Aug 2016

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PO BOX 106 954, AUCKLAND CITY 1143<br />

Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz<br />

AUGUST <strong>2016</strong><br />






CORE<br />

UNIQUE<br />

WATER<br />


THIS IS WHY patients<br />

can experience a surface<br />

so soft, it feels like nothing.<br />


*Perez-Gomez I, Giles T. Clin Optom 2014;6:17–23. NP4:A21601422433

10 free ticket,<br />

flight and<br />

hotel packages<br />

available now!<br />



SATURDAY 10 TH & SUNDAY 11 TH SEPTEMBER <strong>2016</strong><br />

Join 500 optometrists (including more than 100 non-Specsavers<br />

optometrists) at this year’s SCC for two days in September –<br />

for one of Australia and New Zealand’s premier optometry CPD and<br />

networking events.<br />

Saturday – Clinical Education Sessions: Afternoon session across two concurrent<br />

streams (Therapeutic / Clinical Skills). University, Optometry and Hospital led.<br />

Worth 3 CD Pts and 3 General Pt in 2015.<br />

Sunday – Specsavers Clinical Conference: Full day session on a single stream<br />

(Therapeutic and Clinical topics). Ophthalmology led.<br />

Worth 6 CD Pts and 1 General Pts in 2015. Exhibition also in place.<br />

To find out more and to access the SCC Booking Portal (ticket registration and<br />

