Aug 2016

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
AUGUST 2016
ULTRASOFT
HYDROPHILIC
SURFACE GEL
SILICONE
HYDROGEL
CORE
UNIQUE
WATER
GRADIENT
THIS IS WHY patients
can experience a surface
so soft, it feels like nothing.
PERFORMANCE DRIVEN BY SCIENCE TM
*Perez-Gomez I, Giles T. Clin Optom 2014;6:17–23. NP4:A21601422433

10 free ticket,
flight and
hotel packages
available now!
YOUR PERSONAL INVITATION
BRISBANE CONVENTION & EXHIBITION CENTRE
SATURDAY 10 TH & SUNDAY 11 TH SEPTEMBER 2016
Join 500 optometrists (including more than 100 non-Specsavers
optometrists) at this year’s SCC for two days in September –
for one of Australia and New Zealand’s premier optometry CPD and
networking events.
Saturday – Clinical Education Sessions: Afternoon session across two concurrent
streams (Therapeutic / Clinical Skills). University, Optometry and Hospital led.
Worth 3 CD Pts and 3 General Pt in 2015.
Sunday – Specsavers Clinical Conference: Full day session on a single stream
(Therapeutic and Clinical topics). Ophthalmology led.
Worth 6 CD Pts and 1 General Pts in 2015. Exhibition also in place.
To find out more and to access the SCC Booking Portal (ticket registration and
accommodation), go to spectrum-blog.com/book/SCC
Non-Specsavers Optometrists: to enter into a prize draw
for ten free ticket / flight / accommodation packages, contact
Sinead Convery on +61 427 754 076 or sinead.convery@specsavers.com
When: Saturday 10th and Sunday 11th September 2016
Where:
Theme:
Detail &
Costs:
Brisbane Convention & Exhibition Centre
‘Collaborative Care – a new era in eye health’
Saturday: Clinical Education Sessions
12:00pm to 5:00pm
$150 + GST
Saturday: Welcome Event
Gallery of Modern Art
6:45pm to 10:45pm
Event hosted by the Specsavers
Professional Services team: no charge
Sunday: SCC
7:30am to 6:00pm
$340 + GST
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 August 2016.indd

Facing the future?
Innovation
nation
EDITORIAL
BY JAI BREITNAUER
In the world of Antipodean optometry, 2015 was a
unique year. Optometry graduates found they had
an additional 110 newly qualified optometrists to
contend with on the job market as a direct result of
two new courses at universities in Australia.
Flinders, based in Southern Australia, launched
its optometry course in 2009. It’s the only
university outside the Eastern states offering
such a qualification and strongly targets potential
students from rural areas. While Deakin, based in
Melbourne and Geelong, launched its fast-track
optometry masters course in 2012, allowing
students to become qualified in just three and a
half years.
Stu Allan, from OpticsNZ, believes we have seen,
and will increasingly continue to see, a tightening
of job prospects for New Zealand graduates.
“There are now five universities in Australia
offering optometry degrees. What we are seeing
as a result is an excess of graduate optometrists
in Australian metro areas like Melbourne, and the
knock on effect is a reduction in starting salaries in
those locations.
“In New Zealand, we typically see 50 to 60
graduates from Auckland University each year (42
this year), but there aren’t 50 to 60 optometrists
retiring each year, and growth is static. These
students will be looking overseas – traditionally
Australia – for work, and that market is now more
crowded than ever.”
Mark Overton, from Ideology Consulting in
Australia has similar concerns.
“As well as additional graduates, we are seeing
private practice squeezed and so unlikely to be
able to take on new graduate staff. Also there
are more locums looking for permanent work in
Australia now as a result of restructuring within
the corporates.
“It’s true that starting salaries this year were A$5
to A$10k less over here. It’s like filling a cup with
water – you can run the tap as fast as you like but
you’ll just end up with overflow quicker.”
Unlike Allan however, Overton sees the situation
as potentially improving job prospects for Kiwi
graduates, at least temporarily.
“The majority of courses in Australia are in the
Eastern metro areas. When students graduate,
they don’t necessarily want to move. They’ve got
a quality of life, perhaps even a partner, and they
want to make a life for themselves in Melbourne
Stu Allan predicts tough times
ahead for Kiwi graduates
Mark Overton sees good job
prospects for Kiwi graduates
outside Melbourne and Sydney
or Sydney, not the rural areas where there is a
shortage of optometrists.”
Overton suggests that graduates coming to
Australia from New Zealand might be more willing
to go to places like Darwin, where job prospects
are good.
“Many come for two to four years as a bit of an
OE. They don’t have preconceptions about where
they want to be, they just want a good job and are
prepared to travel.”
Looking at the two new courses, Overton also
says they do serve a purpose.
“Both Flinders and Deakin have more of a focus
on rural optometry. Flinders actively recruit
students from rural areas and encourage them to
go back to those places after they graduate. I work
with students from Flinders and the quality of the
graduates is very high indeed.”
Deakin is also actively targeting rural students
from this year, proving that rather than just
saturating a popular student market, both
universities have considered where there might be
a real industry need.
Hirdesh Nair, professional services manager,
OPSM NZ, says he’s confident the new courses
won’t affect Kiwi graduates.
“There are very few New Zealanders studying
in Australia and most Aussies won’t be looking to
come to New Zealand for work. OPSM have had
room for six graduates this year, mostly in our
regional areas. Of course it is hard to predict the
job market needs when you don’t know who is
retiring or what new practices are opening, but we
are in the position where we want graduates.”
Nair says the new courses in Australia aren’t
saturating the market, noting there is one school
of optometry for New Zealand, a country of four
million people, and only five in Australia, a country
of 26 million people.
“If you do the math, then by rights Australia
should have six schools. Western Australia doesn’t
have any universities offering optometry.”
Like Overton, Nair says he believes it’s all about
lifestyle choices, and whether graduates are willing
to travel regionally. He also believes as more
practices move to seven-day trading more jobs will
open up.
“New Zealand is currently the least affected by
the new schools. When Australia gets back-filled,
then we may see a problem.”
It’s this backfilling that is worrying Allan, who
agrees there are regional vacancies in New
Zealand, but finding a job is more complicated
than location and remuneration alone.
“The more provincial you go, the better the
salary. This is true in New Zealand with places like
Gisborne or Whangarei. But graduates seem to be
motivated by other things, like the team dynamic,
mentors with a genuine desire to share knowledge
and being exposed to a wide cross-section of
patients in their first two years, more than money.”
Allan says he believes the best chance of new
graduates securing a job is to specialise early on
in areas like behavioural optometry and make
themselves stand out.
“If you asked new graduates would they have
chosen to complete the same path of study,
knowing what the job market is like, I wonder
how many would say ‘yes’.
“There is no question it is a fantastic
profession; strong primary healthcare links,
meaningful, privileged, and with exposure to
patient life stories. The stories from journeyman
optometrists over the years are emotional,
rewarding and empowering. But looking ahead
there is a clear need to develop sub specialities,
to differentiate based upon clinical strengths.”
Are you a recent graduate? What was your
experience of finding a job or moving into the
job market? We’d love to hear your story. Drop
us a line at editor@nzoptics.co.nz. ▀
DV805-0416
This month has flown by, not least because
of all the exciting and newsworthy
developments we’ve been exposed to. Don’t
panic, I’m not talking about Brexit (although as a
Brit, and a staunch #REMAIN voter, it has certainly
occupied much of my time), but rather within the
industry. Our inboxes have been flooded with news
about new research, business partnerships and
product launches that have buoyed my optimism
about this exciting industry.
Times are a-changing, none of us can deny that.
And in this fast-paced ‘uber’ world we now live
in, reinvention is essential to success. The optics
industry is not immune to this and I’m pleased to
see this has been recognised across the board.
As our optometrists’ healthcare mandate
becomes even more retail focused, as our ‘patients’
become ‘clients’, as style and convenience begin to
play an even greater role as a driving force behind
consumer eye-health awareness, our practitioners,
researchers and behind the scenes business people
are doing some great things – and we’ve tried to fill
this issue with some of them. This month we’ve a
fabulous Focus on Business column from self-styled
retail geek, Juanita Neville-Te Rito (p.6) and we also
take a look at how bricks and mortar trading is
merging with the digital world (p.9). Jason Dhana
offers us a very colourful take on the European
Glaucoma Congress (p.10) – proving that making
connections is not only essential to quality patient
care, but quite fun too! And we uncover how the
job-market is changing for this year’s optometry
graduates (p.3).
We look at Oculo’s quest to pull together an ‘eyehealth
eco system’ (p.4) and oDocs flirtation with
art at Motat (p.6). And don’t miss the stunning
young lady modelling Optique Line’s new Mersey
Beat range on p.9, none-other than Optique Line
founder John Nicola’s daughter Helen.
We hope you enjoy reading this issue as much as
we enjoyed making it. ▀
Jai Breitnauer, Editor, NZ Optics
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NEW ZEALAND OPTICS
3

News
in brief
TECHNICAL COLOUR
California-based EnChroma, founded in 2010, has sold nearly
30,000 sets of sunglasses to people with colour-blindness who
are now able to see in technicolour for the first time. In news
reports the company’s glass scientist and co-founder, Dr Don
McPherson, said it all began more than a decade ago when he was
manufacturing glasses for laser surgery. When he tried them on, he
noticed his normal colour vision was enhanced. He offered them to
a colour-blind friend who found he could differentiate between red
and green for the first time. One of the unintended consequences
of the lenses Dr McPherson had developed was they absorb some
wavelengths of
light making them
beneficial for
people with colour
deficiency. The
current lenses aid
about 80% of people
and the company is
trying to develop a
new product for the
other 20%.
CONTACT LENS BOOM
The global market for contact lenses grew to US$9.4 billion in
2014 from US$8.9 billion in 2013, according to the report, Contact
Lenses: Technologies and Global Markets.
Published in June, the report says the CL product market is expected
to grow at a five-year compound annual growth rate (CAGR) of
1.9% from 2015 to 2020, increasing from US$9.2 billion in 2015 to
US$10.1 billion in 2020. The rigid and hybrid lenses segment should
grow at a five-year CAGR of 9%, reaching US$466 million in 2020.
The others segment, including intraocular lenses and advanced
optics lenses, reached about US$2.2 billion in 2014, up from nearly
US$2 billion in 2013, and should grow at a five-year CAGR of 4.1%
during the forecast period.
RODENSTOCK AND CAMBODIA VISION
Rodenstock Australia has received a Certificate of Appreciation
from Cambodia Vision for its ongoing support. Strong supporters
of the not-for-profit organisation, the Rodenstock team attended
the annual Cambodia Vision fundraising dinner at the end of
June where they accepted the certificate. Cambodia Vision was
established in December 2006 to work with small provincial towns
in Cambodia on blindness prevention and basic healthcare. Research
shows Cambodia has a high incidence of preventable blindness with
approximately 70,000 new cataract cases each year. The foundation
survives solely through sponsorship and community support.
FIRST ASIAN BCLA CONFERENCE
The British Contact Lens Association (BCLA) will hold its first
conference outside the UK at the Cordis Langham Place Hotel in
Hong Kong from 13 to 14 September this year. The conference will
cover myopia management, presbyopia and dry eye. “The conference
is a perfect opportunity to hear the latest research including new
papers from some extremely talented professionals in Australia and
Asia,” said BCLA president Brian Tompkins in a statement.
The event, titled Correction for the Future, is a partnership
between the BCLA and the Hong Kong Cornea and Contact Lens
Society. Registration is open now.
GENETIC GLAUCOMA
Flinders University ophthalmology experts have joined US
colleagues to discover a new genetic cause of primary congenital
glaucoma, reported Australian Optometry. Glaucoma in children is
often more aggressive than in older people and requires multiple
surgeries and life-long daily treatment. Quoted in the article,
Flinders research leader, ophthalmologist Professor Jamie Craig,
said the study will use samples from around the world to link the
disease to mutations in the TEK gene, which can lead to a poorly
formed or absent cell-membrane receptor protein for proper
development of a drainage channel, leading to elevated eye
pressure over time. He said it’s hoped, through further research, a
new genetic test could be developed as well as better treatments.
Oculo teams up
with Optomates
Oculo, a new internet-based, secure-messaging service
designed to connect eye care professionals, has teamed up
with Monkey Software, another Australian-based company,
whose practice management software system, Optomate, is one of
the most widely used in New Zealand.
“Oculo is committed to quality patient care and also to
streamlining practice workflows,” says Dr Kate Taylor, CEO of Oculo.
“Optomate is a leading software for optometrists, widely used
by independent practices and covers scheduling, billing, supply
chain management, patient records and more. This is a really
exciting partnership, as it’s our first integration demonstrating our
commitment to working widely across the eye care industry. It is
the first step toward other integrations.”
Dr Taylor reiterated the need for wider communication and
teamwork in order to provide the best service to clients.
“Our aim is to connect the eye care ecosystem. This partnership
will make it easier for independent optometrists to tap into what
Oculo has to offer. We are also reaching beyond an optometry and
ophthalmology platform, to offer access to low vision services,
support groups and additional networks that offer a continuity of
Chewing it over
The Save Sight Institute at the University of Sydney
has developed a simple ‘chewing gum’ test to help
prevent blindness.
The test requires patients to chew gum at a rate of
one chew per second to unmask claudication of the
jaw muscles – a symptom specific to giant cell arteritis
(GCA). This condition, most common in people over 50,
can be hard to diagnose because the symptoms, such
as headaches and vision problems caused by artery
inflammation in the head, are often subtle and easy to
associate with other conditions. The ‘chewing gum’ test
can reproduce a patient’s tell-tale pain, allowing further
investigation with a blood test and an arterial biopsy to
confirm diagnosis.
Outlined in a letter in June’s New England Journal of
Medicine, researchers presented two cases where the
chewing gum test allowed clinicians to better characterise jaw
pain, confirm a diagnosis and successfully treat both patients.
The 4 days of Optics
23 - 26 September 2016
care for eye patients, enhancing the quality of their experiences and
outcomes.”
Dr Taylor also noted this partnership would make it easier for
independent practices to access the services Oculo provides. Chris
Monks, director of Monkey Software, reiterated this point.
“Independent optometrists are committed to providing the best
possible quality of clinical care. We recognise that today collaborative
care is an important part of optometrists’ contribution to eye care,
and so we are keen to facilitate this.
“Working with Oculo, who have grown with a vision for enhanced
eye care, is a good fit for Optomate’s dedication and ongoing
investment to support our optometrists’ commitment to patients.
Communications through Oculo will also help our optometrist users
connect with GPs and other medical specialists - important both
for patient care and to promote the central role of optometry in
primary eye care.”
Oculo’s software was developed at the Centre for Eye Research
(CERA) in Australia. The Australian roll-out began in April and now
exceeds 1,000 users, with 215 ophthalmologists and 400 practices. It
was officially launched in New Zealand in June. ▀
GCA is one of the most common causes of blindness in older
people and a condition that poses a high risk of death.
The test is currently undergoing further study. ▀
CCLSA
registrations open
Registrations are now open for the Cornea and Contact Lens
Society of Australia’s (CCLSA’s) next master class, which will take
place at the beautiful Ayers House in Adelaide from 26 to 27
November, immediately after the Blue Sky Congress.
This year’s programme will include presentations on finding
the confidence to increase the percentage of contact lens
wearers in your practice, three different perspectives on
applications for contact lenses outside refractive correction,
identifying dry eye, secrets of the edge design of RGP contact
lenses and managing acute contact lens complications. ▀
NEW CONJUNCTIVITIS DRUG
The US Food and Drug Administration (FDA) has accepted a New
Drug Application (NDA) from Nicox for AC-170, a novel, proprietary,
cetirizine eye drop formulation, for the treatment of ocular
itching associated with allergic conjunctivitis. This is the first time
cetirizine, a second-generation antihistamine, has been used in
a topical drug for the treatment of ocular itching associated with
allergic conjunctivitis. AC-170 was developed by Aciex Therapeutics,
which became a wholly-owned subsidiary of Nicox in October 2014
and was subsequently renamed Nicox Ophthalmics.
LIVE THE EXPERIENCE
silmoparis.com
ACBO FAREWELLS BERNIE
Bernie Eastwood has stepped down as president of the Australian
College of Behavioural Optometrists (ACBO) to focus on opening a
new Perth-based practice. The ACBO Board has invited current vicepresident
Steve Leslie to assume the role of acting president until
the next AGM, at which time an election will be held for the role of
president and any other Board vacancies. The ACBO Board thanked
Bernie for her considerable contribution and her commitment to
her profession. ▀
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 Jai Breitnauer, editor, on 022 424 9322 or editor@nzoptics.co.nz.
For advertising, marketing, the OIG and everything else, please contact Lesley Springall, publisher, on 027 445 3543 or lesley@nzoptics.co.nz.
To submit artwork, or to query a graphic, please email lesley@nzoptics.co.nz.
NZ Optics magazine is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times a year, by New Zealand Optics 2015 Ltd. Copyright is held by
NZ Optics 2015 Ltd. As well as the magazine and the website, NZ Optics publishes the annual New Zealand Optical Information Guide (OIG), a comprehensive listing guide that profiles the
products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The views expressed in this publication are not necessarily
those of NZ Optics (2015) Ltd.
4 NEW ZEALAND OPTICS August 2016.indd

