April 2017

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY
FOR OPTOMETRISTS AND EYE CARE PROFESSIONALS
PO BOX 106 954, AUCKLAND CITY 1143
Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz
APRIL 2017
Introducing AIR OPTIX ®
plus HydraGlyde ® contact lenses

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

Assessing astaxanthin in NZ
BY LESLEY SPRINGALL
Moves are afoot to put a so-called wonder
product, astaxanthin, through some
rigorous testing in New Zealand to gain
some clinically-significant data about its effect
on eye health, including macular degeneration,
cataract and even presbyopia.
Astaxanthin (pronounced asta-zan-thin), a
carotenoid found in algae and responsible for the
red colour in salmon and shellfish, is a powerful
antioxidant and the key ingredient in Kiwi
company Supreme Health’s Advanced Vision Care
product and other health supplements.
Auckland optometrist and researcher Grant
Watters is leading the charge for New Zealand to
run a clinically significant study into astaxanthin’s
effects on the eye. His interest was sparked in the
organic pigment by an article in NZ Optics ’ June
2016 issue which led him to undertake a detailed
and thorough international literature review of
astaxanthin.
The research is all very positive for astaxanthin’s
health benefits but there’s no real in-depth clinical
studies, says Watters. “I just wanted to do it for
personal interest, but also I could see the potential
that this had for some more in-depth research and
development.”
Completely serendipitously, Watters also has a
link to Supreme Health through Kerry Paul, the
company’s chief executive who took over the helm
of what was then Supreme Biotechnologies from
former CEO and co-founder Tony Dowd (see story
below). Paul was CEO of Manuka Health, which
produces health
products from
Manuka Honey, and
helped fund some
research Watters
undertook with
Associate Professor
Jennifer Craig at the
University of Auckland
into the effects of
manuka honey on
blepharitis (see NZ
Optics ’ October 2016
Grant Watters
issue). This research
was backed by New Zealand angel investor Ray
Thomson, who’s also an investor in Supreme Health
and Manuka Health and so also knows Watters. Both
Paul and Thomson are keen to see and potentially
support some detailed research into astaxanthin and
its effects on eye health, says Watters, who’s already
initiated a meeting with A/Prof Craig and her team
to see if he can get the ball rolling.
To help encourage interest, Watters has also
sent his literature research to a number of eye
care health practitioners to see if they would be
interested in being involved in a study, should it go
ahead. But, he stresses, though he’s excited about
the potential of astaxanthin, it’s still incredibly
early days.
“It has enormous potential. But the articles I
researched are a little bit light weight, so there’s
a need to do some better, more evidence-based
research, so I’m trying to get people interested,
especially as there’s very likely to be some finance
available for a PhD or Masters research project.”
Watters literature review includes studies from
all over the world, especially Asia. There are a
number of animal studies showing the potential
of astaxanthin in photokeratitis, cataract and
light-induced retinal damage, while a small human
study has shown it to be more effective in treating
dry eye disease compared with omega-3 alone.
A 1994 study by Dr Mark Tso of the University
Supreme Health unveils
new look
Kiwi company Supreme Health has a new a
name and a new boss as the company gears
up to become a significant player in the
international health supplements market.
The company’s former name, Supreme
Biotechnologies, simply didn’t reflect the company’s
desire to produce a wide range of natural health
products, says the still relatively new CEO Kerry Paul.
All the company’s products, including the one
for eye health, Advanced Vision Care, contain
astaxanthin, a powerful antioxidant produced by
algae. The company farms its astaxanthin from
freshwater green algae in a specially-designed
and developed plant in Nelson, developed in
partnership with researchers at the Cawthorn
Institute. The company’s algae-growing facility
is a unique, fully-enclosed, indoor environment,
providing the perfect nutrient and light conditions
for the algae, and ensuring it remains free
from environmental contaminants, says Paul.
The astaxanthin is then supported in each of
the company’s health products by other active
ingredients which target the same condition. So,
for example, the Vision Care product combines
astaxanthin with lutein, zeaxanthin and saffron.
“We’ve created a new brand called Supreme Health
and rationalised some of the other brands we had,”
explains Paul. “But our Vision Care product remains
very much a focus for us as it’s quite unique on the
world stage; there’s really no other product like it.”
There are several studies demonstrating the
promise of astaxathin in eye health and its positive
effects beyond those identified through the far
better-known AREDS2 (see box), says Paul. Studies
Supreme Health’s astaxanthin cultivation plant in Nelson, showing the green and red phases
of algal production
Kerry Paul
which have now been reviewed comprehensively
and independently by Auckland optometrist
and researcher Grant Watters, who’s keen to
do something a little more significant on the
xanthophyll carotenoid (see story above).
Paul is also keen to see some more clinicallysignificant
research generated on astaxanthin’s
effects on the eye to comprehensively demonstrate
its positive effects to consumers and the wider eye
health community, who are also, always looking for
better ways to help their patients and protect their
sight. So now Supreme Health has had a complete
re-branding that better explains who and what it
and its products are, says Paul, the company’s keen
to further develop its distribution channel within
the industry.
“It is exciting. Getting everything in place has
taken quite a big effort, but we know we have a
product here that can help people’s vision, so we’re
keen to work closely with the eye health sector so
they can get to know our product and, hopefully,
begin recommending it for their patients’ benefit.”
For more about the product and becoming a
distributor see the ad on p9. ▀
AREDS2 The Age-Related Eye Disease Study 2 (AREDS2) was a multi-centre, randomised
trial designed to assess the effects of oral supplementation of macular xanthophylls (lutein and
zeaxanthin) and/or long-chain omega-3 fatty acids (docosahexaenoic acid) [DHA] and eicosapentaenoic
acid [EPA] on the progression to advanced age-related macular degeneration (AMD). An additional goal
of the study was to assess whether forms of the AREDS nutritional supplement with reduced zinc and/
or no beta-carotene works as well as the original supplement in reducing the risk of progression to
advanced AMD. Enrolment concluded in June 2008 and participants were followed between five and six
years. Source, and for more: www.areds2.org
of Illinois, was the first to show
that astaxanthin could help halt
the progression of, and prevent,
macular degeneration, while other
studies have shown astaxanthin
to have significant benefits in
combating other diseases such as
diabetes, epilepsy, dementia and
heart disease.
A marine anti-oxidant,
astaxanthin was not considered by
the AREDS2 (see box) researchers
as it doesn’t naturally occur in our
diet and we only get small amounts
from seafood, such as salmon and
shellfish, explains Watters. The
literature considers it a “superantioxidant”,
about 6,000 times
more powerful than vitamin C and
500 times more powerful than green tea. Unlike
vitamin C, however, which can be harmful at high
doses by becoming pro-oxidant and thus can
damage cells, astaxanthin, so far, doesn’t appear to
have any harmful side effects.
But the real beauty of astaxanthin, the key
difference between it and other antioxidants
is most are either water soluble or fat soluble,
which restricts which parts of the body they reach,
says Watters. Astaxanthin is both, so it can reach
outside and inside cells…it can penetrate the
blood-brain and thus the blood-eye barrier.
“There is a recurring theme [in the literature] that
oxidative damage and inflammation is damaging
to all of the sensitive ocular tissues… Therefore,
there is a lot of potential for further well-designed
research and clinical trials on the ocular benefits
of astaxanthin supplementation in humans,
due to astaxanthin’s powerful antioxidant and
immunomodulatory properties, perhaps in
conjunction with other well-researched beneficial
substances to the eye such as omega-3 fish oil/krill
oil, and its close carotenoid relations lutein and
zeaxanthin,” summarises Watters.
Watters is still finalising his literature review
for potential publication, but says the basic
conclusion is more work needs to be done to
show the legitimacy of astaxanthin as a medicinal
compound, but so far the signs are promising. ▀
It’s all go….
EDITORIAL
What a month it’s been. First the races,
then the Squint Club, Specsavers’
awards, complete with Dame Edna,
the inaugural (somewhat controversial) Silmo
Sydney, and let’s not forget the media scrum for
Kylie’s new specs. NZ Optics has been at them
all and they’re all covered in our own Kiwi style
in the following pages, so you can make up your
own mind about what’s hot and what’s not!
We’ve also got all the details of what’s
coming up at RANZCO NZ in Paihia in May and
Chalkeyes stops to mull over RANZCO’s plans
to be the Microsoft of the ophthalmic world,
raising a few good questions along the way.
My particular favourite, however, has got to
be MDNZ’s annual race day. Being a sponsor
or taking a table is a great way to say thanks
to all your staff and supporters for a great
year (December after all is too hectic). The
excitement of the races, fun, drinks, dinner,
industry colleagues and you’re supporting MD
awareness; what’s not to love.
Lesley Springall, publisher, NZ Optics
Sunday 21st May
Full Day of Clinical Diagnosis points applied for
Waipuna Conference Centre, Auckland
Topics will be delivered in an entertaining 12 min
rapid-fire fashion, along with interactive panel
discussions. Some of the topics include:
º Drugs used for managing acute anterior uveitis
º How can optometrists stay safe prescribing oral medications?
º Remote diagnosis and treatment of vision-threatening disorders - modern telemedicine today
º Nutrition, supplements and alternative remedies - current research
º Off-label use of drugs for vision-threatening disorders
º Prescribing of topical antibiotics - how to choose? How to monitor and withdraw?
º Herbal medicines in eyecare - are they as innocent as many believe?
º Glaucoma drugs - managing the glaucoma patient who does not respond to first line therapy
º Glaucoma Collaborative Care - advanced therapeutics training with NZNEC
º Acute and chronic side effects from glaucoma eye drops
º The latest in dry eye drugs/therapies - DEWS update 2017
º Allergy eye drops and vasoconstrictors: myths and realities
º Drugs used in the optometric management of herpes simplex keratitis
For more topics, speaker programme and to register visit:
www.regonline.co.nz/otc_2017.co.nz or call 06 833 6160
With thanks to our sponsors
GOLD SPONSORS
BRONZE SPONSORS
At the races with Dr Hussain Patel, Focus on Research’s
series editor
April 2017
NEW ZEALAND OPTICS
3

