significant effect is that with spectacles the eyes can<br />

move behind the lens altering the optical effectiveness of the<br />

peripheral defocus-control. For example, when the principal<br />

of peripheral defocus-control was incorporated into a contact<br />

lens correction, a 34% reduction of myopia progression was<br />

found in a similar age group of children 3 .<br />

Further evidence for the potential of optical control of<br />

myopia progression with a novel contact lens design has been<br />

provided by the local research of Drs Nicola Anstice and John<br />

Phillips at the School of Optometry and Vision Science. These<br />

researchers trialled a dual-focus soft contact lens design<br />

where the central distance correction zone was surrounded by<br />

a concentric addition zone to produce simultaneous myopic<br />

retinal defocus. Myopia progression in adolescent children<br />

was reduced by at least 30% in the eye wearing the dualfocus<br />

treatment lens during the first 10 months of the study 4 .<br />

This lens design provided the basis for the CooperVision<br />

MiSight lens which is currently undergoing worldwide clinical<br />

trials (see p6).<br />

Orthokeratology (ortho-k) is typically utilised to correct<br />

myopia by flattening the corneal epithelium overnight to<br />

reduce the effective corneal power during waking hours. A<br />

secondary effect has been identified in several longitudinal<br />

studies where ortho-k has been shown to significantly reduce<br />

myopia progression by up to 45%. As ortho-k lenses flatten the<br />

central cornea, while leaving the peripheral cornea relatively<br />

steeper, the production of relative peripheral myopic defocus<br />

has been suggested as the potential mechanism for the<br />

reduction of myopia progression effect.<br />

A retrospective audit of clinical records from the public<br />

Myopia Control Clinic at the University of Auckland shows<br />

both dual-focus soft contact lens wear and ortho-k were<br />

equally efficacious in controlling myopia progression, with<br />

rates of progression following treatment falling to about 1/10<br />

of the pre-treatment rates in young adolescent patients 5 .<br />

The authors concluded that clinicians, on the basis of current<br />

evidence, should be offering contact lens-based methods of<br />

myopia control to patients at-risk of progression.<br />

Pharmacological control<br />

The ability of atropine to reduce the progression of axial<br />

myopia has been recognised for nearly 150 years. However,<br />

with the commercially available topical 1% concentration,<br />

the side-effects of mydriasis, photophobia and cycloplegia<br />

have limited its use as a myopia intervention. Meta-analysis<br />

of recent RCT studies has convincingly demonstrated that<br />

atropine eye drops in high dose (1% and 0.5%), moderatedose<br />

(0.1%) and low dose (0.01%) can slow the progression of<br />

myopia in children 6 . The demonstration in a number of trials<br />

that the low dose 0.01% atropine has comparable clinical<br />

efficacy, but minimal side effects, when compared to the<br />

higher doses, has led to its use in myopia control by a number<br />

of practitioners in New Zealand. Furthermore, a lower degree<br />

20 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>

of myopia rebound has been found when ceasing<br />

treatment with low dose 0.01% atropine (-0.72D)<br />

when compared to 1.0% atropine (-1.15D).<br />

Experience from the Myopia Control Clinic<br />

suggests that the requirement for low-dose<br />

0.01% atropine to be made up by a compounding<br />

pharmacy monthly, and associated cost, is the<br />

main impediment to this treatment being used<br />

more widely for myopia control.<br />

Outdoor activity and myopia control<br />

It is now well-established that spending increased<br />

time outdoors lowers the risk of developing<br />

myopia in children 1 . This is not a simple<br />

substitution effect and can counter the risk of<br />

developing myopia associated with increased<br />

periods of near work and the presence of parental<br />

myopia. A meta-analysis of the epidemiological<br />

evidence found that every additional hour per<br />

week of outdoor activity reduced the odds of<br />

myopia developing by 2%. However, outdoor<br />

activity does not appear to reduce the progression<br />

rate of myopia once developed.<br />

While trials in East Asia involving structured<br />

outdoor activities either during or after school<br />

have demonstrated this reduction in myopia<br />

incidence over the period of one to two years,<br />

other studies have shown that compliance<br />

with incentivised but voluntary programmes<br />

of outdoor activity decreases quickly within<br />

one year. One answer to the issue of decreased<br />

compliance with outdoor activity programmes<br />

over time may be to change the indoor lighting<br />

environment in schools. In Northeast China,<br />

an intervention trial showed that increasing<br />

the average school room desktop illumination<br />

from less than 100 lux, to approximately 500<br />

lux, resulted in a statistically significantly lower<br />

incidence of myopia (4% vs 10%) when compared<br />

to the non-modified lighting group after one<br />

year. While this is relatively early evidence<br />

from one trial and requires further replication,<br />

intervening by changing the lighting conditions<br />

of the indoor school environment may prove to<br />

be an effective public health measure against<br />

myopia development in the long term.<br />

The AAO conference symposium posed the<br />

question as to whether the standard of care for<br />

early myopia has changed given the evidence for<br />

effective myopia control interventions available<br />

to practitioners. The symposium concluded that<br />

while it might still be too soon to definitively<br />

say this is so, particularly with issues around the<br />

availability of low dose 0.01% atropine for the<br />

treatment of myopia progression, practitioners<br />

should be making their patients and caregivers<br />

aware of the options now available to control<br />

myopia progression and the potential benefit<br />

of reducing the final myopic refraction of the<br />

patient as an adult. A second session on myopia<br />

control at the AAO conference concluded with<br />

a presentation from a practitioner who has<br />

successfully set up a practice which specialises<br />

in myopia control in the USA. More locally, the<br />

February <strong>2017</strong> edition of NZ Optics reported<br />

on the opening of practice in Tauranga which<br />

will concentrate on the more secondary care<br />

aspects of optometry including myopia control.<br />

The advent of both evidence-based optical and<br />

pharmacological methods of myopia control<br />

provides an excellent opportunity to optometrists<br />

to provide up-to-date eye care which will<br />

potentially have long-term ocular health benefits<br />

to the patient. The interest in, and presentations<br />

on myopia control, at the AAO conference made<br />

it clear that this is an important area of ongoing<br />

development for both practitioners and optical<br />

companies in the near future. ▀<br />

References<br />

1. Rose, K.A., A.N. French, and I.G. Morgan, Environmental<br />

Factors and Myopia: Paradoxes and Prospects for<br />

Prevention. Asia Pac J Ophthalmol (Phila), 2016. 5(6): p. 403-<br />

410.<br />

2. Schaeffel, F., Myopia-What is Old and What is New?<br />

Optom Vis Sci, 2016.<br />

3. Sankaridurg, P.R. and B.A. Holden, Practical applications<br />

to modify and control the development of ametropia. Eye<br />

(Lond), 2014. 28(2): p. 134-41.<br />

4. Anstice, N.S. and J.R. Phillips, Effect of Dual-Focus Soft<br />

Contact Lens Wear on Axial Myopia Progression in Children.<br />

Ophthalmology, 2011. 118(6): p. 1152-61.<br />

5. Turnbull, P.R., O.J. Munro, and J.R. Phillips, Contact lens<br />

methods for clinical myopia control. Optom Vis Sci, 2016.<br />

6. Huang, J., et al., Efficacy Comparison of 16 Interventions<br />

for Myopia Control in Children: A Network Meta-analysis.<br />

Ophthalmology, 2016. 123(4): p. 697-708.<br />

About the author:<br />

* Andrew Collins is a<br />

senior tutor and registered<br />

optometrist who has<br />

worked in the Department<br />

of Optometry and Vision<br />

Science at the University of<br />

Auckland since 1994. He is<br />

currently enrolled in a parttime<br />

PhD researching the<br />

role of light exposure in the<br />

development of myopia.<br />

Kilsgaard joins DEG<br />

Jacob Kilsgaard<br />

SAFETY,<br />


Confidence behind the wheel with Rodenstock Road driving glasses.<br />

See better. Look perfect.<br />






Without Rodenstock Road: Restricted peripheral vision with conventional<br />

progressive lenses.<br />

Danish company Kilsgaard Eyewear has<br />

joined the Design Eyewear Group (DEG)<br />

to help grow its international sales.<br />

“The Kilsgaard brand has an elegant,<br />

minimalistic and innovative expression and is a<br />

perfect match to the brand portfolio of Design<br />

Eyewear Group,” said Lars Flyvholm, CEO of<br />

Design Eyewear Group. “Kilsgaard Eyewear will<br />

right away benefit from our strength in sales<br />

and distribution, while we clearly will benefit<br />

from their straightforward business model and<br />

their strong relations to the fashion scene.”<br />

Kilsgaard Eyewear was founded in 2008 by<br />

Jacob Kilsgaard, who will now supervise design and<br />

brand development as a creative consultant for<br />

DEG, added Flyvholm. “The close relation to Jacob<br />

will ensure the future development of the brand.”<br />

Headquartered in Denmark, the Design Eyewear<br />

Group emerged from three design companies:<br />

Danish companies ProDesign and Inface, and<br />

With Rodenstock Road: Perfect overview of traffic and rapid change of focus<br />

between dashboard, GPS and mirrors thanks to optimal fields of vision.<br />

For more information speak to your Rodenstock Account Manager or visit www.rodenstock.com.au<br />

Kilsgaard joins DEG brands like WOOW, distributed in ANZ by Eyes Right Optical<br />

French eyewear firm, Face à Face, which also owns<br />

the popular WOOW brand. The company’s strategy<br />

is to develop and market a portfolio of individual<br />

designer brands to customers worldwide. It<br />

currently has an international annual turnover<br />

of more than 400 million Danish Krone ($79.4<br />

million). ▀<br />


<strong>March</strong> <strong>2017</strong><br />



NZ ophthalmology research celebrated<br />

Dr Charlotte Jordan, winner of the <strong>2017</strong> Calvin Ring prize, flanked by her parents, Annette Jones<br />

and Peter Jordan, and good friend Charlotte Ring<br />

Himanshu Wadhwa with summer student awardees Sunny Li, William Cook and Joevy Lim<br />

Drs David Fitzpatrick-Cockram and Rasha Altaie<br />

Summer students awardees Ye Li, Ji Soo Kim, Michael Wang and Lize Angelo<br />

Professor Trevor Sherwin (R) presenting the William MacKenzie Medal to Jeremy Mathan<br />