UNIQUE WATER GRADIENT
ULTRASOFT
HYDROPHILIC
SURFACE GEL
SILICONE
HYDROGEL
CORE
THIS IS WHY patients
can experience a surface
so soft, it feels like nothing. ** 1
DAILIES TOTAL1 ® contact lenses have an ultrasoft surface,
almost as soft as the corneal epithelial cells. 2–5
The First and Only Water Gradient Contact Lens
>80% 33%
>80%
~0.01
MPa
Contact Lens Cross-Section
Enlarged Water Gradient Surface Modulus
UNIQUE WATER GRADIENT
Features different surface
and core water contents 6 LASTING LUBRICITY
Hydrophilic surface gel
approaches 100% water
LOW SURFACE MODULUS
Modulus of ~0.01 MPa at
the outermost surface 2,4
at the outermost surface †2
Let your patients experience the DAILIES TOTAL1 ® contact lens difference today.
PERFORMANCE DRIVEN BY SCIENCE
*Dk/t = 156 @ -3.00D. **Based on wearers agreeing with the statement, “while wearing my lenses, I sometimes forget I have them on”. †In vitro measurement of unworn lenses.
References: 1. Perez-Gomez I, Giles T. Clin Optom 2014;6:17–23. 2. Angelini TE et al. Invest Oph & Vis Sci 2013;54:E-Abstract 500. 3. Angelini T. Hydrogel surface viscoelasticity and
mesh-size characterized with microrheology. ARVO, 2013:E-abstract 1614872. 4. Dunn AC et al. Tribol Lett 2013;49(2):371–378. 5. Straehla JP et al. Tribol Lett 2010;38:107–113.
6. Thekveli S et al. Cont Lens Anterior Eye 2012;35(Supp1):e14.
See product instructions for wear, care, and safety information.
© 2016 Novartis. Alcon Laboratories (Australia) Pty. Ltd. 10/25 Frenchs Forest Road East, Frenchs Forest, NSW 2086, Australia. Phone: 1800 224 153. 109 Carlton Gore Rd, Newmarket
1023, Auckland, New Zealand. Phone: 0800 101 106. 07/16 ALC0550a NP4:A21601422433
August 2016.indd NEW ZEALAND OPTICS
5

oDocs collaborates at MOTAT
Focus
on Business
DRIVING CUSTOMERS DIGITALLY
Seven ways to use social media
to get customers in store
Increasingly I am talking with retail
businesses who have got themselves
tied up in knots over social media. In
particular, how they can use it to drive
awareness or visitation to their physical
location. More commonly physical
stores typically use social media to drive
customers to their website, but there are
many other opportunities to be explored.
Here are seven social media strategies
I’ve learned while watching others
achieve success.
1. Offer special offers (dare I say coupons)
only redeemable in your store.
This is one of the most basic strategies,
but it is effective. If you are launching
a new product you can offer additional
value or discount to drive shoppers instore.
Something like “mention this tweet
and get half off your next purchase,” or
post an image that the customer shows
the sales assistant in order to receive the
special offer.
It’s important to distinguish this
approach from typical online coupon
strategies, such as using coupon codes
at the checkout. The key is to funnel
shoppers into your chosen physical store
by not allowing this to be redeemed
anywhere else.
Smoove Clothing is well renowned for
utilising this method in their secret sales
promotions - where customers have to
provide the “secret password”, which is
posted on social media, in order to get the
exceptional sale discount.
2. Host a special event.
The type of event will depend almost
exclusively on your customers. For
example, young hipsters would
probably be excited by a live music or
art collaboration. But a foodie audience
might like to watch a celeb chef do a
demonstration, meet the maker or have
their book signed.
Once you decide on the nature and
date of your event, start promoting the
heck out of it. Farmers, with their Fashion
Fixes by Lisa O’Neil in-store events, is an
example which drives great enthusiasm
and excitement with shoppers and results
in massive sales in-store.
3. Attend a local event and use a
designated hashtag.
If you are too small to host an event
of your own, you can always attend
someone else’s event. For example, get
involved at a local festival by walking
around handing out free samples or
flyers. The event is bound to have a
Twitter hashtag associated with it. Start
posting images of your business at the
event and use accompanying hashtags.
This will greatly increase your visibility
and relevance to a target local audience,
making them far more likely to visit your
physical location.
Lululemon recently attended the
Wanderlust healthy living/yoga event at
Western Springs along with 2000 fitness
fanatics. Prospective customers were
drawn to Lululemon’s bubble experience
(bean bags and music in a completely
clear bubble) where they snapped photos,
took videos and shared their thoughts
with their social networks. Leveraging
#thesweatlife, Lululemon continues to
drive interest in-store by hosting free
yoga sessions on Saturday mornings,
BY JUANITA NEVILLE-TE RITO*
bringing together an eco-system of
awareness and visitation.
4. Post images of your physical location.
Posting real-time pictures of your
business on a regular basis brings to
life who you are, what you stand for
and all the perfect reasons a customer
should come and visit. New entrant
Good Grocer NZ ritually posts about
what’s new, fresh, tasty, the view of the
store, or customers having a good time.
It doesn’t matter what type of pictures
you take, as long as you take relevant and
appealing ones. These appealing pictures,
posted regularly, will convince your social
followers that your physical location is
worth the visit.
5. Show off your best asset - your
employees and your partners
People like to see other people. Show off
these bright shining stars by employees’
posting images of them having a
good time and/or put up profiles of
each individual and bring to life their
personalities.
Give your social followers a look at
the types of people responsible for
keeping the business going. This gives
your physical location a warmer, more
welcoming appeal that encourages
increased foot traffic.
6. Encourage social reviews.
Take advantage of the people who have
already visited you. You can do this in your
store by making signs that encourage
visitors to post images and descriptions
of their experience or through other
communications you may have. Another
option is to do this online, by making a
post that asks your followers to recount
their most recent in-store experience.
Try to be original in your phrasing and
respond to the people who have both
good and bad things to say.
7. Share and retweet your fans.
Nothing breeds brand loyalty like shares
and retweets. If you see a customer post
something positive about your physical
location, share or retweet it and thank
them for their positive feedback. Doing
this regularly naturally encourages more
feedback from your in-person customers
but also shows off the fact that you
appreciate your customers and makes your
physical location more visible.
Using social media is not hard – it
just requires courage, consistency,
commitment and most importantly
relevant and interesting content. Be brave
and bold. Try different things. Attract those
moths to your flame. And if all else fails, a
picture of a cute dog will always work. ▀
ABOUT THE AUTHOR:
* Juanita Neville-Te Rito
is the founder of retail
specialist consultancy,
The Retail Collective.
With more than 25
years’ experience in
the retail sector, and
a personal passion for
shopping, she is full
of insights that can
transform the brand
experience provided by retailers at every level.
Visit www.retailgeek.co.nz for more or follow her
on Twitter: @JuanitaNeville or Instagram:
@juanitanevilleterito
The Idea Collective has launched a new collaborative
installation with oDocs EyeCare at the Museum of
Transport and Technology (MOTAT) in Auckland.
An ongoing MOTAT exhibition, the Idea Collective is
designed to celebrate New Zealand’s vibrant innovation
culture by matching up visionaries, artists and
entrepreneurs to create installations across five pavilions.
oDocs was paired with New Zealand film director
Armagan Ballantyne and her partner Jon Baxter to create
a visual installation that would draw public attention to
eye health and the work of oDocs.
The oDocs’ collaboration has resulted in a giant eye that
the audience can peer inside to see how the eye works.
The eye is watching a video which begins to deteriorate
in front of the audience in line with the symptoms that
would be suffered by a macular degeneration patient.
“As a visual artist, I’m so passionately in love with my
sight, I can’t imagine being without it,” said Ballantyne
at the launch event on 7 July. “The Idea Collective
matched me and Jon with oDocs. We spent some time
hanging out, found out what they did and looked at the
space available. It didn’t take us too long to come up
with the idea - we knew it had to be an eye. We wanted
something the audience could really experience, that
would make them think about their own sight and
consider the impact of blindness.”
oDocs EyeCare won an innovation award last year for
their exciting work around smartphone-based eye test
apps. They noted that of the 285 million people suffering
from blindness and vision impairment worldwide, 80% of
those cases were preventable and 90% of those were in
developing countries. oDoc’s aim is to use its technology
to make eye tests accessible, affordable and sustainable,
and to compliment the work around low vision already
being carried out in developing countries.
Innovation really happens easily in New Zealand, there
is a maker culture here, but the story is often started but
not realised,” said oDocs’ CEO Hanna Eastvold-Edwins.
“We’re a lucky start-up to have the momentum we do.
The pavillions provide patrons with an interactive
experience so they become part of the artistic process
Buchanan Optometrists sold
Alain Brideson and Hanna Eastvold-Edwins from oDocs with visual artist
Armagan Ballantyne (right)
New Zealand is rallying around us to give us that critical
mass we need to get out and into the market.”
New Zealand is smaller than most markets and oDocs
needs this community support to succeed, she added.
“We’re not trying to replace optometry. But there has
been a 50% rise in diabetes globally and only a 2% rise
in ophthalmology. The model needs to change. There
aren’t enough trained staff in developing countries…our
screening model can, ultimately, help reduce the number
of people who may unnecessarily lose their sight.”
The Idea Collective is open at MOTAT daily from 10am
to 5pm. ▀
The Idea Collective have a large space at MOTAT with six exhibits and a break out area
Hallertau Brewery were one of the sponsors at the launch event, attended by artists, industry
specialists and representatives from the Idea Collective and MOTAT
Buchanan Optometrists in Christchurch has been bought by Matthews Eyewear Eyecare. Based in Riccarton,
and formerly in the CBD, Buchanan Optometrists was owned and operated by Ian Buchanan from 2006.
“After the earthquakes, we decided to relocate our family to Adelaide,” says Ian Buchanan. “I was running
the practice remotely, and now we have settled in Tauranga.”
Buchanan recently became a partner at Mt Maunganui Specsavers, which spurred on the sale of the business he
had been overseeing remotely since 2013.
“The sale was completed in May and it’s been a smooth transition. The long-term staff have retained their jobs
and the business has rebranded to Buchanan & Matthews Optometrists.”
Matthews Eyewear Eyecare, now has nine stores across the North and South Island, including practices in
Hamilton, Wellington, Kapiti, New Plymouth, Nelson and Blenheim. It remains a family-owned business with each
practice having its own local flavour and a commitment to high quality eye care. Unfortunately, Philip Matthews
was not available for comment at the time of going to press. ▀
6 NEW ZEALAND OPTICS August 2016.indd