News
in brief
GRAPHENE CLS REPEL RADIATION
A team of researchers from Seoul National University have
discovered graphene-coated contact lenses can protect the eye from
harmful electromagnetic radiation and moisture loss, which could
help advance wearable eye electronics. In the study, led by Professor
Byung Hee Hong, raw egg white, covered with contact lenses with
the graphene-coating, remained relatively uncooked when heated in
a microwave, as the graphene coating absorbed and dissipating the
electromagnetic energy, while a bottle capped with a graphene lens
lost 30% less water than the control.
B3 FIGHTS GLAUCOMA
Vitamin B3 added to drinking water
prevented mice genetically-predisposed
to glaucoma from developing the disease,
found a study published in Science. “The
vitamin administration was surprisingly
effective, eliminating the vast majority of
age-related molecular changes and providing
a remarkably robust protection against glaucoma,” said Jackson
Laboratory Professor Simon John who headed up the research team.
The B3 treatments boosted the metabolic reliability of aging retinal
ganglion cells, keeping them healthier for longer, he said.
NAION DRUG TRIAL UNDERWAY
A two-year, multicentre phase II/III trial is underway on a new
drug for non-arteritic ischemic optic neuropathy (NAION). Often
referred to as ‘stroke of the eye,’ NAION is characterised by sudden
vision loss in one eye without pain and is one of the most common
reasons for sudden optic nerve-related visual loss in older people.
The study, known as QRK207, for the drug’s parent company, Quark
Pharmaceuticals, seeks to evaluate the safety and efficacy of QPI-
1007, a novel siRNA (small interfering RNA) drug candidate for ocular
neuroprotection.
MACTEL GENES IDENTIFIED
A group of international scientists have discovered the genes
believed to cause macular telangiectasia type 2 (MacTel2), a rare,
neurovascular degenerative retinal disease that affects the macula,
causing loss of central vision. The study group, led by Professor
Melanie Bahlo and Dr Thomas Scerri of Melbourne’s Walter and
Eliza Hall Institute of Medical Research, identified five key regions in
the genome most likely to influence the risk of developing MacTel.
The findings, published in Nature Genetics, will help researchers
better understand the disease and support further research into
preventative efforts and treatment, said researchers.
ZEISS AND DEUTSCHE TELEKOM
Zeiss and Deutsche Telekom (DT) have announced a partnership
designed to explore and drive the future of data glasses. With
innovative smart glass optics and leading connectivity, Zeiss and
DT combine two elements critical for the success of these products,
said Zeiss. Zeiss has already developed a prototype for small, easyto-wear
data glasses, which allow information to be projected into
the wearer’s field of view, while Telekom is working on the network
connection technology.
CORNEA TRANSPLANTS: SEX NOT A FACTOR
There is no evidence linking the success of corneal transplants and
gender in Australia, said Professor Keryn Williams, director of the
Australian Corneal Graft Registry (ACGR), in an interview with The
Lead South Australia in response to a British study of 18,000 patients
which made the link. “We reported back to our surgeons that
following the paper from Britain, we have looked back at our 30,000
plus records in Australia and we just don’t see it…[gender selection]
just isn’t necessary.”
RODENSTOCK, PORSCHE RENEW LICENCE
Rodenstock and Porsche have extended
their licensing contract for another 10
years, giving Rodenstock continued
global control of all Porsche frames’
development, production and sale.
Oliver Kastalio, Rodenstock’s managing
director, said, “We have been working
with the Porsche Design Group very
successfully for over 15 years and will continue this successful
collaboration on the same scale. I am delighted about it.”
AUSCRS REGISTRATION OPENS
Registration has opened for the 21st Australasian Society of Cataract
and Refractive Surgeons (AUSCRS) conference on 2-5 August 2017 at
Hamilton Island Convention Centre on Hamilton Island, Queensland.
This year the focus is on new directions in cataract and refractive
surgery. For more or to register visit www.auscrs2017.org.au
3D RETINAS’ TRIAL CLOSER
Using human embryonic stem cells, a team of researchers led by Dr
Hans Keirstead at Aivita Biomedical in California, has successfully
developed a complete retinal organoid consisting of laminated
retinal progenitor cells and retinal pigment epithelium (RPE) which,
in preclinical trials, formed synaptic connections with the host to
restore vision. As the company gears up manufacturing, Dr Keirstead
told Modern Retina he anticipates clinical trials may now be just two
years away
New ocular sensitivity tool
The Brien Holden Vision Institute (BHVI) has unveiled a new
instrument to measure ocular sensitivity to help quantify
corneal sensation and determine if it is within or outside the
normal range.
Dr Klaus Ehrmann, BHVI’s director of technology, revealed details
about the new instrument in a poster presentation at the Association
for Research in Vision and Ophthalmology (ARVO) Asia meeting in
February in Brisbane.
It’s been designed to help practitioners better and more quickly
measure discomfort to improve their diagnosis and treatment
recommendations and works by propelling small droplets of sterile
liquid through a micro-valve onto the surface of the eye, explained
the Institute in its newsletter. “The sensitivity threshold is established
by increasing the intensity of the stimulus until the patient reports
a positive response. Mechanical, chemical and thermal stimulation
is achieved by adjusting the properties of the liquid. The dedicated
hardware and custom-written software control all the operating
parameters, including ejection pressure, precise position targeting,
temperature and droplet size.”
Explaining the need for a new ocular sensitivity instrument, the
Institute said ocular discomfort is primarily attributed to contact lens
wear, refractive surgery, meibomian gland dysfunction and aging. “It
is something we all experience from time to time; however, it could be
an early symptom of more serious ocular diseases, such as keratoconus,
shingles or herpes. Efforts to diagnose, treat and understand the
underlying causes have been hindered by a lack of suitable methods
to quantify ocular sensitivity. Traditional instruments are either
inaccurate, difficult to use or not generally available.”
Rose lens launch
After more than two years of development, Paul Rose says he’s
excited to be launching his first ever soft lens for keratoconus
patients, the Rose K2 Soft, in New Zealand.
“We released it in the UK in May 2016. It’s now available in France
and Scandinavia and is about to be launched in the US, so it was the
right time to bring it to New Zealand.”
In the past, Rose says he stuck to rigid lenses for a number of
reasons, not least the quality of vision. “You’re never going to move
to a soft lens for better vision. But there are lots of other good
reasons to use soft lenses. For one thing, many optometrists have no
experience in fitting rigid lenses – a soft lens will allow them to treat
www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand
Dr Klaus Ehrmann (left) at the Asia ARVO conference in Brisbane
All change at St George’s
After a short period of upheaval, Christchurch-based St George’s
Eyecare has announced the appointment of Dr Paul Baddeley
as lead ophthalmologist, alongside corneal specialist Dr
Wilfried Rademaker. Dr Baddeley was recruited from the UK, and took
up the staff position at the private clinic in July 2016. He says he’s
settling into life in Christchurch well.
“I had been looking to move to Australia, but a friend of mine
in New Zealand said it is better here! He was right of course!”
laughed Dr Baddeley when NZ Optics met up with him in February.
“The lifestyle here in New Zealand is wonderful. I live pretty much
opposite the water and I love to windsurf, and it’s great to be close to
the mountains for hiking and mountain biking.”
Dr Baddeley, who was working as a consultant ophthalmologist on
the south coast of England before relocating, has a special interest in
ocular plastics and lacrimal surgery. Having only worked for the NHS,
he says he is enjoying the facilities at St George’s.
“It’s great to have all the latest equipment and more time to spend
with patients. But St Georges is a charity hospital too. It’s an unusual
model of care – a consultant-led service at an affordable price, but
with no compromise on quality.”
Greg Brooks, CEO of St George’s, was behind the launch of the
dedicated eye care clinic in 2015.
“We had always had ophthalmology surgery at St Georges, and
ophthalmologists leasing consulting rooms, so when many of the
ophthalmologists left to open their own theatres we realised we
could offer a more accessible price by moving to an employment
model. We felt there was a place in the market for high quality yet
affordable private eye care.”
St George’s is a registered charity and offers a number of full and
part-funded cataract surgeries each year, with applicants decided on
merit by a committee, says Brooks.
“We reach out to optometrists to work collaboratively, and receive
referrals from many parts of the South Island, Canterbury and the
West Coast. Referring optometrists can support a patient’s application
BHVI’s new instrument can be attached to any slit lamp and is easy
to use by unskilled operators, says the Institute, plus both the patient
and operator are masked to the applied stimuli for more reliable
results. “A complete measurement takes two to three minutes. This
new method of corneal stimulation opens a wide range of new
applications from detecting abnormalities in corneal sensation to
diagnosing corneal diseases and monitoring the effectiveness of
treatment options.”
See next month’s NZ Optics for more on the Brien Holden Vision
Institute and what drives the Institute’s extraordinary CEO Professor
Kovin Naidoo. ▀
their keratoconus patients. It’s also good for those in the early stages
of the disease, or who have a sensitivity to rigid lenses – it can be
used as an entrance level lens.”
Rose was put off developing a soft lens in the past due to the quality
of the materials available, but says there are now materials that have a
good level of oxygen permeation and are also able to be cut on a lathe,
which was the driving force behind developing the new product.
The official New Zealand launch of the Rose K2 Soft, took place at
the CCLS conference in Nelson at the end of March. The lens will be
manufactured by Corneal Lens Corporation in Christchurch.
See NZ Optics ’ May issue for more detail about the new lens. ▀
Receptionist Di Prankerd with ophthalmologist Dr Paul Baddeley
for funding for surgery if they feel they can’t afford it. By offering this
service we hope to take some of the pressure off the public system.”
St George’s opened in 1928 and has always had a philanthropic
focus, even though it is a private hospital. Its employment model for
ophthalmology surgeons – unique in the private sector in New Zealand
- allows it to keep its prices at an accessible level, says Brooks.
Dr Baddeley replaces US ophthalmologist Dr Ralph Lim, who
returned to the US after a short stint in the lead ophthalmology role
for personal reasons, and Dr Graham Wilson from Gisborne, who
stepped in to help for a brief tenure during the recruitment process.
Both Dr Baddeley and Brooks are hoping to appoint more medical
staff within the eye care clinic in the near future. ▀
For general enquiries or classifieds please email info@nzoptics.co.nz
For editorial, please contact Lesley Springall at lesley@nzoptics.co.nz or +64 27 445 3543
For all advertising/marketing enquiries, please contact Susanne Bradley at susanne@nzoptics.co.nz or +64 27 545 4357 in the first instance, or Lesley Springall at lesley@nzoptics.co.nz
To submit artwork, or to query a graphic, please email susanne@nzoptics.co.nz
NZ Optics magazine is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times a year, by New Zealand Optics 2015 Ltd. Copyright is held by
NZ Optics 2015 Ltd. As well as the magazine and the website, NZ Optics publishes the annual New Zealand Optical Information Guide (OIG), a comprehensive listing guide that profiles
the products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The views expressed in this publication are not necessarily
those of NZ Optics 2015 Ltd or the editorial team.
4 NEW ZEALAND OPTICS April 2017

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April 2017
NEW ZEALAND OPTICS
5

OMG it’s Kylie!
In a glittering spectacle, complete
with 360° glitter bomb photo studio,
canapes, champagne and a full-on
fashion catwalk, pop star Kylie Minogue
formally launched her debut eyewear
collection for Specsavers to a host of
Australian media representatives.
The event was attended by more
than 60 media representatives and
guests who, after supping on canapes
and champagne for more than an
hour, were then ushered into another
section of the elegant upstairs rooms
of The Establishment in Sydney’s
city centre. In a slick fashion show,
models showed off 25 glasses and four
sunglasses from the collection, but all
present were there to see Minogue,
who didn’t disappoint, stepping on to
the catwalk with all the glamour one
expects from a worldwide pop icon.
Together with event MC and E!
Australia host, Ksenija Lukich, Minogue
captivated the audience – one star
struck fan even jumping onto the
catwalk to embrace her – revealing
that she herself has “hundreds of
pairs” of glasses which lie dotted
around her house and office as she’s
forever forgetting where she’s left
them. “It’s crazy I know!”
Wearing one of her favourites
from the collection, ‘Kylie 13’, she
engagingly discussed how the whole
experience designing the glasses and
working with Specsavers had been a
fabulous experience. “I’ve taken a lot
of inspiration from the many frames
I’ve collected over the years, style icons
I admire and classic shapes and styles.
“At my request, we made sure the
collection includes some petite styles.
I know what it’s like searching for
glasses and not being able to find any
that fit. We’ve really made sure there’s
something in there for everyone.”
Each frame in the collection features
an angled temple and Minogue’s
iconic ‘K’ tag for, in the words of the
promotional material, “a chic but
understated hint of Kylie glamour”.
“Expressing yourself with your
glasses provides a fantastic
opportunity to change up your look,
which I personally love to do,” she said.
“I like to combine that functional dayto-day
look with a little more glamour
for the evening. That’s something
I’ve incorporated into the collection,
through what I like to call a hint of
subtle bling!”
Juan Carlos Camargo, Specsavers
head of frames added, “A trendsetter
since topping the charts nearly 30
years ago, Kylie’s style has evolved
into a refined, elegant and feminine
look that I’m sure will appeal to all
New Zealanders. The Kylie
effect is powerful and her
mass appeal and timeless
style made for the perfect
partnership.”
The range was launched
throughout Specsavers
stores in Australia and
New Zealand on 9 March. ▀
SNOWVISION
CHARITABLE
TRUST
The Trustees of the Snowvision Charitable Trust
announce the offer of three scholarships – two for New
Zealand optometrists (with one scholarship funded by
the NZAO) and one for a final year student completing
the BOptom – to undertake a period of four weeks
clinical study at the State College of Optometry, State
University of New York (SUNY), New York. The successful
applicants will be expected to spend a minimum of 40
hours per week in the Optometry Department pursuing
clinical studies as approved by the Trustees.
The scholarship is for a maximum of NZ$7,000 and covers one
return advance purchase economy airfare from Auckland to
New York and the tuition fees at SUNY. Assistance in finding
accommodation will be given if needed.
The conditions of the scholarship include:
The optometrist must be in full-time practise in New
Zealand and must practise optometry full-time in New
Zealand for two years following their return from SUNY.
The student must practise optometry in New Zealand
for two years at the completion of their degree.
The holders must provide a written report of their time at
SUNY to the Trustees within two months of their return.
The holders must be prepared to give a brief (five
minute) report to the Snowvision Down Under
conference in August, 2018 in Queenstown.
The holders must agree to their report, either in whole
or in part, being published in NZ Optics magazine and
elsewhere at the discretion of the Trustees.
Requests for application forms should be
sent to:
Snowvision Charitable Trust
P O Box 222, Mosgiel
Email: hcaithness@xtra.co.nz
Applications will close on May 31, 2017. The decision of
the Trustees will be final and in the event of there being
no satisfactory applicant, no scholarship will be awarded.
Hamish Caithness
Trustee
6 NEW ZEALAND OPTICS April 2017
David Robinson
Trustee
Kylie doing what Kylie does best at the launch of her new frames range
J&J buys AMO
Johnson & Johnson completed its acquisition of Abbott
Medical Optics (AMO), a wholly-owned subsidiary of Abbott.
The US$4.3 billion deal includes ophthalmic products in
three areas of patient care; cataract surgery, laser refractive
surgery and consumer eye health. These product lines now join
the Acuvue brand contact lenses business under a newly formed
division called Johnson & Johnson Vision.
“This joining of global leaders in contact lenses and surgical
ophthalmic devices represents a significant step toward Johnson
& Johnson’s long-standing strategy to become a leader in eye
health, helping to improve and restore sight to more patients
around the world,” said Marius Fourie, Australia and New
Zealand country manager at Johnson & Johnson Vision.
At nearly US$70 billion, Johnson & Johnson identifies
eye health as one of the largest, fastest-growing and most
underserved segments in healthcare today. The acquisition
is part of its growth strategy in this area, but it envisages no
changes in its current service to customers, it said in a series
of statements released to the media. “Over the longer term,
Johnson & Johnson plans to apply our innovation processes to
both organisations and make further investment in eye health
to develop product enhancements….Because our products
serve distinct eye health segments, our contact lens/consumer
eye health and surgical businesses will continue to operate
separate customer-facing organisations after close, while taking
advantage of opportunities to support each other.” ▀
ODOB scope changes
After a long period of consultation and “careful
consideration”, the Optometrist and Dispensing
Opticians Board (ODOB) has made some significant
changes to the Optometrists Scopes of Practice.
Key changes include: rationalising the current optometrist
scopes of practice from four scopes to just one - the
‘Optometrist Scope of Practice’; defining the ‘Optometrist
Scope of Practice’ in a more comprehensive way; including the
prescribing of medicines; and introducing a new time-limited
scope of practice – the ‘Provisional Scope of Practice’ – for
overseas-qualified optometrists
For more visit: www.odob.health.nz. The changes take effect
from 1 April. ▀
In other news on the latest ODOB board changes see p23.
Silmo Sydney wins
court case
Australia’s Federal Court dismissed court action brought by the
Optical Distributors & Manufacturers Association of Australia
(ODMA) against Expertise Events, Silmo Sydney’s event organiser
and formally ODMA’s.
ODMA alleged Expertise Events had breached ODMA’s intellectual
property rights and ODMA would be financially damaged as a result so
obtained an injunction against Expertise Events’ use of its own customer
lists.
In a media release issued by Expertise Events, managing director Gary
Fitz-Roy said, “However, when the matter was brought to a head and
ODMA was required to prove its claims, it failed to demonstrate that the
injunction should be maintained… Justice Burley of the Federal Court
of Australia ruled against ODMA (and) ordered that the injunction be
discharged in its entirety.
“Justice Burley said that the evidence was that claimed losses would be
because of the competition that a new fair brings rather than any alleged
misuse of ODMA’s intellectual property…. Further, Justice Burley found that
the evidence did not indicate any material harm would occur to ODMA
if the injunction was discharged, that any loss would be compensable in
damages and that the evidence did not establish ODMA’s claims regarding
Expertise Events’ use of information to promote Silmo Sydney.” ▀
For more on Silmo Sydney see p17.
Ocular therapeutics
Registration is now open for the second, annual Ocular
Therapeutics Conference which, after a date change, will now be
held on Sunday 21 May 2017 at the Waipuna Conference Centre in
Auckland.
The conference, which is put together by the University of
Auckland’s Buchanan Ocular Therapeutics Unit, will cover a range
of topics from inflammatory eye diseases and remote diagnosis and
treatment of vision-threatening disorders, to current research on
nutrition, supplements and alternative remedies as well as analysis
of all manner of drugs and drops currently on the market and in
development.
Topics will be delivered in entertaining 12-minute, rapid-fire sessions
and interactive panel discussions, say organisers, which will enhance
your everyday practice and offer an opportunity for a full-day of
clinical diagnosis and enhancement points. ▀
For more information see the ad on p3.