Drs Stuti Misra and Jie Zhang with Jina Han and Samantha Simkin<br />

Dr Peter Ring, Professor Colin Green and Alison Ring<br />

Jasha Morarji and Maryanne Dransfield<br />

Maree McInerney, Dr Hussain Patel and Tina Fitness<br />

Dr Dean Corbett, Dr Stephen Best and Professor Trevor Sherwin<br />

Hutokshi Chinoy, Maree McInerney and Dr Mark Donaldson<br />

Frazer Coutinho, Dr James Slater and Salim Ismail<br />

The <strong>2017</strong> Excellence in Ophthalmology & Vision Research<br />

awards evening, celebrating the best of the country’s<br />

young ophthalmology researchers, was an upbeat and<br />

warm affair.<br />

Professor Charles McGhee, the Maurice Paykel Chair<br />

of Ophthalmology at the University of Auckland, was<br />

an amusing MC, peppering the evening with interesting<br />

personal anecdotes about the award winners and others they<br />

have worked with in the department.<br />

He also outlined the department’s annual activities noting<br />

the steep rise in the number of papers published from one<br />

publication a year in 1999 to 1.6 papers a week in 2016; the<br />

many special people and organisations whose donations<br />

have made the growth of the department and its rising<br />

reputation for excellent ophthalmology research possible;<br />

and the staff, research fellows and others behind the scenes<br />

whose dedication to the students and the department result<br />

in evenings such as this.<br />

PhD presentation – Samantha Simkin<br />

Samantha Simkin presented her thought-provoking PhD<br />

study into neonatal and infant eye screening.<br />

The two main aims of her PhD were to determine the<br />

efficacy of telemedicine retinopathy of prematurity<br />

(ROP) screening and to identify the prevalence of ocular<br />

abnormalities, including retinal haemorrhages in a New<br />

Zealand newborn population.<br />

Results for ROP showed that of the 1285 newborns<br />

screened, 83 had Type 1 ROP with no new ROP or retinal<br />

problems detected after six months, demonstrating the<br />

effectiveness of the telemedicine programme. In the study’s<br />

other results, retinal haemorrhages were shown to be<br />

associated with delivery modality, while ocular abnormalities<br />

were identified at a significantly higher rate, 15%, compared<br />

with other established screening programmes in New<br />

Zealand (0.1% for hearing and 0.2% for the heel prick test),<br />

raising the question of whether all newborns should be<br />

screened in the future in New Zealand.<br />

Calvin Ring Undergraduate Award –<br />

Dr Charlotte Jordan<br />

The Calvin Ring Undergraduate Award was a full-on family<br />

affair this year, with Dr Peter Ring handing his presentation<br />

duties to daughter Charlotte Ring as the awardee, Dr<br />

Charlotte Jordan, has been one of her closest friends since<br />

they were both in their teens. She is also the only recipient<br />

to have actually known Dr Calvin Ring before he died in 1998<br />

after a long and internationally distinguished ophthalmology<br />

career.<br />

Named after Dr Ring’s father, the Calvin Ring Prize<br />

recognises the best all-round undergraduate medical student<br />

in clinical ophthalmology. The annual award was established<br />

to encourage interest and awareness of ophthalmology<br />

among medical students in memory of Dr Calvin Ring<br />

who believed that ophthalmology in Auckland needed<br />

an academic focus. Selection for the award is based on<br />

excellence in examination, clinical knowledge and diagnostic<br />

and management skills in ophthalmology.<br />

In a moving and occasionally amusing presentation,<br />

Charlotte Ring praised her friend “Charlie J” or “CJ’s”<br />

22 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>

dedication and work effort, having not<br />

only studied optometry, being a dedicated<br />

ophthalmology researcher and medical student,<br />

but also a mum to two young children and wife to<br />

Auckland ophthalmologist Dr Shanu Subbiah.<br />

“I’m in awe of you and your dedication to<br />

your career,” she said. “Not only have you been<br />

awarded this and other accolades during your<br />

medical studies, but you were also awarded the<br />

senior prize in optometry during your optometry<br />

degree for which you achieved first class honours<br />

and then continued on to do your PhD. I couldn’t<br />

be more proud…”<br />

William MacKenzie Medal –<br />

Jeremy Mathan<br />

The newly appointed Professor Trevor Sherwin<br />

kept the evening upbeat with an amusing look at<br />

the William McKenzie Medal awardee, medical<br />

student Jeremy Mathan’s rather casual email<br />

pitch – “Hi Trevor” – to come and work in the<br />

department.<br />

Mathan is already an accomplished presenter<br />

“with a David Attenborough tilt to him,” said<br />

Professor Sherwin, having won a number of<br />

awards for his presentations despite being<br />

so early into his career. Mathan has already<br />

published three papers: ‘Autonomous corneal<br />

repair using autologous corneal repair using<br />

In-vitro adult stem cell expansion’; ‘Analysis<br />

of glaucoma subtypes and corresponding<br />

demographics in a New Zealand population’;<br />

and ‘Sphere-forming cells from peripheral<br />

cornea demonstrate the ability to repopulate<br />

the ocular surface’. He has also been involved in<br />

the Aotearoa Research into Keratoconus (ARK)<br />

study, looking at the epidemiologic, demographic<br />

and basic clinical characteristics of people with<br />

keratoconus managed by optometrists in New<br />

Zealand.<br />

The William MacKenzie Medal is awarded<br />

annually for early excellence in eye research.<br />

Arthur Thomas Paterson Scholarship –<br />

Dr Divya Perumal<br />

Dr Stephen Best presented the Arthur Thomas<br />

Paterson Post-graduate Scholarship, noting every<br />

one of the registrars who has won this prize since<br />

it the first was awarded in 1994, has been one of<br />

his registrars at some stage.<br />

The award was established to assist newly<br />

qualified Kiwi ophthalmologists to continue their<br />

post-graduate studies overseas and thus return<br />

to New Zealand with new skills to serve the<br />

populace. Unfortunately this year’s award winner,<br />

Dr Divya Perumal, had already left to take up a<br />

glaucoma fellowship with Manchester Royal Eye<br />

Hospital in the UK, so was not present to receive<br />

her award on the night.<br />

Summer Studentships<br />

Associate Professor Jennifer Craig presented the<br />

awards for the summer students:<br />

Lise Angelo, whose study was titled:<br />

‘Confirming a novel therapeutic target in human<br />

retina for the treatment of chronic inflammatory<br />

disease’ (Betty Bennett Summer Studentship)<br />

William Cook: ‘Rocket science and ‘super’<br />