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NEW ZEALAND OPTICS
7

SPECIALITY CL FORUM BY ALEX PETTY*
ORTHO-KERATOLOGY FOR THE POST-LASIK CORNEA
Before we delve into our next case I should
make it known that shortly after my
last column was published in May I was
summoned to an urgent meeting with the
NZ Optics editorial team. Disturbing reports
had emerged of the readership falling asleep
when perusing the contents of Speciality
Contact Lens Forum. Admittedly, I was shocked
that there were optometrists out there not
captivated by weird rigid lenses like me. I was
issued an ultimatum: inject some personality
into my case reports or be shipped back to the
penal colony across the Tasman as penance for
the crime of dull writing. Jokes aside it is great
to see the energy Lesley and Jai are putting into
the magazine and I’m excited and grateful to
help out in a small way as NZ Optics evolves.
Naturally I apologise in advance for the glut of
‘dad’ jokes and inappropriate puns that I now
have free-reign to include in future missives.
On to the optometry.
We all know that the results of laser refractive
eye surgery are becoming increasingly
impressive. However, the reality is that despite
the success of the initial surgery, zero refractive
error is not a guarantee as the years continue.
One report suggests that in a 2-13 year followup
of LASIK patients only 64.8% of low myopes
and 37.3% of high myopes remained within
±0.50D of their attempted correction 1 . Not
only can a cornea change shape over time but
the onset of presbyopia can humble/anger
the patient that expects the rest of their life
to be devoid of optical aids. Unsurprisingly the
typical post-LASIK patient is highly reluctant to
return to their bespectacled former selves. This
is where contact lenses come in.
Traditionally I have found that even
experienced optometrists are wary to meddle
with a patient’s cornea that has already been
permanently reshaped by our colleagues in
ophthalmology. You wouldn’t re-glaze a cake
created by a top chef would you? There are
concerns about flap dehiscence, the structural
weaknesses of a thinner cornea and perhaps a
reluctance to incur the wrath of the patient’s
eye surgeon should something go wrong,
(“You put WHAT on my perfectly designed
cornea?!”). Perhaps we should proceed with
caution. Research shows that the central
flap interface following LASIK has only 2.4%
of the strength of normal stroma, while the
peripheral margin is 10x stronger at 28% 2 .
However, the general consensus is that the
use of contact lenses in conjunction with
lasered corneae is quite safe, as despite the
histologically weakened interface LASIK flaps
are quite robust. A fantastically designed
study performed LASIK on the eyes of 18
rabbits then ejected them from a fighter jet
cockpit to see what happened. They concluded
that ‘healed LASIK flaps...are stable when
subjected to a rapid vertical ejection at nine
times the force of gravity 3 . I would hazard a
guess that this is more than most eyes endure
with the use of a contact lens.
Fitting standard contact lenses to a
remodelled cornea is not always straight
forward however. Frequently, following
laser eye surgery, the corneal curvature falls
outside the normal limits that off-the-shelf
You wouldn’t reglaze a cake like this! My birthday treat in 2012
soft contact lenses are designed for. By way of
example I should divulge that I had a highly
successful iLASIK surgery to both of my highly
myopic eyes three years ago courtesy of Dr
Trevor Gray and the team at Eye Institute.
My refractive error was eliminated (but not
my long axial lengths sadly, more on this in a
future article) and I see a superb 6/4.8 unaided
now with just a hint of astigmatism in my
right eye. Needless to say I am one of the
optometrists in the pro-LASIK camp. Prior to
my surgery I was the best contact lens wearer
I had ever met, with complaints of discomfort
few and far between. At the launch of one of
the fantastic new daily-disposables recently
I popped a few -0.50D lenses in to test them
out. Within five minutes they were in the bin.
With every blink the vision would blur over, I
had a noticeable foreign body sensation and
the lens quickly dried out rendering it useless.
Turns out my new 35D corneae did not take to
kindly to a one-size-fits-all policy.
Post-LASIK dryness can also be a factor when
using a contact lens, even with a customised
daily RGP (which can be an excellent option
to mask corneal irregularities and fit the
unusual bespoke cornea). Fortunately, we
live in a realm of new technologies and their
applications: It may surprise you that many
post-laser refractive surgery patients with
troublesome residual refractive error do very
well when fitted with ortho-Keratology lenses.
Cue the deafening sounds of aghastment.
Fitting an already heathen device to a
previously altered cornea? You must be mad!
Indeed, in the main orthokeratology ‘bible’;
John Mountford’s Orthokeratology: Principles
and Practice published back in 2004, there is
no mention of fitting ortho-K to the post-
LASIK cornea (although John is working on
a new edition which may address this). A
pubmed search shows no articles about
ortho-K on a post-LASIK cornea. Despite this
many experienced ortho-Keratologists around
the world practice ortho-K on the post-LASIK
cornea with excellent results. I personally
believe there is no more harm in fitting ortho-
Keratology lenses to a lasered cornea than to a
virgin example. It is the understanding of most
orthokeratologists that the refractive effect of
ortho-K comes about due to modification of
the epithelial cells of the cornea, although the
jury is still out in some circles. This OCT (Fig 1.)
of a patient of mine using ortho-K lenses for
high myopia illustrates this by showing the
thinned epithelium centrally and thickened
layer para-centrally. The stroma remains
relatively uniform. In contrast all forms of laser
refractive corneal surgery involve permanent
modification to the stroma of the cornea.
The mechanism of refractive change in
these two modalities are mutually exclusive.
In post-LASIK ortho-K the main challenge
comes with designing the back surface of an
orthokeratology lens to firstly fit the paracentral
cornea safely and comfortably, and
secondly remodel the central epithelium in a
way to correct the refractive error. Let’s look at
an example:
A 67-year-old lady saw me due to the sudden
appearance of flashes and floaters the previous
weekend. Dilated exam revealed a benign
posterior vitreous detachment. The woman
had hyperopic LASIK carried out to both eyes six
years before but she was having more trouble
with her distance vision lately. She was also
sick of using reading glasses. Unaided distance
vision was only R 6/10 and L 6/12 and refraction
revealed residual hyperopia of R +0.75/-0.25
x 175 (6/5), L +1.50/-0.50 x 85 (6/5). Her
topography confirmed her hyperopic LASIK with
tangential maps showing a flatter para-central
ring encircling a steeper central cornea (Fig 2.).
Her left cornea was slightly steeper which was
surprising given the higher hyperopic error.
Given the foundations were essentially already
in place hyperopic post-LASIK orthokeratology
was offered to this patient. We chose to further
steepen her cornea in a monovision set up, with
her dominant right eye for distance
and her left for near tasks.
In these complex cases using
topography-based lens design is a nobrainer
for me. To marry the correct
peripheral fit with the appropriate
sagittal height and base curve for the
desired refractive change with a trial
lens would be time-consuming and
inaccurate, even if such a post-LASIK
hyperopic design set existed. Instead
I plugged the patients topography
into rigid lens simulation software
EyeSpace (Innovatus Technology,
Fig 3.) and designed a custom hyperopic
ortho-K lens for each eye. Because the cornea
is reasonably regular we can use a rotationally
symmetrical lens to get a great fit. Of course
with all hyperopic ortho-K the lens base curve
is steeper than the existing corneal curvature to
create additional plus power.
One month later the patient was thrilled
with her vision as she was no longer using
reading glasses and seeing well at distance.
Her right eye was seeing 6/6 N8 with a
modest central steepening. Her left eye was
6/15 N4 with an impressive 4.7D steepening
in a well centred location (Fig 4.). Importantly
she experienced no discomfort and her cornea
was pristine with no trace of corneal insult.
Unfortunately, not all post-LASIK refractive
error is regular. Post-LASIK ectasia can be
highly debilitating and severely limit the
corrective options available. In some cases,
highly customised ortho-K lenses can be
used to remodel the irregularity and improve
vision. A patient of mine in his mid-50’s had
myopic LASIK done over a decade before but
had developed severe post-LASIK ectasia in his
right eye and moderate ectasia in his left eye
since then. The better left eye had a variation
of 7D of axial power along the 150 meridian
leading to unaided acuity of 6/12 and a
refraction of -1.00DS (6/6 with aberrations).
This gentleman was very keen to explore his
ortho-K options and we settled on fitting only
the left eye with a custom myopic ortho-K
lens. This had an aspheric back optic zone with
a diameter to match the treatment zone of his
myopic LASIK (Fig 5.).
In these cases, interpreting the axial
difference map can require some thought.
Rather than creating a uniform degree of
refractive change in the form of a ‘bulls-eye’
that we are used to with simple myopic
ortho-K, instead we are trying to create a
post-ortho-K cornea that is more regular.
This will decrease the aberrations in the
optical system. You will see in the axial
difference map (Fig 6.) that the ortho-K lens
has succeeded in steepening the flat section
of the cornea at axis 150 and flattening
the steep section opposite this. The patient
was seeing 6/6 unaided with only a quarter
diopter of residual cylinder when using his
lens. He commented that the halos around
streetlights were much reduced, although
not completely eliminated. His main gripe
was that we couldn’t do the same treatment
on his severely ectatic right cornea due to
its ‘munted’ irregularity! Patients with other
forms of irregular corneae such as forme
fruste keratoconus can also be treated with
ortho-K lens in a similar way (often with an
inferior ‘tuck’ quadrant specific design) as
long as the practitioner is mindful to monitor
the cornea at each aftercare for signs of
progression or insult.
These cases highlight how versatile the
practice of orthokeratology is these days. No
longer is it reserved for simple myopia and
it can be a great problem-solver for those
particular patients that are determined to be
spectacle-free! It is encouraging to know that
when my LASIK goes kaput (as it is bound to,
given my eyes’ record to date) I will have ortho-K
up my sleeve to restore my super-vision.
Tune in next time as I regale you with a story
about the night we invented a revolutionary
contact lens at the pub, and how it did not turn
out to be quite as ingenious as we expected... ▀
1. Dirani M, Couper T, Yau J, Ang EK, Islam FM,
Snibson GR, Vajpayee RB, Baird PN. Long-term
refractive outcomes and stability after excimer laser
surgery for myopia. J Cataract Refract Surg. 2010
Oct;36(10):1709-17.
2. Schmack I, Dawson DG, McCarey BE, Waring GO 3rd,
Grossniklaus HE, Edelhauser HF. Cohesive tensile
strength of human LASIK wounds with histologic,
ultrastructural, and clinical correlations.J Refract
Surg. 2005 Sep-Oct;21(5):433-45.
3. Goodman RL, Johnson DA, Dillon H, Edelhauser HF,
Waller SG. Laser in situ keratomileusis flap stability
during simulated aircraft ejection in a rabbit model.
Cornea. 2003 Mar;22(2):142-5.
Fig 1. Anterior OCT showing the thickness profile of the corneal epithelium in myopic
orthokeratology. Note this well-fitted lens does not touch the cornea within the
treatment zone.
Fig 2. Our patient’s post hyperopic LASIK corneal topography showing the relatively
steep central cornea R+L respectively.
Fig 3. EyeSpace simulation, post-lens tear profile and the real lens on the left eye.
Note the slightly irregular central tear profile due to the LASIK result.
Fig 4. Axial difference map of the left eye showing the well-centred +4.7D
topographical change.
Fig 5. Our second patient’s EyeSpace simulation of his customised myopic ortho-K lens
over his irregular post-LASIK left cornea.
Fig 6. Axial difference maps showing our second patient’s irregular post-LASIK corneal
topography in Exam A, the more regular post-ortho-K cornea in exam B and the
unusual difference map showing how this patient’s cornea has been modified to
decrease the aberrations due to his ectasia.
* Alex Petty is a Kiwi
optometrist who
graduated from the
University of Auckland in
2010. He has an interest
in specialty contact lenses,
ortho-K and myopia
control.
8 NEW ZEALAND OPTICS August 2016.indd