April 2017 NEW ZEALAND OPTICS
7

Fabulous day for MDNZ
Macular Degeneration New Zealand
(MDNZ) hosted it’s fourth annual charity
race day on Saturday 18 February at
Ellerslie Race Course in Auckland.
A party atmosphere pervaded as 290 supporters
of macular degeneration awareness from inside
and outside the industry gathered together
for a wonderful day of racing fun in the newly
refurbished Guineas Room. Guests were treated to
a gourmet lunch, entertainment throughout the
day and a fantastic auction. There were also spot
prizes for the best hat and best dressed, a raffle
and second chance draws for those who didn’t
back the right horse for each race.
MC Stephen Stuart was ably supported
throughout the enjoyable day in the presentation
of prizes and draws by racing supporter Di
Goldsworthy and MDNZ trustee Dr Andrew
Thompson.
“We really appreciate the support of the eye
world at this event,” said Phillippa Pitcher, MDNZ
general manager. “It’s our biggest fund raising
event and we simply wouldn’t be able to achieve
anywhere near the awareness we need to achieve
without it, so thank you.”
Race sponsors included Auckland Eye, Retina
Specialists, Visique Rose Optometrists and Optical
Instrument Company, while many more such ‘eye
friends’ purchased tables of 10 bringing their staff,
colleagues, customers and friends, said Pitcher.
The extensive array of auction items came from
businesses far and wide including Visique, VBM
Eyewear, Specsavers and Parker & Co. “We are
grateful to them all and to those who attended.”
In total $25,000 was raised on the day, which
goes directly to support those with macular
degeneration, their families and their carers. ▀
Belinda Way (left of the banner) and guests from the Ophthalmic Instrument Company with the winning horse Splurge,
jockey Danielle Johnson and Splurge’s owners
Gingernuts, the winner of the Retina Specialist’s
Avondale Guineas
MDNZ’s race day supporters’ team Philippa Pitcher, Grace Jones, Dr Andrew Thompson, Margaret Barron,
Sandra Budd and Chris and Annie Bradley
Dr Rachel Barnes (third from left) with guests of Retina Specialists trackside before the Avondale Guineas race
Diane Cook, Sandy Grant and Marinka Hood
Visique Rose’s Jagrut Lallu and Tavidream co-owner
Murray Darroch
A few of the three-table team representing Visique Rose Optometrists from Hamilton,
including Jagrut Lallu (centre) and Paul Rose CNZM (third from right)
NZ Optics team and friends: Nick Griffiths, Tracey Ellin, Paul Rooney, Rachel Oliver,
Alex Petty, Jai Breitnauer and Susanne and Chris Bradley
Suzanne Lavendar, Dr Andrew Thompson and Kathie Sale from Tauranga Eye
Specialists’ table
MDNZ trustees Allan and Viv Jones with MDNZ chair Dr Dianne Sharpe
and MC Stephen Stuart
Blackmore’s Nicole Jellard, Ash Dharan, Zana Frempton and Kylie JIllings
8 NEW ZEALAND OPTICS April 2017
OPSM NZ’s Samantha Payne, James Melton and Hirdesh Nair
Auckland Eye’s Kathryn Philipson, Dr Archie McGeorge, Yvonne New, Kirsten Harris, Dr Sarah Welch, Dave Harris,
David and Penny Haydon, Paula Farrar and Tony Cradwick

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For more information about the product please visit our
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April 2017
NEW ZEALAND OPTICS
9

Focus
on Business
Joining a franchised network – legal tips
and insights from a specialist retail and
franchise lawyer
The retail sector in New Zealand is changing
rapidly, global brands and retailers are
increasing their presence both online
and instore. Optometrists and opticians are
undoubtedly feeling the impact and they are
not alone, other healthcare providers such as
veterinarians, general practitioners and pharmacists
are experiencing a similar shift. Independents are
moving to incorporate retail concepts offering
complementary products and services, for example
veterinarians are expanding their practice and
offering pet products, dog grooming services and
educational courses for pet owners.
Remaining as an independent optometry outlet
may suit your business and patients, however
many small businesses and start-ups find joining
an existing franchise works best for them. We look
at the pros and cons.
Good reasons to join a franchise
New Zealand is the world’s most franchised
country per capita, with a 2012 survey by Franchise
New Zealand showing 485 brands and 22,400
franchisees – with anecdotal evidence showing a
significant increase in the last few years.
Common motives for joining a franchised
network:
• increased competition
• a change in client/patient and retail consumer
expectations
• advancement in technology and access to
training and support
• buying power and access to suppliers
• professional marketing and advertising,
including social media
• employee recruitment, training and career
support
• succession planning, for example, sale of the
business on retirement
Franchisees gain the benefit of using the
franchisor’s local or global brand, know-how,
operating systems, marketing, online/social media
presence and have access to the approved product
supply chain during the term of the franchise
agreement.
You remain responsible for your business
operations, employees, tax and payments to
the landlord and suppliers; you are after all an
independent business proprietor.
The fees and payments generally include an
initial franchise fee (upfront fee and training
costs) and an ongoing royalty and marketing levy
that is usually based on a percentage of gross
sales. It is important to understand the scope of
what services and support are provided to ensure
you get value for money.
The marketing and advertising support offered
by a franchisor is generally provided on a national
level and importantly includes social media
as one of the growth channels for targeting
patients/clients and retail consumers. If your
optometry outlet is in a regional area, you should
ensure there is sufficient local spend or you have
the ability to negotiate local marketing and
advertising. This may include radio, print and
community event sponsorship.
A franchised business operating under a known
brand might be easier to sell. It is common for
business owners to join a franchised network
as part of an overall succession plan. This can
assist with the sale process on your exit or
retirement. You should check if the franchisor
has an accreditation with any of the major banks,
this will assist when a prospective purchaser is
securing finance to purchase.
Why don’t we all join a franchise?
Franchising is not a business model that suits
everyone. As a franchisee you need to be
coachable and open to sharing information
about your businesses, including employees,
development areas, product/range knowledge
and financial performance.
Compliance with a franchise agreement
and accepting guidance and directions from
BY KATRINA HAMMON*
a franchisor may not be palatable to all
independent optometry outlet owners.
If you are motivated to work on the business not
just in the business, then you may be put off by
the fees payable to a franchisor for the support,
marketing and other training offered.
The costs to join a franchised network should
be negotiable and take into account the extent to
which you need to make changes to the fitout and
other equipment in the business (this will depend
on the current state of repair and the franchisor’s
requirements), the balance of the term of your
lease, any landlord or franchisor contributions
to the fitout costs and the current financial
performance of the optometry outlet.
It is important to understand the obligations
that will apply in the event you propose to sell or
transfer the franchised business. Generally the
franchisor will have a first right to purchase and the
franchisor must approve any prospective purchaser.
Consent to the sale and approval of the prospective
purchaser cannot be unreasonably withheld, this
includes the sale of shares and changes to the
franchisees ownership. The franchise agreement
may contain a transfer fee to be paid to the
franchisor in the event the franchised business
is sold or transferred. Often this amount covers
the franchisor’s costs to approve the franchisee
and legal costs of preparing the new franchise
agreement and related documents.
There may be an additional training fee payable
by the purchaser to complete the franchisor’s
training programme. All of these costs should be
considered when you set the sale price for your
franchised business. The franchisor may offer
support to a franchisee wanting to sell their
business, this may include introducing prospective
franchisee purchasers and recommending brokers.
Due diligence, legal advice and Franchise
Association of New Zealand
As with purchasing any business or signing a
contract, you should do your due diligence and
seek legal, accounting and business advice from
your trusted advisers.
Talk to existing franchisees in the network,
request financial details from the franchisor
and read the franchise agreement and related
documents that the franchisor provides. Most
sophisticated franchisors have a disclosure
document that explains the terms of the franchise
agreement and provides more detailed information
regarding the franchisor, payments, costs and
obligations you should expect as a franchisee.
It is important that you consult with a lawyer that
has experience advising prospective franchisees.
A fee estimate should be obtained before you
instruct your lawyer to review and report to you on
the Franchise Agreement. If there are protracted
negotiations then legal costs can escalate, an
experienced franchise lawyer will direct you as
to the key clauses that should be discussed and
where necessary, amendments to the franchise
agreement requested.
New Zealand has no specific franchise law, but
the Franchise Association of New Zealand acts
as a voluntary regulatory body for responsible
franchisors, providing a voluntary code and
rulebook, networking, learning opportunities and
advice. Refer to the Franchise Association of New
Zealand website for helpful information, checklists
and a free course for prospective franchisees. www.
franchiseassociation.org.nz ▀
ABOUT THE AUTHOR:
* Katrina Hammon is a specialist
franchising, distribution and
licensing lawyer at Duncan
Cotterill. Katrina has wide-ranging
experience in the retail sector and
has worked with local and global
brands to expand locally and to
emerging markets in the Asia-
Pacific region. Katrina is excited
about the changing face of retail
and the opportunities for retailers.
NZ holds its own at awards
New Zealand
Specsavers
were well
represented in the
2017 Specsavers’
Awards for Excellence,
celebrating the UK
company’s 10 years on
this side of the world.
In a glittering, black-tie
ceremony, complete
with Australian
bespectacled icon,
Dame Edna Everage,
more than 600
Specsavers store
partners gathered
together for drinks and
dinner at the newly reopened
International
Convention Centre
(ICC) in Sydney’s
Darling Harbour.
Nigel Parker, Specsavers Australia and New Zealand
managing director, talked about the extraordinary
growth the franchise company has experienced since
opening its original wholesaling and manufacturing
business in Port Melbourne 10 years ago, today
recording a turnover of A$800 million in Australia
and A$110 million in New Zealand.
With the formalities out the way, store partners
were more than ready to party following a full-day
of closed-door partner seminar presentations.
Winners were announced in several “excellence”
categories covering dispensing, clinical, overall
performance (Australia and New Zealand),
customer service, team culture and Store of the
Lynsey Beeney and Ian Russell
MC, Australian Today Show’s, Lisa Wilkinson with
Dame Edna
Overall award winners Specsavers Mount Maunganui’s Glenn Dunkerley, Ian Buchanan and Clare Hodge
with ANZ MD Nigel Parker and global CEO John Perkins
Year (Australia and New Zealand).
Mt Maunganui Specsavers was named overall
winner in Excellence in Overall Performance and
Store of the Year (NZ), while Hastings Specsavers
scooped Excellence in the Community for its
charitable work. Dunedin was a finalist in
Dispensing Excellence, while Riccarton Windmill
and Hastings were also finalists in Clinical
Excellence.
The upbeat evening was capped off in riotous
form by Dame Edna who presented a cheque
for A$125,400, raised over the course of the
evening, to the evening’s charity partners, CanTeen
Australia and New Zealand.
Simon Barradell, Rahul Parmar and Chris Edwards
Hastings’ Jennifer Dobson and Niall McCormack flank Nigel Parker (left) with co-award
winners Rob Petrini and Yavani Mudally from Shellharbour, and global CEO John Perkins
Specsavers welcomed 74 new graduate optometrists to its stores in its first 2017 intake, including
19 from New Zealand (pictured below). The new graduates were put through their paces during
a three-day graduate induction process, covering communication, team work and establishing an
effective clinical routine to ophthalmic equipment technical knowhow and the franchise company’s
charitable endeavours, at the company’s Port Melbourne Support Office, Manufacturing and Training
Academy. A second Graduate Induction will take place in July. ▀
10 NEW ZEALAND OPTICS April 2017

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© CooperVision April 2017 NEW 2017 ZEALAND OPTICS
11

MACULAR MILESTONES
target
What’s hot in the world of
macular disease research
Geographic atrophy
treatment available 2019?
Geographic atrophy (GA), the advanced
“dry” form of age-related macular
degeneration (AMD), describes areas
of atrophy from the choriocapillaris through
to the photoreceptor outer segments. It
progresses slowly and inexorably over years to
decades leading to profound central vision loss.
The prevalence of GA has undoubtedly been
seriously underestimated with recent data
showing the prevalence of GA being about
equal to “wet” AMD. Increasing life span
and a rapidly ageing population portend a
huge burden of GA in New Zealand, with an
estimated 57% increase of affected persons
by 2038. Currently, nearly 50% of blind
registrations in this country are for advanced
AMD (combined wet and GA). For more than
a decade we have had the very effective anti-
VEGF treatment for wet AMD, so blindness
from wet disease has reduced dramatically.
This implies that an increasingly higher
proportion of new AMD blind registrations will
be due to GA.
Currently, GA is a disease without a
treatment. The current management of GA is
surveillance and ensuring patient awareness
BY DR DAVID WORSLEY*
for the development of wet AMD. However,
there is hope for more as we may be on the
cusp of a new era in the management of
GA. This is the result of a flurry of research
in recent years providing a much better
understanding of GA.
Fig1. Geographic atrophy is characterised by round or oval regions of
hypopigmentation within which choroidal vessels are more visible
than adjacent regions
An effective treatment has been a hard
nut to crack as it turns out the disease is
multifactorial, thereby making a therapeutic
more elusive. This may be why there
have been some failures of promising new
drugs for GA such as eculizumab. However,
there are still several novel therapies in trial
that offer hope with perhaps the first being
available within the next two years.
The most fully investigated and biologically
plausible theory for the pathogenesis of GA
relates to hyperactivity of the alternative
complement pathway. A number of agents
targeting components of the pathway are in
development. The agent furthest along the
development path, lampalizumab, targets
complement factor D. Unfortunately, it is
administered by monthly intravitreal injection
and judging by past experience this will be very
expensive. A phase II trial demonstrated a 20%
reduction in progression of GA at 18 months.
Two large phase III trials are underway and,
if positive, lampalizumab could be available
here as early as 2019. However, not all phase
III trials confirm a positive phase II trial result.
In my last Macular Milestones’ column (NZ
Optics , December 2016), I detailed how Fovista,
in combination with an anti-VEGF agent, had
very positive phase II results. The results of two
Phase III trials, which have since been reported,
are disappointing with no added benefit
found for Fovista. To my mind, this may be
because Fovista was trialed against anti-VEGF
monotherapy, which is already very effective
alone. Perhaps it should have been trialed for
suboptimal anti-VEGF responders, as are some
other promising agents.
There are a number of other potential
therapies being investigated. Of particular
interest are several inexpensive existing drugs,
doxycycline, metformin and brimonidine,
that have been repurposed for treating GA.
Doxycycline, a tetracycline antibiotic, may
reduce photoreceptor cell loss and slow the
progression of GA. Metformin, a diabetes drug,
may slow DNA damage thereby minimizing GA
progression. The glaucoma drug brimonidine,
delivered by an intravitreal insert over six
months, may be neuroprotective, thereby
also reducing photoreceptor loss and slow GA
progression. All three are undergoing clinical
study.
Stem cell transplantation is being explored by
numerous investigators. It is hoped that stem
cells, usually transplanted under the retina,
will regenerate the retinal pigment epithelium.
There is a lot of media hype around stem cell
therapies but the reality is that it isn’t that
simple and there are potentially limiting issues.
The treatment of GA continues to be a
global unmet medical need. An effective
treatment has remained elusive; currently
there are no positive results from any phase
III clinical trials. The three trials closest to
providing results are the Chroma and Spectri
studies of lampalizumab and the TOGA study
evaluating low dose doxycycline. If successful,
lampalizumab will face the Pharmac hurdle
for funding expensive new drugs. If the
experience of seeking funding for anti-VEGF
drugs is anything to go by, this will be difficult.
Arguing for an expensive drug to treat a disease
that slowly progresses over years to decades
seems unlikely when it was difficult to argue
for funding for anti-VEGF agents to treat a
rapidly blinding disease. Additionally, there
will be the major burden of providing monthly
intravitreal injections for a large number of
patients. Brimonidine implants are also likely to
be expensive. On the other hand, doxycycline
and metformin are very cheap and, if proved
effective, won’t be a major healthcare burden.
Interesting times may be ahead. ▀
About the author
*Dr David Worsley is a
medical and surgical retinal
specialist at Hamilton Eye
Clinic and Waikato Hospital
with a particular interest
in the rapidly evolving
treatments for AMD. He
is a trustee for Macular
Degeneration New Zealand
and is a medical advisor
for several biomedical
companies.
NZ looms large at APAO
The University
of Auckland’s
ophthalmology
department gained a
number of accolades
at the 32nd Asia
Pacific Academy
of Ophthalmology
(APAO) Scientific
Congress in
Singapore in March.
At the President’s
Dinner, outgoing
president, Professor
Dennis Lam from
Hong-Kong formally
handed over the chain of office to the new, 21st
APAO president, Auckland’s own Professor Charles
McGhee, while Professor Trevor Sherwin and Dr
Stuti Misra were both awarded APAO achievement
awards for their many contributions to the APAO
Scientific programme. Plus 17 staff from the
department, including Associate Professor Dipika
Patel, Professors Helen Danesh-Meyer and Philip
Polkinghorne and Nigel Brookes, attended the
event and presented or chaired more than 30
presentations or sessions.
In the department’s staff newsletter, following
the event, Prof McGhee said the department had
one of the largest, active, research delegations
present, considering the small population of
New Zealand. “I was particularly proud that
several major international speakers commented
so positively on how professionally our team
presented complex, novel ideas in a manner that
all could easily understand, especially since APAO
has delegates from so many diverse nations.
Certainly, the quality or our research was easily on
par with the best from other countries.”
Prof McGhee, chair of ophthalmology at
Auckland University and director of NZ’s National
Eye Centre, will now preside over APAO until
2019, including the lead up to the APAO Congress
in Auckland in 2020, which will be the biggest
gathering of medical specialists New Zealand has
ever experienced.
The APAO is one of the oldest supra-regional
ophthalmic societies, having been founded
in 1960. It represents 19 countries and many
Professor Charles McGhee is handed the 21st APAO
presidency by outgoing president Professor Henry Lam
Professors Trevor Sherwin and Charles McGhee with
Dr Stuti Misra at the APAO Congress awards
professional societies and has more than 50,000
members from across Asia Pacific including India,
China, Japan, Australia and New Zealand. The
Asia-Pacific region is home to more than half of
the world’s population and, according to data
published by the World Health Organisation, of
the estimated 285 million visually-impaired people
in the world, more than 180 million reside in Asia-
Pacific. Thus, ophthalmologists in the Asia-Pacific
region have an important role to play in the fight
against preventable blindness, said Prof McGhee.
There has only been one previous president from
New Zealand, Dr Calvin Ring, who presided over
the society from 1989 to 1991. ▀
WOC comes
downunder
In other international ophthalmology
conference news, the International Council
of Ophthalmology has announced, via social
media, that its biennial World Ophthalmology
Congress 2022 will be held in Melbourne and
will be put together in close collaboration with
the Royal Australian and New Zealand College of
Ophthalmologists.
WOC 2018 is being hosted by the Spanish
Society of Ophthalmology and will be held in
Barcelona, Spain, from 16-19 June, 2018.
12 NEW ZEALAND OPTICS April 2017

