Dec 2015

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY
PO BOX 106 954, AUCKLAND CITY 1143
Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz
December 2015
Platinum Partners Cover3.indd 1
December 2015.indd 1
16/11/2015 11:56:33 a.m.
19-Nov-15 3:26:37 PM

CALLING ALL
UK OPTOMS!
…WANT TO STAY IN
NEW ZEALAND OR AUSTRALIA?
Go to
spectrum-blog.com
for all the current
opportunities!
With a significant shortage of optometrists being
experienced across the optometry profession
in metro, regional and rural areas, we’re calling
all UK and Irish optometrists currently in
New Zealand and Australia to talk to us. We have a
wide range of opportunities for you to consider.
Across the two countries this year we will open
15 new stores and expand a further 65 stores
with additional consulting rooms and the latest
automated equipment – and we need to beef up
our professional team to meet demand, as it rises.
About you
You’re an OCANZ qualified optometrist and already
working (or due to work) for the length of your
current working visa – but you would like to stay
on for longer, or even permanently.
We can help
If that sounds like you, we should talk.
Lately, more and more OCANZ qualified UK
and Irish optometrists are asking us about
staying in either New Zealand or Australia
for the longer term and we have the
roles available to make that goal a reality
in both countries.
Let’s get the conversation started
Whatever your goal, both short and longer
term, now’s the time to talk to our professional
recruitment team members about the options for
employed and partnership roles – they’re ready to
talk to you right now.
In the first instance contact Raj Sundarjee on
0800 773 077 or raj.sundarjee@specsavers.com
NZ Franchise
System of
the Year
2014
Retail
Innovator
of the Year
2014
Multichannel
Retailer
of the Year
2014
Roy Morgan
Research
No. 1 for eye tests
2014
FCA International
Franchisor
of the Year
2014
FCA Social
Responsibility
Award
2014
FCA Established
Franchisor
of the Year
2013
FCA Excellence
in Marketing
Award Winner
2013
Australian
Retailer
of the Year
2013
Australian
Retail Employer
of the Year
2013
Asia-Pacific Best
Retail Training
Organisation
2013
2 NEW ZEALAND OPTICS December 2015
December 2015.indd 2
19-Nov-15 3:26:38 PM

Strategy for
distinction
Coopervision’s Joe Tanner with Indie Grewal
Indie Grewal knew he had to find a point of difference when he
opened his optometry practice in 2001. At the time, the town of
St. Alban’s—a half-hour’s commute north of London—already had
seven practices servicing a population of 57,000.
Grewal started with an idea borrowed from his former employer
to do away with trial frames and lenses, relying strictly on a digital
autorefractor instead. Grewal thought the concept “blew the idea of
eye examination” out of the water, simply because nobody else was
doing it, and that informed his thinking for developing his practice.
“We wanted to take that idea to St. Albans with us,” Grewal told an
audience of nearly 100 optometrists at a presentation in Auckland on
October 14. “I wanted to wow people when they came in for an eye
examination….We took a lot of time in our exams, talking to people
and at first we wondered why they were walking away, but they came
back to us in time, because we had talked to them.”
Grewal’s efforts over the last 15 years helped him survive the global
financial crisis and thrive in a market that by some measures is far
more grinding on independents than in New Zealand. In addition
to corporate chains and online competition, in the UK retailers such
as Wal-Mart also employ optometrists to provide some form of
vision test, relying on the speed of the transaction and reinforced by
economies of scale to turn a profit.
“At Tesco you can have an exam that costs you £15. I can’t see how
they make money unless they are literally churning out customers.
Interestingly, optometrists at Tesco, when they’re not busy , have to
stock shelves,” said Grewal.
Grewal’s presentation, Growing an optometry business in a highly
competitive environment, offered a case study in lateral thinking. The
presentation was part of an antipodean seminar tour, sponsored by
Coopervision.
While Grewal runs an independent practice, it is still part of an
association of 30 practices throughout suburban England, he said.
“I was lucky to have flexibility, as long as I gave them business plans.”
And his plans have evolved over time. With so much competition
from supermarkets, online outlets and chain optometrists (all of
which, according to Grewal, forces them to compete on price) Grewal
and his business partner went for eye exams in another town as a
research exercise.
The two things he said he found were that the big corporate chains
appeared far more interested in selling spectacles than providing
detailed eye exams—indeed, the chains did eye tests for visual acuity,
but not real exams, in his opinion, and the people who examined him
showed no interest in his particular case history, he said.
“Nobody asked me what I did for a living. Nobody asked if I had any
hobbies. Nobody talked to me about contact lenses.”
So, with the information they collected, Grewal set out to find ways
to “prevent our business from sliding.”
To do this, his practice made three major changes: it extended its
examinations from 30 minutes to 40 minutes; they began ordering
contact lenses for every person they examined who needed them; and
they began focusing on age-segments of the market overlooked by
chains, particularly children below 14 years and adults over 45.
With the extended exams, “I had a long time with each person
coming in to find out a little more about them, to get a sense of what
we could do, to create a need or to find something out about them
that they didn’t know there was a visual solution for,” Grewal said.
Stocking up on contact lenses matching patients’ prescriptions
based on the most recent refraction allowed Grewal to have further
conversations. Grewal said that for younger patients, he raises this as a
“soft conversation” with parents.
For older patients, namely presbyopes, the additional examination
time allowed Grewal to measure best sphere, binocularly, as well as
sensory dominance, which to the patient seemed to be simply part of
the basic eye examination. Grewal would ask if the patient had ever
tried contact lenses, and provided trial contacts which he had already
ordered for the patient to walk around with outdoors for ten minutes.
Grewal said the contact lens strategy is a long-term investment that
provides more profitability over time than a pure spectacle business.
The result of Grewal’s overall strategy was that after four years,
the contact lens business has become lucrative, while his spectacle
business has slowly, but inevitably recovered following the impact
of the global financial crisis. Indeed, Grewal’s competition, which
had reached 11 practices in his town in 2011, thinned out following
the crisis and is now down to nine. ▀
Happy holidays and thanks
EDITORIAL BY LESLEY SPRINGALL
With the October-November conference season finally over,
we can relax a little heading into the holiday season.
And to be honest a little rest is needed after
experiencing my first end-of-year CPD educational bootcamp-rush
and my first, albeit fascinating and highly educational, RANZCO
Congress, written up in detail in this issue.
Others also marked their own firsts. Essilor held its first
Platinum Partner conference, packed full of tips and ideas to
motivate and help optical business owners. Christchurch Eye
Surgery hosted its inaugural study day, attracting more than 40
participants from across the South Island.
Eye Doctor’s final Grand Rounds was also well-attended and
well-received, while Eye Institute attracted its largest turnout ever
with more than 275 optometrists plus 46 DOs and support staff
to its inaugural DO conference. Read about what happened at all
these events in this issue.
I’d like to extend a special thanks to our columnists and all those
who stepped in to help us with the multitude of happenings
over the last few weeks, especially our wonderful conference
contributors: for RANZCO, Keli Matheos, Sally-Anne Herring and
Sally Rosenberg, who’s channelling a rather good inner columnist;
OPSM’s Zoe Smith for covering OPSM’s Butterfly Creek gathering;
Dr Rebecca Stack for her take on the Christchurch Study Day; Dr
David Kent who was kind enough to point out my muddling of the
AUSCRS and ASCRS acronyms ever so gently; Maryanne for always
having her camera and a introductory hand ready; and finally
Get to the main
cause of dry,
irritated eyes*
How does Optrex ActiMist work?
Optrex ActiMist contains
liposomes (tiny bubbles fi lled with
moisture) that migrate across the
surface of the eyelid and collect
at the edges of the eye.
Hygienic. Can be used
by multiple people
Lasts 6 months
after opening
These liposomes mix with natural
lipids on the eyelid.
Won’t smudge
make-up
ActiMist liposomes
Convenient and
portable
Natural lipids
ActiMist liposomes
When the eyes are open the new
lipid mixture spreads over the
whole tear fi lm, and helps fi ll the
gaps to restore the damaged
lipid layer.
Suitable for use
with contact lenses
Jauli Chaitanya, a journalist
in the making who was
thrown into the thick of
things by NZ Optics at Eye
Institute’s DO conference.
I’d also like to thank all NZ Optics’ wonderful advertisers, many
of whom took time out of their busy schedules at RANZCO to talk
me through their products, introduce me to people I should meet
and offer me a friendly shoulder when I appeared a little lost.
And finally to all of you who have taken the trouble to meet us, explain
things to us and welcome us into your industry. It’s been an amazing first
few months and I’m looking forward to honing my knowledge with you all
next year, when we return with our February issue.
So from me, Simon and Kirsten (our ever so hard-working
editor and designer) and Nick (hidden behind the scenes
dealing patiently with our accounts and IT ) we wish you a very
Merry Christmas, a very Happy Holiday and a fantastically (and
hopefully, financially) rewarding New Year.
4UP TO
HOURS
RELIEF 2
CLINICALLY PROVEN
Lesley Springall, publisher, NZ Optics
Optrex ActiMist – clinically proven to work
Order stock for your practice today
FREE CALL 0800 393 564 EYELOGIC
www.optrex.co.nz optrex@eyelogic.com.au
Always read the label. Use only as directed. If symptoms persist, see your healthcare professional. †When wearing make-up, it is recommended to apply from 20cm. *Due to disturbed lipid layer of the tear fi lm. References:
1. Lee S et al. Klin Monatsbl Augenheilkd 2004; 221:1–12. 2. Khaireddin R, Schmidt KG. Klin Monatsbl Augenheilkd. 2010; 227: 128-134. 3. Pult H et al. Contact Lens Anterior Eye 2012, 35:203-207. Reckitt Benckiser, Auckland. TAPS DA1541
December 2015
NEW ZEALAND OPTICS
3
December 2015.indd 3
19-Nov-15 3:26:41 PM

Independent bricks, group mortar
Launched just last year, Essilor’s Platinum
Partners programme has grown to more
than 100 practices across the country
continues to expand.
To celebrate this growth and to explore the
potential strength of the group if it really starts to
work together, Essilor held its inaugural Platinum
Partner Conference in Auckland in November,
attracting attendance from 96 of its current 105
partners.
The information-packed, one-and-a-half day
event highlighted efforts Essilor is undertaking to
help independent practices remain independent in
a competitive market.
“You need to celebrate what makes you unique,
because that is what brings your patients to
you,” said Colin Madigan, Essilor ANZ’s director
of communications and devices, launching the
conference. “But there are also opportunities
in terms of supply-chain, public relations, the
Essilor Vision Foundation, frames and practice
management systems software. And that’s what
we want to talk to you about: how as a group
of independents you can potentially look at the
opportunity of leaning against one another,
celebrating independence, but coming together to
use your critical mass to create opportunity.”
The conference ran from November 6 to
November 7 at Auckland’s Stamford Hotel and
gave partner optometrists the opportunity to
put questions to Essilor executives, meet special
product suppliers and learn about programmes
the company has launched to help partners do
business.
Company presentations were anchored around
charismatic, professional keynote speaker Jonar
Nader, a sales, marketing and management guru
from Australia, who was employed to shake
things up a bit and empower the independent
optometrists present to get out there, to stop
worrying about corporate competition and to go
grow their businesses.
The state of things
The share of the market available to independent
practices in the country has been shrinking
over the last few decades, said Essilor ANZ chief
executive Phuong Nguyen, and the key to survival
is fighting back.
Nguyen gave an overview of the areas of practice
independents can focus on to help seize part of
their local market, including children, low vision
patients, dry eye treatment and expanding eye
exams to include OCT scans. He also mentioned
expanding sunglass sales, using practice
management systems (PMS) and purchasing
consumer packages.
Essilor provides services, products and financial
support to its partners in each of these areas and
has also begun to compete for national corporate
contracts to provide on-site eye examination services
for corporate health and safety programmes.
The bottom-line is to help independents compete
against the economy of scale enjoyed by corporate
optometry stores, said Nguyen.
“The value the big chains have is a unique
advantage as they are vertically integrated. They have
the frames, the lenses, the marketing, the systems
and they can do it all faster than we can do it.”
Associated products and finance
To even the playing field, Essilor offers a PMS
package which its independent partners can use
to coordinate a frame order with a lens so that “it
flows seamlessly behind the scene”.
Essilor also promoted E>Eye, a device that directs
intense pulsed light (IPL) flashes at the lower eye
lid to treat dry eye symptoms from Meibomian
gland dysfunction.
Christchurch optometrist and E>Eye distributor,
John Veale gave a brief presentation on the use of
E>Eye in his practice, from researching the validity
of IPL to finally using the E>Eye device as a point of
difference to bring in new patients.
Veale said he started taking ads out on radio,
after being assured of its efficacy, highlighting his
ability to treat dry eye with the device. “People
started to flood in and they came in from other
practices. They’re happy to get treated for dry eye.”
Throughout the conference Essilor discussed
opportunities to help finance new practices,
remodel old practices and purchase equipment,
including the E>Eye.
Appealing to parents
To help independents broaden services to
younger patients, Essilor has launched the Power
of Four programme: sturdy spectacles with UV
protection and polycarbonate frames designed for
affordability and a steady supply line.
Richard and Amy Suckling and John Veale
Essilor ANZ CEO Phuong Nguyen (centre) with
John and Linda Tarbutt
Joanne Hand, Liz Opie, Karen Chambers, Catherine
Churchman and Ian Buchanan
“Parents often come in and say they don’t want
their child to have an expensive frame,” said
Tim Thurn, Essilor ANZ’s director of professional
services. “You’ve all seen parents worry about
losing or breaking frames in days. But when you
can give them this package, all in front of them, for
one price, it’s so much easier.”
Essilor supplies the frames from its warehouse,
so it remains within its own logistics system
and removes worries about stocks from the
optometrists, who simply sell the model, order the
frame and the lenses.
Streamlining supplies
Thurn framed the offering as one way partnering
can streamline supply to support independents in
the service of young patients.
“If we look at the 96 businesses here, there are
potentially 96 different supply chains. That’s not
creating confusion, but it can delay the process.
Having this organised supply chain, you press a
button and you’re done.”
Servicing low vision patients
Finally, Jason Abrahams of HumanWare discussed
the products his company sells which can extend
the life-cycle of engagement with patients
suffering from low vision. “The key benefit of our
technology is independence.”
HumanWare has four main product offerings:
text to speech, magnification, reading machines
for the blind and navigation.
Abrahams said that 70% of Humanware’s market
is aged over 65, with the rest being people of varying
ages who are reaching the end of their options for
correcting vision from different maladies.
“These are vulnerable people and once lens
correction and surgery are no longer viable, that’s
when low vision products are necessary and needed.”
Optometrists do not have to pass these patients
on to the blind foundation, though that’s what
typically happens, he said. “There is a perception
that low vision is too hard to manage. That
couldn’t be further from the truth.” (See associated
story about HumanWare’s reseller offer in
November NZ Optics)
Discarding the invisible
The highlight of the first day of the conference
was the presentation given by Jonar Nader, who
spoke broadly and at length on how small-sized
business can innovate and improve their chances
of success by acting like a bigger businesses. He
also embraced Essilor’s key theme that if practices
put aside their competitive differences with other
independents, they could leverage group efforts to
win against their bigger competitors.
Underlying his thesis is the concept that
innovation is an abused term from a commercial
Renata Watene, Renee Edgar and Peter Grimmer
Cool shirt brigade: Kevin O’Connor, Geoff Sargent,
Greg Nel and Jeremy Fox
Mahir Antwan, Regan Hirst, Nick Mulder, Barbara Collis
and Diana Henderson
perspective, but it’s still an important concept
for all businesses to embrace, and that can only
happen when we “discard the baggage that
prohibits us” from thinking in new ways.
Nader used the example of Amazon.com founder
Jeff Bezos who started out having never sold a
book in his life, but turned the business of book
retail on its head because “he was not encumbered
with all the rules of doing it this way or that way.
“As he had no rules, he made them up.”
The rules or conventions of business become
“invisible” to business owners. They are the habits,
practices and thinking that have become so
routine, people stop thinking about them, he said,
but that doesn’t make them right.
Nader gave examples of “invisible” concepts,
such as the fact that pressing down on a computer
mouse is not what executes an operation, but
rather it’s letting the button go after pressing
down; or that windshield wipers are designed in
such a way they tend to push water toward the
driver’s side of the car, rather than away.
“These subtleties are the cluttering of the brain
where people can never get to the innovative point
Essilor’s Vineet Chouhan with Jenny Stewart and
Carolyn Campbell
Catherine Perry, Bruce Nicholls, Chelsey Wood and
Richard Newson
of discovery, because they are burdened by bad
news. People become so immune to what they do,
they don’t cleanse. It’s not about what you amass;
it’s about what you discard.”
In Nader’s experience, the problems facing
independent optometrists are not new and are
almost identical to those of other small businesses
in any sector.
“Your vulnerabilities are ten years old, and true and
painful, but they are not new. Nothing’s changed.”
The internet, customers moving away, increased
competition are common problems and in
deciding how to make your business innovative
and competitive, business owners should consider
what is on their “wish list” for things to accomplish
to make their businesses better, he said.
“Those just in search of revenue are likely to fail,”
said Nadar. Companies can easily find shortcuts to
increasing revenue by cutting staff, staying open 24
hours a day or other means, but while such moves
may incur spikes in revenue growth, they do not
address the business holistically. What businesses
need to grow is not cost cutting and other methods
of temporarily spiking revenue, he said, but finding
ways to get customers to pay more for their
products and services and to do so “with pleasure.”
This is very much connected to your business’
brand, which connects not only to the investment
you make in marketing yourself—which can be
helped by affiliating with a group—but to the
culture one instills in their business, said Nadar.
“Your brand is the beacon that speaks for you
while you are asleep. It’s not a logo you stick
somewhere...it’s (if a customer) would bet $10,000
that everything they think is promised by your
business will be delivered. And unless they are
confident to bet that, then you don’t have a brand.
You just have a name.” ▀
Cancer Society tick for Essilor
The Cancer Society of New Zealand has named
Essilor’s Crizal UV an approved product, allowing
it to be listed by the Society’s marketing and
product wing, Daffodil Enterprises, as a preferred
product for combating the development of cancer
Crizal is a range of no-glare lenses designed
to protect the eyes from UV radiation. The
company’s listing with the Cancer Society of
New Zealand comes two years after the Cancer
Council of Australia gave the line a similar
recommendation.
UV rays have been shown to contribute to eye
ageing and the appearance of cataracts. Typical
lenses prevent transmission of UV rays through
the front of the lens, but still allowed exposure
from the back and sides. The Crizal range includes
an anti-reflective coating on the back surface of
the lens to mitigate this.
“New Zealand has among the highest cancer
rates in the world,” said Daffodil Enterprises
manager Fiona Mawley in a video presentation.
“It’s possible to be exposed to UV light without
knowing it and our lifestyles dictate that we
want to stay outside in the light 24/7.”
The situation is similar in Australia, where,
despite high rates of cancer and awareness of UV
exposure risk, 75% of lenses sold there are still
basic CR-39 optical plastic.
“This agreement with the Cancer Society is a
way to remind us that we can do something to
make a difference,” said Tim Thurn, Essilor ANZ’s
director of professional services. ▀
www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand
For general enquiries, please email info@nzoptics.co.nz
For editorial and classifieds, please contact Simon Eskow, editor, at 027 288 5401 or editor@nzoptics.co.nz.
For advertising, marketing, the OIG and everything else, please contact Lesley Springall, publisher, at
027 445 3543 or lesley@nzoptics.co.nz.
To submit artwork, or to query a graphic, please email kirsten.newton@outlook.co.nz and copy in Lesley.
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.
4 NEW ZEALAND OPTICS December 2015
December 2015.indd 4
19-Nov-15 3:26:49 PM