Let’s get digital
Integration is the future of high street retail
E Y E W E A R
MERSEYBEATEYEWEAR.CO.UK
Warby Parker’s Green St store, NYC
BY JAI BREITNAUER*
Journalists get invited to many interesting
events, but one in particular piqued our interest
in May. Held at the Sky Tower and hosted by
Microsoft, the theme was Retail in the Digital Age.
As a keen shopper and self-styled digital nerd,
you can imagine I was front row and centre, and
the keynote speaker was NZ Optics own itinerant
business columnist Juanita Neville-Te Rito.
“We’re seeing a significant time of change
within the history of retail,” said Neville-Te Rito,
addressing a small, but well-heeled audience of
retail executives and business leaders. “Digital and
its impact on retail is central to our business today.
It’s the retail ‘new normal’.”
Neville-Te Rito has worked in retail for more than
25 years and is no stranger to change. But the level
of disruption New Zealand in particular has seen
in the last five years is unprecedented – and is best
explained by acknowledging how painfully overused
the word ‘disruption’ actually is – and it’s all
down to new digital technology.
“The retail future is literally in your hands,” said
Neville-Te Rito, referring to the iPads, smartphones
and tablets most people carry around with them
these days. “The emerging customer is in a partial
state of awareness at any given time. Their
shopping journey is complex, influenced by social
media and impacted by technology.”
Omni-channel shopping
Omni-channel shopping is an industry buzzword
used to describe people who purchase using a
complex network of devices, locations and apps.
In reality, no shopper thinks to themselves: “I’m
going omni-channel today”, we just buy to our
own convenience - but that does not mean there
isn’t any truth within the term.
According to Neville-Te Rito the modern shopper
is like a ping pong ball, following a non-linear
path, and the digital layer adds complexity. They
take advice on products from social media, they
will shop for a cheap deal online while still in
store, they want value balanced against product
authenticity.
What a demanding bunch!
As I listened I found myself easily able to apply
this logic to my experiences of shopping day-today,
but how does this apply to optometry?
In the optical world
Optometrists, despite being healthcare providers
at heart, have had to fully embrace their role as
retailers in recent years. Over the last decade
opening hours have extended, weekends have
become another opportunity to do business
and chains – both international and local – find
themselves benefitted by positioning within
malls. Flexibility and availability have become
increasingly important to shoppers, as has
affordability – both for eye care and for frames.
Integrating digital is the next step for the
optometrist already pushing the boundaries of what
the consumer expects from their bricks and mortar
operation. The best thing a retailer can do to make
this work for them is put themselves in the shoes
of their customers and think about the experience
they might want to have both in-store and online.
Are you easy to find, physically and digitally? Are you
responsive? Is your information up to date?
Taking the lead from overseas
“Warby Parker Eyewear opened in the US six years
ago,” said Neville-Te Rito. “Their brand is distinctive
and hipster. They design and manufacture their
own frames with the price point set at as little as
US$99, including a prescription lens and shipping.”
The company has seen a huge amount of success
and much of that is down to where they have
positioned themselves in the market.
“They aren’t selling eyewear, they’ve established
themselves as a tech-based lifestyle brand,” says
Neville-Te Rito. “Their stores aren’t designed for
efficiency; they offer a carefully crafted visual
narrative. Around 85% of their shoppers have
browsed online before going in store, but once
they cross the threshold there is a strong human
element – a member of staff greets you every time
and everyone in the store is fully trained. Most
employees are graduates.”
Every product in the store is at eye level and
the design of the store is streamlined to stop the
customer feeling overwhelmed. Technology instore
keeps things moving, with an easy to see board
showing when appointments are, a photo booth
that prints pictures of you in suggested frames and
clear pricing. All the employees – called associates
– carry tablets to facilitate assisting a customer
and execute a fast, unobtrusive transaction
anywhere in store.
Examples like this clearly show that optometrists
can’t think of their online presence and their high
street presence as two separate entities – after all,
the client doesn’t. They must find a way to meld
the two together to the benefit of the customer
and the bottomline.
Having tech instore, having a strong social media
presence, upgrading your POS hardware to offer
more flexibility and opportunity to make a sale
and keeping your website up to date are simple,
but effective steps to take your business to the
next digital level. Ultimately, your approach must
be customer-first, and that customer increasingly
comes paired with a piece of hand-held tech.
“It’s hard to see through your belly-button,”
says Neville-Te Rito. “You must uncover the retail
ecosystem from the perspective of the shopper in
order to connect with them.” ▀
* *NZ Optics editor Jai Breitnauer has worked in marketing,
PR and digital strategy in addition to her many years as a
consumer and business journalist. She has contributed to many
titles both here and overseas, including business publications
NZ Retail and Idealog, before taking up her current role at NZ
Optics. She is fascinated by the way technology affects small
businesses, almost as much as she is fascinated by the way
words affect people.
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August 2016.indd
NEW ZEALAND OPTICS
9

SPECIAL FEATURE: EUROPEAN GLAUCOMA CONGRESS 2016
BY JASON DHANA*
Wow, New Zealand. So far away! Why did
you come all the way here?” I was asked a
hundred times. Well, why not? Just look
around…with a registration of 3,600 clinicians, more
than 100 quick-fire sessions and over 450 posters,
and the fact that the European Glaucoma Society’s
(EGS) 12th Congress was being held in June in the
picturesque city of Prague in the Czech Republic,
why wouldn’t you come? It was with sheer delight
that I was able to attend my first “confroliday.”
In an impressive feat of organisation, the
2016 Congress was split into varying themes
of glaucoma, intertwined with instructional
courses (topics we could choose by heading to
the allocated room) and poster sessions. Before
getting into the serious stuff, there was an
opening cocktail function where Professor Anja
Tuulonen, European Glaucoma Society president
from Finland, officially opened the event with her
welcoming speech. This was followed by a show
of traditional Czech dancers (think milkmaid-like
outfits and throw in the occasional high-pitched
squeal) who came bearing baskets of freshly-baked
goods and left us with their welcoming smiles.
Challenges in diagnosis and genetics
The first session of the Congress focused on
challenges in diagnosis. Professor Tuulonen
highlighted the suffocation of healthcare systems
due to over referral and outlined the increasingly
popular use of macular GCC (ganglion cell complex)
measurement and its particular advantage in eyes
with PPA and tilted discs, in which a RNFL scan
would present with artefacts. Professor Anders
Heijl of Sweden further reminded us of proper OCT
interpretation, including pitfalls and avoiding the
common trap of “red disease”.
Genetics of glaucoma followed with Professor
Wallace Alward (USA) covering the genomewide
association study (GWAS) which identifies
Swept Source OCT Angiography
RA:28042016/CS
susceptibility loci for open-angle glaucoma. Many
more genes have been identified in the past
decade. Specifically, myocillin mutations have
been found to cause early-onset glaucoma with
elevated IOP. This has also been found to cause
almost all cases of autosomal dominant juvenileonset
open-angle glaucoma. Arising from these
genetic studies, there are targeted therapies in
development. Phenylbutarate (PBA) in particular
has been found to lower IOP in transgenic mice.
Target pressures, palaces and pleasure
It was a pleasure to once again meet Dr
George Spaeth (USA) following his popular
and philosophical talks at this years’ ANZGIG
conference in Auckland. I chose to attend his
instructional course titled What intraocular
pressure is low enough?
An important point to consider prior to
commencing treatment is whether a disability will
develop unless the patient is treated and that the
patient chooses to be treated. “Don’t treat the IOP,
it’s just a number,” Spaeth emphasises. “Treat the
patient!”
Dr Kulvant Singh (USA) chipped in with his
views on target pressures, but said he refrains
from writing target pressures in his clinical notes
for legal reasons and because patients become
overly fixated on it. Instead, Singh works with
percentage reductions or by setting a range,
which can be modified based on risks, benefits
and the clinical course of the disease.
That evening I headed to Žofín Palace – a neorenaissance
building built in 1837, which has
been a centre of cultural and social events and
was the setting for the official congress dinner.
Following some interesting entertainment and
time on the dance floor with consultants from
all over the world “letting loose”, I was ready to
call it a night. My new-found consultant friends,
however, would not have a bar of it and (let’s just
say peer-pressure is my weakness) allowed me to
experience Prague nightlife.
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Gothic spires stand out from the Church of Our Lady before Týn
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Court, scalpels and diagnostic pearls
I arrived the following morning ready for the 8.30
am start, but then wasn’t sure if it was the lack of
sleep or if I had actually walked into a court room
by mistake. The morning’s theme was Glaucoma
Damage Progression and was a series of debates:
fibres vs discs; MD vs VFI; and perimeter vs imaging
device. These all made for some interesting points.
Dr Boel Bengtsson (Sweden) argued her
preference for VFI as is it is more centrallyweighted
than MD, is less sensitive to cataract
than MD and has an improved graphical display.
Structural analysis (imaging) may prove more
useful in monitoring moderate glaucoma and Dr
Bengtsson stressed it has little use in advanced
glaucoma. Also – and I agree with this, based on
my own experience – it’s useful in patients who
are unable to perform a visual field examination.
A major interest of mine is the area of MIGS
(minimally-invasive glaucoma surgery). A literature
review I undertook in this area highlighted the
safety and efficacy of many MIGS procedures
when weighed up with higher-risk penetrating
surgeries such as trabeculectomy. I have also seen
the success of these first-hand within glaucoma
clinics and although only a few MIGS procedures
have long-term data available, there is definitely
potential, which is quickly gaining traction both in
New Zealand and overseas.
Between lecture sessions we had time to wander
the exhibition area, which included the usual
promotion of the latest ophthalmological gadgets.
The opportunity to put my name down for a wet
lab, however, had me very excited and my colleague,
Dr Divya Perumal, and I jumped at the opportunity
to try a cutting-edge (literally) procedure on a
porcine eye. CLASS (CO2 laser-assisted sclerectomy
surgery) involves creating a scleral flap followed by
laser to increase outflow through Schlemm’s canal.
CLASS is used for management of medicallyuncontrolled
open-angle glaucoma that offers
efficacy comparable to trabeculectomy and nonpenetrating
deep sclerectomy, but with superior
10/21/15 12:07 PM
safety. The wavelength of the laser is absorbed
by water so the device’s cutting effect is halted
when the dissection reaches the fluid perculation
(three-year follow-up data is available).
We also got to try our hand at implanting a XEN
gel implant which essentially creates a shallow bleb,
increasing subconjunctival outflow. The next stop
was ECP (endocytophotocoagulation) laser, where
the combined video-light-laser tip made it super
easy to find, visualise and treat ciliary processes.
Another new device, currently in clinical trials,
measures IOP at any given time through the day.
‘Eyemate’ is implanted within the sulcus during
cataract extraction, which then sends an IOP
DRI OCT-1 Triton Series
Swept Source OCT now with OCT Angiography
See. Discover. Explore.
The Topcon Swept Source DRI OCT-1 Triton Series 1 features a 1 micron, 1050nm light
source with a scanning speed of 100,000 A Scans/Sec., providing multi-modal fundus
imaging.The DRI OCT-1 Model Triton rapidly penetrates all ocular tissue without being obscured by
media opacity or hemorrhage. See you at AAO Booth 3732.
Color FA FAF OCT-A
1. Not for sale in the US.
Feeder vessels in a CNV with GA
OCT Angiography image taken with a Topcon OCT Triton
Courtesy of Dr. Carl Glittenberg, MD Karl Lansteiner Institute for Retinal Research and Imaging
The inside of Žofín Palace during the Congress dinner
Jason in his element having a go at the non-penetrating CLASS procedure
Dr Divya Perumal and Jason (with Dr Ben Hoy in the background)
measurement to a non-contact measuring device
via a weak magnetic field. Measurements are also
uploaded to a database and smartphone app,
which can only be accessed by their doctor. The
plastic implant itself is super-thin and flexible,
measuring only 12mm in diameter.
Pressure spikes
On the topic of circadian monitoring, Dr Anastasios
Konstas (Greece) presented on the Impact of
24-hour monitoring in glaucoma care, and stated
there is now comprehensive evidence that IOP
readings every few months are not sufficient in
the management of glaucoma and a single IOP
measurement will miss a lot of IOP-related disease.
Twenty four-hour monitoring isn’t always
feasible, especially in a busy hospital glaucoma
clinic, which churns through high numbers on
a daily basis. Dr Konstas did however state that
a water drinking test would replicate this quite
well. Despite the apparent importance of peak
IOP, Professor Luca Rossetti (Italy) concluded
the mean and peak IOPs are both predictors for
progression, and that the role of IOP fluctuation
as an independent risk factor for progression is
still debated. Furthermore, longitudinal studies
on 24-hour contact lens IOP monitoring are still
required to better understand their clinical value.
Another instructional course I chose to attend
was titled If it’s not glaucoma, then what is it? Dr
Mark Moster (USA) outlined the need to consider
neuro-ophthalmic disease in glaucoma patients.
Why? Because IOP may be normal or elevated in
both, visual field defects may be identical and
cupping can occur in optic neuropathies. He
quoted a study by our very own Professor Helen
Danesh-Meyer from 2001 (proud New Zealand
moment!) which found that cupping occurred in
ischaemic optic neuropathy, specifically 92% in
GCA and only 2% in NAAION. Typical optic neuritis
presentations were highlighted and appropriate
history taking specific to neurological disease was
discussed. Though it’s not practical to scan every
NTG patient, Dr Moster emphasised the need for
an MRI in those with bitemporal loss, optic disc
pallor, reduced colour vision and poor disc/field
correlation. A CT scan is a good second choice.
In conclusion
Overall this was an enjoyable and well-organised
conference which solidified my understanding of
glaucoma. It was pleasing to see that we already
practice most of what was covered, which goes to
show that our very own glaucoma specialists are
in agreement with those around the world and
leaders in their field, many of whom I’m privileged
to work with and learn from.
The Congress further ignited my passion for
glaucoma treatment, and what the future holds
in terms of treatment and technology seems
unimaginable – but it’s all happening right
now. While diagnosis and treatment may prove
difficult, on the contrary there is a lot of potential
in the pipeline which will only make clinical
practice easier. Until then, I shall leave you with
a witty yet unfeigned quote by Professor Anja
Tuulonen during the Challenges in Diagnosis
session, which we can all relate to.
“When you hear a noise in the bush, it’s up to the
clinician to figure out if it’s a rat or a plastic bag.” ▀
* Jason Dhana recently completed his MSc with a clinical
specialisation in glaucoma, under Dr Dean Corbett. He splits
his week between emergency and glaucoma clinics at Greenlane
Hospital, and as a professional teaching fellow within the
School of Optometry and Vision Science, University of Auckland.
10 NEW ZEALAND OPTICS August
1. Not for sale in
2016.indd
the US.
For more information visit, newsgram.topconmedical.com/tritonangexport