SPECIAL FEATURE: PRE-RANZCO 2017
Welcome to Paihia
BY DRS BRIAN KENT-SMITH, STUART CARROLL AND GRAHAM WILSON,
CO-CONVENORS OF THE NZ BRANCH RANZCO 2017 MEETING
Dear Colleagues,
We are pleased to welcome you to
the 2017 RANZCO New Zealand
Branch Annual Meeting to be held at
the Copthorne Hotel, Bay of Islands
from 12 - 13 May 2017. This is the
first time our annual meeting will
have been held in Northland, and
what better setting than the Bay of
Islands.
Nga Taniwha, Tigers and
Traps: Avoiding problems and
acquiring sub-speciality pearls
in ophthalmology
Firstly, a word of explanation
regarding the title of this year’s
meeting. Most of us see a spectrum
of patients not limited to one subspeciality
field of ophthalmology,
and for the most part we all do
a reasonable job. In every field,
however, there are those danger
zones, ‘tiger country’, where we could
get ourselves and our patients into
trouble. That’s where we need the
input of experts in a particular field.
Taniwha are mythical beings that
live in rivers, pools or the sea where
they lie in wait to entrap people
(not all taniwha have nefarious
intent, however, and some may in
fact be protective.) Professor Charles
McGhee has brought together a very
impressive line-up of international
experts to guide us through these
potential danger zones:
• Professor Ken Nischal, paediatrics,
Pittsburgh, USA
• Professor Tien Wong, medical
retina, Singapore
• Professor Tim Sullivan,
oculoplastics, Brisbane, Australia
• Professor Bennie Jeng, cornea and
external diseases, Maryland, USA
• Professor Marian Macsai, cornea,
Chicago, USA
• Professor Janet Marsden,
ophthalmic nurse, Manchester, UK
In addition to our international
guests, we have talks by well-known
New Zealand experts across a
range of sub-specialities, including
the convenor of our scientific
programme, Professor Charles
McGhee. There should be something
of interest for everyone.
Getting there
The Copthorne Hotel is a few
minutes from Paihia in the Bay of
Islands, roughly a three-hour drive
from Auckland. Air New Zealand
flies into the Bay of Islands Airport,
Kerikeri, about a 20-minute drive
from the venue. The historic town
of Russell is a short passenger ferry
ride from Paihia or it can be reached
via the Opua vehicular ferry.
The Bay of Islands is renowned
for its water-based activities from
fishing and diving to dolphin
watching, paragliding and jetboat
riding. These activities are of
course weather-dependent and
knowing New Zealand anything
could happen! No matter what the
weather is doing you can always
find a choice of venues for a latte
or a glass of wine. For more about
what to do, see story p14.
Registration is now open. We hope
you will join us!
RANZCO NZ 2017: Programme
overview
The 2017 RANZCO NZ Branch Annual Scientific Meeting,
incorporating the NZ Ophthalmic Nurses Group, NZ
Practice Managers Group and NZ Society of Orthoptists
Meetings, formally starts on Friday 12 May, after the Branch
executive meetings and register training sessions on Thursday
11 May.
The two-day programme at the Copthorne Hotel, in the
stunning Bay of Islands, focuses on the latest advances in
ophthalmology and its management in New Zealand as
relevant to the delegates for each of the concurrent meetings.
The programme ends with the always popular, and usually very
entertaining, conference dinner on the Saturday night.
This year the New Zealand meeting welcomes a number of
overseas, as well as New Zealand-based, specialist speakers,
plus the new RANZCO president, Associate Professor Mark
Daniell. Details about the international keynotes are as follows:
Professor Ken Nischal,
paediatrics, USA
Fresh from his success at CCLS
Nelson, Professor Ken Nischal
opens the combined specialists
and nurses’ programme on
Friday morning by addressing
corneal opacification; a topic
credited for shaping his career.
British-born Professor Nischal
trained at Kings College
London and completed his
ophthalmology residency at Professor Ken Nischal
Oxford Eye Hospital where he was told an infant born with
cloudy corneas – known as Peter’s anomaly – could not be
treated. Later, while working as a Fellow at the Hospital for
Sick Children, Toronto, Professor Nischal saw a toddler born
with Peter’s anomaly who had been successfully treated with a
corneal transplant. This inspired him to champion infant corneal
transplant while working at Great Ormond Street Hospital
in the UK. When he left in 2011, it was standard practice.
Professor Nischal is now based in the USA as head of paediatric
ophthalmology, strabismus and adult motility at the Children’s
Hospital of Pittsburgh and Professor of Ophthalmology at
the University of Pittsburgh Medical School. He is a pioneer in
paediatric anterior segment disease and surgery.
Professor Tien Wong,
medical retina, Singapore
Chair of ophthalmology and
medical director of the Singapore
National Eye Center (SNEC),
Professor Tien Wong is known for
his research in vascular diseases
and medical retina, with his
research leading him to conclude
retinal vascular imaging could
predict a patient’s risk of
disease. Prior to his appointment
with the SNEC, Prof Wong
was executive director of the Professor Tien Wong
Singapore Eye Research Institute;
chair of the Department of Ophthalmology at the National
University of Singapore; ophthalmology department head at the
University of Melbourne and managing director of the Centre for
Eye Research Australia (CERA). He has published more than 1,000
papers and given more than 300 invited plenary, symposium
and named lectures globally. He has received more than US$50
million in grant funding and has been recognised with numerous
international awards, including the Alcon Research Institute
Award, the Australian Commonwealth Health Minister’s Award,
the Woodward Medal from the University of Melbourne and the
Arnall Patz Medal from the Macula Society. He is also a recipient
of the President’s Science Award, the highest award for scientific
contribution in Singapore.
Toomac Ophthalmic
Toomac look forward to seeing you at RANZCO in the
beautiful Bay of Islands where we will be displaying
the latest Haag Streit Lenstar. We will show you how
to achieve +/-0.5D target refraction in 95% of your
patients using the Hill RBF method. This is a massive
leap in accuracy as current worldwide data suggests only
50-80% of cases achieve this using second and thirdgeneration
formulae.
CONTINUED ON PAGE 14
LEAVE A LEGACY
OF VISUAL FREEDOM.
TECNIS ®
PRESBYOPIA-CORRECTING IOLs
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the intellectual property of their respective owners.
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AMO20530 Tecnis PICOLs Adv NZ-Optics_1/2pp.indd 1
April 2017
NEW ZEALAND OPTICS
14/3/17 10:02 am
13

SPECIAL FEATURE: PRE-RANZCO 2017
Professor Tim Sullivan,
oculoplastics,
Australia
Professor Tim
Sullivan is a
specialist in
oculoplastics and
lacrimal disease.
He completed his
ophthalmology
training in 1988,
then undertook
fellowship
training in
oculoplastics and
orbital disease at
Moorfields Eye
Hospital in London and paediatric ophthalmology
in Toronto. He now conducts the Eyelid, Lacrimal
and Orbital Clinic at the Royal Brisbane and
Women’s Hospital and Royal Children’s Hospital.
Prof Sullivan has more than 120 publications
in peer-reviewed journals, book chapters and
400 presentations at national and international
meetings. He is involved in medical student,
registrar and fellow teaching as professor of
ophthalmology for the University of Queensland.
He is a former president of the Australian and New
Zealand Society of Ophthalmic Plastic Surgery and
the Asia-Pacific Society of Ophthalmic Plastic and
Reconstructive Surgery. Prof Sullivan will be giving
an oculoplastic update, a roundup of challenging
cases and a close-up look at ptosis.
Professor Bennie Jeng,
cornea and external diseases, USA
Professor Bennie Jeng is chair of the department
of ophthalmology and visual sciences at the
University of Maryland School of Medicine. He
studied at the University of Pennsylvania School
of Medicine before completing his ophthalmology
residency and chief residency at the Cole Eye
Institute (Cleveland Clinic), which he followed with
a fellowship in cornea and external diseases at
The Francis I. Proctor Foundation for Research in
Ophthalmology at the University of California San
Francisco. He is actively involved in the leadership
of many ophthalmologic societies, serves on
several committees of the American Academy of
Ophthalmology (AAO) and is actively involved with
the American Board of Ophthalmology. Prof Jeng’s
primary interests are in corneal transplantation,
ocular surface disease, ocular microbiology, eye
banking and artificial corneas. He advocates being
nice, keeping mentors close and being humble
enough to ask for help – among other things – as
the route to success in this field.
Professor Bennie Jeng
Professor Tim Sullivan
Treaty house
Hole in the rock
Paihia
Professor Janet Marsden,
ophthalmology and emergency medicine, UK
Professor Janet
Marsden has been
an ophthalmic nurse
since completing
training and finding
that there were no
jobs in ‘casualty’.
Her initial reluctant
interest developed
into a passion for
ophthalmic nursing,
with a foot in both
ophthalmology and
emergency practice.
She has published Professor Janet Marsden
extensively in both
fields, is an editor of ‘Emergency Triage’, the Manchester
triage system, developed in Manchester and now widely
used internationally. She is chair of ophthalmology and
emergency care at Manchester Metropolitan University
and leads the Centre for Effective Emergency Care
(CEEC). She works closely with the Royal College of
Ophthalmologists in the UK, leading an allied health
section and developing a multi-professional competence
framework for all members of the ophthalmology team.
She is a fellow of the Royal College of Nursing and of the
Faculty of Emergency Nursing, a member of the medical
advisory group for Orbis, the flying eye hospital, for
whom she undertakes regular international work, and
a member of the Ministry of Defence Research Ethics
Committee.
Professor Marian Macsai,
cornea, USA
Illinois-based Professor Marian Macsai is head of ophthalmology
for NorthShore University HealthSystem and ophthalmology
professor at the University of Chicago Pritzker School of
Medicine. She is president of the American Cornea Society,
a past chair of the Eye Bank Association of America and a
member of the American Ophthalmologic Society. A trained
fellow in cornea and refractive surgery, Prof Macsai specialises
in corneal transplants, refractive surgery, cataracts and diseases
of the external eye. She will be discussing trends in corneal
transplantation, eye-banking and the restoration of the healthy
corneal endothelium.
Device Technologies
Discover Bay of Islands
If you’re heading up to the 2017 RANZCO NZ conference you
might want to build in some extra time to explore the stunning
Bay of Islands. Here’s our top suggestions on how to spend your
spare time:
• Catch a ferry from Paihia wharf to New Zealand’s first capital
city – the historic township of Russell, home to some of New
Zealand’s oldest historic buildings, such as the Gables built in
1847. Over its time, the Gables has been a bordello, a bakery, a
shop, a Salvation Army boys’ home and even a hiding place for
sailors who jumped ship. Take your time to mill around the cute
township, but make sure to include time to walk up Flagstaff Hill
to take in the stunning views over the bay.
• Getting to the outer islands is easy. There are several tour
operators to choose from located at the wharf in Paihia. Many
cruises include a trip to the spectacular ‘hole in the rock’ at the tip
of Cape Brett. You may even be lucky enough to be escorted on your
trip by a pod of dolphins or catch a glimpse of other marine life.
• Then there’s the Treaty House at Waitangi where the historic
Waitangi Treaty was signed between the British Crown and
several of New Zealand’s Maori tribes, marking the beginning of
the country New Zealand is today. If you’re staying
at the 2017 Meeting venue, the Copthorne Hotel is
just a short stroll from the Treaty House, the sacred
ceremonial war canoe, the museum of Waitangi
and the popular Whare Waka café, or it’s a couple of
kilometres walk or a quick car ride from Paihia proper.
Proud supporters of RANZCO 2017, we would like to invite all attendants to our stand to
discover the latest Topcon Triton Swept Source OCT. It has proven very useful in retinal
specialist clinics visualising deep retinal tissues to help better decide on treatment,
compared with the spectral domain technology. While small centres, satellite and mobile
clinics, challenged with affordability and space issues, have further increased demand for
the Maestro OCT, especially for retinal screening. A function common to both OCT’s is the
wide scan including macular-, RNFL-, GCL- and real-colour fundus photo, all presented in a
single report. The Maestro and Triton ‘one minute learning curve’ will help staff in today’s
busy clinic environment (anterior scan and networking available), while the Frey VA chart
offers great flexibility, durability and great value.
Chalkeyes tackles the RANZCO Microsoft vision. See p22
• Or for the more fitness-focused delegates, hire a
kayak or take a kayak tour from Paihia or Waitangi
inland to the impressive, horseshoe-shaped Haruru
Falls, spotting nesting birds and old Maori Pa sites on
the way. Guided tours include an in-depth look at the
history and Maori legends of the area.
Professor Marian Macsai
What is the HILL-RBF METHOD?
The Hill-RBF Calculator is a purely data driven IOL calculation method incorporating artificial intelligence,
pattern recognition and a boundary model, for improved accuracy and confidence in IOL power selection.
The Hill-RBF Calculator is not a formula but a new method for IOL power selection. RBF stands for
Radial Basis Function, which is similar to a neural network.
• The Hill-RBF Method is a new paradigm in/for IOL power calculation, featuring pattern recognition and
sophisticated data interpolation leading to improved IOL prediction accuracy.
• The Hill-RBF Method performs equally well on all eyes; short, average and long ones, independent of
specific anatomical features.
• It learns and improves with increased data available. In its current release it works for biconvex IOL’s from
+6.00D to +30.00D with optical biometry data from sources providing measurements equivalent to the Lenstar.
• The Hill-RBF Method is the first IOL calculation approach that informs the user if a result may be inaccurate.
• The Hill-RBF offers 95% accuracy in IOL prediction.
The Hill-RBF Calculator is exclusively licenced on the LENSTAR and is available on the current version
of EyeSuite. All LENSTAR Pro users will have access to it and LENSTAR Essential users can upgrade
to Pro at any time.
Available exclusively on the HAAG-STREIT LENSTAR from Toomac Ophthalmic.
14 NEW ZEALAND OPTICS April 2017