Packed conference for Eye Institute
Eye Institute’s 11th Annual Scientific Conference
was another record-breaker with more than 320
optometrists and, for the first time, dispensing
opticians and support staff attending.
The inaugural, parallel dispensing opticians and
support staff conference (see separate story) filled its
room at Auckland’s Waipuna Hotel and Conference
Centre, while the main auditorium rippled with life as
optometrists attended a series of sharp, 15-minute
sessions from the Institute’s ophthalmologists and
special guest, Margaret Lam, of theeyecarecompany,
award-winning Sydney-based practices and specialist
contact lens (CL) provider.
The exhibitors’ hall and refreshment area also
teemed with life during the breaks as sponsors (see
box) caught up with all the news about the New
Zealand optical scene and delegates discussed the
new products on offer.
CL nous to grow your practice
Lam, who’s also state president of the Cornea
and Contact Lens Society of Australia, kicked off
the proceedings with an update on keratoconus
management, explaining that it is challenging to
get right, but also rewarding. “Patients literally have
sight restored they thought they had lost,” she said.
This was the first of three talks Lam gave through
the day, all designed to show how important and
rewarding (financially, personally and for patients)
it can be if optometrists develop expertise in
speciality CL management.
Her presentation, From little things, big things
grow–practice growth strategies, summarised a
number of case studies showing what a difference
optometrists can make to their patients with better
CL understanding and how that can boost referrals,
increase loyalty and so grow your practice.
In her Ocular therapeutics and contact lenses–
two peas in a pod talk, Lam provided a case study
on microbial keratitis, and gave some insight on
how to spot it. This included: sore, irritated eyes
during waking hours; round focal central corneal
lesion with indistinct, roundish borders with
positive NaFl staining; photophobia; lid oedema;
profuse epiphora; diffuse extensive conjunctival
hyperaemia; and worsening or non-improvement
of symptoms after the patient stops wearing CLs.
Tina Gao, Renita Martis, Nafisa Slaimankhel and Teresa Hsu
Treatment is with topical antibiotic and/or referral
to an ophthalmologist.
Drugs side effects, cataract surgery and AMD
The first of Eye Institute’s ophthalmologists to
take the floor was Dr Shanu Subbiah who outlined
possible ocular side effects of commonly prescribed
systemic medications. This is especially important
for older patients, he said, who are often prescribed
several drugs simultaneously which together can
throw up any number of side-effects.
The number of drugs that can cause ocular side
effects is enormous, said Subbiah. More common
ones, however, include: hydroxychloroquine
(Plaquenil) used to treat malaria and certain autoimmune
diseases, which can cause retinal toxicity
and is often characterised by the “flying saucer sign”;
bisphosphonates, used for osteoporosis, which can
cause a range of “-itis’s” including conjunctivitis,
uveitis, episcleritis and scleritis, but these should get
better if the patient stops taking the drugs; fingolimod
(Gilenya) for multiple sclerosis, which cause macular
oedema in about 1% of cases; and sildenafil (Viagra),
the infamous little blue pill that can cause users to see
everything with a blue tint (cyanopsia).
Later in the day Subbiah tackled Cataract surgery
in the presence of retinal disease, explaining how
one influences the other, and concluding that
patients shouldn’t hesitate to remove cataracts if
they have AMD (age-related macular degeneration)
as it’s often essential to allow the continued
management of their retinal disease.
DED and spotting retinal detachment
Dr Peter Hadden provided an overview of
Amy Royal, Chloe Lovell and Angeline Ng
diabetic eye disease, the extent of the problem
in New Zealand and how it damages the retinal
vasculature causing macular oedema. At minimum,
diabetics should be screened every two years; those
with mild diabetic retinopathy (microaneurysms,
a few dot and blot haemorrhages and mild lipid
exudates) should be reviewed every six months
to a year, while moderate to severe patients
(more extensive changes, plus any venous loops,
beading or other vascular abnormalities) should
be “semi-urgently” referred to an ophthalmologist.
Treatment is by intravitreal injections, usually
with Avastin as Eylea is still too expensive in New
Zealand, he said.
Hadden’s other session on the peripheral retina,
discussed what was important when doing a retinal
examination and what wasn’t. When it comes to
increasing the risk of retinal detachment, benign findings
include cystoid degeneration, paving stone or cobblestone
degeneration, reticular pigmentary degeneration,
equatorial drusen and choroidal or pigmentary
degeneration. Things optometrists should be on the
lookout for, however, include lattice degeneration, snail
tracks (which may be a variant on lattice degeneration),
retinoschisis, retinal tags, horseshoe tears and snowflake
vitreoretinal degeneration.
PDS and glaucoma myths
Professor Helen Danesh-Meyer discussed
pigment dispersion syndrome (PDS), which can
lead to pigmentary glaucoma when pigment cells
slough off from the back of the iris and float
around in the aqueous humour. Those who get it
tend to be young, caucasian myopes, usually male.
Optometrists should identify patients who are
Gary Crowley, David Roberts and Diane Pearson
A surprised Maryanne Dransfield, former publisher of
NZ Optics (now editor-at-large), receives flowers from
Eye Institute’s Dr Trevor Gray to say thank you for her
dedication to the NZ industry over the past 35+ years
“actively dispersing pigment or have blurred vision
during exercise” and monitor them carefully as it
can lead to glaucoma and retinal detachment.
Prior to lunch, Danesh-Meyer also tackled normal
pressure glaucoma, stressing the term needs to
be killed off once and for all as it “is a meaningless
statistical construct that has done more to confuse the
diagnosis and management of primary open-angle
glaucoma than it ever did to enhance it.”
Typical intraocular pressures (IOPs) can vary from
day to day, at night and when we lie flat, she said.
“IOP is a risk factor that varies in importance for
each individual person.”
Scleritis clues, marginal keratitis and laser
review
Dr Peter Ring explained how scleritis can be a
sign for all sorts ailments, including auto-immune
and metabolic disorders and a variety of bacterial
infections. Symptoms include moderate to
severe pain, often deep and boring, and waking
the patient in the morning; redness of the eye;
CONTINUED ON P18
Looking forward to seeing you
for bigger and better next year at our half day workshops on Saturday 5th of Nov
and our Sunday conference on 6th Nov 2016
December 2015
NEW ZEALAND OPTICS
5
December 2015.indd 5
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News
in brief
NEW BLUE LIGHT COATING
ZEISS launched a new scratch resistant AR coating that filters blue
light transmissions from LEDs and computer devices. The DuraVision
Blue Protect coating filters blue light in the 440nm range, which
provides protection from potential phototoxicity, while having
minor impact on the circadian day-night rhythm. Research indicates
exposure to light in the spectrum between 400 and 520nm, with a
maximum at 460nm, is required for biological processes, including
regulating the circadian rhythm and sleep patterns. However, too
much light below 460nm, could be damaging to the eye.
AUSTRALIAN SUMMER
Jono Hennessy is selling a limitededition
Summer in Australia range
of sunglasses for the 2015/2016
season. The range, designed for
women, features colour, fabric
prints and flattering shapes, with
CR39 graduated lenses from rosetinted
to oceanic. Distributed in
NZ by Phoenix Eyewear.
WINTER IS COMING
Mondottica has collaborated with Finnish design house
Marimekko on a collection of 11 eyewear styles for women using
the most popular female names in Finland. This 2015-2016
Winter (Northern Hemisphere) range—with names like Eeva,
Niina and Riita—is marked by “daring shapes, thick temples and
laser-engraved branding” emphasising the “empowered woman
equipped with a positive, openhearted and liberal approach
to life.” Sub-groups of the collection use different materials,
including stainless steel.
ILLUMINATING DYE
Researchers at the Institute of Transformative Bio-Molecules
(ITbM) at Nagoya University in Japan have developed a new
fluorescent dye that offers enhanced photostability for live-cell
imaging by stimulated emission depletion (STED) microscopy. The
dye, C-Naphox, could allow for observation of real-time biological
events over extended time frames at high resolution.
Advances in STED microscopy have enabled nanoscale visualisation
of biological systems. It allows up to 10x higher resolution in living
cells with respect to conventional microscopes by employing a
fluorescence excitation beam in combination with a surrounding
doughnut-shaped STED beam. While the molecules at the centre are
excited to a higher energy state and fluoresce, the molecules exposed
to the STED beam are confined to the ground energy state.
PFIZER, ALLERGAN TALK MERGER
Various news sources in October confirmed two pharmaceutical
giants, Pfizer Inc. and Allergan Plc, have been discussing a
potential merger. The deal, if it eventuates, would be one of the
largest mergers in the history of the pharmaceutical industry.
The Wall Street Journal broke the story, reporting that Pfizer
recently approached Allergan, but the process is at an early stage.
A merger would create a company with a combined market value
exceeding US$330 billion and would provide US-based Allergan
with a tax-haven as Pfizer is “domiciled” in Ireland.
DRY EYE DEVELOPMENTS
A study by researchers at the Keio University School of Medicine
in Tokyo, published in the Asia-Pacific Journal of Ophthalmology,
has hinted at the efficacy of oral pilocarpine in treating dry eye in
patients with Sjögren’s syndrome who are resistant to traditional
treatment. In 15 patients, the dry eye occurred as a complication
of Sjögren syndrome and was too severe to be controlled with
conventional conservative treatment. Depending on the severity
of dry eye symptoms, patients received either 2.5 mg or 5 mg
of pilocarpine, each three times per day. At 3 months, dry eye
sensation declined to 1.7 from 2.5 at baseline. Eye pain scores
also declined and tear film break-up time increased from 2.6 at
baseline to 1.6 seconds at month 1 and, finally, 3.3 at month 3.
FINE-TUNING CLs MANUALLY
A US-based company announced it is developing a contact
lens that will allow for manual adjustment of focal length to
far, middle and near-vision. E-Vision Smart Optics says it has
already developed the basic technology for application in glasses,
ophthalmic diagnostic equipment and augmented-reality headmounted
displays for the military. It recently closed a financing
round to expedite development of the contact lens, which will
contain an electric field surrounded by a near-invisible layer of
liquid crystal material powered by electrodes. These electrodes
can change the liquid crystal layer to create aspheric, hyperopic or
myopic spherical shapes.
QUEENSLAND RESEARCHER WINS INTERNATIONAL AWARD
Professor Joanne Wood of Queensland University of Technology
(QUT) has won the 2015 Glenn A. Fry Award, considered the
Nobel Prize of international optometry. Wood is considered to be
one of the world’s leading experts on visual impairment, aging
and driving. As part of the award presentation, Wood provided
a snapshot of her recent vision and driving studies, including
glaucoma and driving and investigating the impact of various
visual conditions on night-time driving and visibility. ▀
Classifying the visually-impaired
With less than one year to go to
the Rio 2016 Paralympic Games,
Paralympics New Zealand (PNZ)
threw a fundraising event to mark the
countdown and garner support.
The one-year-to-go event in September
was dubbed the Spirit of Gold. It attracted
three corporate sponsors: Cadbury, ACC and
Sanford, and celebrated the involvement of
many incumbent supporters.
PNZ relies heavily on grants, scholarships,
donations and volunteers and the
latter category now includes 17 vision
professionals who have been trained to be
National Classifiers for New Zealand.
Paralympic sport uses a standard national
and international classification system to
ensure competitors are matched properly.
The volunteer classifiers play a pivotal role in
determining an applicant’s qualification as a
“Para-Athlete with Visual Impairment” and
in assessing the classification under which a
qualifying para-athlete can compete.
“What I did last year through funding from
a High Performance Sport NZ scholarship
was to get Dr Richard Warton from Australia
to run a National Classifiers course for Visual
impairment with seminars in Wellington
and Auckland,” says Marguerite Christopher,
PNZ’s classification manager.
Christopher says to become a national
classifier of para-athletes with visual
impairment, you have to be a licensed
ophthalmologist, optometrist or orthoptist
with experience in low vision. International
classifier’s are further trained in courses
associated with a particular event and
are used to qualify para-athletes prior to
international competition. As of this writing,
none of NZ’s visual impairment classifiers
have trained for international classification.
Renee Edgar, an optometrist with
McClellan Grimmer Edgar in Wellington,
Buy-one-give-one
startup turns one
Mr Foureyes is a work in progress.
The social enterprise launched in
October 2014 under the premise
that for every pair of glasses it sold, Mr
Foureyes would donate a second pair to a
child in a low-decile school.
Ravi Dass, the optometrist who co-founded
Mr Foureyes with his wife, Stephanie Hill, is
currently filling out the paperwork required
to set up the “give-one” side of the business
as an official charity.
“We are setting up the charitable arm
because we want to make the business as
clean as possible, from an accountability
point of view,” Dass says, adding that
while there is no need to establish a formal
charity, potential investors and supporters
like to be clear on the structure.
Mr Foureyes, headquartered in Wellington,
already has an inventory of 500 glasses ready
for fitting. It is looking to work with KidsCan
to connect the glasses to the students who
need them. Dass says the company will be
piloting the partnership with KidsCan at a
school in the capital region, soon. But the
aim of the social enterprise is not simply the
provision glasses.
“That is a stepping stone to what we really
want to achieve,” Dass says. “We would like to
be actively working with parents, schools and
their communities to help identify kids who
need glasses. This is particularly important for
kids who might have undiagnosed eyesight
problems—especially hyperopia— that are
affecting their school work.”
The entire idea for the social enterprise
arose partly from Dass’s work as a locum.
“I was working at a paediatric clinic and I saw
there were some children slipping through
the cracks,” says Dass. “There are a number of
procedures put in place to pick up eye problems,
optometrists to do the eye tests, subsidised
glasses, but not everyone has a realtionship with
a GP, or takes advantage of clinics, and that’s
prevalent in low-decile schools.”
The concept of social enterprise is not
the same as a charity. As Dass says it is
was one of the 17
vision professionals
to train as a classifier.
“PNZ sent out a
message to every
optometrist to see
if we’d be interested
in getting involved. I
thought it was quite a
natural fit.”
Edgar says she has
“always been into
sports” and in her spare
time coaches a netball
team, following years of
playing the sport. In the
last 18 months, she has begun treating more
athletes in her practice, and she has also
co-authored a published research paper on
the ability of cricketers to hit a moving target
to determine if their dynamic visual acuity is
superior to non-cricket players.
“The answer was, no, it’s not,” Edgar says,
a little wryly.
Edgar says she has already participated in
one panel to determine if a new para-athlete
was eligible to compete. Initially, a panel of
at least two vision professionals assemble to
review an application. In order to be eligible to
compete, the applying para-athlete must have
impairment of the eye structure or receptors,
impairment of the optic nerves or optic
pathway or impairment of the visual cortex.
Before a new athlete can receive classification,
they must present a reference from their
ophthalmologist and a specific form that
defines the health condition and impairment
they have. The initial panel assesses the
application and conducts further tests.
“We had the first classification and four
of us got together to classify the applicant,”
says Edgar. “We kind of knew he might not
make it and testing confirmed that, but for
a business with a social aim; a business
entity that addresses a social need. Social
enterprise and buy-one-give-one models
are increasingly common overseas and Dass
has found increasing interest in the New
Zealand industry through partnerships with
lens suppliers and frame makers.
“We would love to be working cohesively
with others in the industry to achieve the
overall aim of better identification and
correction of kids’ vision problems so they
can thrive at school,” Dass says.
Dass and Hill, who has worked in public
sector research, analysis and project
management for more than 10 years,
undertook training in social enterprise
management through the Akina Foundation,
an organisation devoted to spurring social
enterprise growth. Mr Foureyes was one of
11 companies to undergo Akina’s inaugural
Launchpad programme, an “intensive
accelerator for teams with big ideas who will
benefit from support, coaching and training”
from experts. The programme includes start-up
training, mentoring and leadership coaching.
Since then, the organisation has found
a willing partner in KidsCan, a long-time
charitable organisation with a readymade
network and resources on which Mr
Foureyes hopes to piggyback as it develops
the eye screening and patient tracking that
is its ultimate goal.
Likewise, a number of lens suppliers have
shown interest in supporting the charitable
side, while one frame supplier, Proof Eyewear,
has found a kindred spirit in Mr Foureyes.
Proof, which sells wooden frames, has made
charitable work part of its fabric, donating
to eye clinics, and supporting reforestation
projects, among other initiatives.
“You’ll find there will be interest in
supporting a social enterprise,” Dass says.
“You just have to look for it and ask.”
Dass himself has been active in charitable
activities since he began his optometry career
in 2004, notably as a participant in VOSO trips,
and serving on the organisation’s board. ▀
Emma Foy and Laura Fairweather train for Rio. Picture: Paralympics NZ
us, it was a great experience.”
The PNZ website currently lists two paraathletes
with visual impairment, Emma
Foy and Mary Fisher. Foy is a para-cyclist
originally from Dargaville, who is a record
breaking, three-time gold medalist in the
UCI Para-Cycling Track World Championship
annual events. As a cyclist with visual
impairment, Foy races on a tandem with
Laura Thompson, a sighted pilot who sits
in front. Generally speaking, cyclists with
visual impairment either have low visual
acuity, less than 6/60, and/or a visual field
less than 20 degrees radius.
Mary Fisher, a student from Wellington,
is a 12-time gold medallist para-swimmer.
Fisher is classified for the individual medley,
backstroke, butterfly, breaststroke and
freestyle. In Fisher’s particular sports class
the range includes para-athletes with “a
complete or nearly complete loss of sight”
who compete with blackened goggles.
Edgar says she looks forward to continuing
as a volunteer classifier. “A lot of times we as
optometrists say, ‘here’s your vision, here’s
what do about it and there’s the door’. I think
it’s really nice to be able to give a little extra.” ▀
Innotec new
frame-lines
Innotec, a member of the Ogi Eyewear
family, has introduced two new styles to
its innovative carbon fibre line, Bowen and
Reiner.
Both styles incorporate “ultramodern
frames” designed to meet the challenge of
marrying comfort, durability and weight,
the company said in a statement.
“At just sixteen grams light, these
futuristic frames integrate stainless steel
and carbon fibre into a classic semi-rimless
shape. Pushing the frontiers of technology,
the Bowen and Reiner define a new pulse
design that is poised to propel Innotec to
the apex of high-tech eyewear.”
The Bowen frames are cut from a single
block of stainless steel, using a process
that eliminates solder-points. The temples
are “featherlight” carbon fibre around a
stainless steel core, fastened to the front
with working rivets and five-barrel hinges
for comfort and lasting fit.
The Reiner frames’ are cut from a select
block of pure stainless steel, also with no
solder-points or weak spots, with carbon
fibre temples attached to the front with
German OBE screws and working rivets,
flexible temple tips and adjustable
nose-pads.
The New Zealand distributor for Ogi
Eyewear is BTP, based in Whakatane. ▀
6 NEW ZEALAND OPTICS December 2015
December 2015.indd 6
19-Nov-15 3:26:54 PM