Clarity appoints Essilor
Clarity 20/20 has appointed Essilor to assess,
repair and replace glasses covered under
Clarity’s insurance programme, and to put
together their cost-effective Snappa frame and
lens package, both offered through participating
independent optometrists.
The new agreement, which came into force in
June, should speed up and simplify the process
of assessing and repairing a patient’s glasses,
says Robert Cormack, director of Clarity. “Essilor is
recognised as one of the leading lens suppliers in
the country … and most independents will have
dealings with Essilor as well as other lens suppliers.”
Unlike some mainstream insurance companies,
Clarity’s policy provides comprehensive likefor-like
cover and does not divert patients away
from their practice, says Cormack, so Essilor will
be responsible for sourcing lenses from other
companies as and when required.
Chris Aldous, senior manager at Essilor NZ, says
Essilor is happy to have Clarity 20/20 on board as a
customer and confirmed Essilor will be supplying
frames and lenses on a like-for-like basis.
Matt Marquis, Clarity’s national sales
development manager, says appointing Essilor is
NZAO 2016
Registrations are now open for the New
Zealand Association of Optometrists (NZAO)
86th annual conference at the brand new
Novotel New Plymouth from 14-16 October.
The three-day conference includes a packed
education programme on the Friday and the
Saturday, and a glaucoma workshop, low vision
seminar and binocular vision workshop on the
Sunday. Keynote speakers include Professor Mitchell
Dul from the US, Dr Kathleen Watt from the
University of New South Wales and Professor Konrad
Pesudovs from
Flinders University
in Adelaide.
Professor
Mitchell Dul
is director of
the Glaucoma
Institute and
professor at the
SUNY College of
Optometry at the
State University
of New York. He
will be speaking
NZAO 2016 Conference keynote
Professor Mitchell Dul from the US
about his 20-
year experience
Lab-grown RGCs expand
research opportunities
A
new
series of studies have shown that retinal ganglion
cells (RGCs) can be generated from patient-specific induced
pluripotent stem cells, allowing them to serve as an in vitro
model for pharmacologic screening and pathophysiology studies.
Commenting on the studies in Ophthalmology Times, Dr Jason
Meyer, associate professor of biology at Indiana
University, and co-author of the paper Ohlemacher
SK, et al. Stem Cells. 2016;34:1553-1562, said
the results could facilitate drug-screening
studies and characterise the pathogenic
mechanisms of disease progression
in optic neuropathies. “It is not
unreasonable to think about
using these patient-specific
cells as a source of spare parts
to repopulate the retina.
However, success in that
area involves overcoming
a number of hurdles in
terms of demonstrating
that the cells survive,
integrate, and function
post-transplantation.” ▀
all about
Clarity’s
aim to help
practices
provide the
best service
possible to their patients, ensuring they keep
coming back time and time again.
“We want the assessment, repair or replacement
of a patient’s glasses to be a really seamless
process. The primary function of Clarity is to
glue patients to a practice; to keep independent
patients in independent optometry. Appointing
Essilor makes the process of repairing or replacing
a patient’s glasses quicker and easier, which is
what’s important for both the patient and the
practice, so that’s what we’re trying to do.
“Clarity allows practices to offer a unique high
value point of difference in their local market,
making the practice the hero in their patient’s
eyes. This helps to maintain and enhance the
relationship between the practice and their
patient, causing the patient to become a
loyal advocate instead of being vulnerable to
competitors.” ▀
of glaucoma and why
optometrists need to be
treating it.
Dr Kathleen Watt is clinical director for the School
of Optometry and Vision Science at the University
of New South Wales. She has a background
in orthokeratology and is currently working
on pathways to eye care for asylum seekers in
Australia. Dr Watt will be discussing ortho-K and
myopia, binocular vision and ortho-K infection.
Professor Konrad Pesudovs is foundation
professor of optometry and vision science at
Flinders University in Adelaide. His main areas
of research are identifying abnormalities to
establish a diagnosis, the longitudinal strategy
required for management of therapeutic cases and
assessing a cataract and identifying optical quality
metrics predictive of visual performance in eye
disease. His presentations will focus on thinking
therapeutically, assessing cataract patients and
diagnosing red eye.
A first aid course is being included in the 2016
NZAO conference programme again to enable
delegates to refresh their first aid skills from two
years before. The conference dinner will be held on
the Saturday night. To register visit
www.nzao.co.nz/NZAO-conference-registration ▀
Focus on
Eye Research
Glaucoma
MOKHLES P, SCHOUTEN J, BECKERS H ET AL. A
SYSTEMATIC REVIEW OF END-OF-LIFE VISUAL
IMPAIRMENT IN OPEN-ANGLE GLAUCOMA: AN
EPIDEMIOLOGICAL AUTOPSY.
Journal of Glaucoma 2016; 25:623-628
Review: The aim of this review was to estimate
the number of treated glaucoma patients with
end of life visual impairment and blindness, and to
determine the factors associated with this.
This study involved a systematic literature search in
relevant databases on end of life visual impairment
and was conducted in 2014. A total of 2574 articles
were identified, of which 5 were on end-of-life visual
impairment and included in the review.
All studies had a retrospective design. A
considerable number of glaucoma patients were
found to be blind at the end of their life with
24% experiencing unilateral and 10% bilateral
blindness. The following factors were associated
with blindness: (1) baseline severity of visual field
loss: advanced stage of glaucoma or substantial
visual field loss at initial visit; (2) factors influencing
progression: fluctuation in intraocular pressure (IOP)
during treatment; presence of pseudoexfoliation,
poor patient compliance, higher IOP; (3) longer time
period: longer duration of disease and older age
at death because of longer life expectancy; and (4)
coexistence of other ocular pathology.
Comment: This review indicates that a significant
proportion of glaucoma patients still become blind
despite our current treatment modalities. Hence
further prevention of blindness in glaucoma patients
is needed. This could be achieved by identifying
patients at an earlier stage of disease as well as
addressing the risk factors outlined above where
possible. Patients at risk for glaucoma-related
blindness need to have a very low target IOP and
need to be closely monitored to prevent glaucoma
progression.
BRANDT JD, SALL K, DUBINER H ET AL. SIX-MONTH
INTRAOCULAR PRESSURE REDUCTION WITH A
TOPICAL BIMATOPROST OCULAR INSERT: RESULTS
OF A PHASE II RANDOMISED CONTROLLED STUDY
Ophthalmology 2016 – Article in Press
Review: The purpose of this study was to evaluate
the clinical efficacy of a topical Bimatoprost ocular
insert. This is a silicon ring (Fig 1. and Fig 2.) that
provides a slow release of Bimatoprost. A parallelarm,
multi-centre, double-masked randomised,
controlled trial was performed and included 130
patients with either open angle glaucoma (OAG) or
ocular hypertension (OHT).
Patients were randomised to receive the
Bimatoprost insert plus artificial tears twice daily or
a placebo insert plus Timolol 0.5% twice daily for 6
months after a screening washout period. Diurnal
IOP measurements were obtained at baseline,
weeks 2, 6 and 12, and months 4, 5, and 6.
The primary end point assessed was the mean
change from baseline in diurnal IOP between the
2 groups. A mean reduction of -3.2 to -6.4 mmHg
was observed in the Bimatoprost arm compared
Fig 1. The Bimatoprost ocular insert
Fig 2. A patient with the device in place
BY DR HUSSAIN PATEL
with -4.2 to – 6.4 mmHg for the Timolol arm over
6 months. Adverse effects were consistent with
bimatopost or Timolol exposure and no unexpected
adverse effects were observed.
The authors concluded that a clinically relevant
reduction in mean IOP was observed over six
months with the Bimatoprost ocular insert and
that seems to be safe and well tolerated. Larger
confirmatory phase III studies are planned.
Comment: This Bimatoprost ocular insert appears
to be a safe, well-tolerated and clinically effective
new delivery device. If confirmatory studies
demonstrate a similar efficacy, the insert may
provide an alternative to daily eye drops and hence
would be ideal in patients who with poor adherence
to therapy or find application of topical eye drops to
be difficult.
MUDIE LI, LABARRE S, VARADARAJ V, ET AL.
THE ICARE HOME STUDY: PERFORMANCE OF
INTRAOCULAR PRESSURE MEASURING DEVICE FOR
SELF-TONOMETRY BY GLAUCOMA PATIENTS
Ophthalmology 2016 – article in press
Review: The purpose of this study was to evaluate
the Icare HOME device for use by glaucoma patients
for self-tonometry. A prospective performance
evaluation of a medical device was performed
and included 189 participants with glaucoma or
suspected glaucoma.
Participants had standardised training and had to
be able to use the Icare HOME device independently.
Those certified obtained 3 IOP measurements
using the HOME device, and these were compared
with measurements obtained from Goldmann
applanation tonometry (GAT) by a clinician. The
agreement between the devices was used to assess
precision.
Out of the 189 participants, 18 were ineligible to
take part in the study. Forty-four (25%) participants
could not complete the study due to difficulty using
the device or failing the certification process. For
those that were able to participate, the Icare HOME
and GAT measurements agreed within 5mmHg in
116 of 127 participants (91%). The mean difference
between Icare HOME and GAT was -0.33 mmHg (SD
3.11 mmHg). No adverse events were reported.
Fig 3. The Icare HOME device
Hence not all participants could learn to use the
Icare HOME device, but for those that could, most
were able to obtain measurements similar to those
obtained by GAT.
Comment: Although not all patients are able to use
the Icare HOME device, in those that can it appears
to be a safe, affordable and reliable method of selftonometry.
The Icare HOME may have the potential
to address an unmet need by providing more
frequent IOP measurements in a patient’s daily life
and hence information relating to their diurnal IOP
variation. Clinical applications also include helping
to identify patients at greater risk of glaucoma
progression (wider fluctuation in IOP) as well as a
patient’s response to treatment. ▀
ABOUT THE AUTHOR:
* Dr Hussain Patel
(MBChB, MD, FRANZCO) is
an ophthalmologist based
at Auckland’s Eye Surgery
Associates and senior lecturer
in ophthalmology with
the New Zealand National
Eye Centre, University of
Auckland. He has a special
interest in glaucoma, and is
actively involved in glaucoma
research, supervision of
research fellows and teaching.
August 2016.indd
NEW ZEALAND OPTICS
11