Squint Club success in NZ
BY DR CHEEFOONG CHONG*
Dr Shuan Dai with Liane Wilcox and Diana Taylor
Robyn Wallace, Dr Wendy Marshman and Donna Corcoran
Drs Frank Martin, Craig Donaldson and Justin Mora with Tammy Miller and keynote speakers Prof Stephen Kraft and Kyle Arnoldi, Prof Jonathan
Holmes, Dr Shuan Dai and Carly Henley
The annual Australia and New Zealand Strabismus Society
(ANZSS) Meeting, affectionately known as the “Squint
Club”, was a resounding success. Held at the Fisher and
Paykel Education Centre at Auckland City Hospital at the end of
February, the 2017 Squint Club was well attended with more than
100 delegates from countries spanning four continents, including
Canada, the USA and India.
Preparations for this meeting started well over a year ago under the
combined leadership of Dr Shuan Dai, convenor of the conference
and the organising committee, Dr Justin Mora and orthoptists, Carly
Henley and Tammy Miller.
Keynote speakers included Dr Stephen Kraft, professor of
ophthalmology and senior clinician scientist from the SickKids
Hospital in Toronto, and Kyle Arnoldi, programme director of the
highly-esteemed Ross Eye Institute Orthoptc Programme in Buffalo,
USA.
Dr Dai officially opened the meeting by welcoming the delegates
and guest speakers. Professor Kraft then kicked off the official
scientific programme by sharing his 30-plus years of experience
in managing acute presentations of childhood esotropia. This was
followed by Auckland registrar Dr Lucy Lu who presented an audit
of neuroimaging outcomes in paediatric strabismus, which found
similar results to Professor Kraft that isolated acute esotropia
in children is a relatively benign condition (only one intracranial
pathology in Professor Kraft’s series). This highlights the critical
role of identifying red-flags and associated signs/symptoms as a
predictor of organic intracranial pathology.
Kyle Arnoldi presented a total of six captivating themed lectures
including, ‘The X-files’ with management pearls on pre-op and postop
residual intermittent exotropia and amblyopia management. She
followed this with a detailed and fascinating account of how our
vergence system works; while an action-packed presentation titled
‘Superheros of Fusion’ brought life to the titans who have moulded
and championed the field of strabismus, reminding us that we all
stand on the shoulders of giants.
Professor Kraft presented a further five lectures highlighting an
unusual case of idiopathic extraocular muscle enlargement, which
has only been reported once before by strabismus surgeon Dr Lionel
Kowal’s group in Melbourne. He also described the outcomes from
his surgical technique for the management of strabismus from
abducens nerve palsy, which has a higher success rate than other
methods reported in literature to date.
Professor Jonathan Holmes, from the Mayo Clinic in the US, shared
his most recent treatment results and current thinking on the future
direction of the management of amblyopia, while our RANZCO
censor-in-chief, Dr Mora, highlighted the importance of standardised
motility exam documentation to aid patient care, examination and
teaching. Dr Mora supports a universal documentation of motility
exam, which would lead to the standardisation of the clinical
motility exam across Australia and New Zealand.
The success of the Squint Club is largely based on the genuine
camaraderie of the ANZSS. Senior strabismologists were candid that,
despite their vast knowledge and experience, they can still learn
from one another’s experience. This year, particularly, there was no
shortage of “what should I do” interesting case studies and video
presentations.
The “live-patient” session was phenomenal. Six patients with mindboggling
strabismus attended the meeting, including one who had
travelled all the way from Sydney. All six patients were examined by
the doyens of strabismology including Ms Arnoldi, Professors Kraft,
Holmes and Frank Martin, Drs Ross Fitzsimons and Lionel Kowal.
These six patients were then presented to the audience and opinions
sought as to how best manage their functional and cosmetically
debilitating squint. As clinicians, we often feel compelled to “help”
(operate on) our patients but we were reminded throughout this
meeting that masterful inactivity may sometimes be the best course
of action.
Following the “live-patient” session was the highly-anticipated
amblyopia update presented by Professor Holmes’ team including Dr
Lisa Hamm and Ms Tina Gao. This was an invaluable opportunity to
hear directly from the chief investigator of the Pediatric Eye Disease
Investigator Group (PEDIG) as well as review the unpublished data
from the international BRAVO (binocular treatment of amblyopia
using videogames) study, including the use of dichoptic stimulation
for treatment of amblyopia.
There was no shortage of captivating speakers, thought-provoking
presentations and instructive sessions at this year’s meeting which,
given it was described by many as the best Squint Club meeting
so far, is testament to the efforts of the organising committee and
presenters. ▀
Drs Nirosha Paramanathan and Shilpa Kuruvilla
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*Dr CheeFoong Chong is a senior ophthalmology registrar and researcher based in the
Department of Ophthalmology at the University of Auckland.
April 2017
NEW ZEALAND OPTICS
15

with
Prof Charles McGhee
& A/Prof Dipika Patel
Series Editors
Managing the Narrow Angle
Introduction
DR SHENTON CHEW*
Glaucoma is ranked as the leading cause of
irreversible blindness by the World Health
Organisation. Whilst the prevalence of primary
angle closure glaucoma (PACG) is approximately a
third of primary open angle glaucoma (POAG), it is
responsible for nearly half of glaucoma blindness
worldwide. It is estimated that compared with
the 20 million people who currently have PACG, by
2040, 34 million people will be affected of whom
5.3 million will be blind 1 .
Risk factors
Major demographic risk factors for angle closure
are older age, female gender and east Asian
ancestry. Smaller anterior segment dimensions
are the major ocular risk factor, with limbal and
axial anterior chamber depth the most strongly
correlated with angle closure. These risk factors are
associated in that anterior chambers shallow with
age, and are shallower in females than males.
Classification
The systems used to classify angle closure
‘disease’ can be confusing as this can be done
based on different factors such as symptoms
and mechanisms. Perhaps the most valuable
classification is that based on three conceptual
stages in the natural history of disease (see Table
1): from iridotrabecular contact (ITC), to anterior
segment signs of the disease including raised
intraocular pressure (IOP) and/or peripheral anterior
synechiae (PAS), culminating in glaucomatous optic
neuropathy. Another advantage is that this system
has been used in epidemiological research to guide
our natural history data 2 .
A patient with an “occludable angle” is
synonymous with being a primary angle closure
suspect (PACS), though in an angle closure
consensus meeting it was felt that the amount of
ITC should reduce to more stringent amount of 180
degrees (two quadrants) 3 .
Gonioscopy
Despite the advent of newer angle imaging
modalities such as anterior segment optical
coherence tomography (AS-OCT) and ultrasound
biomicroscopy (UBM), gonioscopy remains the
“reference-standard” for diagnosing angle closure.
Whilst different clinical grading schemes exist, as
do gonioscopy lenses, the goal is to determine if
there is greater than 180 degrees of ITC and look
for evidence of potential trabecular damage in the
form of PAS or blotchy pigment (Fig 1). Effectively
if, in correct conditions, posterior trabecular
meshwork (usually pigmented) cannot be
visualised then ITC is presumed (see Table 2).
Clinical presentation and management
Symptomatic angle closure is reported at only
30% in Asia and is probably lower in Caucasians.
Classically described symptoms such as haloes and
ocular ache can also be very non-specific. Even more
rare is acute angle closure crisis, which presents
with a constellation of symptoms including nausea,
vomiting and blurred vision, and signs of raised
IOP, corneal oedema and a mid-dilated pupil 4 . This
requires urgent ophthalmic care and has its own
management algorithm. Most angle closure is
thus asymptomatic and picked up incidentally at
optometric or ophthalmic visits. Screening is thus
important and Glaucoma New Zealand advises that
screening for glaucoma should occur every five years
from age 45, and every three years from age 60.
Exclusion of angle closure at these visits, especially
in those with risk factors, is critical.
Table 1.
Classification of primary angle closure ‘disease’
Primary angle closure suspect (PACS)
Primary angle closure (PAC)
Primary angle closure glaucoma (PACG)
Natural history data would suggest that
without treatment, the rate of conversion from
PACS to PAC is approximately 10% per decade 5 ,
whilst the rate of conversion from PAC to PACG is
almost 30% at five years 6 . Traditional treatment
begins with a laser peripheral iridotomy (LPI) and
medical management if the IOP is elevated. The
aim of the LPI is to remove the pupil block that is
causing convex displacement of the iris. This can
potentially reverse the pre-trabecular obstruction
caused by appositional angle closure. Ongoing
medical or surgical treatment of elevated IOP can
still be required due to ultrastructural trabecular
meshwork damage caused by previous contact and
friction, or frank PAS formation. Laser iridoplasty
or miotics, such as pilocarpine, can also be useful
adjuncts in those with peripheral iris issues such as
plateau iris syndrome.
A concern with this traditional algorithm is
that ongoing trabecular meshwork damage
could continue to occur if there is not significant
widening of the drainage angle. Extension of
PAS can be subtle to detect from visit to visit and
significant angle damage is sometimes needed
before the facility of trabecular outflow is affected
and the IOP elevates. For this reason, in those with
symptomatic age-related cataract, lens extraction
has been favoured over traditional treatment as
it greatly widens the drainage angle as well as
leading to visual improvement.
In those without visually significant cataract,
evidence now points towards clear lens extraction
as the treatment of choice in those with high risk
PAC (IOP greater than or equal to 30mmHg) or
PACG at presentation (Fig 2). The EAGLE study is
a recently published randomised controlled trial
that specifically compared clear lens extraction
with traditional management beginning with a
LPI in these patients 7 . IOP was marginally lower at
three years in the lens extraction group, but more
importantly only 21% of these patients received
any further treatment, compared to 61% in the
LPI group who required at least one glaucoma
drop. This reduced need for drops is likely to have
contributed to a measured improvement in patients’
quality of life, as well as better visual function
from refractive improvement in a largely hyperopic
cohort. Importantly there was also a significantly
reduced need for future glaucoma surgery in the
lens extraction group. It should be noted that the
exclusion criteria included those with advanced
glaucoma and those under 50 years of age so that
loss of accommodation would not be a factor. Clear
lens extraction surgery is not without risk however,
especially as these cases can be more challenging
due to biometric factors such as shallow anterior
chamber depth, and should be performed by an
experienced glaucoma or cataract specialist.
In PACS patients without visually significant
cataract, LPI remains the treatment of choice. If the
angle widens significantly and there is no residual
ITC, these patients are safe to be monitored
optometrically for recurrence of ITC, or conversion
to PAC (elevated IOP, PAS) or PACG on a yearly basis.
If ITC remains, then this annual review preferably
remains with the ophthalmologist. If visually
significant cataract develops at any stage, then a
low threshold for surgical extraction should exist.
Summary
*This definition has more recently been reduced to two or more quadrants (180 degrees) by consensus 3
Angle closure disease is a major cause of
irreversible blindness that can be prevented with
adequate screening and management. Gonioscopy
remains the cornerstone of its diagnosis and
classification. If symptomatic cataract exists, lens
extraction is preferred over LPIs and evidence now
points towards the same in those with high-risk
PAC or PACG without cataract.
ITC in three or more quadrants*, but normal IOP, disc and
field, without evidence of PAS*
ITC in three or more quadrants* with either raised IOP
and/or primary PAS. Disc and field are normal
ITC in three or more quadrants* plus evidence of
glaucomatous damage to the optic disc and visual field.
Fig 1. (a) Gonioscopic view of an inferior angle with a corneal wedge (red arrow) helping to identify Schwalbe’s line (SL). Note the blotchy
pigmentation at this level as well as of anterior trabecular meshwork (TM). (b) Diffuse illumination of same angle demonstrating opening of the angle
to scleral spur (SS). (c) Low magnification view of the same patient’s superior angle with a corneal wedge demonstrating ITC (no visible posterior TM)
Table 2.
Key factors for good gonioscopy
Ensure adequate topical anaesthesia
Room illumination should be as dark as possible
Use high magnification and a slightly offset thin and short illumination slit to identify the corneal
wedge, demarcating Schwalbe’s line which is the anterior edge of trabecular meshwork (usually nonpigmented).
Increase the illumination width and perform dynamic manoeuvres (indentation with a 4-mirror/looking
towards the mirror with a Goldman-style lens) to familiarise oneself with the individual’s posterior
trabecular pigmentation if visible and to determine if there is any PAS or blotchy pigment.
Decrease the illumination back to a thin and short beam to document the amount of ITC in primary
position (minor tilt of the lens permissible).
Fig 2. (a) Shallow central anterior chamber and clear crystalline lens in an eye with PAC. (b) AS-OCT pre- clear lens extraction demonstrating angle
closure. (c) AS-OCT post-clear lens extraction demonstrating significant widening of the angle
References
1. Tham, Y.C., et al., Global prevalence of glaucoma
and projections of glaucoma burden through 2040: a
systematic review and meta-analysis. Ophthalmology,
2014. 121(11): p. 2081-90.
2. Foster, P.J., et al., The definition and classification of
glaucoma in prevalence surveys. Br J Ophthalmol, 2002.
86(2): p. 238-42.
3. Weinreb, R.N. and D.S. Friedman, Angle Closure and
Angle Closure Glaucoma. Reports and Consensus
Statements of the 3rd Global AIGS Consensus Meeting
on Angle Closure Glaucoma. 2006, The Hague, The
Netherlands: Kugler Publications.
4. Seah, S.K., et al., Incidence of acute primary angleclosure
glaucoma in Singapore. An island-wide survey.
Arch Ophthalmol, 1997. 115(11): p. 1436-40.
5. Thomas, R., et al., Five year risk of progression of
primary angle closure suspects to primary angle closure:
a population based study. Br J Ophthalmol, 2003. 87(4):
p. 450-4.
6. Thomas, R., et al., Five-year risk of progression of
primary angle closure to primary angle closure
glaucoma: a population-based study. Acta Ophthalmol
Scand, 2003. 81(5): p. 480-5.
7. Azuara-Blanco, A., et al., Effectiveness of early lens
extraction for the treatment of primary angle-closure
glaucoma (EAGLE): a randomised controlled trial.
Lancet, 2016. 388(10052): p. 1389-1397.
About the author:
Dr Shenton Chew
* Dr Shenton Chew is an Aucklandbased
ophthalmologist who
subspecialises in glaucoma and
cataract surgery. He is the current
Chair of the Auckland District
Health Board ophthalmic surgeons’
committee and spokesperson for
Royal Australian and New Zealand
College of Ophthalmologists.
16 NEW ZEALAND OPTICS April 2017