ODMA’s
2015
AGM
ODMA’s new chair, Optimed’s Robert Sparkes
The Optical Distributors and Manufacturers
Association of Australia (ODMA) held its
annual general meeting on November 11,
electing members to its executive committee and
appointing Optimed managing director Robert
Sparkes to replace Designs for Vision founder
Richard Grills as chair.
Grills is not vanishing from the scene, however,
being elected to serve on the executive committee,
along with Mark Altman of Device Technologies,
Phuong Nguyen of Essilor, Brad Saffin of General
Optical, Craig Chick of Hoya, Lionel Minter of Mimo
Australia, Nicole Perry of Safilo and Samantha
Crooke of Younger Optics.
A press release from ODMA referred to Grills as
the “elder statesman” of the organisation, “having
served on the board since 1996.”
During the AGM, Grills paid homage to the
volunteer leadership.
“The nine member executive committee
not only serve unpaid, but the cost to them in
business time and incidental expenses should be
recognised,” he said.
He particularly commended the three outgoing
members, Shamir Australia’s Paul Stacey, Bollé
Australia’s John Toouli and Eyes Right Optical’s
Gaye Wymond, as well as General Optical’s
Johnathon Lewis who left the board earlier this
year after serving for six years.
In other business, Grills said surveys of visitors to
the ODMA 2015 indicated general satisfaction, but
that given the absence of some frame makers, the
organisers would look for a more accessible venue
for ODMA 2017 than the one used this year.
Grills also mentioned that following the success
of the training manuals for independents—
the Optical Retail Guide and the Basic Lens
Dispensing handbook—ODMA has released a
Start Your Own Practice handbook designed “to
provide a starting point for anyone who wants to
open a new practice.”
“The booklet is based on a financial model which
can be used at any stage of a practice from start up
to retirement,” Grills said. ▀
Twitches, bumps and blebs
Eye Doctors made their final Grand Rounds
of the year on October 28 with an overview
of bumps, blebs, twitches and everything
an optometrist needs to know about commonly
used ophthalmic drugs.
Nearly 60 people attended the two-hour
session at the Novotel Greenlane; all well-fed
and feted during the ample breaks between
presentations.
Dr Shuan Dai opened with his keynote
presentation Drugs cure and drugs kill: what do
we need to know? Drugs, he said, have changed
ophthalmology for the better, but frequently
come with side effects that optometrists should
look out for.
Dr Shuan Dai with Theresa Nowak, Anne Durrant
and Dr Andrew Riley
Zane Stellingwerf and Grace Elliott
Dr Mark Donaldson with Dennis Oliver
“I remember in the old days when we treated
glaucoma and 80 to 90% of patients would need
an operation,” Dai said. “Now it’s about 10% and
most of the time the eye drops work like magic, with
minor and not very serious side effects.”
However, as with all pharmacology, drugs not used
as directed can be lethal, as in cases of intentional
poisoning in which the weapon of choice was Visine,
which at one time listed tetrahydrozoline alpha (a
vasoconstrictor) as an active ingredient.
Cycloplegic drops, such as cyclogyl, an
anticholinergic used for dilation in paediatric
eye exams, can lead to necrotising enterocolitis
if not properly diluted or if administered too
often. Dai said optometrists only have to worry
about this for children aged five and under or
those with persistent gastro intestinal issues.
In glaucoma treatment, Trusopt, or dorzolamide
hydrochloride, can cause an immune reaction
in elderly patients, while beta blockers used
at length can cause depression, occasionally
leading to suicide, trigger asthma attacks, and
cause sick sinus symptom.
“None of this is to scare you from prescribing, but
to make us all aware of our responsibility,” Dai said.
Myokymia
Dr Andrew Riley presented on Ocular Myokymia, the
involuntary muscular twitching around the eyes.
“We do see a lot of myokymia and I’m sure
you see that in your practice, as well,” said Riley
“Most of these things are nothing to worry
about. It’s important to reassure your patients.”
Myokymia typically goes away on its own, lasting
short periods of hours or days, but in rare cases it
can last up to 20 years. Myokymia is commonly
associated with fatigue, stress, lack of exercise,
poor diet, caffeine consumption and heavy alcohol
intake. In cases where optometrists can rule out
such associations, Riley advised to look out for
signs of dry eye syndrome, allergies, eye strain or
latent hyperopia.
Riley also discussed conditions that may seem
like myokomia at first, but are of a different nature.
Hemifacial spasms are unilateral twitches around
the eyes, the mouth and the lower face. They are
typically associated with the pressure of a blood
vessel stimulating a close facial nerve as it pulses.
Another condition, blephora spasm, is a bilateral
condition usually presenting with sore eyes and
most often suffered by women aged 50 to 70 years,
but with no clear pathology. As with myokymia,
blephora spasm will often resolve itself in a matter
of days, but the bilateral blinking can become
partly a habit, Riley said. Patients will attempt to
resolve blephora spasm with botox treatment,
which wears off after three to six months. Riley
said optometrists can help by advising patients to
wear ptosis crutches.
Conjunctival lumps
Dr Penny McAllum presented cases to illustrate
different kinds of lumps patients can present to
an optometrist.
In one case, a woman who was to be married
in a few months presented with a cauliflowerlike
lesion in one fornix, which was irritated and
sometimes sticky. This conjuctival papilloma,
with finger-like, vascular lesions and thick
epithelial inclusion bodies, was a symptom of
the HPV-6 virus, McAllum said, which can be
contracted by hand to hand contact. The HPV-6
strain is not associated with cancer, McAllum
added, but they can spread. Interventions
include cutting and cauterising.
Another patient case presented with a red, at
times tender, swelling at the left lower lid, which
had lasted for months, varying in size over time.
McAllum said the patient suffered meibomian
gland dysfunction, and the swelling produced
a discharge, which led her to conclude it was
a granuloma. This is a vascular tumour caused
by inflammation caused by leakage of mucous
material from the meibomian gland producing
an inflammatory reaction inducing rapid growth
of the lump. These too can often go away of their
own accord, but if the underlying cause (such
as a ruptured meibomian cyst) is not obvious,
optometrists can treat persistent symptoms with
hot compresses, massages and scrubs.
Other cases McAllum discussed were a
capillary haemangioma—a red spot filled with
corkscrew shaped blood vessels causing the
patient irritation and intermittent watery eyes;
a conjunctival mixoma—a benign tumour filled
with mucous; and a cyst over a conjunctival
incision from previous squint surgery.
Blebs
Bleb Needling ab interno
Finally, Dr Mark Donaldson discussed bleb needling
to treat complications rising after trabeculectomies,
particularly sight-threatening infections.
According to Donaldson, 1 to 2% of
trabeculectomies result in bleb-related
infections within five years of glaucoma surgery.
There is a higher incidence rate among thinwalled
cystic blebs, which Donaldson said
happened to be the kind of bleb that has the
best pressure-lowering impact.
Infections can take years to present and, over
time, a patient may not associate eye problems
with a trabeculectomy, putting the onus on
optometrists to remind such patients to seek
help should symptoms, such as redness, blurring
and eye pain, arise. ▀
Personalised eye care
every time.
EYE 0764
‘Seasons greetings from the team
at Eye Doctors’
Ascot Hospital call (09) 520 9689
Botany Junction call (09) 277 6787
www.eyedoctors.co.nz
December 2015
NEW ZEALAND OPTICS
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December 2015.indd 7
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SPECIAL FEATURE: RANZCO Congress
Notes from the lecture hall
BY KALIOPY MATHEOS*
The 47th RANZCO Annual Scientific Congress offered an
action-packed scientific programme with an amazing array of
international speakers and local experts.
The calibre of speakers at this year’s event testifies to RANZCO’s
success year after year, attracting leading overseas ophthalmologists
from Australia, the UK, the US and Canada, who presented the latest
in eye research and developments in cataract surgery, glaucoma and
uveitis, to name but a few topics.
Day one: Sunday
The congress commenced on November 1, with several speakers
presenting as part of an Ophthalmic Research Institute of Australia
(ORIA) session. This covered recent progress in understanding the
genetic basis of corneal dystrophies, corneal cross-linking, RPE stem
cell development and applications and new techniques for genetic
manipulations.
Keynote speaker Dr Randall Olson, chair of the department of
ophthalmology and visual science at the University of Utah School
of Medicine, gave the Cornea Update Lecture. A vibrant and practical
presentation, demonstrating how to respect the corneal endothelium
in cataract surgery.
Next Associate Professor John Grigg, head of the Discipline of
Ophthalmology at The University of Sydney’s Save Sight Institute,
gave an insightful overview of the challenges posed by childhood
visual impairment in the annual Council Lecture. Grigg illustrated the
importance of an effective screening programme to detect childhood
Ashton Lindsay, Courteney Lindsay, Drs Jessica and Alistair Papali’i-Curtin
refractive error, and how it rated amongst the most common causes
of childhood disability. He went on to discuss other childhood visual
problems such as cataract, paediatric glaucoma and uveitis reminding
the audience these rare eye diseases are more common than childhood
cancers and cystic fibrosis. Delegates were also given a taste of
emerging new technologies, such as gene-splicing, that potentially will
change the future of diagnostic and therapeutic treatment options.
Day two: Monday
The Best Paper presentations demonstrated the high standard of
research within the ophthalmological community, from the most
junior medical students through to the most senior experts within
each specialty.
Dr Nitin Verma, Suzie Tegan and Drs Stephen Best and Iain Dunlop
Dr Mike O’Rourke, Chantel Burton and Dr Andrew Thompson
3891_bp_wish_NZO_185x260.indd 1
8 NEW ZEALAND OPTICS December 2015
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The John Parr Trophy was awarded to Jessica Trollip for her
presentation on New Zealand laser treatment for retinopathy
of prematurity in the era of ETROP: a ten year outcome. Trollip
presented a retrospective review of 143 patients treated with laser
for ROP from 2005 to 2015, showing the long-term outcomes for
these children appeared more successful compared to international
data, with favourable ROP regression rates.
The Gerard Crock Trophy was awarded to Professor Mark Gillies
for his presentation titled Long-term outcomes of treatment of
neovascular age-related macular degeneration: data from an
observational study, focusing on outcomes of treatment-naïve eyes
with neovascular ARMD using anti-VEGF. Gillies concluded that the
long-term outcome in terms of change in visual acuity appeared
good with a mean improvement of approximately 6.3 letters after six
months of treatment. Visual acuity also appeared to remain better
than pre-treatment acuity for at least a six-year period.
Professor Tin Aung, executive director of the Singapore Eye
Research Institute, presented an update on angle closure glaucoma.
Aung asserted that glaucoma is not a simple disease, as viewed
traditionally. For Angle Closure Glaucoma (ACG), there are many
and variable mechanisms by which the angle can close and there
are many genetic factors associated with ACG. Aung discussed
the increasing evidence clinicians can rely on in choosing an ACG
treatment approach, specifically Selective Laser Trabeculoplasty and
lens removal.
The Sir Norman Gregg lecture was given by Professor Peter
McCluskey, director of the Save Sight Institute at Sydney University,
who presented delegates with an overview of scleritis and a review of
clinical and research-based perspectives from the last 30 years.
The current system of classifying scleritis as nodular or diffuse, he
said, is still valid and useful. Identifying and adequately treating the
underlying systemic disease has improved over the decades, to the
point that complications from scleromalacia perforans, for example,
are rarely seen today.
The Plenary Symposium on Cataract Surgery in 2015 was a novel
and well-executed session with Clinical Associate Professor Michael
Lawless, of Sydney University, leading an “interrogation” of experts
including Drs Ike Ahmed and David Kent and Professors Charles
McGhee and Randall Olsen.
The panel compared their preferences in the management of
various problems commonly encountered clinically and in surgery.
It was refreshing for those of us on the bottom rungs of the surgical
ladder that more than one “correct” and safe approach exists to
manage problems arising in anterior segment surgery.
That afternoon Professors Stuart Graham of Macquarie University
and Jonathan Crowston of Melbourne University chaired a Diagnostic
Dilemmas in Glaucoma discussion. Professor Helen Danesh-Meyer
of Auckland University discussed when to suspect a patient has
more than a “typical glaucomatous progression”. She illustrated the
clinical features that would favour a glaucoma diagnosis compared
to those that would not, reminding all to correlate clinical findings
with the nerve appearance. If progression appears inconsistent with
the vision, visual field or colour vision, neuroimaging is required to
exclude a non-glaucomatous optic neuropathy. Sydney University
Associate Professor Paul Healey undertook a journey through
iridology demonstrating that trauma, inflammation and proliferative
disease can induce iris changes which can help tell a story of
glaucomatous pathology if the clinician is in tune to interpret the
changes demonstrated.
Later in the afternoon delegates had the opportunity to view the
posters and films while being treated to craft beer and dumplings.
This year’s winner of the Community Ophthalmology film was Dr
Angus Turner, McCusker Director of Lions Outback Vision, with Beat
that Sugar. While the winner of the surgical technique section,
and overall winner, was specialist cataract surgeon Professor Rasik
Vajpayee of the Vision Eye Institute with Intrastromal fluid drainage
with air tamponade: anterior segment optical coherence guided
technique for the management of acute corneal hydrops.
CONTINUED ON P10
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December 2015.indd 8
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SPECIAL FEATURE: RANZCO Congress
CONTINUED FROM P8
Day three: Tuesday
Dr Ike Ahmed, from Credit Valley Eyecare in Canada,
presented surgical videos of difficult cataract
procedures, demonstrating the techniques that
have earned him his reputation in the diagnosis and
surgical treatment of highly complex eye diseases.
WA University’s Prof. Dao Yi-Yu’s Ida Mann
Lecture Research discoveries to clinical application:
Developing a new glaucoma filtration surgery,
gave the audience an account of his methodical
approach to developing an effective aqueous stent,
providing insight to the immense time and effort
required to develop new treatments in eye disease.
The Ethics and Professionalism session chaired
by Dr Arthur Karagiannis, from the SA Institute
of Ophthalmology, proposed some challenging
questions to Dr Linda Swan, Prof. Peter McCluskey
and Chai Chuah, director-general of NZ’s Ministry
of Health. The session illustrated the challenges
health professionals face to deliver effective health
interventions (with ever-expanding treatment
options) against the reality of limited funding.
Tuesday concluded with a formal Congress
dinner at parliament house no less. This was a
great occasion executed in an amazing venue,
treating the delegates to fantastic food and some
light-hearted musical entertainment thanks to
2015 Congress Convenor Dr Keith Small and Kiwi
ophthalmologist-in-training Alistair Papali’i-Curtin.
What a wonderful way to bring the Congress to
a wind-down and showcase some of the hidden
home-grown talent this little windy city has to offer.
Day four: Wednesday
The final day saw Associate Professor Anthony
Kwan, from the QLD Eye Institute, chair ANZSRS
evidence based guide to management of dilemmas
in retinal diseases, covering often tricky areas in the
management of retinal conditions ranging from
prophylactic treatment of Sticklers Syndrome to the
current role of scleral buckling. Later Drs Jo Sims
and Ehud Zamir chaired Ocular inflammation in the
complex patient, covering current management
protocols for uveitis in the immunocompromised,
immunosuppressed patient.
In summary, the 47th RANZCO Annual Scientific
Congress showed ophthalmology to be an everexpanding
area with a constant flow of new
insights and advancing technology. ▀
* Dr Kaliopy Matheos is a trainee ophthalmology registrar,
currently working at Greelane Clinical Centre, Auckland.
Congress 2015: a breath of fresh air
BY DR BRAD HORSBURGH, PRESIDENT RANZCO
RANZCO chair Dr Brad Horsburgh and past
chair, Dr Stephen Best, showing there’s no
hard feelings after watching the RWC final
at RANZCO 2015
Awards recognise service
The highlight of every RANZCO
Congress is the graduation and
awards ceremony where several
ophthalmologists are recognised for the
years of service they have given to the
College and the community.
At this year’s event the guest of
honour was Sir Geoffrey Palmer who
recited some interesting medical
cases he has been involved with as
a lawyer.
The College Medal was presented
to Associate Professor Ivan Goldberg
for his leadership and dedication
to colleagues and the broader
ophthalmic community. Dr Stephen
Cains also received the College
medal for his selfless dedication and
leadership.
The Distinguished Service
Award was presented to Professor
Stuart Graham, while Wellington
ophthalmologist Dr Peter Wellings
Wellington, you did us proud!
As host city for our 47th
Annual Scientific Congress,
you enabled the College to stage a
gathering that truly delighted not only
our senses but our intellects too.
To the Scientific Program
Committee, we owe a vote of thanks
for a star-studded line-up of speakers
who challenged our orthodoxies and
dared us to push the boundaries of
our understandings ever further.
No matter what the subject, if
you listened you learned. And that
is the backbone of our beloved and
wonderfully complex discipline. Never
can we know it all. Our path is one
of constant learning and the insights
was awarded the Meritorious Service
Award by the NZ Branch for his
outstanding contribution to clinical
and academic ophthalmology in New
Zealand and Australia.
In private practice since 1976,
Wellings has an enviable reputation
for being an astute diagnostician,
an excellent physician and surgeon
and a demanding and inspiring
teacher, the audience was told.
An outstanding example of the
comprehensive ophthalmologist
the College aims to produce today
Wellings was also credited for
his long involvement with the
Ophthalmological Society of New
Zealand and the Royal Australian
College of Ophthalmologists.
A Distinguished Service Award
was also given to Christchurch
ophthalmologist Associate Professor
Mark Elder, a past chair of the
we gleaned from our colleagues in
Wellington will, above all else, enable
us to continue delivering the best
possible care to our patients and the
broader community.
To our newly-admitted Fellows,
we all offer congratulations. Your
graduation ceremony is one of
life’s most memorable occasions.
Cherish this reward for your years of
discipline and dedication and enjoy
the supportive fellowship of a most
remarkable group of people who share
your passions and ideals.
Congress is always a time for renewal
of old friendships and the flourishing of
new ones. To talk shop with colleagues
in a convivial atmosphere is one of the
Our new Kiwi Fellows (from left): Drs Anne-Marie Yardley,
Logan Robinson, Nathan Kerr, Genevieve Oliver, Jern Yee
Chen and Jesse Gale
NZ QEC and chair of the board of
Ophthalmology Path Examiners and
the College accreditation processes.
The new College Fellows were
presented, among them six New
Zealanders: Drs Anne-Marie Yardley,
Logan Robinson, Nathan Kerr,
Genevieve Oliver, Jern Yee Chen and
Jesse Gale, who had the honour of
reading the College Oath.
great pleasures and benefits of this
annual gathering.
To experience the attractions and
differences of a new city each time
imparts a sense of occasion that
is unique to each Congress. In this
regard, New Zealand hospitality was
an absolute winner! How could we
not be entranced by the extraordinary
natural beauty of the country and the
specific delights of Wellington?
This Congress demonstrated the
admirable strength that a trans-Tasman
College can enjoy. It is something we
should never take for granted.
And so, Melbourne in 2016. I hope
I can meet you all again to share a
new collection of warm memories. ▀
Dr Peter Wellings with his wife Gillian and Drs Bruce and
Wendy Hadden at RANZCO’s awards ceremony
Two New Zealand ophthalmologists,
Drs Stephen Guest and Antony
Bedggood, were among the Trainers of
Excellence recognised.
And finally, a special Certificate
of Appreciation was given to Neil
Forbes, editor of Australian trade
magazine Insight, for his contribution
to ophthalmology throughout the 40
years he has published. ▀
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Orthoptic Scientific Conference 2015
BY SALLY-ANNE HERRING*
This was the first time the New Zealand
Orthoptic Society Inc ( NZOSI) has had the
pleasure of welcoming the Orthoptics Australia
Conference to our shores. Elizabeth Gately-Taylor,
orthoptist from the Wellington DHB provided a
welcome greeting and introduced the Kapa Haka
group to the welcome reception dinner.
The feedback received from the event was
excellent, which boded well for good international
relations. Even the early morning start on Sunday
for the Rugby World Cup, and the less than
favourable outcome for half the delegates didn’t
dampen the atmosphere!
Lisette Wesseling, a Braille teacher and lecturer for
the Blind Foundation NZ (as well as a professional
soprano), gave the welcome address on the Monday.
Profoundly blind, she provided an insight into
how Braille is still providing an independent, selfmotivating
avenue to allow those with no or partial
vision to widen their horizons and explore the world
of literature and science. New apps are now available
that link with a refreshable Braille board and iPads or
computers, so this ancient medium is still expanding
in use in the 21st century.
The highlight, from my perspective, was the Pat
Lance lecture from invited speaker Dr Fiona Rowe, a
highly regarded UK orthoptist. Her recent research
into vision problems post-stroke consolidated the
importance of the orthoptist to provide information,
advice and treatment to enable speedy rehabilitation
of those afflicted. Liaising with other therapists
regarding vision problems allows a more holistic
rehabilitation programme to be established reducing
the financial health burden to the hospital system.
Dr Rowe has even drafted professional best practice
guidelines to assess patients within one month of a
stroke. This does not occur in Australasia due to a lack
of resources namely, staffing and funding.
This linked well with my presentation, which I
gave on behalf of AHANZ (and followed a talk by
Neryla Jolly from the AHPA—the NZ and Australian
Allied Health forums respectively) regarding the
strengthening of inter-professional ties to benefit
the health of our wider populations and the
critical role we, as Allied health professionals, play
in speeding patient discharge from hospital and
maintaining their mobility and independence so
they can remain in the community.
The Myopia Symposium generated a good
interactive panel discussion. Ian Morgan gave
an excellent resume of the emerging epidemic
of myopia. Others then widened the topic with
feedback from recent research showing the current
emerging trend of outdoor light intensities delaying
the progression of myopia. Updates on research
and treatment protocols for Ortho-K and low dose
atropine showed current best practice appears to be
leaning to 0.001% atropine for highly progressing
myopia to delay this over the longer-term. It will be
interesting to see what the future holds in this area.
The low vision session highlighted new aids,
the pros and cons of optical vs electronic options
and other training techniques to maximise vision,
cataract, retinal, strabismus and paediatrics and
the growing issue of diabetes and ophthalmic care
provision.
As New Zealand orthoptists mainly work in
the field of binocular vision, strabismus and
paediatrics, it was good to attend lectures on these
subjects and to have our current practice reinforced
as best practice by those speaking.
We also took the opportunity to hold our
AGM due to the good number of attending NZ
orthoptists. Carly Henley (Auckland) remained
as President and Tammy Miller (Auckland) as
Treasurer, while I handed over the reins as
secretary, after 9 years, to Libby Kelly (New
Plymouth). Lora Parsons (Christchurch) will take
over as IOA rep from myself and Carly. The Next
AGM will be held in conjunction with the RANZCO
and NZOSI meeting in May 2016 in Dunedin. ▀
* Sally-Anne Herring is a part of the Eye Surgeons of Hawkes Bay
practice, an employee of the Hawkes Bay DHB and a regional
specialist in eye movement disorders and their treatment. She is
secretary of the New Zealand Orthoptic Society Inc. and an executive
officer of Allied Health Aotearoa New Zealand (AHANZ).
10 NEW ZEALAND OPTICS December 2015
December 2015.indd 10
19-Nov-15 3:27:01 PM