with
Prof Charles McGhee
& A/Prof Dipika Patel
Series Editors
Preoperative risk assessments to reduce
cataract complications
BIA Z. KIM, DIPIKA V. PATEL AND CHARLES N.J. MCGHEE
Cataract surgery is highly successful but
complications do occur and internationally
studies report an overall complication rate of
approximately 5%. Although not all complications
lead to poor outcomes, the occasional severe
complication can be blinding. With over 30,000
cataract surgeries performed each year in New
Zealand, even a small percentage of moderate
adverse outcomes adds up to hundreds of patients.
Numerous factors increase the risk of a
complication during and after cataract surgery.
Unfortunately, many of these factors are intrinsic
and unavoidable but prior identification of these
risk factors may allow optometrists and ophthalmic
surgeons to appropriately advise patients.
Subsequently, it may be possible to take appropriate
perioperative precautions and adjust intraoperative
techniques to try to reduce these risks.
Corneal opacity
One of the most apparent risk factors on slit-lamp
examination is corneal scarring or haze. If the
opacity is sufficient to obscure fine iris detail on
slit-lamp examination, it may prove problematic
during surgery. To maximise the red reflex during
surgery to facilitate capsulorhexis, the eye may
be manipulated into a better position and the
background or direct co-axial microscope light may
be altered to minimise backscatter of light from
the cornea and cataract. In very severe cases of
scarring, an external light pipe may occasionally
be useful to illuminate structures tangentially to
enable a safe capsulorhexis.
White/dense/mature cataracts
A dense cataract can present multiple problems
during surgery. The large lens may create positive
pressure and tension on the capsule and may
significantly shallow the anterior chamber. The
anterior capsule is also very difficult to visualise over
a white or brunescent cataract, increasing the risk of
a capsule tear or irregular capsulotomy.
The view of the capsule can be improved using
tissue staining e.g. Vision Blue (trypan blue
ophthalmic solution) injected into the anterior
chamber and washed out after it has stained the
anterior capsule blue (Fig 1.). Furthermore, a dense
cataract will require more phacoemulsification
energy than a soft lens. Since total ultrasound
energy can be associated with postoperative
corneal oedema and intraocular inflammation, a
phaco-chop technique that generally requires less
energy may be preferable. 1
Fig 1. Intraoperative photograph during capsulorhexis - anterior lens
capsule stained with Vision Blue over congenital white cataract.
Fuch’s endothelial corneal dystrophy
(FECD)
Other risk factors may be more subtle. Individuals
with mild FECD may be asymptomatic or unaware
of minor changes in vision. However, patients with
FECD are at greater risk of corneal decompensation
and need to be aware of the possible longer-term
consequences such as a corneal transplant. Thus
all corneas need to be examined carefully for signs
of FECD eg. guttata and increased pachymetry
(Fig 2.). A preoperative central corneal thickness
12 NEW ZEALAND OPTICS August 2016.indd
(CCT) greater than 620µm is associated with
an increased probability of requiring a corneal
transplant following cataract surgery and for each
10µm increase beyond 620µm, the odds of corneal
decompensation increase by 1.7 times 2 .
Damage to the compromised endothelium may
be prevented by reducing the flow of fluids in
the anterior chamber during surgery and using
a ‘soft-shell’ technique (a dispersive viscoelastic
device coats and protects the endothelium
while a cohesive viscoelastic deepens the
anterior chamber and maintains the working
space) 3 . Furthermore, torsional rather than
longitudinal phacoemulsification can reduce the
dissipated ultrasound energy, thereby minimising
endothelial injury 2 .
Pseudoexfoliation syndrome
Pseudoexfoliation is associated with a significant
number of problems in cataract surgery, including
poor pupillary dilation, zonular weakness
leading to zonular dialysis or lens dislocation
with vitreous loss, postoperative intraocular
pressure spikes, capsular phimosis, cystoid
macular oedema, prolonged inflammation, and
corneal decompensation. However, the white/
grey dandruff-like material mostly on the pupil
margin and anterior lens surface, indicative of
pseudoexfoliation, can be easily missed on casual
slit-lamp examination, especially with an undilated
pupil (Fig 3.). Peripupillary iris transillumination
and pigmented pupillary ruff atrophy may also
provide clues of underlying disease.
With prior knowledge of these risk factors the
patient can be better-informed and surgical
planning can be modified, eg. lower anterior
chamber irrigation rate, insertion of a capsular
tension ring, augmented pharmacological and/
or mechanical pupillary dilation (synechialysis, iris
hooks). Hydrodissection and hydrodelineation of
the cataract can cause further downward stress
and zonular compromise, thus should be performed
carefully. A zonule-friendly phaco-chop technique
and a gentle two-instrument rotation of the nucleus
are also helpful. It is also useful to work in the central
anterior chamber with copious viscoelastic, avoiding
the friable capsular periphery and shallowing of the
anterior chamber. Towards the end of the surgery,
thorough removal of viscoelastic is important in
minimising significant postoperative IOP spikes 4 .
Phacodonesis
Phacodonesis is the tremulousness or subtle
movement of the lens with eye movements,
which may occur due to a previous eye injury,
pseudoexfoliation or other causes of zonular
compromise or lens subluxation. Phacodonesis may
be detected by asking the patient to move their eye
quickly from side-to-side and up-and-down while
the clinician observes the eye on the slit-lamp. The
patient may also be asked to look directly ahead
while the clinician gently strikes the upright of
the slit-lamp head support 2-3 times (obviously
warning the patient beforehand). The transmitted
energy through the head/chin rest may produce a
flickering lens reflex or frank movement.
Similar adjustments can be made to surgical
techniques as previously highlighted in
pseudoexfoliation to reduce stress on the zonules
and also plan for additional techniques such as
sutured capsule tension segments or rings.
Anaesthetic
Generally, contemporary cataract surgery is
performed under regional (peri-bulbar/sub-
Tenon’s anaesthesia [STA]) or topical (drop/gel)
anaesthesia, with or without low-level oral or
intravenous sedation. A larger volume regional
anaesthesia may increase the intraocular pressure
and shallow the anterior chamber, occasionally
making surgery a little more difficult. Since an
incision is required in the infero-nasal conjunctiva
for STA it may be associated with subconjunctival
haemorrhage, that on occasion may be extensive.
Although not sight-threatening and self-resolving
over 7-14 days, the dramatic appearance may
Fig 2. Slit-lamp photograph showing corneal endothelium with guttata
in Fuch’s endothelial corneal dystrophy.
Fig 3. Slit-lamp photograph of white/grey pseudoexfoliative material on
pupil margin.
be unsettling for patients and relatives. Topical
anaesthesia may avoid any injections but requires
adequate patient cooperation, as the eye is able to
move much more freely during the procedure.
Therefore, preoperative assessments should
include potential language barriers, anxiety
levels, ability to lie flat for up to 30 minutes,
head tremors, and antiplatelet/anticoagulant
medications that may predispose to bleeding.
Systemic medications
Oral Doxazosin and similar alpha-blockers used
for prostatic and urinary symptoms are associated
with intraoperative “floppy iris syndrome” – the
iris billows and has a tendency to prolapse through
the surgical incisions whilst the pupil progressively
constricts during surgery. This can lead to extremely
complicated surgery and extensive iris damage.
Unfortunately, these issues are not resolved by
simply stopping the medication prior to surgery.
Thus ophthalmologists may need to consider a
number of strategies including: creating longer
corneal incisions and maintaining the anterior
chamber depth to prevent peripheral iris prolapse;
augmented pharmacological pupil dilation (e.g.
intra-cameral phenylephrine); and mechanical
dilation/iris stabilization (e.g. iris hooks or rings).
Inflammation
Intraocular inflammation such as chronic anterior
uveitis that is not entirely quiescent should
generally be controlled and stable for around six
months before embarking on cataract surgery.
Perioperatively, patients may require an increased
dose of corticosteroid or other immunosuppressive
therapy to reduce the risk of significant
postoperative inflammation and flare-ups.
Risk stratification
Complication rates generally decrease with
increasing experience of surgeons 5 . Thus, it is
imperative that cases are allocated appropriately,
especially in teaching hospitals where there is a
vast range of surgeon experience. Preoperative
risk stratification systems have been devised to
assess the risk of complications for individual
patients. They may help minimise complications
by identifying and allocating the higher risk cases
to appropriate surgeons in a standardised manner.
In a recent study in Auckland, two preoperative
risk stratification systems were evaluated – one
system devised by Muhtaseb et al 6 and another
system used in the Buckinghamshire NHS Trust.
Each system takes into account different risk factors
and a final risk score is calculated by adding up the
risk factors in each case (Table 1). Subsequently,
the Muhtaseb system was implemented to assist
allocation of cases to registrars, fellows and
consultants and further analyses are underway to
examine the impact on complication rates.
It is imperative that risk factors are identified and
documented preoperatively for such cataract risk
stratification systems to work effectively. Apart
from allocating cases to appropriately experienced
surgeons, they support surgeons of all levels to
take precautions in order to reduce complications.
It also allows practitioners involved in preoperative
assessments to focus discussions on specific risks
with individual patients, which is critical in providing
the best quality of cataract surgery, and most useful
in postoperative management. ▀
Table 1. Preoperative risk factors as per the Muhtaseb and
Buckinghamshire risk stratification systems for cataract surgery.
RISK FACTORS M-SCORE B-SCORE
Age (years) >88 1
Ametropia (>6 D of
myopia or hyperopia)
Axial length -
Brunescent/white/
dense/total cataract/no
fundus view
1 -
80-90 years 1
90+ years 2
26mm 1
>30mm 2
3 3
Corneal scarring 1 -
Diabetic retinopathy - 1
Fuchs endothelial
dystrophy
- 1
Only eye - 1
Oral alpha-receptor
antagonist
Phacodonesis 3
Pseudoexfoliation 3
-
Doxazosin 1
Tamsulosin
or similar
Posterior capsule plaque 1 -
Posterior polar cataract 1 -
Previous vitrectomy 1 1
Shallow anterior chamber
(

Grand Rounds part II
Dr Penny McAllum, Kathryn Bierre, Jill Mottram and Olga Hammond
The second instalment in the Eye Doctors
series of Grand Rounds was held at
Ormiston Hospital, Botany Junction on 8
June. Sponsored by Bausch + Lomb, the event
saw a gathering of local optometrists to hear
presentations by Drs Andrew Riley, Shuan Dai,
Penny McAllum and Mark Donaldson.
Wound healing
Keynote Speaker Dr Andrew Riley opened with
a look at wound healing in the eyelid area. He
talked about how complex the healing process
is, considering the skin is made up of so many
different types of tissue that we still have a lot to
learn about.
There are four typical stages of healing:
haemostasis is the immediate response,
with inflammation over the next 0-4 days,
proliferation and/or granulation over 4-21 days,
with remodeling taking up to two years. Dr Riley
described cleaning a wound, removing loose
sutures, topical or oral antibiotics and offered
five examples of abnormal wound healing and
suggested responses. Infection is possibly the most
common problem. Wound breakdown can occur
if there is tension on a wound or a poor healing
response. Pyogenic granulomas are relatively
common vascular lesions but are misnamed as
they are neither infectious nor granulomatous, but
an excessive healing response. They can be treated
with local steroids or removal. The use of topical
preparations to reduce the appearance and size of
scar tissue can also be useful.
New optometry
certificate for CLs
The importance of blurred vision
Dr Shuan Dai offered his insights on when blurred
vision needs to be investigated urgently. He noted
that sometimes patients confuse double vision
with blurred vision, and how important it is to
ascertain if it is monocular or binocular. He talked
about the case of a 21-year-old male who, suffering
from headache and anxiety, was prescribed antidepressants.
A few months later he began to suffer
from blurring vision. It was recommended by his
referring eye specialist, that the anxiety medication
be stopped and his vision appeared to improve. At
first it seemed obvious it was a simple medication
side-effect, however, four months down the track
the patient again presented with blurred vision,
headaches and a slow pupil response to light.
His slightly reduced vision couldn’t be improved
with refraction and his optic nerves were swollen.
An urgent MRI scan showed a large pineal gland
tumor causing obstructive hydrocephalus which
was likely the cause of his initial symptoms.
Dr Dai emphasised that we should have a low
threshold to refer for further investigations for
any person with sudden onset of double vision
or unexplained blurring vision, especially among
younger patients.
Who needs crosslinking
Dr Penny McAllum talked about corneal
collagen crosslinking for keratoconus, focusing
on who needs it and who doesn’t. She noted
that crosslinking has become a widely-used
and effective treatment for keratoconus
patients, but it is not suitable or helpful for
everybody. Only those with mild or moderate
keratoconus, that shows signs of progressive
deterioration, require treatment. The treatment
works by combining riboflavin and UVA light
to induce free radical production, resulting
in a strengthening of the cornea by inducing
more bonds within the collagen fibrils and
adjacent collagen fibrils. The Dresden protocol,
which involves removing the central 8mm of
the epithelium before applying the riboflavin
solution, is the most commonly used and
proven method. However, it is time consuming,
painful and cannot be used on a patient
with extensive corneal thinning, explained
Dr McAlllum, adding that other alternatives,
such as transepithelial crosslinking, rapid
UVA treatments and new types of riboflavin
solution, show promise. Dr McAllum noted that
the earlier crosslinking is performed, the more
sight there is to save. With this in mind, she
said she is happy to perform the procedure on
children as long as progressive keratoconus is
demonstrated. After the procedure the patient
can expect pain for the first one or two days
and some blurring of vision for up to three
months. Some patients experience haze for up
to a year, but vision often improves slowly over
1-2 years due to flattening of the cornea.
Dealing with ICE
Dr Mark Donaldson presented “Summer ICE” –
two cases of irido corneal endothelial syndrome,
presented to him on consecutive balmy Februaries,
where normal endothelial cells are replaced with
abnormal migratory cells.
Evidence supports a herpes virus aetilology
for at least some cases of ICE. Patients afflicted
with ICE have reduction in vision from corneal
opacification and disruption of the normal iris
architecture. Glaucoma is a major complication,
which is a secondary elevation in pressure arising
from abnormal epithelial cells migrating over the
trabecular meshwork. For cases with glaucoma,
surgical treatment is invariably required.
The first case study was a 54-year-old female
who presented in February 2015 with mild blurring
of vision, noticeable on waking, in her right eye,
which resolved over over the space of an hour.
The IOP of her right eye elevated from 24 mmHg
on presentation to 35 mmHg on full medical
treatment within 10 months. The second case
was of a 32-year-old woman who presented in
February 2016 presenting to her optometrist with
glare affecting her right eye. Anterior segment
OCT scanning clearly showed thickening of the
posterior cornea in both cases, assisting greatly in
the diagnosis. The glare was caused by stray light
entering the eye through correctopia and tracts
of iris atrophy. The first case, which had no iris
abnormality, was Chandlers syndrome; the second,
essential iris atrophy – both sub-types of ICE.
Grand Rounds – where next
The next Eye Doctors Grand Round will be held
on 21 September at Novotel, Greenlane. All
optometrists are welcome to attend. ▀
Dr Andrew Riley, Yvette Beatie from sponsors B+L and Dr Shuan Dai
Selina Phuah, Lily Chang and Beverly Payne
Ascot Clinic (09) 520 9689 - Botany Junction (09) 277 6787
The Australian College of Optometry (ACO)
has launched a new post-graduate level
course for optometrists wishing to learn
more about speciality lenses and advanced lens
fitting.
Gary Filer, Heather Laird and Naomi Meltzer
Presenters for the Certificate in Advanced
Contact Lenses (ACO-CACL) course include
Professor James Wolffsohn, deputy executive
dean of the School of Life and Health Sciences EyE DOctORS GRAND ROUNDS
GRAND ROUNDS - 2016
at Aston University in the UK; Associate
Professor Richard Vojlay from Melbourne; CCLS
2016
We look forward to seeing you.
Australia president Jessica Chi, ACO’s Dr Adrian
Bruce and more.
Offered as a flexible, remote learning syllabus
the certificate will feature a practical local clinical
21st September - Novotel, Ellerslie
experience placement within Australia and/or
New Zealand and should be completed within
No registration fee . cPD points available
the recommended four to six-month time frame.
“In-depth study is a great opportunity
Visit our website for more details.
for optometrists who have a real interest
in a particular area to gain an extensive
understanding in their field of expertise,”
said Jolanda de Jong, ACO’s general manager
of professional development. “It clearly
Dr Andrew Riley
Dr Mark Donaldson
demonstrates to patients that their optometrist
FRANZCO
FRANZCO
has been motivated to undertake study and
is up to date with current best practice and
Dr Penny McAllum
Dr Shuan Dai
knowledge.” ▀
EYE 0765
FRANZCO
FRANZCO
Health in the
cloud
Leading New Zealand health organisations
have welcomed the Ministry of Health’s
official acceptance of Microsoft’s Trusted
Public Cloud services for advancing the country’s
electronic health service capabilities.
In an announcement on 8 July, Microsoft New
Zealand confirmed Microsoft’s core cloud services
Azure, Office 365 and Dynamics CRM Online,
have met the Ministry’s requirements for storage
of personal health information.
Barrie Sheers, the managing director for
Microsoft NZ, says the Ministry of Health’s
decision to accept the use of Microsoft’s public
cloud will be transformative for the eHealth
agenda in New Zealand.
“New Zealand’s health tech industry is today
worth $1.3 billion to the local economy and our
country significantly punches above its weight
on the international stage with health tech
innovation. With leading exporters like Orion
Health, and more than a hundred other smaller
independent software vendors, the health tech
sector in New Zealand is one that continues to
grow and provide burgeoning opportunity for
export to the fast growing global health market.”
Scott Arrol, chief executive of New Zealand
Health IT (NZHIT) says his organisation is fully
supportive of the Ministry of Health’s decision to
accept Microsoft’s cloud services.
“I am delighted by this news as it further
supports the ability for health providers and
digital partners to utilise advanced technologies to
enable the delivery of enhanced services to New
Zealanders. At the same time, the Microsoft cloud
will provide another important platform with
which to operate their business models, develop
and deploy innovative solutions for the local and
international markets and advance this country’s
ability to be a leader in the delivery of high quality,
responsive and personalised health outcomes.”
New Zealand health providers currently
using Microsoft’s cloud services include Ryman
Healthcare, Orion Health, St John’s Ambulance
Service and Plunket. The services are also used
by IT solution providers for the health sector,
including Datacom, Stratos, Volpara, McKesson
and Intergen.
Christchurch-based Gabe Rijpma, senior
director of Health and Social Services Asia
at Microsoft, says that with the advent of
personalised medicine, genomics, intelligent
sensors, advanced diagnostics and laboratory
tests, data usage by health organisations will
increase as the sector builds ever more advanced
models of the human body.
“Being able to process all this data, store it,
analyse it and make intelligent predictions on
the results will usher in a new era of healthcare
that will radically transform the way care is both
diagnosed and delivered.” ▀
www.eyedoctors.co.nz
August 2016.indd
NEW ZEALAND OPTICS
13