SPECIAL FEATURE: SILMO
Silmo Sydney unveiled
BY LESLEY SPRINGALL
The much anticipated and discussed new
Australasian optical fair, Silmo Sydney, took
place at Sydney’s newly refurbished and
reopened International Conference and Exhibition
Centre from 9 – 11 March.
A proportionally-large contingent of Kiwis
attended and though the exhibition never
appeared in the least crowded, there seemed to be
some real buying taking place; an anecdotal view
confirmed later by exuberant exhibition organiser
Gary Fitz-Roy, managing director of Expertise
Events.
“At the end of the day the thing that’s
overwhelming that’s coming out has been about
quality and buying. That’s the message from the
show floor and I think if you’ve got anything new
and you’ve done your pre-marketing, you’ve done
very well.”
Fitz-Roy said visitors also commented on the
newness of the exhibitors, with 50% of exhibitors
being new or not having exhibited in Australia for
the past 10 years, though this was less obvious to
this media commentator, who was delighted to
see many familiar faces among the exhibitors.
Silmo Sydney did have an obvious bias towards
frames manufacturers and distributors compared
with equipment suppliers and contact lens
companies who were in very short supply. Most
Kiwi delegates questioned, however, admitted
they were primarily there for the frames
companies and to see if they could find anything
new to add to their collections.
There was a friendly, uncluttered and unhurried
atmosphere, aided by generous amounts of
champagne on a number of stands, with teams
obviously happy to support Silmo Sydney’s launch.
“There’s been a real camaraderie and excitement
on the show floor,” said Fitz-Roy. “From the moving
in, everyone got on with helping each other
[showing people] they want something different;
they want something more fun.”
As to whether Silmo Sydney was going to be
an annual event, Fitz-Roy refused to be drawn
until his team had had a few weeks to crunch the
numbers and review the feedback from attendees
and exhibitors.
“We always said we would wait
until we did the first show and then
we would evaluate. There’s certainly
a level of interest from the floor to
go annually, but what will dictate it
ultimately will be the exhibitors and
the visitors. But we really haven’t
made a decision yet.”
When pushed, Fitz-Roy admitted
Expertise Events had booked dates
for next year, but also said there
could be an argument for holding
Silmo Sydney every two years in
the year it’s older rival ODMA (see
story p6) doesn’t hold a fair and/
or in other key centres in Australia.
He added, however, that one thing
that does change each year is
frames and given the success of
this year’s show, where frames and
buying dominated, there could be
an argument for making frames
and buying an even greater focus,
distinguishing it still further from
ODMA, in future years.
Fitz-Roy said he was grateful for
some of the exhibitors’ obvious
support for the new fair giving
each and every one of them a quite
frank thank you letter on the last
day. “We know you have a choice
and we also are very aware of the
politics some have had to endure.
Right from the move in and the
first two opening days there has
been positivity and cooperation in
making the event a success, and we
sincerely appreciate it,” he wrote.
Education sessions
On the educational-side, the
National Retail Association held
a series of talks at one end of the
show each day, featuring a range of
speakers covering topics as diverse
as dispensing training and building
a strong social media campaign
to selling skills and dealing with
information overload.
At the other end of the hall,
international market research
company GfK’s talks on ‘Five macro
Silmo Sydney organiser Gary Fitz-Roy
trends impacting the way shoppers shop today’
and the changing economics of the optometry
industry in Europe and how that relates to
Australia attracted full houses. According to
Justin Lewis, GfK’s head of healthcare research,
the key macro trends practices should take into
consideration are:
1. Identity – Target customers based on values, not
demographics
2. Experience – Create experiences not
transactions. Inject emotion, fun, novelty and
sensory stimulus into the shopping experience
3. Redefining value – Offer customers more
than just the sale. Identify the ‘value-adds’ that
separate you from your competition
4. Considered consumption – Demonstrate that
you are a good corporate citizen (socially and
environmentally) and use that to set yourself apart
5. Sense of wellbeing – Identify and communicate
how the products and services you sell address
the needs of consumers and give them a sense of
wellbeing ▀
silmoparis.com
SHOW
Nicola and Richard Newson at the
Sunshades stand
Fleye co-founder Annette Estø
Zeiss’ Alex Hamilton, Jacqui Hannah and Thomas Klenk proudly
displaying their new snow googles range
Tributes for Silmo president
Shortly before the opening of Silmo Sydney, word
spread through the optical community about
the death of Philippe Lafont, president of Silmo
and champion of the well-known Paris show’s
international expansion plans.
Silmo director Eric Lenoir was due to attend and
support Silmo Sydney’s exhibition organiser Gary
Fitz-Roy and the opening of the new downunder
show when news hit, forcing him to cancel his
Australian travel plans.
The sudden death of Lafont (age 70) from a heart
attack was met with an outpouring of grief from
the industry, especially in Europe where he was
well-known as the founder of Lafont eyewear, now
run by his sons, Thomas and Matthieu Lafont. A
statement released by Silmo paid tribute to Lafont.
“It is with deep sadness that we announce the
CR Surfacing’s Jessica Adams and
Eyepro’s Tom Frowde
CONTINUED ON PAGE 18
Tavat manager and founder’s
daughter Roberta Baines
Optica’s Brent Rushworth, Jacquie Ellis and Brent Rundle with John Veale
death of Philippe Lafont.
Since 2012, Philippe Lafont
has devoted himself to
developing the exhibition,
seeking to make Silmo a
flagship forum for all industry
stakeholders. Continuing the
work begun by Guy Charlot,
Philippe’s commitment has
Philippe Lafont
seen Silmo become a valuable
tool for opticians and helped to
raise the profile of the French optics sector. Under his
leadership, Silmo has also pursued its international
development. His death is a huge loss for all who
were fortunate enough to work with him. Silmo’s
team extend their deepest sympathy to his family
and friends.”
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April 2017
NEW ZEALAND OPTICS
17

SPECIAL FEATURE: SILMO
Happy birthday
Eyes Right
Twenty-five years ago, Gaye and
David Wymond combined their
optical and business expertise to start
Eyes Right Optical and Silmo Sydney
proved the perfect opportunity to
celebrate in style.
Proud family firm Eyes Right’s large
stand, showcasing all its popular
brands including Morel, Face à Face,
Zac Posen, WooW and Prodesign,
overflowed with friends, team
members, customers and champagne
as everyone gathered to wish Eyes
Right a happy birthday. Also there, as
a central part of the team, were Mike
Sladen and son Gethin and Rae Long
from Mike Sladen Optical, distributors
of Eyes Right’s brands in New Zealand,
and the French consul-general,
Nicolas Crozier, representing Eyes Right’s long association
with France. Eyes Right was also celebrating its 15-year
partnership with 137-year-old French eyewear company
Morel.
Addressing the audience, champagne in hand, Gaye
Wymond, thanked everyone for coming. “Twenty-five years
is a significant milestone and certainly an opportunity to
stop and reflect. This show, Silmo Sydney, has afforded us
just a small glimpse of the huge optical industry that we
have and the enormous variety of products from which to
choose.
“Over the years we have developed a number of nonnegotiable
criteria which must be met before we will
proceed [with a new supplier]. A once-off collection is
relatively easy to create and manufacturer, but to be able to
constantly create and manufacture amazing collections of
quality frames and sunglasses, year-after-year, is the true key
to success. These are the partners that we choose to partner
with because our reputation is ultimately your reputation.”
Morel’s ability to combine its 137-year expertise in the
industry with “outstanding creativity” is a major asset in
an increasingly global optical market, said Wymond, and
key to that is the company’s independence, making it “free
from any constraints.”
Eyes Right Optical’s team celebrates 25 years with founders Gaye and David Wymond and French consul-general Nicolas Crozier (centre)
Eyes Right for kids
Eyes Right Optical has added two new
brands to its collections, both aimed at
the younger end of the market.
The new ranges from Nickleodian’s
SpongeBob SquarePants and wellknown
toddler toy manufacturer Fisher-
Price are perfectly designed for younger
spectacle wearers, says Will Cooksey,
one of Eyes Right Optical’s national
sales managers.
The Fisher-Price range have a twoyear
warranty and all the temples can
be removed and replaced with a velcro
band, so are appropriate for wearers
aged 0 to 3 years of age, and can be easily
placed and removed by parents. Whereas
Eyes Right’s Will Cooksey with the the company’s
new children’s ranges
the SpongeBob range is also very tough-wearing but aimed at older kids, up to 11
years old, says Cooksey, and features a unique 180° flexible hinge.
Eyes Right identified both brands at Silmo Paris last year and decided to
introduce them to Australia and New Zealand. Both ranges are available in
New Zealand from Mike Sladen Optical.
Modstyle now in NZ
Australian optical wholesale company Modstyle has new owners
and, for the first time in its 35-year history, its two main house
brands Avanti and Eclipse are now being sold in New Zealand.
Mark Wymond and sister Lisa, Eyes Right Optical’s national sales
and fashion brands sales directors respectively and children of Eyes
Right founders’ Gaye and David Wymond, bought Modstyle late last
year, with Mark taking over as managing director.
The brands are not competitive to Eyes Right Optical’s as they are
more towards the budget end of the market, said Mark Wymond,
though they are still manufactured to a high standard, coming
mainly from Korea.
“We purchased Modstyle in July last year. We used to be family
friends with Royce Jackson, the founder of Modstyle, and when we
took it over we found they weren’t selling to New Zealand, so that
was my first point of call…and we’re very excited about the prospect.
Our motto is quality eyewear at affordable prices.”
Getting to grips with customs and shipping to New Zealand has
been a learning curve though, laughs Wymond, but he has had his
parents’ expertise to help him through.
“What we bought is a company with a really strong reputation and
the sales team is very experienced and well-liked in the industry, but
it’s been a lot of learning, which is great. I’m learning things that
Gaye and David did 25 years ago when they set up the New Zealand
market, so they went through all these customs headaches I’ve never
been exposed to before.”
The first Modstyle shipment hit New Zealand’s shores in March and
is being distributed by Brad Boult from CMI Optical.
Avanti particularly is a very fashionable, colourful range, says
Boult, that should fit into practices looking for something not
too pricey that can
be a second pairoffering
or for other
promotions. “The
key fact for practices
is it’s a very reliable
brand, supported by
a company which
has a long-history of
supplying this product.
It’s brand new for
New Zealand and it’s
really exciting because
its full of colour. You
don’t last for 35 years
in Australia if you’re
not offering a good
product, so in New
Zealand we see this
growing very quickly
and taking a good
part of that middle
market.”
Brad Boult with Modstyle’s new co-owner Mark Wymond
Gates Eyewear’s Jeremy Wong and Lee Pittard on the MYM stand with Von Arkel’s Philippe Donikian
Rodenstock’s Nicola Peaper and Roslyn Boland with Lauren Jenkins and Sebastian Mann
The For Eyes team, Matthew and Molly Whittington and Tanja and Velimir Minic at the Silmo
Sydney after party at the Rocks
Jono shares the spotlight
Jono (centre) with the rest the Jono Hennessy team at Silmo Sydney
True to style, one of the most colourful
stands at Silmo Sydney was Jono
Hennessy’s. With its backdrop of plants,
dotted with hidden little koalas; brightly
coloured parrots; well-lit, elegant display
stands; and staff sporting sparkly kaftans
- including Jono’s wonderful managing
director and wife Louise Sceats – it was a
pleasure to view the new ranges.
But the new Jono Hennessy (previewed
in our March issue), Carter Bond (see
p20) and high-tech men’s brand Zeffer
(soon to be named Zeffer Nash) ranges
Kaleos, Louis share the stand
weren’t alone on the stand this year,
other brands such as Kaleos (Spain), Louis (Belgium), Simple (France)
and Adrian Marwitz (Germany) were also artfully displayed next to
Jono’s own brands.
Jono said he and Louise spoke to a number of small, independent
eyewear designers, like himself, from other parts of the world at
the most recent Silmo Paris and Munich Opti fairs with an idea to
promote some form of transworld partnership.
“What I’d love is to have is a group of six or seven independent,
smallish eyewear designers, manufacturers that are family groups,
to join together as an association and we all sell all the products all
around the world. It would be a group of complimentary designers…
we’d share all the tradeshows, share the cost, share the selling, and
then together we’d become a bigger force within the whole industry.”
This will also help the independent optometrist, said Jono, as they
will be able to carry truly independent brands, where they can talk
about the individual behind them and who they are. But it’s still
very early days and the shared display at Silmo Sydney was simply a
small pilot project to gauge reaction, he stressed. “I’m only talking to
people at this stage. But I’m doing it because everything is changing
(like the Essilor-Luxottica partnership) and I think we should do
something to [support] the independent side of the industry.”
18 NEW ZEALAND OPTICS April 2017