accommodation), go to spectrum-blog.com/book/SCC<br />

Non-Specsavers Optometrists: to enter into a prize draw<br />

for ten free ticket / flight / accommodation packages, contact<br />

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

When: Saturday 10th and Sunday 11th September <strong>2016</strong><br />

Where:<br />

Theme:<br />

Detail &<br />

Costs:<br />

Brisbane Convention & Exhibition Centre<br />

‘Collaborative Care – a new era in eye health’<br />

Saturday: Clinical Education Sessions<br />

12:00pm to 5:00pm<br />

$150 + GST<br />

Saturday: Welcome Event<br />

Gallery of Modern Art<br />

6:45pm to 10:45pm<br />

Event hosted by the Specsavers<br />

Professional Services team: no charge<br />

Sunday: SCC<br />

7:30am to 6:00pm<br />

$340 + GST<br />

NZ Franchise<br />

System of<br />

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No. 1 for eye tests<br />

2014<br />

FCA International<br />

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of the Year<br />

2014<br />

FCA Social<br />

Responsibility<br />

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FCA Established<br />

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of the Year<br />

2013<br />

FCA Excellence<br />

in Marketing<br />

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2013<br />

Australian<br />

Retailer<br />

of the Year<br />

2013<br />

Australian<br />

Retail Employer<br />

of the Year<br />

2013<br />

Asia-Pacific Best<br />

Retail Training<br />

Organisation<br />

2013<br />

2 NEW ZEALAND OPTICS <strong>Aug</strong>ust <strong>2016</strong>.indd

Facing the future?<br />

Innovation<br />

nation<br />



In the world of Antipodean optometry, 2015 was a<br />

unique year. Optometry graduates found they had<br />

an additional 110 newly qualified optometrists to<br />

contend with on the job market as a direct result of<br />

two new courses at universities in Australia.<br />

Flinders, based in Southern Australia, launched<br />

its optometry course in 2009. It’s the only<br />

university outside the Eastern states offering<br />

such a qualification and strongly targets potential<br />

students from rural areas. While Deakin, based in<br />

Melbourne and Geelong, launched its fast-track<br />

optometry masters course in 2012, allowing<br />

students to become qualified in just three and a<br />

half years.<br />

Stu Allan, from OpticsNZ, believes we have seen,<br />

and will increasingly continue to see, a tightening<br />

of job prospects for New Zealand graduates.<br />

“There are now five universities in Australia<br />

offering optometry degrees. What we are seeing<br />

as a result is an excess of graduate optometrists<br />

in Australian metro areas like Melbourne, and the<br />

knock on effect is a reduction in starting salaries in<br />

those locations.<br />

“In New Zealand, we typically see 50 to 60<br />

graduates from Auckland University each year (42<br />

this year), but there aren’t 50 to 60 optometrists<br />

retiring each year, and growth is static. These<br />

students will be looking overseas – traditionally<br />

Australia – for work, and that market is now more<br />

crowded than ever.”<br />

Mark Overton, from Ideology Consulting in<br />

Australia has similar concerns.<br />

“As well as additional graduates, we are seeing<br />

private practice squeezed and so unlikely to be<br />

able to take on new graduate staff. Also there<br />

are more locums looking for permanent work in<br />

Australia now as a result of restructuring within<br />

the corporates.<br />

“It’s true that starting salaries this year were A$5<br />

to A$10k less over here. It’s like filling a cup with<br />

water – you can run the tap as fast as you like but<br />

you’ll just end up with overflow quicker.”<br />

Unlike Allan however, Overton sees the situation<br />

as potentially improving job prospects for Kiwi<br />

graduates, at least temporarily.<br />

“The majority of courses in Australia are in the<br />

Eastern metro areas. When students graduate,<br />

they don’t necessarily want to move. They’ve got<br />

a quality of life, perhaps even a partner, and they<br />

want to make a life for themselves in Melbourne<br />

Stu Allan predicts tough times<br />

ahead for Kiwi graduates<br />

Mark Overton sees good job<br />

prospects for Kiwi graduates<br />

outside Melbourne and Sydney<br />

or Sydney, not the rural areas where there is a<br />

shortage of optometrists.”<br />

Overton suggests that graduates coming to<br />

Australia from New Zealand might be more willing<br />

to go to places like Darwin, where job prospects<br />

are good.<br />

“Many come for two to four years as a bit of an<br />

OE. They don’t have preconceptions about where<br />

they want to be, they just want a good job and are<br />

prepared to travel.”<br />

Looking at the two new courses, Overton also<br />

says they do serve a purpose.<br />

“Both Flinders and Deakin have more of a focus<br />

on rural optometry. Flinders actively recruit<br />

students from rural areas and encourage them to<br />

go back to those places after they graduate. I work<br />

with students from Flinders and the quality of the<br />

graduates is very high indeed.”<br />

Deakin is also actively targeting rural students<br />

from this year, proving that rather than just<br />