vision’, which assessed the reproducibility and<br />

comparability of ocular higher order and corneal<br />

aberrations<br />

Darina Khun: ‘The effect of semifluorinated<br />

alkanes on tear fluid dynamics’<br />

Joevy Lim and Ji Soo Kim: ‘Effects of pressure<br />

and heat on corneal biomechanics’, to determine<br />

if different modes of meibomian gland<br />

dysfunction treatment using heat alters the<br />

biomechanical parameters of the cornea (Eye<br />

Insitute Summer Studentship)<br />

Charisse Kuo: ‘Investigation of corneal<br />

epithelium matrix production in healthy and<br />

keratoconic corneas’<br />

ANZGIG (now ANZGS) <strong>2017</strong><br />

The Stamford Plaza on a sweltering Brisbane<br />

summer weekend was the setting for the<br />

<strong>2017</strong> Australia and New Zealand Glaucoma<br />

Interest Group (ANZGIG) meeting. This was<br />

a great chance to catch up with colleagues,<br />

discuss challenging cases, learn the latest results<br />

from some high-quality glaucoma research<br />

taking place in Australasia and hear about the<br />

inspirational work of invited speaker Professor<br />

Keith Martin from the Department of Clinical<br />

Neurosciences at Cambridge University. It was<br />

also timed to coincide with the Association for<br />

Research in Vision and Ophthalmology (ARVO)<br />

Asia conference across the river at the Brisbane<br />

Convention Centre for those who wanted to get<br />

their CPD points for the year off to a flying start!<br />

Cases, driving and genetics<br />

The two-day ANZGIG conference commenced on 4<br />

February with a collection of cases. Dr Jo Koppens<br />

from Auckland presented an interesting case of<br />

normal tension glaucoma leading to a discussion<br />

of the possible protective effect of statins in<br />

glaucoma. Other cases included the challenges<br />

of managing patients with nanophthalmic eyes<br />

and raised IOP, highlighting the high-risk of<br />

complications of any sort of ocular surgery.<br />

The second session addressed an issue that<br />

many ophthalmologists struggle with - glaucoma<br />

and safety to drive. Given the ageing population<br />

with many people still driving into their 80s this<br />

is going to be an increasingly common situation.<br />

Loss of a driving licence can have a severe<br />

detrimental effect on quality-of-life through<br />

loss of independence leading to isolation and<br />

depression, with secondary effects on other<br />

members of the family.<br />

Dr Jim Stewart outlined the situation in New<br />

Zealand, with our option to refer the decision to<br />

the chief medical examiner of the Land Transport<br />

Safety Authority if we feel a further opinion is<br />

required, and the potential use of a practical<br />

driving exam by an occupational therapist.<br />

Professor Joanne Wood from the Queensland<br />

University of Technology, a world expert on<br />

driving and visual impairment, highlighted it was<br />

unclear if current Australian visual standards<br />

(which are similar to NZ) were suitable and the<br />

Estermann visual field may not test the most vital<br />

areas or in a way that is relevant to driving.<br />

Professor Wood undertook some very<br />

interesting research comparing patients with<br />

moderate to severe glaucoma with age-matched<br />

controls using an on-road assessment with a<br />

trained instructor in a dual-control car. She found<br />

the patients with glaucoma had only slightly<br />

lower overall safety scores than the controls,<br />

but had twice as many critical errors where the<br />

instructor had to intervene. None of the standard<br />

visual field measures were strongly correlated<br />

with driving safety. She suggested tests involving<br />

motion sensitivity may have better predictive<br />

value. In her research, combining visual field<br />

scores with tests of cognition and strength<br />

showed a better correlation to the driving score.<br />

The other factor making it difficult to determine<br />

the effect of glaucoma on driving was that the<br />

“normal” controls made a high number of driving<br />

errors!<br />

The biggest discussion at the AGM of ANZGIG<br />

was changing the name as there was a feeling<br />

that we should transition from being a “Group” to<br />

a “Society” (having started out as a “Club”!). After<br />

a near unanimous vote it was decided that in<br />

future this group will be known as the Australia<br />

New Zealand Glaucoma Society (ANZGS).<br />

The Lowe Lecture was delivered by Professor<br />

Martin of the University of Cambridge and was<br />

titled ‘Beyond IOP’. He discussed the ongoing<br />

need to develop better ways to protect patients<br />

heading towards significant visual loss. He<br />

outlined the early use of stem cells and the<br />

growth factors they release which were found<br />

to be protective but cause reactive gliosis. He<br />

described newer techniques whereby genes are<br />

introduced into retinal ganglion cells (RGCs) using<br />

viral vectors. This research has reached human<br />

clinical trials, initially testing technique safety<br />

on blind eyes. Further trials on neuroprotective<br />

agents are likely and in the future we may be<br />

combining strategies to replace and regenerate<br />

RGCs.<br />

Professor Martin was followed by Professor<br />

Jamie Craig from Melbourne who updated us<br />

on advances in glaucoma genetics. He broadly<br />

grouped the glaucoma phenotypes into those<br />

where there was a single gene mutation causing<br />

severe disease such as myocilin, which makes up<br />

a very small proportion of glaucoma cases, and<br />

compared this with the more common situation<br />


Drs Jay Meyer, Nicholas Johnston and Graham Reeves at ANZGIG in<br />

Brisbane<br />

where individuals are born with a “bad hand” of<br />

genes that individually only increase the risk of<br />

glaucoma slightly, but together contribute a risk<br />

up to five times greater. Professor Craig said he<br />

sees a future where genetic analysis may allow us<br />

to better understand an individuals’ risk profile<br />

so we can better personalise their treatment.<br />

Already through The Australian and New Zealand<br />

Registry of Advanced Glaucoma, researchers<br />

are using genetic profiles to help screen family<br />

members of those patients with severe glaucoma.<br />

False irides, vascular factors and MIGS<br />

The second day started with another set of<br />

challenging cases, the most notable being a<br />

patient who had undergone surgery in India<br />

of angle-supported iris implants to change the<br />

colour of her eyes and then suffered recurrent<br />

episodes of anterior uveitis with raised intraocular<br />

pressure. She refused treatment for a<br />