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19

Fashion update
European fairs MIDO, 100% Optical and Copenhagen Specs
drove a number of new range releases this month. Here’s a
selection of the latest new eyewear on offer in New Zealand:
William Morris
Sticking closely to its British roots and heritage, William
Morris launched a new summer collection at 100% Optical.
The company says the collection delivers bold colours
and head-turning designs such as the distinctive frame
pictured from the Black Label collection. Distributed by
Phoenix Eyewear.
Living the good light
Transitions has launched a new global campaign encouraging spectacle
wearers to ‘Live the Good Light’ by choosing Transitions lenses.
Designed to attract and engage a younger generation of single vision
wearers to the photochromic market, the campaign was previewed to customers
and eye care professionals in the United States and will run across digital media
platforms in Australasia in the months ahead. Campaign advertisements show
people in work and social settings enjoying the light with Transitions lenses.
“What we have tried to do with this campaign is to show young people in their
everyday life,” said Darragh O’Connor, Transitions’ vice president, global marketing.
“Live the Good Light focuses on young people and their experience with the
brand and demonstrates the stylish aspects of the Transitions range - with the
aim of engaging new wearers and continuing Transitions’ connection with core
customers.”
The campaign also reiterates the protection Transitions lenses offer against UV
and harmful blue light, said the company. For more, see Transitions’ ad on p7. ▀
Budri Eyewear
Marble frame manufacturer Budri, previewed by NZ Optics in
our coverage of the 2016 Paris optical fair, has released a new,
limited collection of 15 marble frames. Due to the complexity
arising from the material itself, making eyewear in marble
demands constant research and experimentation, said the
company. To handle these challenges, Budri’s eyewear lab
employed skilled chemists, engineers and geologists to come up
with a special fibre which gives the front and temples greater
strength and lighter weight.
Palladio, Budri’s take on the classic aviator model, pictured
here, comes in two colours, the bluish “Denim” and green
‘Rainforest”. Lenses for the Budri marble collection are provided
by Zeiss and the frames are distributed direct by the company.
CocoSong
Coco Song’s new range CCS continues the brand’s
exuberant use of natural elements, such as silk, dried
flowers and feathers, laminated into new crystalline and
transparent acetates or pearl colours. The result is a line
of much lighter frames both with regards to colour and
the fresh and bright style, says the company, adding it is
aimed at a younger audience. The new CCS range comes in
four models, each available in six vivid colours. Coco Song
is available direct from Area98
Seraphin
Seraphin from Ogi has introduced four new models inspired by
nature in a faux-wood style. Banning, pictured here, is named
after a Minnesota state park. The frames are handcrafted from
select acetate to resemble natural timber then carved and
matted to create its refined-rugged appeal. Seraphin says the
soft square silhouette of the Banning makes it an ideal fit for
men with a variety of face shapes. It comes in a range of natural
tones such as Evergreen and Atlantic Blue. Distributed by BTP
International Designz.
Kuboraum
Designed in Germany and handcrafted in Italy, Kuboraum
has released a series of new collections, including the Klimt
and Burri series, as a tribute to famous artists. The Burri
acetate sunglasses, featured here, have a sculptural surface
resembling a network of microscopic cracks and intertwining
sterling silver threads. Distributed by EyestyleAsia.
Carter Bond
Jono Hennessy (see p18) unveiled its new Carter Bond
selection at Silmo Sydney. Sticking with the rounder shapes
revealed at Silmo Paris, the new models have evolved the
brand’s luxury acetate and metal combinations to the next
level. The range features tiny belt buckle trims to matt gold
Windsors, with sunglass clips available for most models to
add that extra touch of luxury outside.
Talking to NZ Optics at Silmo Sydney in March, founder
and designer Jono Hennessy Sceats also provided a glimpse
into the future of the brand. “We’re doing lots of metal
combinations and upgrading everything to wonderful
acetates with gorgeous metal temples and titantium nose
pads. But what I really want to do is much bigger women’s
frames. Women are buying really groovy glasses now... I’ll
do quite a bit of square and get away from the cats eye. But
the tortoiseshell acetates combined with the wood effect
and horn are just great.”
A lot of the new designs have gone to the factory and he’s
hoping to unveil some at ODMA in July, though admits that
Luxottica lens news
Oakley introduced a new Prizm lens at MIDO while Ray-Ban
has introduced a new range of Chromance sun lenses, “for
eyes that love colour”.
Oakley’s new Prizm lens is based on new technology that
adjusts visibility for specific sports and environments. By
enhancing colours where the eye is more sensitive to detail,
the Prizm lens technology improves performance and
ensures greater safety, as it increases visibility without the
20 NEW ZEALAND OPTICS April 2017
Valentino
Valentino’s new Mirage collection was launched at MIDO.
The transparent nylon of the VA4008 model, coupled
with silver metal and smoke grey lenses, is also available
in pale-gold and gun-metal styles. These large, square
sunglasses are characterised by a series of overlays held
together by discreet studs. The key bridge is reinforced by a
metal insert, that supports the adjustable nose pads, and
is topped by a straight double bridge. The slim temples,
fixed to the frame front by a visible hinge, have acetate
tips signed with iconic studs.
The VA4010 square, shiny acetate model is a true
extension of the brand’s rock style and the straight, thick
frame front defines an ‘80s profile’ for those not afraid to
stand out, said the company. Distributed by Luxottica.
could be a tight timetable. We’ll just have to wait and see,
he smiles. Distributed by Phoenix Eyewear.
limitations of traditional coloured lenses, said the company.
Ray-Ban says its new range of Chromance sun lenses
will revolutionise users’ view of the world and take colour
experience to the next level. The new lenses enhance colour
contrasts to provide sharper and more defined images, said
the company. “By calibrating light, Chromance lenses make
the spectrum of visible colours lighter and brighter while
filtering out harmful UV rays and eliminating glare.”
Oakley and Ray-Ban are distributed by Luxottica. ▀
Stars and their eyes:
Forest Whitaker
You’ve probably seen this
enigmatic star in roles such as
the sadistic Ugandan dictator Idi
Amin in The Last King of Scotland, or
more recently as hard-nut head-case
Saw Gerrera in Rogue One: A Star Wars
Story. There’s no doubt Whitaker is an
excellent character actor, but one of the
things that undoubtedly gives him an
edge when playing the bad guy is his
drooping left eye-lid.
“It’s a genetic thing,” Whitaker told
Esquire magazine, explaining the
condition is called ptosis and his dad
also had it.
“I think, maybe for other people, it
informs the way they see me. But I
don’t really think about this eye, other
than the times people talk about it, or
when people take photographs of me
sometimes they might say stuff about
it. I don’t think it makes me look bad or
anything. It just is.”
Whitaker has said that he has
considered surgery for it, mostly
because it affects his vision, however it
has become something of a trademark
for him. ▀
It’s all in the material
Neubau has launched a new
eco-friendly collection where
everything from the frames
to the packaging and point-of-sale
materials are made from recycled
materials.
The new range of frames are made
from eco-friendly plastic, naturalPX,
and the cases have a cellulose base that
requires no glue. The cleaning cloth is
made from recycled PET bottles and
the box and point-of-sale materials
are made from recycled paper and
cardboard.
“We always want to keep improving
in our aim to make spectacles that
don’t just measure up to aesthetic and
practical needs but
also to ecological
standards,” said
the company in a
statement.
NaturalPX is
described by Neubau
as an eco-friendly
polymer made from
organically-sourced
and renewable
primary products;
65% is based on an
oil extracted from the
seeds of the castor oil
plant.
“We are supporting our environment’s
natural cycle. As the high quality of our
products is of exceptional importance to
us, this material also has to live up to the
same renowned standards of excellence
as the materials we have been using
until now: light in weight, super flexible
and sturdy, without any limitations in
terms of colouration, from deep colors to
a long-lasting transparent crystal clear
finish,” said the company.
The three new models, Dani (pictured),
Valerie and Bob are now available in
New Zealand. Neubau is owned by
Silhouette International, headquartered
in Linz, Austria, distributed by Euro
Optics. ▀

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April 2017
NEW ZEALAND OPTICS
21

RANZCO: The eye
world’s data repository?
by
Chalkeyes
The Royal Australia New Zealand College
of Ophthalmology (better known to all of
us as RANZCO) has been very busy in the
wider world of optometry recently. It’s initiatives
in this area include a data-sharing deal with
Specsavers; publication of a series of RANZCO
referral pathways and guidelines; and planning
for a RANZCO electronic health record (EHR) data
repository on the servers of Sydney University.
As NZ Optics reported some optometrists
are not happy either with the singling out of
Specsavers for collaboration or the ‘take over’ by
the RANZCO brand of data sets and guidelines
for optometry. Indeed, outsiders might think the
ophthalmologists’ guild is trying to make a grab
for the means of production in eye care.
Until recently, ophthalmic knowledge was
esoteric, protected by solidarity between
members of the profession that results from
a long acculturation process over more than
15 years, starting from when a budding young
doctor first goes to college. There has sometimes
been reluctance to pass on that knowledge, for
example, to optometrists, and apprenticeships are
very highly regulated.
The default policy of the profession has been
to limit sharing of patient data and to not
let in or even encourage involvement from
administrators or other outsiders. But something
has put a bit of a fire under the folk at RANZCO.
The new initiatives demonstrate a move away
from defending the ophthalmological patch to
collecting lots of data and sharing it.
RANZCO’s new policies are pre-emptive and
are an attempt to control all data from both
ophthalmology and optometry and keep it in a
RANZCO-managed repository. Immediate past
President Brad Horsburgh openly stated RANZCO
wants to be the Microsoft of the ophthalmic
world and this is one way it can help achieve that
lofty goal.
The RANZCO project’s home base is Sydney and
this has a familiar ring. The Fight Retinal Blindness
(FRB) project is led by Professor Mark Gillies,
an ophthalmologist at Sydney University¹. FRB
researchers have been trying to persuade all clinics
working with age-related macular degeneration
(AMD) to enter their details online. But there is
no easy way of working seamlessly with existing
EHR systems. Standards’ work, such as that by
the IHE’s eye care committee, has got stuck. IHE
or ‘Integrating the Healthcare Enterprise’ 2 has a
marketing crisis and falling buy-in from vendors. In
fact, a global communication standard for medicine
has always been about to succeed, but has not
delivered usefully despite 20 years of effort.
A solution for FRB would be to simply take over
the whole record system for ophthalmology
and optometry and this is what the RANZCO
EHR project wants to do. RANZCO through the
aggregating of big data would own the repository.
It will determine the data points and provide the
dashboard whereby individuals can access their
results. Chalkeyes suspects it will get push back
and believes there’s still a lot of unanswered
questions that need to be answered: will RANZCO
make the data available to regulators such as
insurance companies or government-funded
institutions such as DHBs? How will it make
everybody use its EHR? What does it mean for
the non-ophthalmological side of the industry if
it is forced to comply with guidelines and data
collection that is so largely controlled and defined
by the ophthalmological side of the industry?
RANZCO’s role model is the American Academy
of Ophthalmology (AAO)’s IRIS (Intelligent
Research in Sight) Registry for collecting clinical
data from all ophthalmologists 3 . In a video on
AAO’s site, the main presenter suggests we are
“moving from a knowable present into a very
uncertain future”. He suggests ophthalmologists
will be coming under increasing economic, social
and regulatory imperatives and the solution is to
move from “cost-independent clinical decisions”,
to “value-driven” ones, and thus ophthalmologists
need their own data to prove their worth.
IRIS is a “comprehensive, longitudinal and
patient-focused clinical data registry”. It is run
on proprietary software and, in a sense, the AAO
has solved the ‘standards’ wars by choosing a
vendor, FIGmd 4 to do the work for it. Ever since
EHRs began, attempts have been made to share
data for research and on trying to get a free, open
source standard for healthcare communications.
The choice of an industry vendor to implement
this by the AAO is a measure of the failure of the
standards’ work to deliver anything truly useable.
In the US, the IRIS Registry is explicitly marketed
as a defence system for ophthalmology. The
people behind IRIS argue ophthalmologists need
to have robust and unassailable data of their
own, because “if we don’t provide it we will have
no control over the data by which we shall be
judged”. The threat is that “otherwise someone
else will be telling us what we do, devaluing
our commitment to the Hippocratic Oath”. The
vision is for monthly reports back to practices
so that individual clinicians can compare their
performance to that of colleagues, and identify
gaps and shortcomings in their own practice, all
run by FIGmd.
There is a very spooky quality to the silence
surrounding RANZCO’s proposals here. Does
it mean that DHBs will have to use RANZCO’s
software interface because RANZCO’s doctors will
not be audited if they worked on anything else?
A glance at the RANZCO guidelines for glaucoma
referrals, for example, shows a very hierarchical
structure with ophthalmologists on top of the
pile and everybody else, such as optometrists,
nurse specialists and other eye health workers
locked firmly into a subordinate position in the
food chain 5 . Maybe this is justified, given the small
numbers of ophthalmologists and their exclusive
ability to bear medico-legal responsibility and
do surgery. But those assumptions, at the very
least, need to be robustly challenged by all in the
industry before the path is set, especially by those
of us not in Australia!
New Zealand is different in two crucial ways
from Australia. Firstly, optometry is not subsidised;
the impoverished elderly population of pensioners
who are on little more than $1000 a month
income cannot afford the ticket for an optometric
entry to eye care. Secondly, there is a strict
segregation of public and private sectors in New
Zealand, with separate premises and separate
record systems. Many private ophthalmology
offices in New Zealand have their own electronic
records which might be able to be customised to
allow RANZCO software interfacing. Is that what it
has in mind?
But there is no EHR at all yet for ophthalmology
in New Zealand DHBs. They nearly all run the
Orion package Concerto 6 that, at the moment,
does not even support the filing of electronic
images. Although Concerto has a capability of
displaying images and reports, it has not been
turned on and the DHBs are using cardboard or
not displaying images at all. Could ‘Concerto’
interface to the RANZCO software? Will the
DHBs here accept RANZCO’s self-audit as a valid
currency and allow RANZCO software on their
servers? Most importantly, does RANZCO’s vision
help address the gridlock and turmoil now in our
public sector clinics?
Undoubtedly the DHBs would also like to control
a database of ophthalmic activities themselves in
their efforts to control costs, funding and monitor
doctors, just as the Centres for Medicare and
Medicaid (CMS) services do in the US 7 . CMS is the
US government healthcare funding agency and
has signalled it will accept the AAO audits. It’s
a moot point if the DHBs and the New Zealand
Medical Council would follow that lead.
RANZCO’s initiatives are being proposed as a
responsible path in an environment where we are
moving from the known into the unknowable,
and their guidelines may support and assure
safe practice for all. The alternative view is that
RANZCO is trying to lock us in to present economic
and social dynamics in a bid to protect its current
position at the top of the eye care food chain.
There is a French saying: ‘plus ça change, plus
c’est la même chose’ – the more things change, the
more they stay the same. This no longer applies in
eye care. RANZCO is instead ‘changing to remain
the same’. Something radical had to be done to
keep the RANZCO brand at the top. Owning the
territory makes sense and that is what is on the
table for contention or acceptance. ▀
References
1. Fight Retinal Blindness promotional video starring Mark
Gillies www.youtube.com/watch?v=ROyaDyIGvpE
2. IHE is an initiative by healthcare professionals and
industry to improve the way computer systems in
healthcare share information. The Eyecare division
developed the General Ophthalmic Evaluation and
Cataract cCDAs. Its vendor support has been minimal.
www.ihe.net/Eye_Care/
3. The home page of the AAOs IRIS registry project which
uses proprietary software to interact with participant
EHRs. www.aao.org/iris-registry
4. FIGmd, a US company that manages QA and self-audit
on behalf of a number of medical specialties in the US
including cardiology and now ophthalmology. See a
promotional video from Flora Lum, head of AAOs QA
process. www.figmd.com
5. An example of RANZCO guidelines with a very well
defined hierarchical management structure and pathway
which reflects the present demographic and financial
structure in Australia but perhaps not NZ Eyecare www.
ranzco.edu/ArticleDocuments/176/Guidelines%20for%20
collaborative%20care%20of%20glaucoma%20patients.pdf.
aspx?Embed=Y
6. The website of Orion company, NZ’s big international
player in the world of EHRs, in nearly all DHBs with its
data integration product ‘Concerto’. www.orionhealth.
com/nz/
7. The website of the US biggest payer organisation in
healthcare, the US Government funded Centers for
Medicare and Medicaide services providing care to 100
million Americans. www.cms.gov
The views expressed by Chalkeyes are his, or
hers, alone and not necessarily the views of NZ
Optics . If you wish to comment on Chalkeyes’
views, please email a brief letter to the editor
at info@nzoptics.co.nz for consideration.
Eyewear outside the square
In collaboration with the world-renowned Royal
College of Art, UK optical fair 100% Optical
showcased the finalists of its fourth design
competition at its event in London in February.
This year the brief was ‘Visionary’ with organisers
requesting a more scientific approach and focus
on vision and seeing, considering “the design
aesthetic as well as comfort and practical design
Runner-up Alice Pott’s frames ‘Interlockable’
to enable the wearer to see at work and play.”
Six finalists were shortlisted, all showing an
interesting mix of materials and shapes. The
winner was first-year fashion and textile student
Becky Hong, who entitled her entry, ‘My Tribe’. She
described her frames as “flip down protection lenses
to give the wearer the option to transition from
indoor to outdoor.” Hong was awarded £500. ▀
Becky Hong’s winning frames
‘My Tribe’
Retro-chic design winner
Tetsuya Okada, owner of
the quirky Globe Specs
optical store in Tokyo, is
the 2017 winner of the MIDO
eyewear show in Milan’s annual
Bestore (a play on Best Store)
Award. Okada is described
as a Japanese eyewear ‘icon’
with more than 30 years of
experience in the high-end
optical industry. His store, Globe
Specs, is home to a range of
international and Japanese
designer frames.
The Bestore Award was
created by MIDO to celebrate
optical stores around the
world whose design ideas
shape trends and where originality, innovation
and an exciting atmosphere promote a unique
shopping experience. Participating stores are
assessed by an international panel of experts
Global specs winning interior in Tokyo
on the originality of their interior design
and product display, maximization of client
interaction, effective communication and visual
merchandising. ▀
22 NEW ZEALAND OPTICS April 2017