saturating a popular student market, both<br />

universities have considered where there might be<br />

a real industry need.<br />

Hirdesh Nair, professional services manager,<br />

OPSM NZ, says he’s confident the new courses<br />

won’t affect Kiwi graduates.<br />

“There are very few New Zealanders studying<br />

in Australia and most Aussies won’t be looking to<br />

come to New Zealand for work. OPSM have had<br />

room for six graduates this year, mostly in our<br />

regional areas. Of course it is hard to predict the<br />

job market needs when you don’t know who is<br />

retiring or what new practices are opening, but we<br />

are in the position where we want graduates.”<br />

Nair says the new courses in Australia aren’t<br />

saturating the market, noting there is one school<br />

of optometry for New Zealand, a country of four<br />

million people, and only five in Australia, a country<br />

of 26 million people.<br />

“If you do the math, then by rights Australia<br />

should have six schools. Western Australia doesn’t<br />

have any universities offering optometry.”<br />

Like Overton, Nair says he believes it’s all about<br />

lifestyle choices, and whether graduates are willing<br />

to travel regionally. He also believes as more<br />

practices move to seven-day trading more jobs will<br />

open up.<br />

“New Zealand is currently the least affected by<br />

the new schools. When Australia gets back-filled,<br />

then we may see a problem.”<br />

It’s this backfilling that is worrying Allan, who<br />

agrees there are regional vacancies in New<br />

Zealand, but finding a job is more complicated<br />

than location and remuneration alone.<br />

“The more provincial you go, the better the<br />

salary. This is true in New Zealand with places like<br />

Gisborne or Whangarei. But graduates seem to be<br />

motivated by other things, like the team dynamic,<br />

mentors with a genuine desire to share knowledge<br />

and being exposed to a wide cross-section of<br />

patients in their first two years, more than money.”<br />

Allan says he believes the best chance of new<br />

graduates securing a job is to specialise early on<br />

in areas like behavioural optometry and make<br />

themselves stand out.<br />

“If you asked new graduates would they have<br />

chosen to complete the same path of study,<br />

knowing what the job market is like, I wonder<br />

how many would say ‘yes’.<br />

“There is no question it is a fantastic<br />

profession; strong primary healthcare links,<br />

meaningful, privileged, and with exposure to<br />

patient life stories. The stories from journeyman<br />

optometrists over the years are emotional,<br />

rewarding and empowering. But looking ahead<br />

there is a clear need to develop sub specialities,<br />

to differentiate based upon clinical strengths.”<br />

Are you a recent graduate? What was your<br />

experience of finding a job or moving into the<br />

job market? We’d love to hear your story. Drop<br />

us a line at editor@nzoptics.co.nz. ▀<br />

DV805-0416<br />

This month has flown by, not least because<br />

of all the exciting and newsworthy<br />

developments we’ve been exposed to. Don’t<br />

panic, I’m not talking about Brexit (although as a<br />

Brit, and a staunch #REMAIN voter, it has certainly<br />

occupied much of my time), but rather within the<br />

industry. Our inboxes have been flooded with news<br />

about new research, business partnerships and<br />

product launches that have buoyed my optimism<br />

about this exciting industry.<br />

Times are a-changing, none of us can deny that.<br />

And in this fast-paced ‘uber’ world we now live<br />

in, reinvention is essential to success. The optics<br />

industry is not immune to this and I’m pleased to<br />

see this has been recognised across the board.<br />

As our optometrists’ healthcare mandate<br />

becomes even more retail focused, as our ‘patients’<br />

become ‘clients’, as style and convenience begin to<br />

play an even greater role as a driving force behind<br />

consumer eye-health awareness, our practitioners,<br />

researchers and behind the scenes business people<br />

are doing some great things – and we’ve tried to fill<br />

this issue with some of them. This month we’ve a<br />

fabulous Focus on Business column from self-styled<br />

retail geek, Juanita Neville-Te Rito (p.6) and we also<br />

take a look at how bricks and mortar trading is<br />

merging with the digital world (p.9). Jason Dhana<br />

offers us a very colourful take on the European<br />

Glaucoma Congress (p.10) – proving that making<br />

connections is not only essential to quality patient<br />

care, but quite fun too! And we uncover how the<br />

job-market is changing for this year’s optometry<br />

graduates (p.3).<br />

We look at Oculo’s quest to pull together an ‘eyehealth<br />

eco system’ (p.4) and oDocs flirtation with<br />

art at Motat (p.6). And don’t miss the stunning<br />

young lady modelling Optique Line’s new Mersey<br />

Beat range on p.9, none-other than Optique Line<br />

founder John Nicola’s daughter Helen.<br />

We hope you enjoy reading this issue as much as<br />

we enjoyed making it. ▀<br />

Jai Breitnauer, Editor, NZ Optics<br />

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<strong>Aug</strong>ust <strong>2016</strong>.indd<br />