SPECIAL FEATURE: RANZCO Congress
RANZCO practice
manager’s conference
BY SALLY ROSENBERG*
For those of us who braved the early hours of November 1 to
watch the All Blacks decisively beat the Wallabies there was no
more fitting start to a conference designed as a New Zealand and
Australian joint meeting. We Kiwis felt well proud of our efforts on the
field and could therefore hold our heads high throughout a conference
which had a strong Australian influence.
Not that that is a bad thing—on balance Australia has 40
ophthalmologists per million, whereas New Zealand only has 26
and the number of practices differs greatly too. However, the kinship
the practice managers felt when discussing issues such as privacy
and information security, how to manage doctors with persistently
‘lingering’ clinics and how to manage the balance between workplace
roles and friendships spanned ‘the ditch’ without a problem.
Lisa Hartley (RANZCO’s practice managers group chair) and her
committee are to be congratulated on a thorough programme and
speakers of calibre and sufficient variety to keep that post-lunch
session free of the often troublesome desire to snooze. My one
niggle would be that there should have been an explanation of
housekeeping at the venue and reminders throughout the day.
Timekeeping during the sessions would also have been useful.
Not downplaying any speakers not specifically mentioned,
highlights for me, included Scott Bell’s opening session on marketing
the practice; the Medical Insurance Group’s (miga’s) eye-popping
stories; the update from RANZCO CEO David Andrews; the Real
Learning Experience founder Simon Thiessen’s talk on leadership; and
David Wenban, managing director of the Australian Health Industry
Group, on performance management.
Bell, from Nexus Day Hospitals, engaged us all in a table top exercise
identifying what we use for ‘marketing’ our practices, having first
provided a good background and definition of marketing. Debunking the
marketing = advertising myth was the key message. Our group exercise
identified many elements of brand strategy and promotion, the other
two cornerstones of marketing. The footer on practice emails through
to the use of face-to-face visits, signage in rooms, uniforms and public
education events are all opportunities to market beyond advertising.
Bell’s research indicates that the number one marketing tool is
the patient letter or report back to the referrer. His data shows that
making a special effort to personalise that communication will
generate more new referrals than any other method.
Patient complaints form the basis of most legal action against both
doctors and, increasingly, against practices in Australia. Although New
Zealand has the Accident Compensation Corporation (ACC), which
is a shield against most medico-legal claims, the miga presentation
was still relevant. Mitigating the risk of legal action arising from
complaints, the majority of which are about treatment received, is
important for any practice. Mitigation can take the form of sending
a note to a referrer about persistent non-attendance of a patient,
documenting phone calls attempting to rebook and training staff to
recognise urgent cases. Miga advise this training should extend to all
front-line staff as they are often the first point of contact.
I could not write this article without mentioning MDFA and MDNZ. As
a well-established organisation Macular Disease Foundation Australia
have set the bar high and offer a wealth of programmes, services and
research. The A$2.8million in research grant money it provided this year
will no doubt lead to discoveries about how to manage a pervasive health
issue. The advocacy role played by the Foundation to central Government
is extremely important to keep macular disease front of mind and
therefore more likely to attract further funding. Its early days for Macular
Degeneration NZ and the population here has a long way to go simply
in terms of awareness. However, the helpline, public education and free
online CPD course for medical professionals are all effective steps in a
pathway to management and relief for those with macular degeneration.
Keep up the good work!
The update from David Andrews provided a good balance between HR
advice on performance appraisal and learning needs analysis. Andrews
reminded us that the RANZCO Employee Assistance Programme is
available to all members’ practices. One unanswered question, however,
is the benchmark of staffing ratio per doctor in practices. That could be a
challenge given the spectrum of single doctor practices through to multidisciplinary
businesses but one we should not give up asking.
Simon Thiessen and David Wenban provided two excellent sessions
on leadership and performance management, separated by a panel
discussion on leadership and a technical update about laser-assisted
cataract surgery. Both of these sessions were aimed at the chunky
end of the challenges practice managers face every day. Impactful
messages from both included “you manage ‘things’, you lead people”
and “process protects everybody”.
The two presentations were well timed for day three of the
conference as they included elements of management that could
be absorbed and personalised to each practice’s needs. Delegates
had created such good collegiality by day three that we were able
to compare and contrast our own situations and learn from others,
providing some good final discussions from the conference.
Why were these particular sessions highlights for me? Because the
response of the delegates in the room and the engaging conversation
afterwards meant the benefits were easily learned. That said, every
delegate will have his or her own take on the conference; there were
plenty of notes being taken throughout.
Overall I’d like to extend a thank you to the organisers of the
conference. The topics were relevant, meaningful and, for most
people, there would have been take out ideas that could be
implemented. After all, we are practice managers. ▀
* Sally Rosenberg is practice manager of Hamilton Eye Clinic. She was also a speaker
at the Practice Managers Conference, giving a fascinating account of what happened
when fire damaged her practice earlier this year and providing several invaluable crisis
management tips, leading to acknowledgements for a job well done.
RANZCO: What’s new
The exhibitors’ hall at the 47th RANZCO
Scientific Congress was abuzz with
chat about new products, including
the latest developments in cross-linking,
intraocular lenses (IOLs), software, scanners
and OCT angiography. But for many of the
exhibitors NZ Optics spoke with, the congress
was as much about catching up with the
doctors, practice managers and news, as
introducing new products and promoting the
success of older ones.
AFT Pharmaceuticals
“Activity on the first day of any congress is
always mix-and-mingle and ‘where are my
mates’,” said Ben Olsen, AFT Pharmaceuticals
key accounts manager.
Given the ever-increasing interest in dry eye,
Olsen was kept busy throughout most of the
conference demonstrating the correct use of
AFT’s Hylo-Fresh and Hylo-Forte multi-dose,
preservative- and sulphate-free eye drops
for post-operative lubrication and dry eye
treatment. The bottles are designed to deliver
the same dosage with each application, with a
pump system that keeps the drops from going
back into the reservoir and an anti-bacterial
strip, all to prevent contamination.
“A patient will go to the pharmacy for their
dry eyes, and they’ll use anything because it
Dr Will Cunningham, Professor Helen Danesh-
Meyer and Dr Narme Deva
is cheap,” Olsen said. “But, for older patients,
the dosage can be inconsistent, and many will
ultimately seek a more effective treatment
if their dry eye persists. The advantage of
Hylo-Forte is because its viscosity is so high,
and the size of the nozzle allows to express at
a horizontal level, they can apply the product
easily, with the correct training.”
BP Software
Best Practice (BP) Software launched in
2004 and has been steadily grabbing market
share in Australia with its management
software since. In April this year it entered
New Zealand, having acquired Houston
Technology, the Hamilton-based medical
The Cataract
Refractive Suite
BY ALCON
software company.
Houston Technology not only expanded
BP’s market but gave it the product
Australasian doctors had been asking for:
a software programme for specialists and
allied-health organisations, said Lorraine
Pyefinch, who co-founded BP with her
husband, Frank. “Houston specialised in
specialists.”
In fact, with contributions to its coding
from the likes of now-retired Kiwi
ophthalmologist Dr Mike Mair, Houston’s
VIP programme has particular strength in
ophthalmological practice. Thus, the team
from BP was eager to attend Congress to
connect with practice managers and doctors
who have been looking for the combination
of Houston’s specialist focus and BP’s easeof-use,
said Pyefinch.
“Everyone is starting to get their head
around the concept of accessing more
data, sharing more data, improving overall
care and connecting with other health
care providers. So specialists are taking up
technology now in a more serious way.”
After establishing a new office in Hamilton
(opened officially just after RANZCO) and
beefing up its staff numbers, BP is on a
brand-building campaign and is focusing on
how VIP can be improved still further.
Advancing
CATARACT SURGERY
Advancing
CATARACT SURGERY
CONTINUED ON P17
Alcon NZ Optics UltraSert-ORA single page 420x297_099-15_4 outlines.indd 2
December 2015
NEW ZEALAND OPTICS
15/09/15 9:52 AM
11
December 2015.indd 11
19-Nov-15 3:27:02 PM

Focus
on Business
BOOSTING RECRUITMENT
SUCCESS
BY THERESE MCNAUGHTEN*
Hiring new staff can be a minefield.
Your intention will be to attract, source, recruit and retain the very
best talent and skill set for your business, but how can you be sure
you are doing this effectively? How can you reduce costly hiring
mistakes; and how can you ensure you are doing your best to attract
and retain the best talent?
To get your recruitment project off to a flying start, begin by
focusing on the position description you need. Get it wrong and
it can have an impact not only on how your recruit, but whom
you recruit. Planning is key. Taking time to write a well-defined
position description will ensure you attract the right level and
quality of candidates, reduce attrition in the long-term and support
a successful employer/employee relationship. It gives clarity and
guidelines, helping to manage future expectations for both the
new staff member and for their manager. Use it to support your
recruitment and selection process, job review times and training and
development. Other key recruitment considerations include:
Analysing what’s missing
Clearly identify the resource gap/skills that are missing and need to
be found for your business. If you are replacing someone, ask yourself
if you would you look for the same skill set? Is there someone suitable
in the business that could be upskilled to fill this role? This is a good
time to re-evaluate what you need to make the position description
more successful for all concerned.
Considering the impact
Define the purpose of the role and identify the main impact you
want. Think about the outcomes you require.
Identifying core skills
Identify the skills needed to help achieve the key purpose of the
position. Consider core critical skills that are negotiable and those
that are not negotiable for the role. What is the minimum level of
tertiary qualifications required? Remember most skills can be taught
but a good attitude cannot!
Working out the support required
Do you have or will you need an induction plan? What training is
needed? What career path are you offering? What scope and level of
remuneration and incentives are required? Consider why the person
you want, would want to work for you? And how will you will attract
and source them?
Leading the recruitment process?
Have you got the time and in-house level of expertise to conduct the
recruitment for your business? Consider outsourcing some or all of
the process to a recruitment professional to help you save time and
money.
Here is a WOF-style checklist for a position description:
• Company information - the title of the position, reporting to.
• Purpose/description of the role—an outline of the overall purpose
and content of the role.
• Job Requirements—a list of the Key Result Areas (KRA’s)—4-8
specific tasks or duties you want them to contribute. First list the
key area and then list the key tasks/activities they will need to
undertake, eg. Manage financials—provide up to date monthly
sales and P&L reports.
• Key Performance Indicators (KPI’s)—how you will measure the
results: sales, milestones, goals, targets etc.
• Relationships both internal and external they will manage
• Experience required - consider the specific experience you require
for this role including skills, knowledge and qualifications. List skills
and describe the level of competency required in each, eg. Customer
service—at least three years of telephone and face-to-face
• Personal attributes—in today’s ever-changing work environment
consider flexibility, adaptability and a positive attitude to learning.
All go a long way to creating a positive and productive work force.
Other considerations
During this process, think about how you can highlight your
company’s key selling-points in the position description. Identify
unique features this role offers a candidate and highlight incentives
and opportunities for career development and innovation, investment
in education and community involvement.
Lastly, you may also consider outlining the remuneration package
components—base, targets, benefits, staff discounts, health
insurance etc. where applicable. You can keep this on your own copy
and remove for applicants if you wish it to be confidential.
In further columns for NZ Optics I will expand on the considerations
above, outline tips for writing good recruitment ads and provide you
with some compelling interview techniques. ▀
* Therese McNaughten is a director and founder of Wholeoranges
Consulting, a boutique recruitment firm that provides flexible
recruitment services to businesses nationwide, and a business
coach for those going through career transitions. For more, contact
Therese at therese@wholeoranges.co.nz or visit
www.wholeoranges.co.nz.
Largest ever AUSCRS meeting
BY DR DAVID KENT*
A
record number of attendees gathered
to listen to the most comprehensive
programme on cataract and refractive
surgery available in this part of the world at
this year’s Australasian Society of Cataract
and Refractive Surgery (AUSCRS) meeting.
Held at Peppers Resort in Noosa from
October 7-10, AUSCRS 2015 continued
to uphold practices making it uniquely
entertaining, including the banning of ties
and jackets, allocating amusing themes
to many of the sessions and dressing up
speakers in outrageous costumes, with
accompanying music and videos.
Many ophthalmology registrars also
attended the AUSCRS Advanced Trainee
Programme, which provided the basics in
cataract surgery, intraocular lenses and
corneal and refractive surgery.
At the main meeting four overseas
speakers presented: the current president
of the American Society of Cataract and
Refractive Surgery (ASCRS) Robert Cionni;
the immediate past president of ASCRS, Eric
Donnenfeld; Roberto Bellucci from Italy; and
Gilles Lesieur from France.
Cionni presented The Gold Medal Lecture,
Managing Loose Zonules. He outlined the most
important innovations in cataract surgery in the
presence of compromised zonules, including
the development of phacoemulsification,
viscoelastics and capsular tension rings, and
he discussed the Ahmed capsular tension
segmentas well as the Malyugin modified CTR
that can be injected.
Until recently the loops around the anterior
capsule margin were usually sutured to the
sclera in the ciliary sulcus using Prolene. More
recently—since the discovery that Prolene
degrades and gives way over 10-20 years—
there has been a move to using Gortex 6-0
sutures as the best choice for scleral sutures.
Cionni showed how to do two separate
sclerotomies and then use 25 gauge
disposable retinal forceps to pull the two
ends of the Gortex suture through the two
sclerotomies. He recommended using a two,
one and then one throw knot with Gortex
sutures before rotating the knot inside the
eye. He also covered important surgical
principles and gave many useful insights.
The presenters were all dressed up in outfits
and helmets suitable for extreme outdoor
sports for the next session on, Complications
and challenging cases: too close for comfort.
President Dr Graham Barrett channels his inner Kermit at AUSCRS 2015. Photos courtesy of MiVision
Surgical videos included management of an
eye that had a chronically dislocating anterior
chamber IOL, astigmatic surprise with a
trifocal IOL due to IOL tilt, dislocating of a
Verisyse iris clip IOL, the use of an artificial iris
in a patient with trauma and IOL exchange in
juvenile chronic arthritis.
In the following session there were
presentations on adjustable IOL, controversies
in corneal collagen cross-linking and the use
of toric IOLs in keratoconus.
AUSCRS president Dr Graham Barrett
dressed as Kermit the Frog for the session
entitled Muppets or Masters: The role of
new technology, while other presenters
dressed up as science fiction heroes. The
topics included femtosecond laser assisted
cataract surgery, trifocal IOLs, intra-operative
aberrometry to assist with IOL power and
astigmatism management and extendeddepth-of-focus
IOLs. The audience was asked
to vote if each topic made the presenter a
muppet or a master?
Day two included a discussion about
the role of posterior corneal astigmatism
estimation and/or measurement to assist
with toric IOLs. There were presentations that
compared the three different trifocal IOLs
from Zeiss, FineVision and Alcon, as well as
comparisons of different extended-depth-offocus
from AMO Surgical and Oculentis.
Another presentation compared contrast
sensitivity and glare testing in patients with
trifocal IOLs and normal age-matched eyes
and found no significant difference. There
was general agreement there was now no
reason to use a bifocal diffractive multifocal
IOL when trifocal IOLs all gave a much better
range of unaided vision and extended-depthof-focus
gave useful near vision, without
the same degradation of low light and
night time vision found with trifocal IOLs.
Another session included presentations and
Dr’s Rod Keillor, Mark Ruddel and Brett Rogers at AUSCRS
debate about the merits or lack of merit of
femtosecond laser assisted cataract surgery.
The third and final day was also of a
high standard. The first session on corneal
surgical controversies debated the merits
of endokeratoplasty surgery, deep anterior
lamellar keratoplasty in keratoconus and
whether or not there was a role for excimer
laser in combination with corneal collagen
cross-linking for patients with keratoconus.
One of the highlights of day three was a
session entitled Refractive Round Up, in which
Barrett dressed as a native American chief
complete with a small live pony, while the
other presenters dressed as cowboys. There
was a case presentation of a woman in her
70s who developed progressive keratoconus
leading Eric Donnenfeld to comment that
most late keratoconus cases are due to floppy
eyelid syndrome and chronic rubbing of the
affected eye.
The final night was celebrated with the
Gala Dinner, with the theme Hot Night in
Havana.
Next year the 20th meeting of the AUSCRS
will be held at the newly renovated Sheridan
Mirage in Port Douglas from July 20-23rd. ▀
* Dr David Kent is an Ophthalmologist with Fendalton
Eye Clinic in Christchurch and the current New Zealand
representative to the International Society of Refractive
Surgery and AUSCRS
OPSM a-flutter in Butterfly Creek
BY ZOE SMITH*
OPSM held its National Mini-
Conference on October 18, with 40
optometrists attending from as far
north as Whangarei down to Dunedin.
The one-day event at Butterfly Creek
in Auckland included guest speakers
Drs Rachel Barnes and Andrea Vincent
from Retina Specialists, who led a talk on
abnormal and normal peripheral retinal
conditions. Vincent discussed the use of
Optos ultra-widefield imaging scanner and
its ability to diagnose rod-cone dystrophies.
In using Optos’ fundus autofluorescence
(FAF) imaging, she said, abnormal FAF
images in rod-cone dystrophy correlate
highly with the visual field loss.
Optometrists then shared case
reports, confirming diagnoses with the
ophthalmologists. My favourite case was
one from Evan Tennant of OPSM Dunedin,
who discussed the case of a man who’d
been diagnosed several years ago as
simply having retinal pigment, but a reexamination
of his FAF images indicated the
patient actually had a rod-cone dystrophy.
The event included a Red Eye Workshop
led by fellow optometrist Jason Dhana and
myself. In the workshop, attendees were
split into two groups to review eight cases
of red eye, covering differential diagnosis,
treatment and management. Dr Hussain
Patel was on hand to give feedback on tricky
treatment scenarios and advice on “dodgy
looking discs,” glaucoma case analysis.
Emma Gilles from Johnson & Johnson
gave a presentation on the new 1-day
Moist Multifocal. It was refreshing to learn
about the reasoning behind material choice
and design of the lens to help give our
presbyopic patients more natural vision.
Graeme Curtis from CLC then led us through
piggybacking solutions in Keratoconus and
other ways to improve lens centration for
those troublesome cone fits.
The day ended with another round of
cases, including successful orthoptic
treatment of intermittent exotropia in
a child presented by Melissa Thomson
of Thames OPSM; and a spontaneous
hyphaema case presented by Craig Holmes
of Tauranga OPSM.
Many thanks must go to the event
sponsors Johnson and Johnson Visioncare,
Designs for Vision and Alcon, without whom
the event would not have been possible. ▀
* Zoe Smith is an optometrist at OPSM Royal Oak and
a clinical supervisor teaching fellow at Auckland
University Eye Clinic.
Pauraic O’Sullivan, Jared Beetham and Hirdesh Nair
Zoe Smith, Dr Andrea Vincent and Dr Rachel Barnes
AFT mulls IPO
AFT may go public to raise capital on
the NZX and ASX stock exchanges,
the company said in a statement.
AFT is considering an initial public offering
to raise of $45 million, with a $4 million selldown
by the Atkinson Family Trust, which
owns 87% of the company.
The company intends to continue
introducing new products in New Zealand
and Australia, and expand internationally
through third-party licensees and
distributors. Half of AFT’s 2015 revenue was
from New Zealand, 47% from Australia and
the remainder from the rest of the world,
primarily southeast Asia, where the company
began doing business in mid-2014.
The company sells 109 products across
Australia and New Zealand, and has
licensing or distribution agreements in over
35 countries. ▀
12 NEW ZEALAND OPTICS December 2015
December 2015.indd 12
19-Nov-15 3:27:08 PM