Ye Li: ‘Is keratoconus a stem cell disorder?’<br />

TECNIS ®<br />

Sunny Li: ‘The cornea: wound healing and<br />

changes after cataract surgery’ (Tom Cat Summer<br />

Studentship)<br />

Micah Rapata (absent): ‘Characterisation of the<br />

inherited maculopathies from the NZ Inherited<br />

Retinal Disease Database’ (Ombler Trust Summer<br />

Studentship)<br />

Michael Wang (last year’s William MacKenzie<br />

Medal winner): ‘Clinical and microbiological<br />

profile of Pseudomonas aeruginosa keratitis at<br />

Greenlane Clinical Centre’ (NZAO Education and<br />

Research Fund)<br />

Kenny Wu (absent): ‘Quantification of laserinduced<br />

choroidal neovascular lesions in a mouse<br />

model of AMD’ ▀<br />




long period before finally consenting to having<br />

one explanted. Audience members shared their<br />

experiences with similar patients and advised it<br />

may be necessary to enlist a psychiatrist to help<br />

engage with these patients as there is often an<br />

element of body dysmorphic disorder that makes<br />

rational discussion of the implant risks very<br />

difficult.<br />

Professor Stuart Graham from Sydney gave<br />

the Gillies Lecture discussing the importance of<br />

vascular factors in glaucoma, including research<br />

into patients with nocturnal blood pressure drops.<br />

So-called “big dippers”, whose blood pressure<br />

drops more than 10% overnight, have a three<br />

times greater risk of glaucoma progression.<br />

The only recommended remedy is to make sure<br />

any systemic hypertension is not over-treated<br />

and avoid beta-blocker use, which may further<br />

compromise optic nerve head perfusion. Professor<br />

Graham also discussed the controversy about<br />

whether obstructive sleep apnoea is relevant in<br />

glaucoma. His conclusion was there are probably<br />

several different disease processes involved in the<br />

pathophysiology of glaucoma and postulated that<br />

future genetic testing may allow better distinction<br />

of phenotypes and so guide us in individualising<br />

treatment.<br />

Professor Bill Morgan from Perth added to the<br />

vascular discussion with his work on venous<br />

pulsation and disc haemorrhages, providing<br />

further evidence of the importance of looking<br />

for haemorrhages to identify patients who are<br />

progressing.<br />

The final session covered minimally invasive<br />

glaucoma surgery (MIGS) with a collection of<br />

experts sharing their experience with different<br />

devices and offering advice in terms of patient<br />

selection and technical tips. This was finished with<br />

some very informative and entertaining videos<br />

from Dr Graham Lee of Brisbane, complete with<br />

music appropriate for the sticky situations he<br />

demonstrated!<br />

Overall this was a great conference with<br />

enlightening and entertaining speakers and I look<br />

forward to next years’ instalment in Sydney. ▀<br />

* Dr Graham Reeves is based at the Manukau Superclinic and<br />

Eye Institute and has a special interest in the diagnosis and<br />

management of glaucoma.<br />

TECNIS is a trademark owned by or licensed to Abbott Laboratories, its subsidiaries or affiliates. All other trademarks are the intellectual property of their<br />

respective owners. AMO Australia Pty. Limited. Level 3, 299 Lane Cove Road, Macquarie Park, NSW 2113. AMO Australia Pty. Limited (Incorporated in<br />

Australia) PO Box 401, Shortland Street, Auckland, 1140. © <strong>2017</strong> Abbott Medical Optics Inc. | www.AbbottMedicalOptics.com | PP2016CT1775<br />

AMO20468 Tecnis Symfony Adv NZ-Optics.indd 1<br />

<strong>March</strong> <strong>2017</strong><br />

4/1/17 10:59 am<br />



with<br />

Prof Charles McGhee<br />

& A/Prof Dipika Patel<br />

Series Editors<br />

Atypical infectious keratitis<br />

– a rising scourge<br />



Corneas may be infected by a myriad of<br />

pathogens, and in temperate countries such<br />

as New Zealand, bacterial infections account<br />

for the majority of cases of infectious keratitis.<br />

All forms of infectious keratitis have one thing in<br />

common – their potential to cause devastating<br />

visual loss.<br />

Although relatively uncommon, corneal<br />

infections with atypical microbial pathogens<br />

(eg. Acanthamoeba, fungal, microsporidia, nontuberculous<br />

mycobacteria) are notoriously difficult<br />

to diagnose and treat, often resulting in poor visual<br />

outcomes.<br />

The past decade has seen a rise in the incidence of<br />

atypical infectious keratitis. An outbreak of fusarium<br />

keratitis was described in Singapore in 2005 and<br />

was linked to the use of ReNu with MoistureLoc. In<br />

2006, an increase in the incidence of Acanthamoeba<br />

keratitis was linked to the use of AMO Complete<br />

MoisturePlus. Although product recalls led to a<br />

dramatic drop in cases of fusarium keratitis, the<br />

incidence of acanthamoeba keratitis continues to<br />

rise, the cause of which remains uncertain. Indeed,<br />

recent data from Greenlane Clinical Centre indicates<br />

that the number of cases of Acanthamoeba keratitis<br />

presenting annually has doubled in the period 2009-<br />

2016 compared to 2001-2009.<br />

Risk factors<br />

Taking a detailed history is crucial when it comes<br />

to raising suspicion of an atypical corneal infection.<br />

The vast majority of cases of Acanthamoeba<br />

keratitis occur in contact lens wearers and is typically<br />

associated with swimming, using hot-pools/hottubs<br />

or showering with contact lenses in situ. Risk<br />

factors also include washing contact lenses in tap<br />

water, particularly if sourced from a water tank.<br />

A major red flag for fungal infection is trauma<br />

involving vegetable matter. Other risk factors<br />

include recent travel to a tropical country, chronic<br />

ocular surface disease or systemic immune<br />

deficiency, and poor contact lens hygiene.<br />

Non-tuberculous mycobacterial corneal<br />

infections are rare and are usually preceded by a<br />

surgical intervention (most commonly LASIK), or<br />

corneal trauma.<br />

silmoparis.com<br />

24 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong><br />

SHOW<br />

Fig 1. Slit lamp biomicroscopy images of atypical infectious keratitis showing (a) corneal epitheliopathy (arrows) in a patient with Acanthamoeba keratitis, (b) a dense<br />

stromal infiltrate in severe fungal keratitis, and (c) a focal stromal infiltrate (arrow) with intact overlying epithelium in a case of microsporidium keratitis.<br />

Fig 2. In vivo confocal microscopy images of the cornea showing (a) double walled cysts (arrows) in Acanthamoeba keratitis,<br />

(b) branching lines in fusarium keratitis and (c) diffuse fine hyper-reflective spots in microsporidium keratitis.<br />