News<br />

in brief<br />


California-based EnChroma, founded in 2010, has sold nearly<br />

30,000 sets of sunglasses to people with colour-blindness who<br />

are now able to see in technicolour for the first time. In news<br />

reports the company’s glass scientist and co-founder, Dr Don<br />

McPherson, said it all began more than a decade ago when he was<br />

manufacturing glasses for laser surgery. When he tried them on, he<br />

noticed his normal colour vision was enhanced. He offered them to<br />

a colour-blind friend who found he could differentiate between red<br />

and green for the first time. One of the unintended consequences<br />

of the lenses Dr McPherson had developed was they absorb some<br />

wavelengths of<br />

light making them<br />

beneficial for<br />

people with colour<br />

deficiency. The<br />

current lenses aid<br />

about 80% of people<br />

and the company is<br />

trying to develop a<br />

new product for the<br />

other 20%.<br />


The global market for contact lenses grew to US$9.4 billion in<br />

2014 from US$8.9 billion in 2013, according to the report, Contact<br />

Lenses: Technologies and Global Markets.<br />

Published in June, the report says the CL product market is expected<br />

to grow at a five-year compound annual growth rate (CAGR) of<br />

1.9% from 2015 to 2020, increasing from US$9.2 billion in 2015 to<br />

US$10.1 billion in 2020. The rigid and hybrid lenses segment should<br />

grow at a five-year CAGR of 9%, reaching US$466 million in 2020.<br />

The others segment, including intraocular lenses and advanced<br />

optics lenses, reached about US$2.2 billion in 2014, up from nearly<br />

US$2 billion in 2013, and should grow at a five-year CAGR of 4.1%<br />

during the forecast period.<br />


Rodenstock Australia has received a Certificate of Appreciation<br />

from Cambodia Vision for its ongoing support. Strong supporters<br />

of the not-for-profit organisation, the Rodenstock team attended<br />

the annual Cambodia Vision fundraising dinner at the end of<br />

June where they accepted the certificate. Cambodia Vision was<br />

established in December 2006 to work with small provincial towns<br />

in Cambodia on blindness prevention and basic healthcare. Research<br />

shows Cambodia has a high incidence of preventable blindness with<br />

approximately 70,000 new cataract cases each year. The foundation<br />

survives solely through sponsorship and community support.<br />


The British Contact Lens Association (BCLA) will hold its first<br />

conference outside the UK at the Cordis Langham Place Hotel in<br />

Hong Kong from 13 to 14 September this year. The conference will<br />

cover myopia management, presbyopia and dry eye. “The conference<br />

is a perfect opportunity to hear the latest research including new<br />

papers from some extremely talented professionals in Australia and<br />

Asia,” said BCLA president Brian Tompkins in a statement.<br />

The event, titled Correction for the Future, is a partnership<br />

between the BCLA and the Hong Kong Cornea and Contact Lens<br />

Society. Registration is open now.<br />


Flinders University ophthalmology experts have joined US<br />

colleagues to discover a new genetic cause of primary congenital<br />

glaucoma, reported Australian Optometry. Glaucoma in children is<br />

often more aggressive than in older people and requires multiple<br />

surgeries and life-long daily treatment. Quoted in the article,<br />

Flinders research leader, ophthalmologist Professor Jamie Craig,<br />

said the study will use samples from around the world to link the<br />

disease to mutations in the TEK gene, which can lead to a poorly<br />

formed or absent cell-membrane receptor protein for proper<br />

development of a drainage channel, leading to elevated eye<br />

pressure over time. He said it’s hoped, through further research, a<br />

new genetic test could be developed as well as better treatments.<br />

Oculo teams up<br />

with Optomates<br />

Oculo, a new internet-based, secure-messaging service<br />

designed to connect eye care professionals, has teamed up<br />

with Monkey Software, another Australian-based company,<br />

whose practice management software system, Optomate, is one of<br />

the most widely used in New Zealand.<br />

“Oculo is committed to quality patient care and also to<br />

streamlining practice workflows,” says Dr Kate Taylor, CEO of Oculo.<br />

“Optomate is a leading software for optometrists, widely used<br />

by independent practices and covers scheduling, billing, supply<br />

chain management, patient records and more. This is a really<br />

exciting partnership, as it’s our first integration demonstrating our<br />

commitment to working widely across the eye care industry. It is<br />

the first step toward other integrations.”<br />

Dr Taylor reiterated the need for wider communication and<br />

teamwork in order to provide the best service to clients.<br />

“Our aim is to connect the eye care ecosystem. This partnership<br />

will make it easier for independent optometrists to tap into what<br />

Oculo has to offer. We are also reaching beyond an optometry and<br />

ophthalmology platform, to offer access to low vision services,<br />

support groups and additional networks that offer a continuity of<br />

Chewing it over<br />

The Save Sight Institute at the University of Sydney<br />

has developed a simple ‘chewing gum’ test to help<br />

prevent blindness.<br />

The test requires patients to chew gum at a rate of<br />

one chew per second to unmask claudication of the<br />