Changes
at ODOB
ODOB has appointed Wellington-based optometrist,
Annette Morgan, to the board, replacing previous chair
and long-serving optometrist member Damian Koppens
from Paterson Burn.
Koppens was appointed to the board in September 2010 and
served two three-year terms before deciding not to renew for
a third time in November last year, to allow him to spend more
time with his family. In an announcement last month, ODOB
thanked him for “his significant and valuable contributions and
unwavering dedication to his work for the board.”
ODOB board member, Associate Professor Jennifer Craig
was elected as chair in his stead, while fellow board member,
Wellington practice owner, Jayesh Chouhan was elected deputy
chair in December. Other board members include Joanne Talbot
(lay member); Ross Tayler (optometrist); Kristine Hammond
(dispensing optician); Annette Morgan (optometrist); Lorraine
Helson (dispensing optician); and Irene Durham (lay member). ▀
NZOSS dons their runners
Members of the New Zealand
Optometry Student Society
(NZOSS) put their trainers
on and joined the 45th Round the
Bays, 8.4km scenic-charity race on
Sunday 5 March. Nick Stuhlmann,
NZOSS sports representative, said
the NZOSS Round the Bays team had
a healthy 20 participants, with Nick
Lee securing the fastest time at 43.14
mins.
Participating members were:
Yixiang Shao, Joseph Stone, Oliver
Ou, Kylie Mann, Sung Park, Jae Hyuck
Son, Helena Chen, Jason Lee, Nick
Lee, Andrew Kim, Laura Matthews,
Alicia Han, Yesom Kim, Louise Howse,
Charisse Kuo, Celine Fung, Nick
Stulhmann, Jason Kumar, Aimee
Aitken and Simran Kaur.
Well done all! ▀
NZOSS Around the Bays team
MORE CLASSIFIEDS ON PAGE 24
Naomi Meltzer BSc, Dip Opt, PostGrad.Dip.Rehab.
Low Vision Optometrist
Ph: (09) 520 5208
0800 555 546
Fax: (09) 520 5515
PO Box 28486
Auckland 1541
info@lowvsionservices.nz
www.lowvisionservices.nz
low vision
services
Low Vision Consultations available at
REMUERA, TAKAPUNA, MANUKAU and PUKEKOHE
An Optometrist dedicated to Low Vision support.
PRACTICE FOR SALE
CHRISTCHURCH
Unique opportunity to acquire long established practice in the busy
Riccarton suburb of Christchurch. The spacious premises are fitted
out to a high specification custom design and have an excellent
high profile location on Riccarton Road opposite Westfield Mall.
The client base is large, extremely loyal and appreciates the
individual and personal clinical service that the practice offers
alongside high quality optical dispensing. With scope for further
growth this practice offers an exceptional opportunity to practice
your own brand of independent optometry.
For a confidential discussion email
Julia Saulsbury: js.visoncare@xtra.co.nz
PART-TIME OPTOMETRIST WANTED
CHRISTCHURCH
If you strive for excellence, have a keen eye for detail, enjoy
working with children, then this is your opportunity to extend
your skills and join our busy practice. No weekend work, no
late nights. The position offers 3 days a week long-term, with
flexibility of more days to start. Experience with children’s
vision testing preferred, but not essential as training will be
offered before starting position. Interest in contact lenses and
OrthoKeratology also a bonus.
Please send your CV and expression of interest to
leza@anstice.co.nz
NEED TO REPLACE YOUR LETTER CHART?
AcuityKit has a comprehensive range of digital eyecharts for eye-care
professionals. Ideal for low vision and domiciliary work.
Visit our website www.acuitykit.com or email john@acuitkit.com
FULL-TIME OPTOMETRIST
REQUIRED - AUCKLAND
An exciting opportunity exists for an Optometrist
at Specsavers New Lynn. This is a full-time
position with a professional team that places
customer service at the centre of their interaction
with every patient.
Specsavers New Lynn offers comprehensive
optometry support including pre-testing, modern
equipment, training and continuing education.
In addition, you would be working with other
experienced optometrists with whom you can
discuss those interesting cases. The role will
require a late night and a weekend day however
we are aware of the importance of work/life
balance and provide flexibility with those days.
If you can offer excellent communication skills,
work well as part of a team, are commercially
minded and have lots of motivation then you
would be welcome in our busy, well-organised
store.
Contact Philip Walsh with your CV and covering
letter at dir.newlynn.nz@specsavers.com
CONTACT LENS SPECIALIST
FULL-TIME CHRISTCHURCH
Corneal Lens Corporation (CLC) is seeking to
employ a consulting contact lens specialist. CLC
has built a solid reputation for delivering a highquality
product and service since 1971, today
they have one of the most modern contact lens
laboratories in Australasia.
Employed as a consultant, your role will be to
support practitioners with contact lens fitting,
while taking full advantage of the very latest
technology such as SMap Topography Data
fitting, Icloud simulated fitting and Topography
fitting of contact lenses.
You will also support managerial functions and
represent CLC by attending conferences and
workshops around the country as required.
• Flexible start date
• Salary and package terms by negotiation
• Experience with and a passion for contact
lenses is strongly preferred.
Great employer, a highly innovative company
located in a great location, does this sound like
you?
Applications (CV and cover letter) to stu@
opticsnz.co.nz by 5 pm, Thursday 20 April 2017.
For more information, please email or call
(03) 5466 996 or 027 436 9091.
WORK AS YOUR
OWN BOSS
At OPSM, we are passionate about opening eyes to
the unseen. Our advanced technology enables us to look
deeper to ensure we give the best care to every customer.
OPSM in New Zealand is looking to expand their Locum
Optometrist network.
LOCUM OPTOMETRISTS – NEW ZEALAND
As a locum you will be your own boss, you will have
the flexibility to set your own hours and will be exposed
to lots of different patients and locations across New
Zealand all while gaining lots of skills and experience.
We are looking for Optometrists who share our passion, are
willing to learn quickly and want to join our customer focussed
teams in making a difference to how people see the world.
WHAT’S ON OFFER:
• Great working environment
• Fantastic locum rates $$
• Accommodation and flights
• Latest technology
• Luxury brands
• New friends and having fun
GLAUCOMA NZ PROFESSIONAL
EDUCATION PROGRAMME
2017 Programme Open
for Enrolments!
• The online web-based Professional Education Programme is
approved by the ODOB for a maximum of 10.5 Clinical Diagnostic
(CD) Credits
• The programme consists of seven new cases each year – each
with a case history, questions and answers for self-directed
learning, followed by an associated web-based examination
• Successfully passing all cases awards 10.5 CD credits.
While mainly directed at optometrists, the programme is open to
anyone in eye health, including orthoptists, nurses and technicians.
For further information please visit www.glaucoma.org.nz
JOIN OUR TEAM
For a chance to be your own boss and part of an amazing
team, contact us for a confidential, no obligation chat.
CONTACT:
Hirdesh Nair
hirdesh.nair@opsm.co.nz or call +64 21 523 282
Robbie Singh
robbie.singh@luxottica.com.au or call +64 21 750 847
OPSM.CO.NZ/CAREERS
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NEW ZEALAND OPTICS
23

MORE CLASSIFIEDS ON PAGE 23
THE BEST OF
BOTH WORLDS.
OPPORTUNITY KNOCKS IN
WELLINGTON & CHRISTCHURCH
PALMERSTON NTH
& SHIRLEY
OPPORTUNITIES
AVAILABLE TODAY!
ISLANDS
As 2017 gathers pace, so too do the opportunities
for optometrists at all stages of their careers in
and around both Wellington and Christchurch.
A total of seven Specsavers stores are available for you
to choose from – and we have multiple positions available,
depending on your experience. We have graduate positions,
full-time roles, locum opportunities – and we can even
discuss the pathway to partnership if you believe you are
ready to look at store ownership.
Whatever your situation, there has never been a better time
to talk to our team about what roles are available now and
what is in the pipeline. While 2016 was another year of strong
growth for Specsavers stores across New Zealand, 2017
promises just as much for those looking to develop
their careers.
Talk to us now and we can tell you about great
rates of pay and our unrivalled professional
development program.
Contact Chanelle Coates on 0800 717 350 or
chanelle.coates@specsavers.com
SEE OUR PALMERSTON NORTH AND SHIRLEY
OPPORTUNITIES ON SPECTRUM-BLOG.COM
EXPERIENCED OPTOMETRIST
FULL-TIME WHANGAREI
Busy independent practice in Whangarei is seeking to employ an
optometrist with a minimum of two to three years experience.
The practice is well-respected for its clinical strength and only
uses first-class optometry equipment.
• Start date mid-May 2017
• Salary and package terms by negotiation
• Future opportunity to explore a shareholding in the business
Great employer, great location, does this sound like you?
Applications (CV and cover letter) to stu@opticsnz.co.nz by 4pm,
Thursday 20 April 2017. For more information, please email or
call (03) 5466 996 or 027 436 9091.
DISPENSING OPTICIAN
WELLINGTON CBD
CapitalEyes Optometrists require a
Dispensing Optician for our city practice.
We work as a team to provide high quality eyecare, eyewear and
customer service. We consider our dispenser as an integral part
of the team.
This role also includes frame stock purchasing and has the
potential for manangment responsibilities to the right
applicant.
So if you’re ready for the next step up in your career, then this is
the role for you.
For more info contact Kevin O’Connor on 027 4993451 or email
kevin@capitaleyes.co.nz
All applications treated in strict confidence.
CHOOSE YOUR
AUSSIE ADVENTURE
WE SEE YOUR
FUTURE WITH US
At OPSM, we are passionate about opening eyes to
the unseen. Our advanced technology enables us to look
deeper to ensure we give the best care to every customer.
At OPSM, we are passionate about opening eyes to
the unseen. Our advanced technology enables us to look
deeper to ensure we give the best care to every customer.
OPTOMETRISTS
QUEENSLAND AND NORTHERN TERRITORY
WITH ATTRACTIVE SALARY PACKAGES
We are looking for Optometrists who share our passion
and want to make a difference to how people see the
world. Whether you like the city, the surf or the outback,
we’ve got the role for you with our teams in:
• Bundaberg
• Darwin
• Katherine
• Mackay
• Mt Isa
• Toowoomba
• Townsville
JOIN OUR TEAM
You can look to take on a fixed period role or even
consider a more permanent move - who knows, you might
fall in love with the place. Depending on the location,
salary packages up to 175K including superannuation,
accommodation, annual return flights to visit family and
friends and relocation support for the right candidate.
Start your journey with us today! Graduates or recent
graduates are very welcome to apply.
OPTOMETRISTS
NORTH & SOUTH ISLAND, NEW ZEALAND
Our New Zealand business is looking for passionate
Optometrists to join the team.
• Whangarei – full time
• Wellington Float – full time
• Thames – full time
• Dunedin – full time
• The Plaza – full time
• Napier/Hastings – 32 hours per week
When you join OPSM, you work within a team who
are committed to providing the best possible eyecare
solution with exceptional customer service. You will work
with world class technology including our exclusive
Optos Daytona ultrawide digital retina scanner. You
will have many opportunities for continuing professional
development and can enjoy career flexibility through
our extensive store network. You can also make a
real difference in the way people see the world by
participating in our OneSight outreach program.
JOIN OUR TEAM
Start your journey with us today! Recent graduates are
very welcome to apply.
CONTACT:
Brendan Philp
brendan.philp@luxottica.com.au or call +61 418 845 197
Kim Shepherd
kim.shepherd@opsm.com.au or call +61 408 763 575
CONTACT:
Hirdesh Nair
hirdesh.nair@opsm.co.nz or call +64 21 523 282
Robbie Singh
robbie.singh@luxottica.com.au or call +64 21 750 847
OPSM.COM.AU/CAREERS
OPSM.CO.NZ/CAREERS
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24 NEW ZEALAND OPTICS April 2017