Up until 2003, microsporidial keratitis was<br />

primarily observed in immunocompromised<br />

individuals. There was subsequently an increase<br />

in reported cases of microsporidia keratitis in<br />

immunocompetent individuals in South East Asia.<br />

Risk factors include contact lens wear and trauma<br />

with exposure to contaminated water or soil.<br />

Diagnosis<br />

Clinical signs alone are usually unreliable in<br />

distinguishing the causative<br />

organism. In the case of<br />

atypical corneal infections,<br />

this is attributed to the<br />

great variability in clinical<br />

presentation. Studies report<br />

that over 90% of cases of<br />

Acanthamoeba keratitis<br />

are initially misdiagnosed<br />

as viral, fungal or<br />

bacterial keratitis. Corneal<br />

epitheliopathy (fig 1a)<br />

occurs early in the course of<br />

the disease and may have<br />

a dendritiform appearance<br />

similar to that observed<br />

in herpetic keratitis.<br />

Subepithelial infiltrates may<br />

mimic adenoviral keratitis.<br />

Other presentations include<br />

ring-shaped or focal stromal<br />

infiltrates and corneal melt<br />

or perforation. The presence<br />

of radial keratoneuritis is<br />

virtually pathognomonic<br />

for Acanthamoeba keratitis,<br />

as it occurs rarely in<br />

other keratitis, but this<br />

sign is also uncommon<br />

in acanthamoeba and is<br />

usually only observed early<br />

in the course of the disease.<br />

The stromal keratitis<br />

caused by fungal infection<br />

(fig 1b) usually resembles<br />

bacterial keratitis. Features<br />

that are thought to aid<br />

in distinguishing fungal<br />

keratitis include stromal infiltrates with feathery<br />

edges, and satellite stromal infiltrates. In some<br />

cases, the overlying epithelium may remain intact<br />

despite extensive stromal involvement.<br />

In non-tuberculous mycobacterium keratitis, the<br />

infiltrates have may have an unusual, focal, waxy or<br />

“cracked windshield” appearance and may develop<br />

satellite lesions or a ring infiltrate.<br />

Microsporidial keratitis often mimics herpetic<br />

keratitis, presenting with multifocal epitheliopathy,<br />

or stromal infiltrates (fig 1c) with surrounding<br />

corneal oedema and keratic precipitates.<br />

For patients who are on empirical treatment for<br />

presumed bacterial keratitis, if there is not at least<br />

some sign of improvement within the first four to<br />

seven days, viral or atypical causes of the keratitis<br />

should be actively considered and the temptation<br />

to use corticosteroids should be actively avoided.<br />

Investigation<br />

Tissue sampling and culture remain imperative<br />

in the diagnosis of infectious keratitis. Atypical<br />

pathogens are often fastidious, requiring<br />

specialised culture systems and some cultures may<br />

take days to weeks to become positive.<br />

The difficulty in isolating the causative organism<br />

in atypical keratitis is reflected by the observation<br />

that only 30 to 40% of cultured cases among<br />

patients with Acanthamoeba or fungal keratitis<br />

have a positive culture.<br />

In culture negative cases where there is a lack of a<br />

favourable clinical response, a repeat corneal scrape<br />

is recommended and, in some cases, a corneal<br />

biopsy may be required.<br />

In vivo confocal microscopy (IVCM) is a rapid,<br />

non-invasive technique that enables imaging of<br />

the living human cornea at the cellular level. IVCM<br />

is a useful adjunctive tool when Acanthamoeba<br />

or fungal keratitis are suspected. However, the<br />

resolution limits of this instrument (approaching<br />

one micron) preclude its use in detecting bacterial<br />

or viral infections. IVCM has a sensitivity and<br />

specificity of approximately 90% for the detection<br />

of fungi or Acanthamoeba.<br />

On IVCM imaging, Acanthamoeba cysts may appear<br />

as double-walled cysts, signet rings, and bright spots<br />

(fig 2a). However, inflammatory cells also appear as<br />

similar bright spots, and may easily be confused with<br />

Acanthamoeba cysts leading to erroneous diagnosis.<br />

The presence of double-walled cysts, signet rings<br />

should therefore always be sought.<br />

Fungal hyphae characteristically appear as bright<br />

linear branching structures on IVCM images (fig 2b).<br />

Microsporidia may be diagnosed on IVCM by the<br />

presence of diffuse punctate hyper-reflective inter<br />

and intracellular dots (fig 2c).<br />

Conclusion<br />

Atypical corneal infections pose significant diagnostic<br />

challenges, particularly due to the wide variability<br />

in presentation, overlapping clinical signs, and<br />

difficulties in isolating causative organisms. Early<br />

detection of these cases is crucial and relies on<br />

having a high level of suspicion based on the history,<br />

clinical signs and response to treatment. In particular,<br />

the temptation to start corticosteroids should be<br />

avoided if there is uncertainty in the diagnosis. ▀<br />

References<br />

Patel DV, Rayner S, McGhee CN. Resurgence of Acanthamoeba<br />

keratitis in Auckland, New Zealand: a 7-year review<br />

of presentation and outcomes. Clin Exp Ophthalmol.<br />

2010;38(1):15-20<br />

Patel DV, McGhee CN. Acanthamoeba keratitis: a<br />

comprehensive photographic reference of common and<br />

uncommon signs. Clin Exp Ophthalmol. 2009;37(2):232-8<br />

Kheir WJ, Sheheitli H, Abdul Fattah M, Hamam RN.<br />

Nontuberculous Mycobacterial Ocular Infections: A Systematic<br />

Review of the Literature. Biomed Res Int. 2015;2015:164989.<br />

Garg P. Microsporidia infection of the cornea--a unique and<br />

challenging disease. Cornea. 2013 Nov;32 Suppl 1:S33-8.<br />

Garg P.Fungal, Mycobacterial, and Nocardia infections and the<br />

eye: an update. Eye (Lond). 2012 Feb;26(2):245-51.<br />

About the authors:<br />

* Associate professor Dipika Patel is based in the Department<br />

of Ophthalmology at the University of Auckland. Her research<br />

interests include anterior segment imaging and investigating<br />

potential therapeutic applications for corneal stem cells.<br />

* Professor Charles McGhee is head of the Department of<br />

Ophthalmology at the University of Auckland, and senior<br />

ophthalmic surgeon at Auckland City Hospital. Prof McGhee’s<br />

clinical interests<br />

include corneal<br />

diseases such as<br />

keratoconus, corneal<br />

dystrophies, corneal<br />

transplantation,<br />

cataract surgery and<br />

complex anterior<br />

A/Prof Patel<br />

Prof McGhee<br />

segment surgery<br />

following trauma.