Truth, lies and statistics
I
recently received a Survey Monkey survey
from one of the BIG FOUR contact lens
companies.
This one dealt with marketing and data
collection by contact lens companies and
sought to determine our perceptions on such
things.
I am generally happy to complete surveys
and have done many in my time. Sometimes
they drive you nuts and may take 15 to
20 minutes to complete. I find that rather
tedious. Some surveys offer to pay me
US$15.00 and then send me a bank cheque.
When you try cash it in it takes weeks to clear
and the bank charges are often greater than
the amount you receive. Fortunately my bank
has offered to waive the bank fees when they
see how ridiculous it is – when I would have
to pay $25.00 to get $15.00 meaning it costs
me $10.00 to do the survey! A recent survey
offering me US$15.00 had a condition that I
now had to complete an American W-8 tax
form in order to receive the payment. I don’t
like filling in forms at the best of times so I
kindly declined. I did suggest that this was
nonsense and if they could find a way to pay
me without form filling I might consider it. I
got no response.
We can thank terrorism and money
laundering for such over the top ludicrous
form filling for trivial amounts of money,
never mind the hassles we all have at airports
these days.
I’ve done quite a few surveys from
companies wanting to launch a new lens,
product, drug or solution. They seek to
determine what we think a good name would
be for their new product. Some of the names
they come up with are ridiculous with just
a few that make sense. You have to list and
grade your preferences, sometimes among
twenty names and as you drill down they ask
more and more questions and cross-check
your answers. It all gets rather silly and is a
time wasting irritation.
That said, I once did a survey for a market
research company employed by a world
leading contact lens company. They even had
images of the boxes of lenses and the name
they were thinking of. It was obvious to me
who the company was and I immediately
contacted colleagues in said company telling
them how pleased I was to see that they were
launching a silicone hydrogel lens. My local
contacts were somewhat in the dark, but it
didn’t take long for their top people in the
USA to make contact, wondering how the hell
this guy in ‘Nuzillin’ knew about their secret
lens. It was all rather interesting I must say.
My View
At any rate let’s get back to the recent survey
I referred to. Among other things the survey
was asking if we thought that contact lens
companies should market their brand directly
to consumers.
Of course they should and of course they
do. All one needs to do is take a look at
YouTube to see what marketing some of the
companies do in the US, EU, Asia, Japan etc.
Of course when I am seeing a patient I
always recommend the lens that’s best for
them. Even if they did ask for a lens they had
seen advertised, it would not necessarily be
the one that I prescribe.
We are now in the 21 st Century and
marketing rules. The survey also asked
questions about companies being involved in
social media. Again of course they are: social
media is now making traditional marketing
look staid and old fashioned and if one believes
what you see and read, this is where it’s at.
They also asked if we had issues with
companies data mining and obtaining
patient information via social media and
apps. I don’t believe you can stop companies
getting patient data and contact details, as
the patients (consumers) voluntarily provide
that information. The way I see it is that
modern youth are very free with their privacy
and details, much like the hippies were in the
‘60s with free love! I have not promoted CL
company apps to my patients but I see that
there may be some positives, like improving
compliance and providing reminders. I simply
tell my patients who battle to remember
when to change lenses to programme a
reminder into their smartphone. Of course
having the majority of my in-range patients in
dailies avoids many of these issues.
Privacy
I avoid providing contact lens companies with
any patient details apart from their name
on orders. They do not get their address,
DOB, phone or email. In the old days in my
practices – before the internet - we used
to have a multipage self-carbon order pad
with tear offs, so the order that was faxed/
posted/delivered to the companies simply
had a patient reference number and nothing
else. (We had been stung once or twice by
companies who had tried to contact our
patients directly and thus had learned our
lesson decades ago). These days with privacy
acts and so on it is even more important for
you to make sure patient data is retained and
not shared.
These days some companies offer to ship
contact lenses direct to the consumer. It’s not
something I’m happy with and have never
used such systems.
The paranoid conspiracy theorists reckon
that contact lens companies are building
databases of contact lens wearers so
that they can send the consumer/patient
marketing info and potentially cut out the
optometrist and supply lenses directly. I
doubt that this is likely to happen. Contact
lens companies know on which side their
bread is buttered. Let’s face it optometrists
are the gatekeepers and prescribers of the
bulk of contact lenses in the world. Some
are prescribed by ophthalmologists (like in
France) and dispensing opticians and others
with contact lens prescribing licences (like
we see in the UK, US and Canada) but this
is not the bulk of prescribing. If contact lens
companies start direct selling to patients and
bypassing contact lens practitioners then I
suspect that contact lens market penetration
would drop significantly: practitioners will
stop proactively prescribing lenses. We have
seen some major legal battles in the US
where certain online contact lens retailers
and others with vested interests have tried
to alter legislation to make contact lenses
freely available without prescription. They
seek to dumb down contact lenses to generic
non-medical commodities. There are also
moves afoot to allow for kiosks that ‘examine
eyes’ and spit out a CL or spectacle Rx. That’s a
discussion for another day.
Bias?
Some surveys ask leading questions and
require ‘forced choices’. I’m generally not
happy with responding to such items. Thus
I avoid completing such surveys as I believe
they provide biased and skewed data and
statistics. Some allow for an ‘other’ option
and allow you to add comments: In my
experience, when I have tested such options
to see if they are read by asking for an email
response, I never get one so deem it to be a
waste of time.
At any rate these are my views on some
of the questions that are being asked. I’d be
interested to see what this survey’s results
show, if they are ever shared. I would probably
have broken down respondents by age: I’m
sure we would see quite skewed data as we
did in Brexit recently with massive differences
in perceptions between the younger and older
generations.
I reckon younger practitioners are much
more accepting of social media, TV marketing
and advertising than older practitioners but
of course I could be wrong.
Truth, lies and statistics eh? ▀
Getting behind MD awareness
The recent 2016 Macular Degeneration New
Zealand (MDNZ) Awareness week was a success
based on a marked increase in the turnout
to national seminars and phone calls to MDNZ for
further information.
The week-long campaign from 23-
29 May continued the Association’s
strong focus on the benefits of early
intervention and use of the easy-touse
Amsler Grid.
Phillippa Pitcher, MDNZ general
manager, said there has been
a steady increase in awareness
around the benefits of early
detection through regular eye
examinations, especially where a
relative has been affected by MD or
there has been a history of smoking.
MDNZ managed a greater reach
through a more strategic approach
to the use of social media and the
willingness of 10 New Zealanders
to share their personal stories in
the hope that people would take
heed of symptoms and act quickly
to preserve their vision, she said.
“Recent statistics supplied to
MDNZ show our continued focus
on the benefits of early detection
and smarter use of communication
Good diet for MD
New Zealanders are set to benefit from new
research identifying optimum weekly diets for
preventing age-related macular degeneration
(AMD) – New Zealand’s leading cause of blindness.
Dr Graham Wilson, ophthalmologist and clinical
director at St George’s Eye Care in Christchurch, is
investigating what New Zealanders need to eat to
help prevent AMD and minimise the progression of
the disease for those who already have it.
A range of New Zealand-specific
dietary scenarios will be identified
along with the associated cost.
There is also potential to model
Maori, Asian and Pacific Island
diets. It is the first time that
macular degeneration research of
this nature has been carried out in
New Zealand.
“It is well documented that
improvements in diet, for
example increasing intake of
green leafy vegetables, fish and
nuts, can reduce the risk of AMD
progression in those with early
signs of the disease,” says Dr
Wilson, who is undertaking the
research project alongside his
brother Dr Nick Wilson, professor
of public health at the University
of Otago.
“We aim to take it one step
further by modelling the perfect
New Zealand diet. The results will
be very applicable to the average
Kiwi, providing real, tangible
information to help prevent
the disease and minimise its
progression.”
Research will be carried out by
accessing a University of Otago
database that identifies nutrient
channels is making a difference. This year we were
able to directly access nearly 242,000 people, over
the age of 60, who use Facebook through our use of
a ‘Humans of New York’ approach. Those 10 personal
stories, from people from all walks of life, really
helped us to get the message out
there in a positive way.”
Awareness was also built up
through a series of interviews
on the main media channels
with MDNZ trustee Dr Andrew
Thompson, MDNZ chair Dr
Dianne Sharp and supporter Dr
Jim Borthwick. There was also
digital signage in 21 shopping
malls around the country and four
outdoor billboards in Auckland.
Pitcher said the uptake and
support of the campaign by
optometrists and ophthalmologists
throughout the country was
amazing.
“Many took out advertisements
in their local papers, arranged
competitions where, for example,
winners received a free eye check,
and sent out MD information to
their clients via their mailing lists.
New look online for VOSO
New Zealand charitable trust Volunteer
Ophthalmic Services Overseas (VOSO) has a
brand new website with content contributed
by all the current and some former trustees.
In a statement the organisation gave special thanks
to former trustee Malcolm McKellar, who dreamt of
a website that would both increase public awareness
of the charity as well as provide an online platform
for the public to donate directly to VOSO. “We would
also like to thank former secretary Ravi Dass who
secured the domain name and provided many of the
great photos on the site,” said VOSO secretary and
Auckland-based optometrist Kylie Dreaver.
The website was kindly built by The Drop’s Mark
Dromgoole, nephew of retired optometrist Colin
Beckwith. The organisation was also keen to thank
its main financial supporters the NZAO, RANZCO
and the University charitable trust, and Air New
Zealand, which helps the organisation with its cargo
requirements, as well as all the optometrists and
ophthalmologists who have personally supported the
MDNZ Awareness takes pride of place at Vivian
Edgar in Te Puke
This support helped us greatly to
spread our message far and wide.” ▀
VOSO trustee and retired Thames optometrist Hywel Bowen at work for VOSO
organisation over the last 30 years.
This year VOSO has a combined surgical and
optometry trip to Tonga, an optometry trip to Samoa
and has sent surgical supplies to Fiji, where limitations
in IOLs have led to reduced cataract surgeries being
performed. For more about VOSO’s activities, visit the
new site at www.voso.org.nz. ▀
levels and costs of common New Zealand foods. Linear
programming techniques will be used to optimise the
nutrients for AMD prevention across a range of diets,
including those constrained by cost.
The benefits are not limited to eye health, says Dr
Wilson.“What is good for your eyes is also good for your
heart and in preventing certain types of cancer. The
research findings will also be applicable to prevention
of other diseases.” ▀
MORE CLASSIFIEDS ON PAGE 16
PRACTICE CO-ORDINATOR / OPTICAL
ASSISTANT / DISPENSING OPTICIAN
We require a star team player who also thrives in an autonomous
environment. If you have an eye for detail and organisation, have
a passion for eyewear and fashion and enjoy the sales challenge
then we would love to discuss the position with you further.
Hours include a late night and some Saturday work on a rostered
basis.
Email your CV to Kristine on kjensen@eyesofhowick.co.nz or
phone 0274824477.
EQUIPMENT FOR SALE
Chair stand, vertometer, slit lamp and other accessories for sale.
Please email bdclworks@gmail.com for further equiries.
14 NEW ZEALAND OPTICS August 2016.indd