Award-winning oDocs
OphthalmicDocs’ Eye Care project won the
People’s Choice award and was highly
commended in the Health and Science
category at this year’s New Zealand Innovators
Awards.
oDocs, the brainchild of Gisborne Hospitalbased
registrar Dr Hong Sheng Chiong, combines
smartphones with an app and 3D printable
attachments to allow accurate, but low cost,
mobile visual acuity tests, slit-lamp examinations
and retinal imaging with a lens that gives a 40
degree look into the back of the eye (see NZ
Optics October 2015).
oDocs was nominated in five categories at the
Awards, including Hong himself being nominated
for the “Most Inspiring Individual” category.
The New Zealand Innovation Council held its
Innovation Awards on October 21 at the Cloud
in Auckland.
It was a month of awards for oDocs, with
the company also being named winner of the
Clinician’s Challenge-Act Project award at the
2015 Health Infomatics New Zealand (HiNZ)
conference in Christchurch the previous day.
While fellow eye professional, senior registrar,
Dr James McKelvie won the Clinician’s Challenge-
New Ideas category for his electronic referral,
risk assessment and real-time audit of cataract
surgery initiative.
McKelvie’s concept is a web-based, end-toend
application, which replaces the paper-based
system currently used in the health service,
for tracking and assessing the 37,000 cataract
surgeries performed in New Zealand every year.
The system features instant online referrals,
pre-operative surgical risk analysis and real-time
audit of surgical results. Both Hong and McKelvie
received $8,000 to continue developing their
initiatives as part of their awards.
Health Minister Jonathan Coleman
congratulated McKelvie and Hong in a statement,
saying their initiatives showed innovation was
alive and well in the health IT sector. “It’s great
to see clinicians finding better use of information
and technology to deliver more timely quality
patient care which can enable clinicians to
spend more time with patients and less on
administration. We want to see more health
Dr Hong Sheng Chiong and Hanna Eastvold-Edwin receive
the People’s Choice award from Idealog’s Vincent Heeringa
Maryanne Dransfield with Sandra Budd, Hong Sheng
Chiong, Paulette Cotter and Rick Hoskin in the Cloud
care delivered in the community and people
living healthier lives away from hospitals. Using
technology has a key role to play in this.” ▀
Chch first Study Day a hit
BY DR REBECCA STACK*
Christchurch Eye Surgery held its inaugural
optometry Study Day on November 7, with
more than 40 attendees from throughout
the South Island.
The Study Day included a morning lecture series
followed by an afternoon of clinical case discussions
and debates, presented and presided over by the
ophthalmologists of Christchurch Eye Surgery.
Dr Malcolm McKellar gave a presentation on
pterygium management, concluding that even
small, innocuous pterygia can significantly degrade
vision and removal should be considered when
patients have altered vision.
I presented on watery eyes. An altered blinking
pattern is a common cause of watery eyes
and optometrists should check for a patient’s
completeness of blink, lid laxity and eyelid closure.
In Dr Jim Borthwick’s presentation on macular
hole surgery, he said a dry cornea degrades the
image in OCT, but artificial tears can improve the
scan when the quality is poor.
In her lecture, Visual disturbances after stroke,
Dr Jo-Anne Pon pointed out that hemianopia poststroke
can be as debilitating as hemiparesis.
Other topics covered included:
• Cross-linking is not indicated in patients with
keratoconus if their vision cannot be corrected
with glasses or contact lenses (Spectrum of
corneal ectasias by Dr John Rawstron)
• Patients with an epiretinal membrane need a
dilated fundal exam to exclude a peripheral
retinal tear (Interpreting a macular OCT by Dr
Sean Every)
• All patients on topical, inhaled and oral steroid
should have regular IOP screening (Steroid
induced glaucoma by Dr Allan Simpson)
• Biometry before cataract surgery needs to be
repeated until stable in contact lens wearers;
there is no arbitrary time frame. (“Presbyond”
laser correction by Dr Ian Dallison)
• The refractive goal after cataract surgery
is the patient’s refractive goal not piano.
Dr James McKelvie recieves his Clinician’s Challenge award
from Graeme Osborne, National Health IT Board director
Alan Benjamin, Michael Brown and Stephen McCreadie
tour the plant room of Christchurch Eye Surgery
(Accommodative options after cataract surgery
by Dr David Kent)
Optometrists were given a lunchtime tour of the
newly opened theatre facility, a highlight for some,
especially exploring the first floor plant room.
The expert panel discussion in the afternoon was
led by Dr Malcolm McKellar, presenting anonymous
questions from the audience. This challenged the
ophthalmologist panel on a range of clinical and
ethical issues including access to care in the public
sector and co-management of glaucoma patients.
This session provided a valuable opportunity to
discuss issues in a collaborative fashion.
The day ended on a less serious note with an
ophthalmic quiz, which I presented. The Richie
McCaws team, also known as Dr Every, Rochelle van
Eysden, Alistair Thomson, Leesa Stewart, Dabin Kim,
Susan Thompson and Rich Faloon-Cavender, were
victorious. They successfully solved the World Health
Organisation acronym S.A.F.E. and made 34 words of
four or more letters from the word “optometry”. (See
if you can get closer to the 98 there are in total!)
The Christchurch Eye team look forward to
hosting the next symposium following its first
successful outing. ▀
* Dr Rebecca Stack of Southern Eye Specialists is a director of
Christchurch Eye Surgery
Focus on
Eye Research
Paediatrics: Retinopathy
of Prematurity
RETINOPATHY OF PREMATURITY: NEW
ZEALAND RECOMMENDATIONS FOR CASE
DETECTION AND TREATMENT
Dai S, Austin N et al
Journal of Paediatrics and Child Health 2015; 51:
955-9
This paper sets out recommendations for
retinopathy of prematurity screening (ROP) in
New Zealand.
Review:
The current guidelines provide a comprehensive
framework for good practice, stating that infants
must be screened if they are 26 weeks
first screen at 4 weeks postnatally), as well as for
subsequent screenings according to examination
findings. The authors suggest Retcam screening
is the preferred screening modality performing
as well as binocular indirect ophthalmoscopy, but
provides an objective record, can be undertaken
by trained non-physicians and a remote ‘expert’
opinion obtained when required. When treatment
is required, it must be undertaken in a centre
with available expertise. Diode laser remains the
established modality (although argon laser is an
alternative where diode is unavailable). Intravitreal
bevacizumab should be considered where ROP has
not responded to laser and aggressive posterior
ROP (APROP).
Comment:
These screening recommendations provide a
comprehensive framework for any clinicians
undertaking ROP screening. Prior to this paper, the
only published ROP screening recommendations
in New Zealand date from 1990. While the 1990
recommendations are unlikely to miss children with
severe ROP resulting in severe visual impairment,
there was concern regarding documentation of
screening and delays in screening/treatment due to
babies being transferred between different units.
Such occurrences are much less likely with these
guidelines.
VISUAL IMPAIRMENT DUE TO RETINOPATHY
OF PREMATURITY (ROP) IN NEW ZEALAND:
A 22-YEAR REVIEW
Tan Z, Chong C et al
British Journal of Ophthalmology 2015; 99: 801-6
Review:
This retrospective case notes review focuses on
children registered with the Blind and Low Vision
Education Network New Zealand (BLENNZ),
registered with ROP as the primary cause of
visual impairment between 1991-2012. Data
was analysed in two study periods (1991-2004
and 2005-2012) due to changes in ROP screening
and treatment following the ETROP trial, which
advocated earlier treatment of less severe ROP. In
all, 232 children were identified as being treated
for ROP within the study period (109 in period
1, 123 in period 2). Of these, 36 children were
identified as having significant visual impairment
(

SPECIAL FEATURE: ADONZ Conference (continued from November’s NZ Optics)
Daring to be different
Global myopia
There are a number of things that irk Elaine Grisdale,
head of professional services and international
development at the Association of British Dispensing
Opticians (ABDO). One is the declining number of DOs in
Britain who still offer bespoke eyewear to their patients,
another is ill-fitting eyewear paraded around as if it’s the
latest fashion by Hollywood icons, like Zoe Saldana (see
picture). Yet another is DOs feeling bored or frustrated by
others’ lack of understanding or use of their abilities.
With the latter in mind, the 2015 ADONZ key note
speaker set out to inspire New Zealand’s dispensing
opticians with ideas to put some excitement back into their
roles and demonstrate their long list of oft forgotten skills.
Her first presentation, titled Dare to be different -
creating opportunities with bespoke eyewear, though
a little off the mark as Kiwi DO’s qualifications don’t
include a bespoke block, was a fascinating insight into
the skills and tools of the trade of a good DO. It provided
a number of options of what to do should you be faced
with a returning All Black’s nose, which doesn’t lend
itself to off-the-shelf frame options, and encompassed
the dos and don’ts of good fitting, tips for both inspiring
patients and taking control of the process.
In Smarter dispensing for presbyopes, Grisdale
guided delegates through the myriad possible mishaps
for getting it right for presbyopes and provided an
enlightening history lesson on the development of
lenses, including some personal insight about the man
who invented progressive lenses, Bernard Maitenaz, for
Essilor forerunner Société des Lunetiers.
With so many lens options for presbyopes today, it’s
important for a good DO to do their own research, she
said, so ask for the results of clinical trials, especially
double-blind wearer trials. “Make your lens rep work.
And ask to trial their lenses if you wear progressives.”
Another key part of every successful dispense is factfinding
to build a picture of the person in front of you:
what do they want to wear their glasses for?
“We are all very bad at multiple dispensing, but you don’t
have one pair of shoes for every occasion, so why should
you have one pair of glasses for everything,” said Grisdale.
Other presbyopic dispensing tips included not over
promising; letting the patient tell you what is the
most comfortable reading distance for them; correct
measuring; having the best tools for measuring and
fitting; and making time for measuring, even it means
Actor Zoe Saldana in her “ill-fitting” specs
ADONZ key note ABDO’s Elaine Grisdale
making a second appointment.
All the best practices keep two diaries, one for the
optometrist and one for the DO, she said.
“When a patient leaves your practice they will not
judge it on the quality of the eye exam unless the
optometrist has discovered something that will stop
them going blind; they will judge you on the quality of
their vision, so dispense what is best for your patient’s
needs, remembering that might be more than one pair.”
And finally, she added, “don’t say ‘come back if you have
any problems’. Don’t plant the word ‘problems’ in their
mind. Just say, ‘come back, any time if you have
any questions’.” ▀
epidemic looms
There’s a dim future ahead of us
in global vision health if we don’t
start doing something about
the increasing prevalence of myopia, Dr
David Wilson told delegates at the 2015
ADONZ meeting in Hamilton.
According to a research paper authored
by Wilson, research manager, Asia- Pacific,
for the International Centre for Eyecare
Education at the University of New
South Wales, and the late Brien Holden
and others, and presented as part of
Wilson talk’s at ADONZ, there will be five
billion myopes in the world by 2050, 20%
of them with high myopia and facing loss
of vision.
“Our hypothesis was that with this
massive increase in myopia and high
myopia, it’s imperative to control the rate
of high myopia to reduce the financial
and social burden costs associated with
it,” he said.
The research paper was a metaanalysis
of population studies of myopic
rates, which sifted through more than
2,000 published surveys to find 145
papers that matched the project’s criteria.
Recent published studies on myopia
in China have made headlines (see
associated story in November’s NZ
Optics) and there is some response by the
governments of China and Taiwan to curb
the prevalence and progression of the
condition.
In Taiwan, one study showed 97%
of military conscripts are myopic.
The government has recently passed
legislation prohibiting children under
two from using smartphones and
iPads threatening parents with a steep
fine if caught.
Research predicts 75% of Japanese and
77% of people living in Singapore will
be myopic by 2050, said Wilson,
while New Zealand, with a current
7% myopic rate, faces a sobering 53%
prevalence in 2050.
The research shows we are seeing a
much higher level of high myopia than
any time in the past and because the
problem is related to axial length, the
risk of myopic macular degeneration and
retinal detachment etc. will threaten
vision more and more, he continued.
Wilson and his fellow Australian
researchers persuaded the government
to invite World Health Organisation
representatives, together with global
myopia experts from 16 countries, to
convene to tackle the problem. The
group developed a standard definition
of myopia and, more importantly,
agreed to lobby WHO leadership
to recognise myopia as a separate disease.
“The next step is in their hands,” Wilson
said, but practitioners need to keep up to
date with control measures. “The younger
you can get to myopes, the better you can
control the effects.”
Controls includes Ortho-k, other
contact lenses, extended-focus lenses,
atropine therapy and spending more
time outdoors with less “near-work” or
other behavioural modifications.
“In Australia, the message is about
getting more time outdoors, not doing
as much homework and limiting time
on screens,” Wilson said. “Countries like
Taiwan are taking notice and treating it
seriously. But Australia and New Zealand
have been complacent because myopia
hasn’t raised its ugly head yet.” ▀
NEW Shades of Brown
now available in brown
GRAND OPENING – 23 SEPT. 2016
The appeal of Transitions ® XTRActive ® lenses just became a lot more
compelling: it is now available in brown through Younger Optics.
During the past European Summer, brown sunglass tints proved to be
hotter than ever in the fashion stakes.
Beyond fashion, Transitions XTRActive in brown also deliver significant
wearer benefits:
• Brown offers superior contrast
and visual acuity
• Brown is ideal for both bright
and overcast conditions
• Brown provides extra definition
for wearers with diminishing vision
• Darkest Transitions everyday
lens outdoors
• Activation behind the windscreen
of a car
• 100% UV blockage
Now is the time to recommend the additional benefits of brown
Available at Younger Optics
Phone: +61 8 8241 9800 Email: info@youngeroptics.com.au
Transitions, the swirl, and XTRActive are registered trademarks and Adaptive Lenses
is a trademark of Transitions Optical Inc., used under licensed by Transitions Optical Ltd.
www.youngeroptics.com
REINVENTING BUSINESS.
23> 26 SEPT. 2016
PARIS NORD VILLEPINTE
Conception : CARLIN
SILMOPARIS.COM
14 NEW ZEALAND OPTICS December 2015
December 2015.indd 14
19-Nov-15 3:27:12 PM