The art of cornea in Brisbane<br />


This year’s highly successful and well-attended<br />

Australia and New Zealand Cornea Society<br />

(ANZCS) conference was held in Brisbane on<br />

the day before the commencement of the ARVO-<br />

Asia conference. The venue was the beautiful<br />

Queensland Gallery of Modern Art (GOMA) at<br />

Southbank and the one-day conference attracted<br />

almost 100 ophthalmologists, eye-bankers and<br />

those interested in cornea and visual sciences.<br />

The programme was fast-paced but with ample<br />

time for discussion. It covered the whole gamut<br />

of corneal disease in one day – rather than<br />

over the normal annual two-day meeting – so<br />

delegates could also attend ARVO-Asia. Sessions<br />

were divided into sections that included updates,<br />

new investigations, state-of-the-art techniques,<br />

controversies and the annual Doug Coster Lecture.<br />

The principal guest speakers were Dr Mike<br />

Straiko (USA) and Professor Shigeru Kinoshita<br />

(Japan).<br />

The global trend towards Descemet’s membrane<br />

endothelial keratoplasty (DMEK) was highlighted<br />

by a number of speakers, but particularly in<br />

a beautifully presented “DMEK masterclass”<br />

presented by Dr Straiko. It was quite clear that in<br />

the USA and Australasia, however, the majority<br />

of endothelial keratoplasties are still successfully<br />

carried out using the DMEK forerunner, Descemet’s<br />

stripping automated endothelial keratoplasty<br />

(DSAEK). The majority of tissue for DSAEK is now<br />

being prepared by eye banks.<br />

A simple, small, central descemetorhexis without<br />

a transplant, ie. allowing the defect to heal by<br />

sliding of peripheral endothelium, potentially<br />

enhanced by application of Rho-kinase (ROCK)<br />

inhibitors, was highlighted by Dr Greg Maloney<br />

(NSW). Dr Maloney also introduced the audience<br />

to the osteo-odonto keratoprosthesis (OOKP)<br />

programme currently being established in Sydney,<br />

illustrated by the first few treated cases.<br />

Professor Stephanie Watson (Sydney) presented the<br />

compelling advantages of contributing to a corneal<br />

collagen crosslinking (CXL) registry for keratoconus,<br />

the increasingly well-established treatment for early,<br />

progressive keratoconus. While Dr Con Petsoglou<br />

(Sydney) discussed the major development of the<br />

Australian Ocular BioBank in Sydney.<br />

In a landmark Doug Coster Lecture, Professor<br />

Kinoshita discussed the long journey from early<br />

laboratory studies, via animal models, to upcoming<br />

human trials of endothelial cell transplantation<br />

and the utility of ROCK inhibitors. In an academic<br />

tour-de-force Professor Kinoshita outlined<br />

the immediate clinical horizon for endothelial<br />

dysfunction using cultured endothelial cells and<br />

topical agents. In a unique time of rapid changes<br />

in lamellar endothelial keratoplasty, it is now<br />

entirely conceivable that treatment by injection of<br />

cultured cells and application of topical agents will<br />

supplant more invasive surgical techniques within<br />

a decade.<br />

Professor Kinoshita continued in a separate<br />

lecture to highlight the medical and surgical<br />

management of potentially devastating ocular<br />

surface disorders such as Stevens-Johnson<br />

syndrome (SJS).<br />

Dr Graeme Pollock (Melbourne) provided<br />

an annual update of Australasian Eye Banks’<br />

(EBAANZ) activity while his colleague Dr Prema<br />

Finn highlighted key elements of DMEK tissue<br />

selection.<br />

One of the annual highlights of the conference,<br />

the Australian Corneal Graft Registry annual<br />

report, was delivered by Flinders University<br />

research associate Dr Miriam Keane.<br />

The meeting ended with a clinical movie<br />

competition and a new section with interactive<br />

live polling of controversial topics. As always<br />

the mood was upbeat, informal, interactive and<br />

extremely cordial. The fabulous GOMA location<br />

at Southbank, was convivial and refreshing. The<br />

conference dinner in the long gallery was a wellattended<br />

and a most-enjoyably-friendly ending to<br />

a cutting-edge conference. ▀<br />

* Professor Charles McGhee is Maurice Paykel Chair of<br />

Ophthalmology at the University of Auckland and a consultant<br />

ophthalmologist. His clinical interests include corneal disease<br />

and transplantation, and complex anterior segment surgery.<br />

He is the present chair of the ANZ Cornea Society.<br />

Dr Graeme Pollock and Professors Shigeru Kinoshita and Charles<br />

McGhee at the ANZCS dinner<br />

ANZCS diary dates<br />

RANZCO’S Cornea Special Interest Group,<br />

chaired by Professor Charles McGhee, met the<br />

evening before the conference to discuss the<br />

development of the society and to review the<br />

constitution and location of future conferences.<br />

It was provisionally agreed that the ANZCS<br />

conference would rotate to Sydney (2018),<br />

Adelaide (2019), Perth (2020) and Auckland/<br />

Queenstown (2021) to continue this highly<br />

collaborative cornea and eyebank meeting<br />

originally developed by Professor Douglas Coster<br />

in the 1980’s.<br />

Clarity awards<br />

Greerton<br />


OCULUS<br />

Oculus Easygraph<br />

Combination Corneal Topographer<br />

and built-in Keratometer<br />

• Extremely high resolution (22.000 measuring points)<br />

• Short measuring time - fraction of a second<br />

• Non-contact measuring<br />

Visique Greerton’s winning team: Tony Simpson, Brenton Clark, Keith Miller, Deanna Black and<br />

Rachel McDonald<br />

Clarity 20/20 presented Visique Greerton in Tauranga with its<br />

Excellence Award for Achievement for signing up more than<br />

1,000 of their patients to Clarity’s “Peace of Mind” insurance<br />

cover.<br />

“We see Clarity as an important tool for us to ensure we retain our<br />

patients. It also offers us a distinct advantage in our local market<br />

by giving our practice a unique point of difference,” said Visique<br />

Greerton director Keith Miller upon receipt of the award. “Clarity not<br />

only helps to build relationships with our patients, but it enables us<br />

to reward our patients for buying premium products by offering the<br />

second year (cover) for free instead of offering discounts.”<br />

Making a claim is very straight-forward and the glasses are<br />

repaired and returned quickly, added Greerton dispensing optician<br />

Tony Simpson. “Using the Clarity interface is quick and very easy,<br />

the temporary save feature means no admin work is done in front<br />

of the patient. We are extremely happy that many patients have<br />

left satisfied having made a claim, especially one gentleman that<br />

damaged his glasses within an hour of collection having sat on them<br />

in the car!”<br />

Matt Marquis, Clarity’s New Zealand sales development manager, says<br />

Clarity has a simple phiilosophy pitch for practices, “sell more glasses,<br />

more often by offering patients the peace of mind they want.” ▀<br />

$9,990+GST+Freight, for month of <strong>March</strong> <strong>2017</strong> only<br />


®<br />

NEW: RayOne<br />

Call Ralph Mob. 021 990 200<br />

Preloaded IOL<br />

ODMA update<br />

ODMA <strong>2017</strong> will feature a strong educational focus, say<br />

organisers, including revamped Masterclasses and Spotlight<br />

Seminars, with CPD points for delegates from both sides of<br />

the ditch.<br />

Running from 7-9 July in Sydney, ODMA’s Vison Summit on the<br />

Friday includes Professor John Marshall, the Frost Professor of<br />

Ophthalmology at University College London, in association with<br />

Moorfield’s Eye Hospital, and inventor of the excimer laser; Dr<br />

Rolando Toyos from the US who developed the use of intense pulsed<br />

light (IPL) for dry eye disease; and Associate Professor Paul Chew from<br />

Singapore, who invented and commercialised the Glaucoma MP3<br />

Therapy Laser.<br />

ODMA has confirmed that all the major equipment and lens<br />

companies will exhibit and have so far been joined by frame and<br />

sunglass brands like Tom Ford, Jono Henessy, Face à Face, Lafont and<br />

Salvatore Ferragamo to name a few. ▀<br />

For more information, visit www.odma<strong>2017</strong>.com.au<br />

RayOne ® with patented<br />

Lock & Roll technology for a smoother,<br />

more consistent rolling and delivery of<br />

the lens via micro incision<br />

• Rolls the lens to under half its size before injection<br />

• Fully enclosed cartridge with no lens handling<br />

DV857-0217<br />

0800 338 800<br />

designsforvision.co.nz<br />

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and incision size<br />

• Easy to use, true 2-step system<br />

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• 1.65 mm RayOne ® nozzle<br />

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• Full power range, from -10.0 to +34.0<br />