Calling innovators!
Essilor has launched
their international open
innovation challenge to
develop scalable solutions for
measuring refractive errors
in populations with poor
access to eye healthcare. The
announcement, made from
Essilor’s French headquarters on
30 June, is calling for interested
parties to come forward with
ideas around the challenge.
Called the See Change
Challenge, Essilor is seeking
innovative solutions that can
improve the lives of 2.5 billion
people by facilitating access
to vision care. Specifically, the
See Change Challenge aims to uncover low-cost,
easy-to-use and scalable solutions that can be
used by primary vision care providers in developing
countries and low socio-economic areas to
accurately measure eye refractive errors.
“Innovation has always been a cornerstone of our
mission to improve lives by improving sight,” said
Hubert Sagnières, chairman and chief executive of
Essilor International. “Today we are widening our
field of exploration to ensure we meet the vision
needs of the 7.2 billion people in the world. We
are excited to use the open innovation model to
discover new solutions that have the potential to
transform the lives and economic futures of lowincome
populations through improved access to
vision care.”
Essilor is appealing to startups,
universities, app developers,
vision scientists, optometrists,
engineers and all individuals
and organisations to bring their
multi-disciplinary expertise to
develop innovative refraction
solutions. Be that a new piece of
hardware, a new piece of software,
a smartphone app or something
entirely different, the aim is to use
these solutions to speed up the
delivery of vision care in poorer or
more isolated regions by enabling
more people to be easily trained to
become primary eye care workers.
Up to five winners of the first
phase of the Challenge will
receive €25,000 and the opportunity to enter
the second phase of the Challenge, where an
additional €100,000 is up for grabs for the two
final winners. Essilor will also potentially support
the final winners with development contracts to
help them to build and scale up their solution.
Of the 4.5 billion people who need vision
correction, only 1.9 billion actually correct their
eyesight. More than 2.5 billion people still live
with uncorrected poor vision and its social and
economic consequences, and 95% of them live in
developing countries where they lack awareness of
the impact of poor vision and access to basic vision
care solutions.
For more information, or to get involved, visit
www.essilorseechange.com ▀
NZOWA launches website in
time for Visionz 2016
The New Zealand Optical Wholesalers
Association (NZOWA) has launched its
long-awaited website www.nzowa.org.nz
detailing members, their contact details and the
products they offer.
The website also carries details about NZOWA’s
biennial conference Visionz, which is being held
this year from 14-16 October at the Ellerslie Event
Centre in Auckland.
Registration is now open for Visionz 2016
and anyone wishing to attend can also register
through the new NZOWA site. The three-day event
encompasses a comprehensive industry exhibition,
an educational conference (EduVisionz) focusing
on low vision (see story in June’s issue of NZ
Optics) and practice management, including: tips
and advice from a successful retailer’s perspective;
managing people; preparing your business for sale;
handling complaints; and boosting your profile
through social media. Another theme is health
and safety given the recent changes to the health
and safety legislation. This includes a St John’s first
aid course, which will be open to practice owners,
managers and staff and NZOWA members and
staff.
Visionz has been very successful in the past and
has received extremely positive feedback from
attendees so the NZOWA is very pleased to be able
to offer this event to the optical sector again, said
Gary Edgar, NZOWA president.
“NZOWA is putting this event on to bring the
industry together. It is an opportunity for practice
owners and their staff to gain new ideas and
skills to enhance their performance and elevate a
practice’s retail image.”
The low vision conference will run on the Friday
and the practice management programme for
practice owners and staff will run on the Saturday
and Sunday. A Visionz cocktail party will be held on
Friday evening starting at 5:15pm. CPD points are
being applied for. For more visit www.nzowa.org.
nz/conference or email enquiries@nzowa.org.nz ▀
Alcon promotes More Prize
Time in practices
Alcon began rolling
out the second
phase of its directto-consumer
advertising
and marketing campaign
for its Dailies Total 1
contact lens brand
in Australia and New
Zealand on 10 June.
The multi-channel
campaign builds on
the success of the first
phase of Alcon’s “More
Contact Time” campaign,
which launched in
October 2015 and was designed to raise consumer
awareness of contact lenses to drive more patients
into practices to request a contact lens trial.
The second phase of the campaign is designed
to target the core demographic for daily
disposable contact lenses who look for contact
lenses comfortable enough to wear all day and
into the evening, said the company. “The locally
photographed 2016 campaign has refreshed
visuals and was created to engage and connect
with the target demographic.”
The campaign includes ads in key women’s
magazines, social media and digital advertising
and a host of in-practice material. Alcon is also
Key visuals from the second phase of Alcon’s consumer campaign
encouraging practices to take advantage of its
in-practice promotion, the Dailies Total 1 More
Prize Time competition, which runs from June
to September. Prizes include six or 12-month
supplies of Dailies Total 1, GoPro Hero action
video cameras, Fitbit Blazes, iPad Pro’s and a
A$2,000 luxury designer voucher.
“Our 2016 integrated campaign has been
designed to continue to support you by driving
new and existing contact lens patients in-practice
to trial Dailies Total 1. The More Prize Time
competition targets our key demographic and
will give patients an extra incentive to visit your
practice,” said the company. ▀
Style-Eyes
Colourful eyewear
Are your customers afraid of wearing colourful
frames? Sometimes I’ll look at a customer’s
outfit and think, “I love their style - I can sell
them something bright and fun!” Yet after
a long selection process they chicken out
and choose a black or tortoiseshell frame.
How can we help our customers access their
adventurous side?
I asked my spectacle-wearing friends about
their opinions on colourful eyewear.
Anthea says, “I think there is the perception
that you need a bold or daring personality
to wear colourful or otherwise stand-out
eyewear, but in my experience they just
become part of your face or your style if they
are your everyday pair.”
I like to tell customers that while spectacles
are a medical device, they’ve also got an
opportunity to buy jewellery for their face, so
they may as well make the most of it.
Skin tone
“I have always wanted to get coloured frames
but when I go to try them on, none of them are
the right shade for my face.” Anya
There are some people who insist that certain
skin tones only suit certain colours. You’ll hear
things like, “Oh you’re an autumn – try these
green frames.” I’ve never completely understood
the point of Seasonal Colour Analysis and it only
really ‘works’ for white skin. Anyway, this kind of
rule is meant to be broken! Instead of spending
time trying to work out what ‘undertone’ means,
just encourage your clients to try some frames
on – if they like the colour and feel that it suits
them, then that’s a win.
Proof of breaking this rule comes from my
friend Deb who said, “I love colour[ful] frames
and, surprisingly, can wear colours that I didn’t
think I could – like red, purple, pink…” It just goes
to show that if someone is curious about colour,
playing dress-ups in store with frames is the best
way to discover something new that suits.
How do we solve Anya’s case? She stuck with
neutrals and tortoiseshell in the past, but she
thinks that deep emerald green would suit
her and will look for that next. All she needs is
some encouragement.
BY JO EATON
Phone 09 486 4372 or Fax 09 486 3936
info@eyesurgeryassociates.co.nz or
Dr Patel at: patel@glaucoma.co.nz
www.eyesurgeryassociates.co.nz
For more personalised eye care
talk to Dr Hussain Patel
Consultant Ophthalmologist
MBChB, MD, FRANZCO
Eye Surgery Associates are a Southern Cross Health Society Affiliated Provider
Matchy-matchy
“It hasn’t stopped me, but outfit co-ordination
is a consideration. Whether glasses “go” with
your overall style or wardrobe.” Anthea
If customers are concerned about frames
matching clothes, I talk with them about the
colour wheel, which explains the relationship
between different colours and tones, and how
things don’t always need to match to work.
(See www.colormatters.com/color-anddesign/basic-color-theory
for more about this.)
If we’re going by complementary colours for
example, and the customer says they wear a lot
of green, then purple frames are a great match.
For some people who have to wear suits
or uniforms, eyewear is one of the only
opportunities they get to express their
personality through attire. Have a chat to your
customers about how they have to dress for
work and use this as a starting point for your
frame recommendations.
I also use colour as an opportunity to sell a
second pair. If someone is drawn to a colourful
frame, but is concerned about matching their
clothes, I suggest getting a black, grey, brown/
tortoiseshell, or metal frame as a safe second pair.
Every dispenser I know asks their customers
the same question: “How many pairs of shoes
do you have? More than one? Then shouldn’t
you have more than one pair of glasses?”
Trends
Last month, Louise Sceats of Jono Hennessy
told NZ Optics that blue is on-trend, and we’re
certainly seeing many shades of blue in current
frame collections. I’ve also noticed dusky pink
and rose gold metal features in a lot of ranges.
Looking for some inspiration? A few of my
favourite, colourful brands are l.a.Eyeworks,
Theo, Anne et Valentin and Andy Wolf.
And here’s a weird fact for you if all else fails:
Hot pink goes with everything. ▀
* Jo Eaton is an optical dispensing student at RMIT. Originally
from Wellington, Jo became interested in eyewear after
discovering she was myopic at the age of 14. In 2008, many
years after deciding to make unusual glasses her ‘thing’,
she founded eyewear fashion blog ‘Eye Heart Glasses’. When
she’s not immersed in the world of spectacles, she works in
digital marketing, DJs, volunteers for community radio and
is a director of feminist music organisation LISTEN.
SERVICES INCLUDE:
Glaucoma Specialist / Refractive Cataract Surgery
General Ophthalmology / Acute & Emergency Eye Care
Available throughout Auckland
and also in Hamilton
August 2016.indd
NEW ZEALAND OPTICS
15

DISPENSING OPTICIAN /
OPTICAL ASSISTANT
PATERSON BURN OPTOMETRISTS HAMILTON &
SURROUNDS
We are looking for a passionate Dispensing Optician / Optical
Assistant to join our family.
In this role you will offer an amazing eye care experience by
providing exceptional customer service with honesty, care and
absolute attention to customer needs.
We offer a great working environment with continuous support
and professional development opportunities.
To be successful in this role you will:
- Have a friendly, natural and consultative approach to selling
- Be confident, enthusiastic and motivated to succeed
- Have excellent communication and sales skills
- Be a versatile team player
Experience as a Dispensing Optician or Optical Assistant is
preferred.
If you are not yet qualified, we will provide the opportunity and
support to qualify as a dispensing optician.
This position is full time, based in Hamilton and/or Cambridge
and requires some Saturday work.
To apply:
Please email your CV and a cover letter to sandri@patersonburn.
co.nz
CALLING ALL OPTOMETRISTS FROM
AUSTRALIA AND NEW ZEALAND!
Specsavers Invercargill has an exciting opportunity for an
optometrist to take up either a permanent or block position in their
practice.
The practice itself is lead by 2 dedicated store directors and a team
of experienced and passionate employees, who have a strong
reputation within the local community. It has two test rooms, a
dedicated pre-test area, 5 dispensing desks and a loyal patient
database.
WHY SPECSAVERS INVERCARGILL?
You may be aware that Invercargill is the capital of the Southland
region of New Zealand, and the gateway to some of the country’s
most beautiful scenery, cultural attractions, nature reserves and
parks, as well as a city life with lively cafes, restaurants, and bars.
What you may not be aware of is that Invercargill is located an
hour and half from some of the best skiing and snowboarding in
the world – and not only that - free use of an exclusive chalet is
on offer to the optometrist that joins this team!
FULL TIME - DISPENSING OPTICIAN
SPECSAVERS SYLVIA PARK
We are looking for an experienced dispensing optician to join
our three room practice at Specsavers Sylvia Park. This is a
great opportunity to work in a central location in Auckland.
Competitive Salary and bonus package based on experience.
Great training opportunities available through Specsavers on
management and leadership. Specsavers experience is not
essential. Please email Ryan Mahmoud at dir.sylviapark.nz@
specsavers.com or call 021 166 5899.
NEED TO REPLACE
YOUR LETTER CHART?
AcuityKit has a comprehensive range of digital eyecharts for eyecare
professionals. Ideal for low vision and domiciliary work.
Visit our website www.acuitykit.com or email john@acuitykit.com
Paterson Burn Optometrists is one of the largest independent
optometry practice groups in New Zealand. We are totally
independent and Waikato owned and we've maintained our
independence in the ever changing environment of New Zealand
optometry. Our core purpose is to improve people's lives by
providing the best visual solutions available. Paterson Burn
Optometrists value respect, integrity, accountability, enjoyment,
continuous improvement, freedom for initiative and teamwork.
MORE CLASSIFIEDS INSIDE
ON PAGE 14
If you would like to;
* Further develop your clinical skills and practice within a setting
that sees a variety of pathology cases
* Tear up the ski slopes (or observe from the chair lift – your
choice!) by having free use of a chalet on your days off
* Find out about the attractive package and sign on bonus that is
on offer
* Find out how Specsavers can support AUS optometrists to work
in NZ and financially support the earning of your annual CPD
points
Then please contact Carly Parkinson on +61478201057 or carly.
parkinson@specsavers.com for a confidential chat today!
JOIN US FOR
YOUR PERSONAL INVITATION
BRISBANE CONVENTION & EXHIBITION CENTRE
SATURDAY 10 TH & SUNDAY 11 TH SEPTEMBER 2016
Join 500 optometrists (including more than 100 non-
Specsavers optometrists) at this year’s SCC for two days
in September – for one of Australia and New Zealand’s
premier optometry CPD and networking events.
Visit spectrum-blog.com for more info
OR JOIN US FULL TIME...
With growth continuing, our store teams are currently
seeking optometrists to fill permanent roles in the following
NZ practice locations:
North Island • St Lukes
• Kerikeri • Taupo
• Masterton • Tauranga
• Mt Maunganui • Te Rapa
• Pakuranga • Wanganui
• Palmerston North • Wellington
• Paraparaumu CBD South
• Rotorua • Whakatane
South Island
• Dunedin
• Invercargill
• Shirley
We are currently also seeking experienced dispensers for a
variety of our New Zealand stores.
Alternatively, if you’re interested in a move to Australia -
either short or longer term, talk to us for the lowdown on
possible locations in all states.
A trip to SCC as our guest could be the perfect way to see
what's on offer.
To find out more and to explore the T&C'S associated
with this industry-wide offer, contact Carly Parkinson
on 0800 717 350 or carly.parkinson@specsavers.com
– or visit spectrum-blog.com
16 NEW ZEALAND OPTICS August 2016.indd
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