Society of the 3D spectacle
Last issue we brought you an insight
into Silmo 2015, but with so much going
on we decided to split the article in two.
Here’s the promised part II.
BY MARYANNE DRANSFIELD
In the Village section of the fair, where design and
the most innovative ideas jockey for position, I
discovered there is more to a frame than acetate
and metal. The compelling story about the frame
and how it is designed goes deeper, with designers
responding to ever-changing public taste and
exploring new methods of fabrication.
The burgeoning 3D and wooden frame market
was obvious with new companies entering this
sector, along with established brands trying their
hand in these fields.
One of the first in is now taking 3D production
one step further with customisation. Allan Petersen
from Danish company Monoqool has teamed up
with Dutch company Sfered which has developed
3D software and scanning technologies to measure
the face through more than one million points. This
can be used to produce the perfect-fitting frame in
3D printing and milling.
“More companies are entering this market and
I think 3D frames will become a category on its
own,” Petersen said. “My fear is that if newcomers
don’t understand the technology, poor quality
frames are going to be produced and I don’t want
the reputation of this category to be ruined. It’s
not easy and it’s not cheap and the technology is
still evolving.”
Petersen sees customisation as key to the future
of 3D fabrication.
“When I got into 3D printing five years ago, I
always had customisation in the back of my mind.
First I needed to perfect the process and now I
think we have ‘cracked the code’.”
Monoqool’s collaboration with Sfered allows the
customer to choose a frame’s shape and colour.
The Sfered software’s algorithms generate the
chosen frame as a first fit suggestion. An optician
or optometrist can then manually adjust and
customise the frame,
fine-tuning the nose
bridge, base curve
and the pantoscopic
angle.
“This type of product
is what’s going to
set practices apart
from the increasing
competition from
the chains and
Alan Saks getting measured by Monoqool
discounters,” Petersen
said. “Customisation
will differentiate a practice and also puts the
technology into the hands of the practitioner.”
Petersen believes that customised eyewear
eventually will make up 10 to 20% of his business.
Mykita has also entered the digital revolution of
bespoke eyewear. The company says it is bringing
together “anatomical design with avant-garde
technology to set the standard for digitally tailored
eyewear” with all the luxurious attributes of a
hand-crafted product.
At Silmo, Mykita set up a demonstration laboratory
to show off its MY VERY OWN (MVO) system—an
integration of 3D scanning, parametric design
and additive manufacturing that digitally creates
eyewear tailored to the individual topography of a
customer’s face. After selecting an eyewear shape
from the MVO collection, the customer’s face is
scanned and visualised with the selected frame
adjusted to the face contours. The colour of the
frame, lenses and hinges are selected and virtually
composed for a truly bespoke pair of prescription
specs or sunglasses and then 3D printed.
Into the wood
Danish frame design company Fleye presented its
latest stylish collection at Silmo which features a
combination of carbon fibre together with titanium
and wood. The construction involves 23 layers of
carbon fibre finished off with one paper-thin layer
of wood either in ebony, rose wood or oak.
“The technology used ensures a very light
structure. Finished off with titanium temples, the
finished product gives a very warm and natural
Mykita’s lab-like exhibit, featuring a
scanning device to create 3D frames
look to the face. By playing with different colours
in the titanium, you can achieve a very trendy and
unique product and it is very uplifting on the face,”
said Annette Estø, Fleye designer and CEO.
Fleye has been making carbon fibre frames for the
past two years and this is now making up 35% of
the company’s sales. Its next launch will be at the
Munich fair in January. This collection will involve
thin layers of acetate with beta-titanium as a
middle layer to provide extra strength.
Canadian company Spectacle Eyeworks, which
has been in the eyewear business for two decades,
featured an array of show-stopping styles;
eccentric, experimental shapes to fashion-forward
classics with a twist. As well as its new ‘Retro’ and
‘Pussy Galore’ collections, the company also has a
luxury wood & horn collection, featuring stunning
artistic flair. Chief designer Mehran Baghaie
said the firm’s collections consist of a diverse
combination of plastic, titanium and stainlesssteel
styles. Every frame is produced with a slogan.
His favourite is ‘Love is the irresistible desire to be
desired irresistibly.’
More from Oz
Niloca designer Colin Redmond and his wife Josie
have all the prerequisites to be in the eyewear
business. Colin is an international award-winning
industrial designer with a fierce passion for
creating. He designed for Audi in the late ‘90s,
culminating in a Red Dot award received as part
of the iconic TT-model design team. While Josie
Allan Petersen with
Monoqool’s 3D printed
frames
WeWood, which specialises in wood
watches, shows off an example of its new
wood frames
is a dispensing optician who owns a practice in
Melbourne called Scoogle.
After three years of research, designing and
refining ideas, Niloca was officially released in 2011
with a commitment to production within Australia.
Now in eight countries, the company is continuing
to grow and launched a brand new collection for
Silmo called Exotic Fruit. Featuring new bespoke
acetates, the collection is an all-star line-up of
hatched black pin stripe layers and a new tortoise
shell glitter mosaic, finished with a laser engraved
texture map resulting in a very dimensional look.
“All the acetates are custom-made for us. The
design of the frames involved three layers of acetate
being sandwiched together to form the chequered
pattern and a pastel acetate put on top which is
laser etched to achieve the matte finish,” said Josie.
Unlike the previous collection that was hand-made
in France, Exotic Fruit is made in a state-of-the-art
manufacturing facility in Dubbo, Australia by Optex.
Having walked around the show, Josie said she
was concerned about the trend she was seeing in
flat eyewear design.
“It’s very fade orientated and not suitable for
ophthalmic lenses. By nature lenses cannot be
completely flat and especially at the high end of
the market people want free-form lenses and these
can’t be flat. You need the product to work so this
type of design is not sustainable. It’s also very
unflattering for the older face.”
Silmo 2016 will be held in Paris from 23 to 26
September. For more visit: http://en.silmoparis.com/ ▀
The
secret
behind
perfect
vision
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lenses!
These iD WorkStyle V+ lenses are
fantastic. Put them on and could not believe
how clear they are! No distortion between
distance, intermediate and near. The frame
also feels really good, so many thanks HOYA
for the perfect fitting! ”
− Maryanne Dransfield, New Zealand
hoyalens.com.au/VplusTestimonials
NZOptics_halfpage_V+_18x28cm_Dec15.indd 1
December 2015
NEW ZEALAND OPTICS
16/11/2015 12:28:36 PM
15
December 2015.indd 15
19-Nov-15 3:27:15 PM

with
Prof Charles McGhee
& A/Prof Dipika Patel
Series Editors
From corneal transplants
to engineered corneal tissue
BY JIE ZHANG AND DIPIKA PATEL
Introduction
Serious vision loss due to corneal
diseases can be treated by corneal
transplantation. Despite its relative
success, the procedure is not suitable
for all cases and suffers some
limitations. Alternatives approaches
are therefore being explored to
further enhance the treatment
of corneal diseases. This article
provides an overview of the various
corneal transplantation techniques,
commercially available artificial
corneas, and current research on
advanced engineered corneal tissue.
CORNEAL TRANSPLANTS
Each year, approximately 250-300 corneal transplants are performed
in New Zealand. The major indications for corneal transplantation
in New Zealand include keratoconus (41.1%), regraft (17%), aphakic
or pseudophakic bullous keratopathy (13.9%), corneal dystrophy
(10.7%), keratitis (7.9%), and trauma (3.7%). Corneal transplants may
be either full thickness (penetrating keratoplasty (PKP)) or partial
thickness (lamellar keratoplasty). Recent years have seen a surge
in the proportion of lamellar keratoplasties being performed, with
proportions in 2009 of 30.2% in New Zealand, 31.8% in USA, and 40%
in Australia. 1
PKP is the traditional corneal transplant procedure in which the
full thickness diseased cornea is replaced with a full thickness
donor cornea.
The first successful PKP was performed by Eduard Zirm in 1905,
and the technique has been developed and refined over the last
century. The Australian corneal graft registry has recorded 5 and
10 year survival rates of 76% and 49% for ‘contemporary’ PKP
performed from 2000 onwards. 1 Despite the plateauing of success
rates in recent years, limitations of PKP still exist. In particular,
cadaveric donor tissue is a limited resource in most countries
(unavailable in some), with demand increasingly exceeding supply.
The presence of foreign antigens in the donor tissue means that
the grafted tissue is at risk of immunological rejection. Indeed,
graft rejection occurs in one third of corneal transplants and is the
leading cause of graft failure. Although host immune activation
against any layer of the donor cornea is possible, stromal-epithelial
rejection tends to be relatively minor compared to endothelial
rejection which is a major threat to graft survival. It is estimated
that more than half of all PKP failures may be related to acute
endothelial rejection or late endothelial failure. Some of these
problems can be circumvented by transplanting only the layers of
cornea affected by disease whilst leaving the healthy tissue in place
by performing lamellar keratoplasty.
Deep anterior lamellar keratoplasty (DALK) is a procedure that
replaces only the anterior layers of the cornea, leaving the host
endothelium intact, thus avoiding the risk of endothelial graft
rejection, and some of the other complications associated with
PKP and open globe surgery. Post-operative recovery is also faster
than PKP. DALK is suitable for diseases that spare the endothelium
(e.g.stromal scarring, stromal dystrophies, and ectatic disorders such
as keratoconus or post-LASIK ectasia). Visual outcomes, preservation of
endothelial cell density, and the 5 and 10 year graft survival rates (69%
and 49%) are reported to be similar to PKP. 1
Descemet’s stripping endothelial keratoplasty (DSEK) is a procedure
that replaces the host Descemet’s membrane and diseased
endothelium with donor endothelium, Descemet’s membrane, and
a thin layer of posterior stroma. The host epithelium and stroma
remains intact, thus fostering better structural integrity of the
cornea, faster visual recovery, reduced suture-related complications,
and avoids complications associated with open globe surgery.
It is suitable for conditions that affect the endothelium such as
Fuchs’ endothelial corneal dystrophy and bullous keratopathy.
Complications include donor dislocation and endothelial cell loss
during graft insertion. The graft survival rate at 5 years of DSEK is
47%; data for 10 years is not available yet since the technique was
introduced less than 10 years ago. 1
Figure 1. Schematic diagrams of the replacement of different corneal
layers during penetrating keratoplasty, anterior lamellar keratoplasty, and
endothelial keratoplasty.
Artificial corneas
Despite the relative success of PKP and lamellar keratoplasties, they
are not suitable in all cases. For end-stage corneal blindness due to
severe ocular surface disease (e.g. Stevens-Johnson syndrome) and
multiple graft failures, the only approved alternatives for human use
are keratoprostheses (KPro’s). 2
The most widely accepted is the Boston KPro type I, comprising a
front plate with stem containing a PMMA optic, a back plate with
holes for nutrient diffusion, and a titanium locking c-ring; the device
is implanted into a donor cornea before being sutured into the
patient’s eye. Due to improvements in design and improved postoperative
management, the Boston type I KPro was shown to have an
excellent 80-100% retention rate over average follow up periods of
8.5-33.6 months. The Boston type II KPro and the osteo-odonto KPro
are reserved for cases with severe ocular surface disease. The Boston
type II KPro is similar to type I, with the addition of an anterior nub.
The osteo-odonto KPro comprises of a PMMA central optic glued to an
osteodental lamina from a tooth extracted from the patient.
A similar concept is used in the tibia bone KPro. Both autologous
KPros have good biocompatibility and biointegration, but are more
invasive and requires healthy tooth, jaw or tibia from the patient. The
AlphaCor comprises a PHEMA hydrogel central optic interpenetrated
by a spongy PHEMA skirt, but is now rarely used due to complications
including infection, extrusion, rejection, tissue necrosis and
calcification.
In general, KPros suffer complications due to poor tissue integration;
these include formation of a retro-prosthetic membrane, extrusion,
chronic inflammation, infection, melting at the cornea prosthesis
interface, and leakage.
Figure 2. Schematics of the Boston KPro and the Osteo-Odonto KPro.
Engineered corneal tissue
Due to the limitations of corneal transplantation and artificial
corneas, researchers are investigating alternative corneal tissue
substitutes. The ideal substitute should be transparent, closely
resemble the structure of the cornea, have similar elasticity
and tensile strength to that of native tissue (thereby enabling
surgical manipulation), support cell attachment, proliferation and
differentiation, and induce minimal inflammatory response. Here we
describe several lines of research in this field.
Researchers have decellularized and decalcified Tilapia fish scales to
produce an extracellular matrix that consists mainly of type I collagen. 3
The resulting matrix is highly transparent, but has a mismatched
curvature and insufficient elasticity, causing confined cracking when
sutured. The decellularised and decalcified scales are associated with
chronic inflammatory reactions when implanted in vivo. Further
modifications are required before we can consider this to be a clinically
applicable corneal substitute.
Xenotransplantation of porcine corneas is another strategy that
has abundance of supply, and similarity in anatomy and refractive
properties to the human cornea. However, one of the main limits to
xenotransplantation in humans is the existence of natural antibodies
to the terminal galactose α1, 3 galactose (α-gal) epitope expressed
in the cell membranes of all mammals except those of humans and
primates. These antibodies mediate hyperacute or delayed rejection of
the xenograft. Therefore researchers have devised various protocols to
remove cells and xeno-antigens from porcine corneas. Unfortunately,
such treatments are harsh and result in reduced transparency, and are
only able to achieve partial decellularisation. 4
Researchers have developed hydrogels consisting of recombinant
human collagen type III. In vitro studies confirmed that the scaffold
is highly transparent and may be produced with a curvature that
matches the human cornea.
A phase 1 clinical study implanted these hydrogel ALKs in 10 patients
(9 keratoconus, 1 corneal scar). 5 Four years post-operatively all hydrogel
grafts were stably integrated with no rejection episodes. However,
some limitations exist. Overlying sutures were required to keep the
implant in place due to its low mechanical strength, which delayed
epithelialisation prior to suture removal at 6 weeks. Epithelialisation
was complete after suture removal, but the resulting focal corneal haze
remained at 24 months. Overlying sutures likely also caused localised
thinning, fibrosis and surface irregularity. The best corrected visual
acuity at 24 months was below that achieved by PKP for keratoconus.
Therefore improvements to this hydrogel are needed to enhance
clinical application.
A collagen I based scaffold has recently been developed by our
group, possessing many of the desired properties of an ideal corneal
substitute. The scaffold is highly transparent, corneal shaped, and
consists of lamellae of collagen closely resembling the structure of the
human corneal stroma. One distinguishing feature of this scaffold is its
mechanical strength, which is comparable to that of a human cornea.
It has also been shown to support corneal epithelial and stromal
cell attachment and migration. Further work is underway to test the
potential of this material for clinical application.
Conclusions
Whilst penetrating and lamellar keratoplasties continue to be reliable
treatments for blinding corneal diseases, limitations still exist. This
necessitates research into advanced biological engineered corneas
for corneal transplantation. With the advancement of technology,
engineered corneas that are strong and biocompatible hold promise
for the future of corneal replacement.
ABOUT THE AUTHOR
REFERENCES
* Jie is a research fellow in the Department of Ophthalmology,
University of Auckland, supervised by A/Prof. Dipika Patel
and Prof Charles McGhee. Jie is using her biomedical science
background to devise treatments for Ophthalmic conditions,
and is currently focusing on the synthesis and testing of a
novel collagen based scaffold for corneal transplantation.
1. Williams, K.A., M.C. Keane, R.A. Galettis, V.J. Jones, R.A.D. Mills, and D.J. DJ
Coster, THE AUSTRALIAN CORNEAL GRAFT REGISTRY 2015 REPORT. 2015,
South Australian Health and Medical Research Institute: Department of
Ophthalmology, Flinders University
2. Avadhanam, V.S., H.E. Smith, and C. Liu, Keratoprostheses for corneal blindness: a
review of contemporary devices. Clin Ophthalmol, 2015. 9: p. 697-720.
3. Ivan Essen, T.H., C.C. Lin, A.K. Hussain, S. Maas, H.J. Lai, H. Linnartz, T.J. van den
Berg, D.C. Salvatori, G.P. Luyten, and M.J. Jager, A fish scale-derived collagen matrix
as artificial cornea in rats: properties and potential. Invest Ophthalmol Vis Sci,
2013. 54(5): p. 3224-33.
4. Lee, W., Y. Miyagawa, C. Long, D.K. Cooper, and H. Hara, A comparison of three
methods of decellularization of pig corneas to reduce immunogenicity. Int J
Ophthalmol, 2014. 7(4): p. 587-93.
5. Fagerholm, P., N.S. Lagali, J.A. Ong, K. Merrett, W.B. Jackson, J.W. Polarek, E.J.
Suuronen, Y. Liu, I. Brunette, and M. Griffith, Stable corneal regeneration four
years after implantation of a cell-free recombinant human collagen scaffold.
Biomaterials, 2014. 35(8): p. 2420-7.
16 NEW ZEALAND OPTICS December 2015
December 2015.indd 16
19-Nov-15 3:27:15 PM