Dioptres - Largest fully preloaded power<br />

range available<br />

Call Keith Mob. 021 0270 0649<br />

<strong>March</strong> <strong>2017</strong><br />



Style-Eyes<br />

Gender diversity and<br />

eyewear<br />

How would you feel if people refused to<br />

acknowledge who you are and talked<br />

to you like your own identity didn’t<br />

matter?<br />

In the past few years, transgender, gendernon-conforming<br />

and non-binary people have<br />

had a lot more presence in the media and<br />

popular culture. While this exposure has<br />

sometimes lead to greater understanding,<br />

often this doesn’t feed through to the everyday<br />

experiences of our transgender friends.<br />

When I was studying to become an optical<br />

dispenser last year, a transgender friend<br />

told me a story about a recent experience of<br />

shopping for glasses. She is a transwoman<br />

and while browsing for new specs, the shop<br />

assistant made an assumption about her<br />

gender. My friend was looking at the practice’s<br />

selection of women’s eyewear when the<br />

assistant approached without even asking how<br />

she was and told her that the men’s eyewear<br />

was on the other side of the shop. She left<br />

feeling insulted and upset.<br />

How can you make trans and gendernon-conforming/non-binary<br />

people feel<br />

safe and welcome in your shop?<br />

A lesson for all of us who deal with the public is<br />

to never assume anyone’s gender.<br />

Appearances, clothing and accessory choices,<br />

mannerisms and more may make us read<br />

people as men or women because most of<br />

us have spent our whole lives living with an<br />

understanding that there are only two genders.<br />

However, we are beginning to understand there<br />

are many genders, not just men and women.<br />

We need to compassionately approach every<br />

stranger we deal with as an individual.<br />

Here’s what we’ve done in some of the<br />

shops where I’ve worked<br />

• We don’t separate frames by conventional<br />

gender.<br />

• If anyone asks, I tell them that all of our<br />

frames are unisex.<br />

• If anyone is uncomfortable with that or<br />

still confused, I tell them that there are some<br />


frames that are more conventionally feminine<br />

and masculine and, if they like, I can help<br />

them find the right frame to suit their style<br />

and personality.<br />

• I try to use non-gendered language when<br />

referring to a group of people. Instead of<br />

saying, “How are you guys doing today?” I say,<br />

“How are you all today?”<br />

• Be considerate when entering people’s data<br />

into your practice software. Many practices<br />

collect titles and gender. If your software<br />

allows this, perhaps you could turn off the<br />

mandatory collection of this information.<br />

I asked another friend - bespectacled<br />

transgender woman and musician, Simona<br />

- what she would recommend and she said,<br />

“The idea that glasses or clothing - fashion - is<br />

gendered is something we need to unlearn.<br />

Anybody should be able to come into a shop and<br />

look at any piece to try on. It’s the staff’s job not<br />

to judge about the gender of both the customer<br />

or the merchandise. When we do that, we stop<br />

focusing on identity and gender altogether and<br />

the store becomes a place where people are free<br />

to look at whatever they want.”<br />

Get talking with your colleagues<br />

There are plenty of great resources online that<br />

you can share with your colleagues.<br />

For a quick 101 about gender and<br />

terminology, I’d direct you to http://tiny.cc/<br />

gender101. It’s a fact sheet called ‘Inclusive<br />

Language Guide Respecting people of intersex,<br />

trans and gender diverse experience’ and is by<br />

the National LGBTI Health Alliance in Australia.<br />

If you would like to learn more start with<br />

this video, ‘An Introduction to Judith Butler’s<br />

Gender Troubles: www.youtube.com/<br />

watch?v=Z7M6kD5Qt5M<br />

Use it to start discussions about what most<br />

of us have been brought up to believe about<br />

gender.<br />

Want to talk about this? I’d be happy to hear<br />

from you. Email me at jo@eyeheartglasses.<br />

com ▀<br />

Stars and their eyes:<br />

Johnny Depp<br />

The 53-year-old Hollywood actor Johnny<br />

Depp is one of the most recognisable faces<br />

of stage and screen – and not in the least<br />

part because of his infamous tinted glasses. As it<br />

turns out, they’re not just a style choice.<br />

“I’m blind as a bat in my left eye,” admitted<br />

the Pirates of the Caribbean star in a Rolling<br />

Stone interview in 2013. He is also myopic in<br />

his right eye. Depp says he’s suffered from sight<br />

problems since birth and has had to rely heavily<br />

on prescription glasses.<br />

“Everything is just very, very blurry. I’ve<br />

never had proper vision,” he explained, noting<br />

that when he is acting a role, like Edward<br />

Scissorhands, it’s not always possible to<br />

wear glasses and he often can only see a few<br />

centimetres in front of his face.<br />

* Jo Eaton is a native Wellingtonian, now working as a<br />

qualified DO in Melbourne. She runs eyewear fashion blog,<br />

eyeheartglasses.com<br />

Fashion update<br />

As Europe’s fashion houses gear up for the northern hemisphere’s spring/<br />

summer season, New Zealand is benefitting with an influx of versatile, up<br />

to the minute styles.<br />

Fleye<br />

On display at Munich’s OPTIfair in January, Fleye<br />

revealed its innovative new designs inspired by<br />

the Canadian interior and furniture designer, Zoë<br />

Mowat.<br />

“With her intuitive exploration of color and<br />

texture [she] adds a touch of ‘Modern Bauhaus’<br />

to the Fleye SS17 collection,” said the Fleye team.<br />

The Copenhagen-based fashion eyewear brand<br />

has gone for an art deco meets industrial theme,<br />

with beautiful angular detail set in metallic and<br />

hardwearing frames.<br />

Distributed direct from Fleye Australia (see the<br />

<strong>2017</strong> OIG for contact).<br />

Jono Hennessy<br />

Closer to home, Australian brand Jono Hennessy<br />

has released a selection of new and exclusive styles<br />

in anticipation of Silmo Sydney. Also combining<br />

acetate and bold, colourful prints with quality<br />

metal framework and design, many of these<br />

limited edition styles are produced using pure fabric<br />

laminated in cellulose acetate with an interlayer<br />

formulation developed with Mazzuchelli in Italy in<br />

the 1980’s. Distributed by Phoenix Eyewear.<br />



OWN BOSS<br />

At OPSM, we are passionate about opening eyes to<br />

the unseen. Our advanced technology enables us to look<br />

deeper to ensure we give the best care to every customer.<br />

OPSM in New Zealand is looking to expand their Locum<br />

Optometrist network.<br />


As a locum you will be your own boss, you will have<br />

the flexibility to set your own hours and will be exposed<br />

to lots of different patients and locations across New<br />

Zealand all while gaining lots of skills and experience.<br />

We are looking for Optometrists who share our passion, are<br />

willing to learn quickly and want to join our customer focussed<br />

teams in making a difference to how people see the world.<br />


• Great working environment<br />

• Fantastic locum rates $$<br />

• Accommodation and flights<br />

• Latest technology<br />

• Luxury brands<br />

• New friends and having fun<br />


For a chance to be your own boss and part of an amazing<br />

team, contact us for a confidential, no obligation chat.<br />

CONTACT:<br />

Hirdesh Nair<br />

hirdesh.nair@opsm.co.nz or call +64 21 523 282<br />

Robbie Singh<br />

robbie.singh@luxottica.com.au or call +64 21 750 847<br />


Radley from Inspecs<br />

The London-based fashion accessories firm<br />

revealed its new collection in February, which<br />

focuses on little luxuries and stable pieces that<br />

can morph from work into the weekend. Using<br />

prints lifted directly from the Radley design<br />

palette, expect “floral torts, layered berry<br />

tones and vintage inspired caramel,” says the<br />

London team. Distributed by Phoenix Eyewear.<br />

Blackfin<br />

Also going for an industrial look with a splash<br />

of colour, the Blackfin Lamina PLUS range is<br />

making its debut. The brand’s usual, high-end<br />

titanium frames have been accentuated with<br />

acetate – a new material for Blackfin – offering<br />

a quirky and lively take on classic designs.<br />

The acetate is ultra thin and hand-worked to<br />

offer a style note without compromising on<br />

quality, says the promotional material. The<br />

name PLUS will now be used by Blackfin to<br />

describe all models in which their hallmark<br />

titanium is combined with other materials to<br />

add diversity and choice. Distributed in New<br />

Zealand by Beni Vision.<br />

26 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong><br />


10/2/17 3:47 pm


& SHIRLEY<br />







As <strong>2017</strong> gathers pace, so too do the opportunities for optometrists at all stages<br />

of their careers in and around both Wellington and Christchurch.<br />

A total of seven Specsavers stores are available for you to choose from – and we have multiple positions available, depending on your experience.<br />