jaw muscles – a symptom specific to giant cell arteritis<br />

(GCA). This condition, most common in people over 50,<br />

can be hard to diagnose because the symptoms, such<br />

as headaches and vision problems caused by artery<br />

inflammation in the head, are often subtle and easy to<br />

associate with other conditions. The ‘chewing gum’ test<br />

can reproduce a patient’s tell-tale pain, allowing further<br />

investigation with a blood test and an arterial biopsy to<br />

confirm diagnosis.<br />

Outlined in a letter in June’s New England Journal of<br />

Medicine, researchers presented two cases where the<br />

chewing gum test allowed clinicians to better characterise jaw<br />

pain, confirm a diagnosis and successfully treat both patients.<br />

The 4 days of Optics<br />

23 - 26 September <strong>2016</strong><br />

care for eye patients, enhancing the quality of their experiences and<br />

outcomes.”<br />

Dr Taylor also noted this partnership would make it easier for<br />

independent practices to access the services Oculo provides. Chris<br />

Monks, director of Monkey Software, reiterated this point.<br />

“Independent optometrists are committed to providing the best<br />

possible quality of clinical care. We recognise that today collaborative<br />

care is an important part of optometrists’ contribution to eye care,<br />

and so we are keen to facilitate this.<br />

“Working with Oculo, who have grown with a vision for enhanced<br />

eye care, is a good fit for Optomate’s dedication and ongoing<br />

investment to support our optometrists’ commitment to patients.<br />

Communications through Oculo will also help our optometrist users<br />

connect with GPs and other medical specialists - important both<br />

for patient care and to promote the central role of optometry in<br />

primary eye care.”<br />

Oculo’s software was developed at the Centre for Eye Research<br />

(CERA) in Australia. The Australian roll-out began in April and now<br />

exceeds 1,000 users, with 215 ophthalmologists and 400 practices. It<br />

was officially launched in New Zealand in June. ▀<br />

GCA is one of the most common causes of blindness in older<br />

people and a condition that poses a high risk of death.<br />

The test is currently undergoing further study. ▀<br />

CCLSA<br />

registrations open<br />

Registrations are now open for the Cornea and Contact Lens<br />

Society of Australia’s (CCLSA’s) next master class, which will take<br />

place at the beautiful Ayers House in Adelaide from 26 to 27<br />

November, immediately after the Blue Sky Congress.<br />

This year’s programme will include presentations on finding<br />

the confidence to increase the percentage of contact lens<br />

wearers in your practice, three different perspectives on<br />

applications for contact lenses outside refractive correction,<br />

identifying dry eye, secrets of the edge design of RGP contact<br />

lenses and managing acute contact lens complications. ▀<br />


The US Food and Drug Administration (FDA) has accepted a New<br />

Drug Application (NDA) from Nicox for AC-170, a novel, proprietary,<br />

cetirizine eye drop formulation, for the treatment of ocular<br />

itching associated with allergic conjunctivitis. This is the first time<br />

cetirizine, a second-generation antihistamine, has been used in<br />

a topical drug for the treatment of ocular itching associated with<br />

allergic conjunctivitis. AC-170 was developed by Aciex Therapeutics,<br />

which became a wholly-owned subsidiary of Nicox in October 2014<br />

and was subsequently renamed Nicox Ophthalmics.<br />


silmoparis.com<br />


Bernie Eastwood has stepped down as president of the Australian<br />

College of Behavioural Optometrists (ACBO) to focus on opening a<br />

new Perth-based practice. The ACBO Board has invited current vicepresident<br />

Steve Leslie to assume the role of acting president until<br />

the next AGM, at which time an election will be held for the role of<br />

president and any other Board vacancies. The ACBO Board thanked<br />

Bernie for her considerable contribution and her commitment to<br />

her profession. ▀<br />

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

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

For editorial and classifieds, please contact Jai Breitnauer, editor, on 022 424 9322 or editor@nzoptics.co.nz.<br />

For advertising, marketing, the OIG and everything else, please contact Lesley Springall, publisher, on 027 445 3543 or lesley@nzoptics.co.nz.<br />

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

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

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

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

those of NZ Optics (2015) Ltd.<br />

4 NEW ZEALAND OPTICS <strong>Aug</strong>ust <strong>2016</strong>.indd







CORE<br />

THIS IS WHY patients<br />

can experience a surface<br />

so soft, it feels like nothing. ** 1<br />

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

almost as soft as the corneal epithelial cells. 2–5<br />

The First and Only Water Gradient Contact Lens<br />

>80% 33%<br />

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Features different surface<br />

and core water contents 6 LASTING LUBRICITY<br />

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Modulus of ~0.01 MPa at<br />

the outermost surface 2,4<br />

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Let your patients experience the DAILIES TOTAL1 ® contact lens difference today.<br />