SPECIAL FEATURE: RANZCO Congress
CONTINUED FROM P11
Device Technologies
Device Technologies’ large booth was packed with
new technologies and equipment. One of the
highlights was the Topcon Triton DRI/Swept Source
OCT.
The Triton has been on the market regionally for
six months after debuting in Australia at ODMA
this year. The machine was the first commercially
available SS-OCT, a technology that promises more
options for ophthalmologists to peer through
layers of the eye and glean more information on
choroidal structure than time-domain OCT.
Dr Andrew Thompson between Diego Sondregger (left)
and Campbell Gordon (right) of Device Technologies
“The wavelengths allow you to get a broader
depth of focus,” said Device Technologies’ Ryan
Hegge. “So, previously you may focus on the ILM
or RPE and you’d see a dropout depending on
what you were focusing on. Here you can see
we’re focused right up into the vitreous as well as
right down into the choroid.”
A software upgrade to the unit allows for
non-invasive OCT angiography, which—given
the promise of the SS-OCT’s ability greater depth
of focus—could obviate the need for injected
fluorescein angiography in some cases, said Hegge.
Ophthalmic Instrument Company (OIC)
OIC’s team was busy on the other side of the
exhibition floor talking to delegates about the
Nidek Tonoreft III Autorefractor/Keratometer
as well as the Nidek RetinaScan DUO HD OCT &
Fundus imager.
Dr Shuan Dai visits the OIC stand
“OCT is becoming the standard of care for optometry
practice,” said Tim Way, OIC’s general manager.
Going by the recent NZAO conference in October,
Way estimated that at least 80 practices have OCT
units in New Zealand distributed by his company
alone. And the standard for OCT units is quickly
moving toward OCT Angiography. “I think that’s going
to open up a whole world for optometry, because
optometrists can’t do fluorescein or ICG injections, and
being able to provide something that does that could
save the health service a lot of money.”
Alcon
As a Platinum Sponsor of RANZCO, Alcon had a
strong presence during the Congress showcasing
multiple new technologies.
Alcon’s Jonathan Spencer with Drs Rebecca Stack and
David Kent and Greg Engelbrecht, also of Alcon
Alcon’s Centurion Vision System was celebrating
a proud milestone with 100 units installed in ANZ
as of September 2015 and over 90,000 potentially
sight-enhancing procedures expected to be
performed using active fluidics technology by the
end of 2015.
The company has also added to its
cataract refractive suite with ORA with
VerifEYE+ technology. Claimed by Alcon to be
the world’s first intra-operative Wavefront
Aberrometer, ORA with VerifEYE+ provides real time
verification of the surgical plan and information
to change the IOL choice, if required, to achieve a
better refractive outcome for the patient.
Two new additions to Alcon’s AcrySof IOL
range were also presented at RANZCO: Acrysof
IQ PanOptix, Alcon’s trifocal IOL, and Acrysof IQ
UltraSert, Alcon’s pre-loaded delivery system.
PanOptix is a modified quad-focal design with
proprietary ‘Enlighten’ technology, which allows
more light transmission to the retina. It also offers
patients continuous intermediate-to-near vision
with an intermediate focal point at 60cm, which
for many will be more convenient and practical for
various daily tasks than the 80cm working distance
offered by other trifocal IOLs, said Colette Parkinson,
Alcon ANZ’s cataract equipment product manager.
The feedback from surgeons on the Acrysof IQ
UltraSert demonstrations and how smooth
and controlled the delivery system is has been
overwhelmingly positive, she added.
Abbott Medical Optics (AMO)
Towards the middle of the hall, AMO shared one
half of a large stand with popular Kiwi ophthalmic
equipment distributor Toomac (more about this
interesting arrangement in our next issue) with a
joint, and popular, tea and coffee bar.
On show on AMO’s half of the stand were
materials promoting the company’s high-spec,
Tecnis family of intraocular lenses (IOPs). Christian
Oster, the relatively new AMO surgical product
manager, explained the company’s current Legacy
campaign. “We have a broad range of intraocular
lenses and when you put an IOL into your patients
you are leaving a legacy, and we’re suggesting you
should leave a lasting legacy by using the Tecnis
family of IOLs.”
AMO-sponsored breakfast meetings discussed
the benefits of Tecnis IOLs and also featured
Auckland Eye’s Dr Dean Corbett who, together
with Rotorua’s Dr Neil Murray, undertook one
of the first studies on AMO’s Tecnis Symphony
extended range of vision IOL, which resulted in
high levels of patient satisfaction with the brand
new, first-of-its-kind product.
Launched in February this year, initial feedback
has been very positive said Matthew Northage,
RANZCO NZ Executive
Given RANZCO’s 47th Annual Scientific
Congress was held in Wellington, the New
Zealand Branch combined their branch
meeting and AGM with the gathering.
The 2016 NZ Branch Executive is as follows:
Chair: Dr Stephen Ng
Vice chair: Dr Keith Small
Honorary treasurer and secretary: Dr Andrea
Vincent
Members: Dr James Borthwick (ex-officio chair);
Dr Derek Sherwood; Dr Michael Merriman
(chair of the Education & Qualifications
Committee); Dr Jo Sims (director of training);
Dr Peter Hadden; Dr Graham Wilson; Dr James
McKelvie (registrar representative); Dr Mary
Jane Sime; Dr Stephen Best (ex-officio RANZCO
president); Dr Kolin Foo (continuing professional
development representative); Dr Mike O’ Rourke
(Ophthalmology NZ representative); Dr Jo
Koppens: and Dr Brian Kent-Smith.
AMO’s NZ account manager. “It’s going great
guns. It’s really charging. People are getting very
good results, better than they anticipated, which
is really driving growth through word of mouth.”
Designs for Vision (DFV)
Designs for Vision showcased a number of new
products. The Oculus Pentacam AXL was so new,
general manager Brad Grills and his team didn’t
even have a brochure available and, though
they were taking orders for the new all-in-one
cataract surgery device, which also provides IOL
calculations, buyers won’t be sent the product until
after it’s officially launched in February next year.
Another new DFV product, but with
accompanying brochure this time, was the
compact, all-in-one Tomey UD-800, ultrasonic A/B
scanner and pachymeter, the most versatile and
affordable scanner in the marketplace, said Grills,
adding that when Tomey finally settles on the price
it should be about 15% cheaper than its nearest
competitor products. “It’s a really cool product.”
Also on display was the new Nidek MP-3
Microperimeter (distributed in NZ by OIC.), which
incorporates a “real” fundus camera, said Grills.
According to the brochure, the new MP-3 has a
wider range of stimulus intensity, from 0 to 34 dB
and measures perimetric threshold values, even for
normal eyes, while a maximum stimulus luminance
of 10,000 asb allows evaluation of low-sensitivity.
Grills’ response to the Congress: “RANZCO has
been fantastic, apart from the rugby final.”
Heidelberg Engineering
Heidelberg Engineering’s new-improved Spectralis
OCT2 combines a high scan rate with the company’s
proprietary TruTrack Active Eye Tracking technology.
Designed so that Heidelberg’s OCT Angiography
package, due for release next year, can be built in,
with speeds of 85,000 Hz, the OCT2 is more than
twice as fast as previous models.
“There is demand for faster machines,” said
general manager Carey Hazelbank. “When you
do OCT Angiography it is very important that it’s
done at very high speed because it can be a timeconsuming
process. So obviously a machine that is
more than twice as fast reduces the scan time and
increases patient comfort.”
Spectralis is particularly appealing to buyers,
because it is a platform technology, said
Hazelbank, so it can be upgraded and added to as
new developments come to the market.
Heidelberg is also gearing up to launch a new
cataract and refractive imaging platform in 2016,
a product that’s so new, it doesn’t even have a
name yet, let alone a brochure!
OptiMed
A busy Optimed stand
Optimed was kept busy showing a host
of new developments in its catalogue of
diagnostic instruments, laser, surgical and dry
eye products. On show and attracting particular
interest, to name but a few, was the new OCT
and retinal imaging software from Canon; the
new Iridex IQ series of MicroPulse lasers; the new
Accutome Foresight system, released just two
weeks before RANZCO, which integrates A-Scan,
Pachymetry, B-Scan and UBM into one compact
and far more portable console; and the new
LightLink-CXL Corneal Cross-Linking System, with
pulsed mode features to allow the cornea to reoxygenate
during procedures —an advancement
still under study in the US, but attracting a lot of
positive attention in the cross-linking community,
says OptiMed’s Craig Norman.
Optos
Widefield retinal imaging company Optos also
hosted some pretty high traffic throughout the
duration of the RANZCO Congress, with most
interest centred on the company’s latest ultrawidefield
device, The California.
The California is now available in two different
models, one with all four modalities including
colour, autofluorescence (AF), fluorescein
angiography (FA) and indocyanine green (ICG),
and one with the three modalities of colour,
AF and FA. Both models produce 200 degrees,
or 82% of the retina in one single image, for all
modalities.
Optos also showcased its latest
comprehensive image management solution
software, OptosAdvance, available with The
California, which proved to be pretty popular
among delegate ophthalmologists, said Jason
Martone, Optos ANZ’s managing director.
Zeiss
Taking pride of place on Zeiss’ stand was its new
AngioPlex OCT Angiography technology, the first
angiography technology to receive clearance from
the US Food and Drug Administration.
“Ophthalmologists can now utilise OCT images to
assess the blood vessels of the retina at a depth and
clarity never available before,” the company said in a
statement announcing the FDA approval. “AngioPlex
OCT Angiography delivers high-resolution, depthresolved
visualisation of the separate layers of the
retinal and choroidal vasculature, without the need
for an injected contrast dye, as is standard with
fluorescein angiography.”
AngioPlex OCT Angiography visualises blood flow
by detecting motion of scattering particles, such
as red blood cells, within sequential OCT B-scans
performed repeatedly at the same location of the
retina, said Matthew Wensor, Zeiss’ product manager.
“It’s attracting a lot of interest. It’s definitely the No. 1
thing people are talking to us about.”
That interest was evidenced by a special evening
event Zeiss held to discuss its new angiography
technology, featuring Dr Amir Kashani of the
University of Southern California who was
involved in the technology’s development, which
attracted more than 60 ophthalmologists.
Wensor was quick to stress, however, that this
was still very new technology and would not
necessarily replace fluorescein angiography, but
could work as preliminary, non-invasive, quick
screen to see if FA is required. “There is definitely
a buzz about it. It has got the potential to be a
really significant development and we’re all very
excited to be at the forefront of it.”
Corneal Lens Corporation (CLC)
New Zealand’s own CLC was showcasing two key
products Oculocin Propo and MacuShield.
Oculocin Propo is a new product to the NZ
and Australian markets targeting two key areas,
chronic conjunctivitis and periodic inflammation
and dry eye. A sterile, natural pharmaceutical
grade extracts-based eye drop, it contains no
preservatives and is designed to lubricate and
protect the eye from bacterial, viral or fungal
infection as well speed healing and reduce pain.
The better known MacuShield is a food
supplement containing Lutein, Zeaxanthin and
Meso-Zeaxanthin, derived from the marigold
flower, and specifically designed to protect and
support the macula.
Others
With more than 100 exhibitors supporting the
Congress, delegates were spoilt for choice when
it came to trialing new equipment or discussing
new technologies. Other exhibitors who caught
NZ Optics’ eye were: Stiltec, producers of popular
dry AMD product Macutec and dry eye-relief
supplement Lacritec, which delivers a proprietary
blend of omega fatty acids from flax seed, fish oil
and borage oil; Medi’Ray NZ and Capes Medical,
NZ representatives for the Paragon Care range of
medical equipment and devices, and suppliers
of all manner of medical consumables; Bayer,
manufacturer of the increasingly popular Macular
Degeneration drug Eylea; Bausch + Lomb, which
was showcasing a range of new eye health products
including IOLs and other eye surgery products;
Blackmore’s MacuVision; and TearLab, whose
Osmolarity System attracted significant attention
(more on TearLab in our next issue).
Drs Andrew Riley, Paul Herrick and Shuan Dai
A comprehensive delegate pack containing
a multitude of brochures and other marketing
material added to the comprehensive product
education on offer, with some RANZCO supporters,
such as medical publishing company Mi-tec,
opting just for the delegate bag option. Mi-tec
produces high-quality, peer-reviewed patient
education publications for 25 colleges, societies and
associations in Australia and New Zealand.
Given there was so much to take in, here at NZ
Optics we can’t wait to see what RANZCO 2016
has to offer.
See you in Melbourne in November 2016. ▀
December 2015
NEW ZEALAND OPTICS
17
December 2015.indd 17
19-Nov-15 3:27:20 PM

The annual Saks “Best of the Web” 2016
Here follows my 15th
annual Best of the Web.
It’s best read online.
Due to the power of search engines and
the fact that there are only so many
decent eye-related websites, there’s
no point repeating the same old websites year
after year. The numbers of good online journals,
image databases, educational sites and the like
tend to remain relatively static. There are not
floods of worthy newcomers every year.
Hence it is best to review my archived annual
‘Best of the Web’ versions for thousands of
interesting links: 2014, 2013, 2012, 2011, 2010,
2009, 2008, 2007, 2006, 2005, 2004, 2003, 2002
and 2001. (Due to the nature of the web some of
the historical links will be broken.)
This edition will however provide some links to
interesting sites, apps and other interesting and
sometimes random, irreverent pages.
One of the growth areas and trends I
continue to monitor is the role that social
media plays. This is not only in the obvious
arena of marketing one’s services but more
interestingly in closed “educational” groups.
These focused groups cover professional
development, with fantastic learning
opportunities across the professions.
World leading experts are happy to share
their knowledge and skills. Case histories
are presented often with fantastic OCTs,
traditional fundus/super wide field images,
FAF as well as anterior segment, NaFl RGP
images and much else in between. These
groups also foster debate and discuss issues
and challenges that face our professions.
One such group, OD’s on Facebook, boasts
around 24,000 ECP members and is growing
fast. Another Aussie- based group is a much
more intimate affair and I’d say one of the
best educational forums I’ve taken part in. The
interactive discussions can be purely clinical
but are often balanced with humour and
unrelated irreverent comments from some
of the characters we are fortunate to have in
our professions. At times it even gets a little
risqué. There are occasional heated exchanges
between professionals. It’s a seeming evolution
of the longer-running and more static websites
such as the very successful, ODWire.
These guys all claim to be the biggest or
longest running sites – but many are only
a year old with none coming close to the
longevity of In Contact, which hit its 20th
anniversary edition this year.
Despite my doubts about Facebook, it’s a
massive success (1.55 billion regular users!)
Growth and numbers are ridiculous. If you
doubt the power of the Internet (and like
online shopping) visit AliExpress. They did
$US 14.3 billion of turnover in their 11/11 one
day sale with over 54 million discounted items
available!
We may have our issues Downunder but in
many ways we don’t know how lucky we are!
US optometrists are often qualifying with
$US 200,000 student debt and enter a
challenging employment/business market.
Commercialism is rife and managed care
is hurting the professions. To add to their
frustrations many want to pull their hair out
dealing with electronic health records, complex
systems and the bureaucratic dog they call ICD-
10 coding. For the eyes alone there are about
80 pages of codes for every little thing. One
also has to code all the other general health/
medical issues with the total document and
codes covering nearly 1600 pages!
It would kill me.
Conferences, EXPOs, Journals, CPD, Imaging,
Apps & More
If you ever want to view a seemingly
unlimited range for frames then SILMO is the
place to go. They have plenty of equipment
and low vision exhibitors too. I made my first,
long awaited trip to SILMO this year and it
was great. Paris is nice too. They say that the
forthcoming MIDO Expo is another not to be
missed.
The AAO conference was interesting but
personally I find these large meetings too big.
The stats for the 2015 New Orleans meeting
are impressive; 7,489 delegates, 340 CE hours,
2,116 total speakers, and over 170 companies
represented. This of course means it is possible
to attend only a tiny percentage of talks.
There are often conflicts; more than one talk
at the same time one wants to attend, in the
numerous concurrent streams that are run.
This summary of a plenary session is worth
checking out. This caught my eye too; no shit,
really?
I prefer our more intimate and boutique style
conferences we have in this part of the world.
I’ve closely followed the so-called corneal
oxygen wars since my student days. The
research in this arena was performed by
many of my gurus. It formed a very strong
cornerstone of my prescribing. Barry Weissman
has taken another in depth look at it in Corneal
Oxygen: 2015. There’s still much debate. Values
vary quite dramatically between researchers.
Shouldn’t oxygen levels that approach
no-lens conditions be our target? For some
patients a “balance of properties” is needed.
A few patients cannot tolerate si-hy lenses.
Some seem to have a low corneal oxygen
uptake (sippers) while others have a very
high demand for oxygen (gulpers). Observant
clinicians can tell when a given patient needs
more oxygen or a different material. Comfort,
modality, surface friction, biocompatibility
and quality optics, as well as parameter
range and surface properties are also critical
to success. This excellent article sums it up
rather well.
Fortunately most lenses we use today provide
safe daily wear oxygen levels in hydrogels while
many silicone-hydrogels approach no-lens
levels of oxygen supply to the cornea. Reading
his conclusions it seems Barry and I are pretty
much on the same page.
Customising diameter can also make a
difference to comfort for the outliers. Tomas
Quinn makes some good points about
determining the dominant eye for multifocal
and monovision CL fitting. Some history here,
and here too.
CXL controversies are a topical issue. CL
hygiene is important but one eliminates 60% of
lens care risk factors by fitting dailies!
The snowballing move online is leading to
historical changes in the delivery of content. As
of 2016, two of the top three rated optometry
journals, will become online only. Hold onto
your last editions of Optometry and Vision
Science (OVS) and Clinical and Experimental
Optometry (CXO), and one day show your
kids how we used to read journals! The
upside is massive savings in postage, printing
and packaging, which in turn will reduce
plastic pollution, save many trees and much
greenhouse gas. One does hope that these
cost reductions will be passed on in the form of
lower subscriptions and membership fees. The
cynic in me says probably not; they’ll just keep
all the extra dosh.
One of the upsides of online journals is that
it’s easy to save and index papers that interest
you, which I do into the fantastic Papers app.
There is also rich content in terms or more
colour, larger tables and graphs, video and
the ability to save/export something as a
PowerPoint or Keynote slide for lecturing.
Bundled with the latest version of Keynote
- when installed on an iPhone - is the ability
to remote control the presentation from your
phone, as well as see the forthcoming slide,
which frees you to roam when presenting.
I recently upgraded to an iPhone 6S and iOS9.
The 6S is a big step up from my flaky 5. Imaging
is way better, speed is great but battery power
is still an issue. The iPhone is one of the top
inventions of all time. I also upgraded my
MacBook Pro to El Capitan. There are millions of
apps to choose from. Over one hundred billion
have been downloaded from Apple alone.
Serious revenue.
My advice on Apps remains similar to last
year and my favourites remain much the same
too. Uber has proved useful when travelling
but in many countries it is being challenged.
Airbnb is doing to hotels what Uber did to the
Taxi industry. WEMO is useful too. I recently
setup a TILE to track my superb Kiwi-invented
BLUNT umbrella. The only downside of TILE is
that one has to leave Bluetooth on to maintain
the connection and tracking. Photoshop Touch
looks like a great imaging App for iPhone.
Fisheye? Although I use my iPhone camera for
most things, the remarkable Sony Aplha7IIR is
something I’d like. There are just some things
a tiny 5mm camera like the iPhone cannot
do properly. Check out PCMag’s 2015 ‘Best
of’ lists: Useful stuff for SOE, Blogs, CRM, web
monitoring and more.
Here are some useful Low Vision Apps. These
hand-eye coordination apps may be useful for
VT patients, gamers, hackers and nerds alike.
More medical and eye apps here. Will these
‘save your eyes’ apps make a difference? They
can reduce your blue light exposure at certain
times, remind you to take breaks and more. Get
with the spectrum.
Sue, we even care about the eyes of android
users.
Allaboutvision provides some more useful
eye-related apps,
The Leo Wanker Appreciation Society offers
you the Arthur Dunger fitness program, which
he says is “not half bad for the optic nerve”.
Lifehacks. This guy is funny. So is he. He just got
a big gig. How about the great gig in the sky?
Syd doco.
I need some chicken soup aka Jewish
antibiotics. Some coleslaw would be good too.
My tomatoes have set fruit and we should be
eating some before Xmas. Some more tips here.
My Central Otago export quality cherries are
on order. I’m also looking forward to the plum
season. NZ has arguably the best plums and
apples in the universe. What baffles me is why
do councils plant weed trees on pavements
when every pavement tree should be a fruit
tree or olive? Also every pavement or “berm”
should be a veggie garden but alas our councils
are myopic.
He must have been well pissed by the last
one! I have drawers at home just like this
(old frame storage drawers). So does my Dad,
with lots of similar stuff in them. Tools too.
Little drummer boy; innovation. Ben & Jerry.
Gaystarnews has ten gay scenes from 007
(and much more interesting stuff you probably
didn’t know). One of these is on my wish list for
sure; Trakka Jabiru 4x4
This year I heard some super Jazz in New
Orleans at the legendary Preservation Hall.
Book ahead if y’all gonna be in Norlins.
Although he was pretty ill by this stage this
interview makes for interesting watching.
He still has a Camel in his right hand! Crazy
what doctors were endorsing. I used to see
adverts like this in my Dad’s 1950s and 1960s
Popular Science magazines. He bought the
’57 Ford Fairlane back to South Africa when he
did post-grad optometry studies at Indiana in
1957 under the legendary Henry W. Hofstetter.
#Totesamazeballs car. Shoulda kept that Ford.
Worth a few bob now. Dig the wings.
45 years later we are still “just about” to
get the jetpack. I want one but for now I’ll
settle for one of these. When they get the
hoverboard sorted, I want one for sure!
Dynamic earth maps.
Captain Beefheart was another character!
How about some Higgs Bosun Blues? Chris
Prior is the Rock Professor!
That’s it until 2016 when I look forward to
keeping it interesting in my 21st year of In
Contact.
Have a good one, take care and be safe.
Peace on Earth! ▀
CONTINUED FROM P5
photophobia; and lacrimation. Non-necrotising scleritis can
be treated with topical steroids and NSAIDs and necrotising
sclertitis, topical and oral steroids and immune suppression.
There’s no effective treatment for scleromalacia perforans.
Dr Adam Watson discussed the symptoms of marginal
keratitis, which “all starts in the meibomian glands” and
causes immune hypersensitivity. Those with a history of
systemic disease are more prone and symptoms include
redness, ocular surface discomfort, pain, light sensitivity and
watering.
It’s common, but can be treated with lid hygiene methods,
oral doxycycline, and toptical antibiotics and steroids.
Patients should also be persuaded to give their CLs a holiday
until acute symptoms subside and consider IPL (intense
pulsed light therapy) to improve meibomian gland function.
Dr Nick Mantell reviewed PRK and LASIK data over the
last 10-15 years, saying there is some long-term data
showing overall safety is good, but visual acuity has been
“pretty average”. This is improving, however, with improved
techniques, which should come through in further studies.
Weighing up cross-linking
Both Watson and his colleague Dr Simon Dean discussed
corneal collagen cross-linking.
Dean explained how it was becoming more standard to
treat corneal ectatic disorders so people are starting to push
the boundaries a little more, especially as the only risk is to
the cornea.
In isolated cases there is endothelial damage, he said, but
the risks need to weighed up against the positives of treating
a “sick cornea.”
Watson’s talk on cross-linking focused on how most
patients believe it will make them see better. “You have to
temper that. Yes, about 50% do see some improvement, but
it’s more about strengthening the cornea…to stablise vision,”
he said
Cataract complications and corneal transplants
Professor Charles McGhee provided a sometimes
amusing look at the dark side of cataract complications
and, later in the day, an overview of what’s new in corneal
transplantation.
Cataract operations are the “most successful surgeries we
do,” he said, but of course there are occasional complications,
though these are typically mild.
According to the Auckland Cataract Studies I (2002) and
II (2015), co-authored by McGhee, there has been some
improvement over the years, with reported posterior
capsule tears reducing from 4.9% to 2.6%; cystoid macular
oedema, remaining steady as expected, at 3.8% to 3.5%; and
unaided visual acuity (UAVA) of 6/12 or better improving
from 67.7% to 73.9%.
The most common complications include striate
keratopathy, elevated IOP, aqueous leak, persisting anterior
uveitis, cystoids macula oedema and loose sutures. Rare
complications include retinal detachment, choroidal
haemorrhage and endophthalmitis (about 2 per 1000).
As far as corneal transplants are concerned, the long-term
outcome of penetrating keratoplasty (PKP) for keratoconus
is excellent with a 97% survival after 20 years. The jury is
still out on PKP versus deep anterior lamellar keratoplast,
he said, but at least one study has shown there are fewer
complications with DALK, which is becoming well established.
Demodex, Sjorgren’s and ocular rosacea
Dr Trevor Gray and Dean tackled dry eye-related topics
through three sessions. Gray reviewed our understanding
of demodex mites and their role within, and affect on, our
optically-related bodily functions, causing some amusement
among the audience, and ocular rosacea, which can be
treated with improved lid hygiene, artificial tears and
antibiotics. While Dean tackled Sjorgren’s Syndrome, joking
this was “the most dry talk” delegates would hear that day.
An immune disorder, Sjogren’s (SHOW-grins) syndrome
is most commonly identified by having dry eyes and a dry
mouth and can be tackled with normal dry eye treatments.
Closing: more to come?
Closing the conference, Gray confirmed the record
attendance and thanked delegates, many of whom have
travelled from outside Auckland and even the North Island to
be there.
Given the conference’s popularity, and others, such as
Essilor and Visique, timing their conferences to coincide
with the Eye Institute’s, Gray said Eye Institute staff were
currently considering running a workshop series on Saturday
afternoon, before the conference proper on Sunday, and will
be seeking delegates’ views on this over the coming month
and in early 2016. ▀
Eye Insitute 2015
Conference sponsors
Abbott Medical Optics, Alcon, Bausch+Lomb,
Corneal Lens Corporation, Designs for Vision,
Device Technologies, HumanWare, Ophthalmic
Instrument Company, OptiMed, Optrex,
Toomac Ophthalmic, Glaucoma New Zealand
and Macular Degeneration New Zealand
18 NEW ZEALAND OPTICS December 2015
December 2015.indd 18
19-Nov-15 3:27:20 PM