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<br />

look at store ownership.<br />

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<br />

was another year of strong growth for Specsavers stores across New Zealand, <strong>2017</strong> promises just as much for those looking to develop their careers.<br />

Talk to us now and we can tell you about great rates of pay and our unrivalled professional development program.<br />

Contact Chanelle Coates on 0800 717 350 or chanelle.coates@specsavers.com<br />


Millward Brown<br />

Research<br />

No.1 for eye tests<br />

2016<br />

Excellence in<br />

Marketing<br />

Award<br />

2016<br />

Retail<br />

Store Design<br />

Award<br />

2016<br />

Retail<br />

Employer<br />

of the Year<br />

2015<br />

Overall<br />

National<br />

Supreme Winner<br />

2015<br />

Franchise<br />

Innovation<br />

Award<br />

2015<br />

NZ Franchise<br />

System of<br />

the Year<br />

2014<br />

Retail<br />

Innovator<br />

of the Year<br />

2014<br />

Roy Morgan<br />

Research<br />

No. 1 for eye tests<br />

2014<br />

FCA Social<br />

Responsibility<br />

Award<br />

2014<br />

<strong>March</strong> <strong>2017</strong><br />






Grant & Douglas Optometry & Eyewear is seeking a<br />

qualified dispensing optician (or someone currently in<br />

training to be a dispensing optician).<br />

We are a busy independent practice providing excellent<br />

eyecare and eyewear solutions tailored to our customers'<br />

individual needs.<br />

The role will be based mainly in our Havelock North<br />

practice but may require occassional work in our<br />

Hastings practice.<br />

This is a great opportunity for a confident, versatile<br />

individual with the following attributes:<br />

• Experience in customer service with a proven track<br />

record for a high level of customer satisfaction<br />

• Excellent communication and sales skills<br />

• Shows initiative, is reliable and honest<br />

• Strong computer literacy<br />

• Good standard of personal presentation<br />

• Able to work cohesively and productively within<br />

a team.<br />

Monday-Friday, approx 30-40 hours per week (negotiable).<br />

Please email your CV and cover letter outlining your<br />

skills and experience to Anna Byers<br />

abyers@grantanddouglas.co.nz<br />


We have an opportunity for a therapeutically qualified optometrist to<br />

become part of our Total Eyecare team. You need to be competent in full<br />

scope optometry as our private practices embrace all aspects of clinical<br />

work including diabetic retinal screening and myopia control. We are well<br />

equipped with anterior and posterior cameras, topography, automated<br />

Zeiss visual fields and Cirrus HD-OCT. You’ll have the support of experienced<br />

colleagues and opportunities for professional development.<br />

We are looking for a motivated optometrist with a good sense of<br />

humour and someone who works well as part of a team.<br />

Please send your CV to jane@totaleyecare.co.nz<br />

All enquiries will be treated in confidence.<br />



Unique opportunity to acquire long established practice in the busy<br />

Riccarton suburb of Christchurch. The spacious premises are fitted out<br />

to a high specification custom design and have an excellent high profile<br />

location on Riccarton Road opposite Westfield Mall. The client base is<br />

large, extremely loyal and appreciates the individual and personal clinical<br />

service that the practice offers alongside high quality optical dispensing.<br />

With scope for further growth this practice offers an exceptional<br />

opportunity to practice your own brand of independent optometry.<br />

For a confidential discussion email Julia Saulsbury:<br />

js.visoncare@xtra.co.nz<br />


Still under warranty, less than two years old, just serviced Jan <strong>2017</strong>.<br />

Topcon table & 21’’ computer & software licensing key included.<br />

Comes with extra cataract & refractive software packages. Was<br />

used for Capital Vision Research Trust WELKS study.<br />

If interested, please contact Rachel at Capital Vision Research Trust<br />

on 022 394 9980 or info@capitalvision.nz<br />

All offers considered.<br />



OPSM Optometrists in Silverdale is a privately owned (franchise)<br />

practice/store with a supportive and experienced team. We are<br />

seeking a caring optometrist to join our friendly team and work<br />

around 18 hours per week (including Sundays) or alternatively to<br />

just do Sundays (10am to 5 pm).<br />

Competitive salary package and generous product allowances for<br />

the right candidate.<br />

To apply, please email your CV and cover letter to<br />

tracy.kendall-jones@opsm.co.nz<br />

All applications will be treated with the utmost confidentiality.<br />



AcuityKit has a comprehensive range of digital eyecharts for eyecare<br />

professionals. Ideal for low vision and domiciliary work.<br />

Visit our website www.acuitykit.com or email john@acuitkit.com<br />





At OPSM, we are passionate about opening eyes to<br />

the unseen. Our advanced technology enables us to look<br />

deeper to ensure we give the best care to every customer.<br />

At OPSM, we are passionate about opening eyes to<br />

the unseen. Our advanced technology enables us to look<br />

deeper to ensure we give the best care to every customer.<br />




We are looking for Optometrists who share our passion<br />

and want to make a difference to how people see the<br />

world. Whether you like the city, the surf or the outback,<br />

we’ve got the role for you with our teams in:<br />

• Bundaberg<br />

• Darwin<br />

• Katherine<br />

• Mackay<br />

• Mt Isa<br />

• Toowoomba<br />

• Townsville<br />


You can look to take on a fixed period role or even<br />

consider a more permanent move - who knows, you might<br />

fall in love with the place. Depending on the location,<br />

salary packages up to 175K including superannuation,<br />

accommodation, annual return flights to visit family and<br />

friends and relocation support for the right candidate.<br />

Start your journey with us today! Graduates or recent<br />

graduates are very welcome to apply.<br />

CONTACT:<br />

Brendan Philp<br />

brendan.philp@luxottica.com.au or call +61 418 845 197<br />

Kim Shepherd<br />

kim.shepherd@opsm.com.au or call +61 408 763 575<br />




Our New Zealand business is looking for passionate<br />

Optometrists to join the team.<br />

• Whangarei – full time<br />

• Wellington Float – full time<br />

• Thames – full time<br />

• Dunedin – full time<br />

• The Plaza – full time<br />

• Napier/Hastings – 32 hours per week<br />

When you join OPSM, you work within a team who<br />

are committed to providing the best possible eyecare<br />

solution with exceptional customer service. You will work<br />

with world class technology including our exclusive<br />

Optos Daytona ultrawide digital retina scanner. You<br />

will have many opportunities for continuing professional<br />

development and can enjoy career flexibility through<br />

our extensive store network. You can also make a<br />

real difference in the way people see the world by<br />

participating in our OneSight outreach program.<br />


Start your journey with us today! Recent graduates are<br />

very welcome to apply.<br />

CONTACT:<br />

Hirdesh Nair<br />

hirdesh.nair@opsm.co.nz or call +64 21 523 282<br />

Robbie Singh<br />

robbie.singh@luxottica.com.au or call +64 21 750 847<br />


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Thinking of selling your practice - we have buyers<br />

Considering buying - we’ll give you all the options<br />

OpticsNZ specialises in optometry practice sales,<br />

we've helped dozens of Optometrists buy and sell their practices<br />

For more information contact Stuart Allan on: 03 546 6996<br />

027 436 9091 stu@opticsnz.co.nz www.opticsnz.co.nz<br />

• Locum Service<br />

• Recruitment Services<br />

• Practice Brokering<br />

• Business Consultants<br />

28 NEW ZEALAND OPTICS <strong>March</strong> <strong>2017</strong>

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