DO’s programme packed
with positives
Eye Institute’s inaugural Dispensing Opticians
conference, which ran parallel to its popular
one day, annual optometrists’ conference,
was packed to capacity, with extra chairs having
to be brought into the back of the room to seat
everyone.
Dispensing opticians and support staff from
around the country attended the event to hear
about surgical advances, new technologies and
shared care management that could impact
on their side of the business. The 30 minute
Alice Ku, Alisha Walker and Jan Birt
Eye Insitute keynote Margaret Lam shares her wisdom
with our DOs
Dr Trevor Gray chairs Eye Institute’s inaugural DO
conference
As Dr Margaret Lam said, “life is
a continual learning process and
when we start thinking we’ve
learnt enough that’s probably
when we’ve got the wrong
attitude towards life. ”
presentations were delivered by Eye Institute
ophthalmologists and guest speakers Dr Margaret
Lam from Australia’s theeyecarecompany and
contact lens specialists Alan Saks and Grant
Watters of Mortimer Hirst.
Dr Trevor Gray chaired the day and opened the
event with a bold statement: “Education is best
kept fresh and alive, brisk and fast.” He highlighted
that cataract surgery is the most common and
safest prosthetic operation within the ophthalmic
industry whilst being “the most positively
impactful life event for senior citizens.”
Dr Simon Dean discussed meibomian gland
dysfunction (MGD) a common disease and a
leading cause of dry eyes which, if left untreated,
can result in permanent damage to the tear film.
The final morning speaker was Dr Dean Conger
who specialises in glaucoma. Being a lifelong
disease Conger stressed that “most patients, even
if fairly stable,” should be seen every six months
after laser surgery.
Lam gave a number of clinical tips about patient
care and treating ocular emergencies, including
retinal detachments and picking up on red flags
such as flashing lights and floaters. Lam says her
mantra is: “if patients thrive, it means our practices
thrive”.
Dr Peter Hadden emphasised the importance of
early treatment for suspected retinal attachment,
leading to better outcomes requiring less
treatment. He was followed by Grant Watters
who discussed contact lens care and maintenance
and stressed the need for contact lens wearers to
ensure their contacts remain hydrated and clean.
Dr Nick Mantell who specialises in laser vision
correction said the key focus of cataract surgery
was to give the patient the “best possible range of
vision without glasses.” While Dr Shanu Subbiah
discussed the topic of triage and its importance.
The final guest speaker, NZ Optics’ popular
columnist Alan Saks, explained how a monovision
contact lens fitting is a good way to help
presbyopes who struggle with multifocal lenses.
Wrapping up the day Dr Adam Watson talked
about basal cell carcinoma (BCC) and other
common eyelid tumours. He describes BCC as
a “rodent ulcer eating away at the tissue of an
eyelid” if left untreated. Preventions include
sunglasses and sunscreen and educating younger
members of society about the implications of not
caring about their skin and their eyes.
As Dr Margaret Lam said, “life is a continual
learning process and when we start thinking
we’ve learnt enough that’s probably when we’ve
got the wrong attitude towards life. We make our
patients live a better life by providing them with
meaningful improvement in their vision.” ▀
Optoms step up for Kiwi kids
The Essilor Vision Foundation (EVF) has signed
on more than 60 optometrists to provide free
eye exams for students in decile 1 and decile 2
schools across New Zealand.
Established in the US, EVF’s aim is to eliminate
poor vision and its lifelong consequences among
underprivileged populations. As well as the US, there
are now EVF chapters in India, Singapore, Ethiopia,
Namibia, France, Gambia, Tunisia and China, with
Indonesia, Canada, Australia, Colombia and New
Zealand joining this year.
“Our Mission in New Zealand is not just about the
children, but that will be a large part of it,” Essilor’s
director of professional services Tim Thurn said at
the company’s recent platinum conference (see
other story, this issue). “Better vision for kids means
better literacy and fewer societal issues. Fewer
vision issues also means a stronger economy.”
The economic impact is significant, said Thurn.
Research shows that on a global basis, lost
productivity due to vision loss amounts to roughly
US$275 billion a year, with some data showing
a correlation with uncorrected poor vision in
childhood, illiteracy and time spent in prison.
The EVF held its pilot school-screening programme
at Flaxmere Primary School in Hastings (NZ
Optics October), with volunteer help from local
optometrists Jenny Stewart, Frederick Swain, Anita
Pistorius and Tracey Jones and equipment kindly
loaned by Tim Way from the Ophthalmic Instrument
Company (OIC). This pilot found 40% of examined
students were suffering some vision problem,
including high myopia and hyperopia.
“The publicity around this meant others wanted
to get involved and now more than 60 schools
have put their hands up,” said Thurn, adding it’s a
two-way thing for optometrists who get involved.
“These are the communities around which your
practices are built.”
Louisa Wall, MP for Manurewa, also praised the
programme at the conference, commenting that
the video made at Flaxmere School brought a tear
to her eye. “Part of my job here today is to thank
Specsavers reappoints Larsen
Specsavers ANZ
has reappointed
Peter Larsen
to its board as
optometry director,
following a four-year
stint for the company
in a non-executive
consulting role.
Larsen will lead
Specsavers’
Optometry and
Professional Services team, providing education
support and services to the optometrists working in
its 350 stores in Australia and New Zealand (ANZ).
Larsen is a trained optometrist who in 1995 cofounded
a wholesaler that brought branded contact
lenses to Australia and New Zealand, which was
later sold to Coopervision. In 2005 he co-founded
Optovision, a buying group that serves 300 practicemembers
in Australia. He joined Specsavers in 2006.
Specsavers says its regional growth will require an
you and to see if we can get more of you to sign on.
In my community is 27 of 29 of my schools qualify
as decile 1 or decile 2.”
Wall aid that while the DHBs do screen school
children, the information they glean from those
exams does not progress further than sitting in a
file. In-school screenings and follow-ups remove
the barrier many families in low-decile areas face
in taking children to optometrists. Single mothers
working two jobs find it difficult to bring their
children in for tests and many don’t realise their
Community Service cards will cover the cost of eye
tests and glasses.
“From my experience growing up in a low-decile
community and wearing glasses, I know how
important it is to have that clarity,” Wall said.
OPSM helps push eye care
message
OPSM issued a press release to the general media
at the end of October as part of a campaign to
encourage more people to get their eyes tested.
The release stressed that eye strain and damaged
vision was on the increase among children and office
workers and “employers and parents need to do more
to protect the vision of those in their care.”
OPSM optometrist Ashreet Nath was quoted as
saying those Kiwis most at risk are between the
ages of five to 35 due to the long hours on screens
at school, university, the workplace and while they
are socialising. “More and more people are having
problems with their vision including blurred vision, red
eyes, dry eyes, and headaches caused by strain, due to
the amount of time we spend on devices now.”
In the release Nath encouraged people to take
breaks, hold screens as far away as possible and
blink regularly, while parents were encouraged to
limit the screen time of their children. Anyone who
is concerned about their eyes should visit their
optometrist… and ask how they can avoid digital
eye strain, he concluded. ▀
additional 200 optometrists to its current list of 800
full-time equivalent partners, employed and locum
optometrists in ANZ. The company offers 100 CPD
points through its clinical development programme,
provides digital retinal cameras to every practice and
plans to add more support services.
Specsavers ANZ CEO Paul Fussey said the company
needed the right team to support this investment
in the company’s future. “Apart from leading our
optometry and professional services agenda, I know
that Peter is focussed on working with all stakeholders
when it comes to the debate and the formulation
of policy relating to changes and developments in
optometry and professional scope of practice across
the ANZ region.”
Larsen will work with Harrison Weisinger, newlyappointed
director of professional services (global)
on a “host of initiatives, with a focus on enhanced
services and scope of practice issues,” said Fussey.
Wesinger is another Specsavers veteran, having run
its ANZ recruitment section prior to founding the
Deakin University School of Optometry. ▀
CCLS CONFERENCE
CORNEA : OCULAR SURFACE : CONTACT LENSES
WELLINGTON 2016
CONFERENCE
KEYNOTE SPEAKER
Prof Fiona Stapleton, University of NSW
SUNDAY 20 MARCH
MAC’S FUNCTION CENTRE
4 TARANAKI STREET
WELLINGTON
ADDITIONAL WORKSHOP
GLAUCOMA WORKSHOP
Run by Wellington ophthalmologists
Jesse Gale, Graham Reeves, with contributions
from Prof Tony Wells and Dr Chris Murphy
SATURDAY 19 MARCH
CENTRAL WELLINGTON VENUE
Conference and workshop registration opens December 2015.
For more information visit www.contactlens.org.nz
CORNEA & CONTACT LENS SOCIETY
of New Zealand Incorporated
December 2015
NEW ZEALAND OPTICS
19
December 2015.indd 19
19-Nov-15 3:27:22 PM

SPECIALIST SHOPFITTERS & DESIGNERS TO THE OPTOMETRIC PROFESSION
TEL:(09) 486-2070 MOB:(0274) 798-798
Email: tony.maddocks@xtra.co.nz
LOCUM OPTOMETRIST AVAILABLE
Bharat Raniga. Call 021424253 or Email: bharatraniga@yahoo.com
PARTNERSHIP FOR SALE
SUN AND SURF IN THE BAY OF PLENTY? THAT’S
REAL SPECS APPEAL!
Optometry partnership for sale in an established Specsavers
practice. Great central city Tauranga location for over 5 years, and
not in a mall! Excellent growth and returns, a rare opportunity
not to be missed. Contact: Brendan.thompson@specsavers.com
to register your interest!
EQUIPMENT FOR SALE
Topcon Chair and stand, phoroptor, slit lamp, keratometer,
hydraulic table, projector, NCT, Matrix, trial lens set— all in good
condition. Contact c/- info@nzoptics.co.nz, Code: EQFS12
VACANCY IN CENTRAL AUCKLAND
DISPENCING OPTICIAN OR EXPERIENCED
OPTICAL CONSULTANT WANTED TO HELP GROW
FUN & BUSY, INDEPENDENT PRACTICE IN
AUCKLAND
We are looking for an experienced, friendly, self-motivated staff
member to join our small independent team at Epsom Eyecare
Optometrists in the leafy suburb of Epsom, close to Newmarket,
Mount Eden and just five km south of the city centre.
If you like dealing with people, taking initiative, are passionate
about eye health and quality eyewear, and you want to be a
senior and valued member of a team committed to providing the
best customer service, we would love to hear from you.
Please email expressions of interest to Jyotika@epsomeyecare.
co.nz. All applications will be treated in the strictest of confidence.
MAKE A LIFESTYLE CHANGE IN 2016!
Move to a laid-back harbour town surrounded by world class
beaches and forests. Work “flexi-time”, perfect if you enjoy an
outdoor lifestyle or want to have more family time. Independent
practice for sale in Whangarei. Quality fit-out only two years old,
prominent CBD street-corner with large traffic movement, great
landlord and low rent. Loyal patient base that expects premium
eye-care and eyewear. Present owner available to stay on as DO if
required. Contact stu@opticsnz.co.nz or craig@visualeyez.co.nz.
Eyes opened
on VOSO trip
BY ASHLEY GRAY*
Malo e Lelei. This
Volunteer Ophthalmic
Services Overseas (VOSO) trip,
visit to the beautiful Kingdom
of Tonga.
I was excited, yet apprehensive
in the lead-up to the visit. I
didn’t know what to expect.
Of course I had no need to
be worried as it turned out I
enjoyed every moment of my
time in Tonga and I returned
to New Zealand with a new
perspective on eye care.
The trip was from September
19 to 26. Thames-based locum
Hywel Bowen and I provided
optometric services through
the week, going wherever
we were needed and seeing
every patient that turned up.
We provided a basic exam,
taking a brief history—via
translator—followed by
retinoscopy, basic refraction
and external and internal
examinations of the eyes.
We distributed spectacles
from the stock that had been
sent ahead of us. These were
mostly recycled spectacles,
donated by the Lion’s Club and
others, along with some readymades.
We were even able to
give out recycled progressives
and bifocals to some patients,
which was really great. Over
and I saw more than 100
patients and provided about
200 pairs of glasses.
Drs Andrew Riley and
John-Paul Blanc had a full
operating list booked up for
the whole week. They powered
through nearly 50 surgeries,
from cataracts to pterygiums
to melanoma excisions,
making a huge difference in
a country with no resident
ophthalmologists. They were
met with many happy, smiling
faces in post op.
I could write all about the
The author at work
extracurricular activities we
got up to in our week on
Tongatapu—the country’s main
island—but I have been told
what goes on tour, stays on tour,
so I dare not.
It was great to see that every
little bit that was donated to
VOSO really counted. I was
pleasantly surprised by the
high level of organisation that
went into this trip. Everything
ran very smoothly and we
seemed to have everything
we needed. The local nurses
and staff welcomed us
warmly and they impressed
me with their knowledge and
enthusiasm for eye care. I was
very appreciative of all the
work and planning that was
put into our one week. I know
that a lot of effort went into
the organisation and shipping
of all the spectacles, medicine
and surgical equipment.
certainly very busy, but it was
also incredibly rewarding. While
I left the island with a heavy
heart because I wanted to stay
much longer, I also left knowing
that I had made a bunch of great
new friends and had a pretty
life-changing set of experiences
along the way. I highly
recommend getting involved in
this fantastic organisation.
For information on joining
upcoming VOSO trips in 2016,
contact visionzsecretary@
gmail.com.
* Ashley Gray is a therapeutically
qualified optometrist with Gary
Filer Optometrist in Auckland. She
graduated with first class honours
in Optometry from the University of
Auckland and a BSc in Neuroscience
from the University of Otago.
CCLS conference 2016
The Cornea and Contact
Lens Society (CCLS) will
host its 2016 annual
conference on March 20.
This one-day event will be held
at Mac’s Function Centre on
Wellington’s waterfront, near
Te Papa museum. The keynote
speaker will be Professor Fiona
Stapleton, head of the School of
Optometry and Vision Science
at the University of New
South Wales.
Stapleton’s research areas
include the epidemiology of
lens-related disease, ocular
microbiology, bacterial
resistance, contact lens care
systems and ocular defence
mechanisms. According
to the University website,
Stapleton has more than 160
peer reviewed publications,
has contributed 15 chapters
to textbooks and published
a book on the diagnosis and
management of anterior
segment disease.
The CCLS is also offering a
Glaucoma Workshop to delegates
on March 19 to promote safe,
collaborative care for glaucoma.
The seminar will be an interactive
discussion focssing on clinical
cases to highlight evidence-based
decision-making, recognising
dangerous situations and
underscoring concepts relevant
to managing glaucoma in a
population.
The main speakers will be
Wellington ophthalmologists
Drs Jesse Gale and Graham
Reeves, with contributions
from Professor Tony Wells and
Dr Chris Murphy. Registration
for the workshop will be via
the conference registration. A
discount on registration fees
is likely to apply if attending
both the workshop and the
conference.
Registrations will open
in January 2016. For more
information and to register, stay
tuned to www.contactlens.org.
nz. If you aren’t a CCLS member
and are interested in
attending, please contact
secretary@contactlens.org.nz.
20 NEW ZEALAND OPTICS
December 2015
December 2015.indd 20
19-Nov-15 3:27:22 PM