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

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

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

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

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

© <strong>2016</strong> Novartis. Alcon Laboratories (Australia) Pty. Ltd. 10/25 Frenchs Forest Road East, Frenchs Forest, NSW 2086, Australia. Phone: 1800 224 153. 109 Carlton Gore Rd, Newmarket<br />

1023, Auckland, New Zealand. Phone: 0800 101 106. 07/16 ALC0550a NP4:A21601422433<br />

<strong>Aug</strong>ust <strong>2016</strong>.indd NEW ZEALAND OPTICS<br />


oDocs collaborates at MOTAT<br />

Focus<br />

on Business<br />


Seven ways to use social media<br />

to get customers in store<br />

Increasingly I am talking with retail<br />

businesses who have got themselves<br />

tied up in knots over social media. In<br />

particular, how they can use it to drive<br />

awareness or visitation to their physical<br />

location. More commonly physical<br />

stores typically use social media to drive<br />

customers to their website, but there are<br />

many other opportunities to be explored.<br />

Here are seven social media strategies<br />

I’ve learned while watching others<br />

achieve success.<br />

1. Offer special offers (dare I say coupons)<br />

only redeemable in your store.<br />

This is one of the most basic strategies,<br />

but it is effective. If you are launching<br />

a new product you can offer additional<br />

value or discount to drive shoppers instore.<br />

Something like “mention this tweet<br />

and get half off your next purchase,” or<br />

post an image that the customer shows<br />

the sales assistant in order to receive the<br />

special offer.<br />

It’s important to distinguish this<br />

approach from typical online coupon<br />

strategies, such as using coupon codes<br />

at the checkout. The key is to funnel<br />

shoppers into your chosen physical store<br />

by not allowing this to be redeemed<br />

anywhere else.<br />

Smoove Clothing is well renowned for<br />

utilising this method in their secret sales<br />

promotions - where customers have to<br />

provide the “secret password”, which is<br />

posted on social media, in order to get the<br />

exceptional sale discount.<br />

2. Host a special event.<br />

The type of event will depend almost<br />

exclusively on your customers. For<br />

example, young hipsters would<br />

probably be excited by a live music or<br />

art collaboration. But a foodie audience<br />

might like to watch a celeb chef do a<br />

demonstration, meet the maker or have<br />

their book signed.<br />

Once you decide on the nature and<br />

date of your event, start promoting the<br />

heck out of it. Farmers, with their Fashion<br />

Fixes by Lisa O’Neil in-store events, is an<br />

example which drives great enthusiasm<br />

and excitement with shoppers and results<br />

in massive sales in-store.<br />

3. Attend a local event and use a<br />

designated hashtag.<br />

If you are too small to host an event<br />

of your own, you can always attend<br />

someone else’s event. For example, get<br />

involved at a local festival by walking<br />

around handing out free samples or<br />

flyers. The event is bound to have a<br />

Twitter hashtag associated with it. Start<br />

posting images of your business at the<br />

event and use accompanying hashtags.<br />

This will greatly increase your visibility<br />

and relevance to a target local audience,<br />

making them far more likely to visit your<br />

physical location.<br />

Lululemon recently attended the<br />

Wanderlust healthy living/yoga event at<br />

Western Springs along with 2000 fitness<br />

fanatics. Prospective customers were<br />

drawn to Lululemon’s bubble experience<br />

(bean bags and music in a completely<br />

clear bubble) where they snapped photos,<br />

took videos and shared their thoughts<br />

with their social networks. Leveraging<br />

#thesweatlife, Lululemon continues to<br />

drive interest in-store by hosting free<br />

yoga sessions on Saturday mornings,<br />


bringing together an eco-system of<br />

awareness and visitation.<br />

4. Post images of your physical location.<br />

Posting real-time pictures of your<br />

business on a regular basis brings to<br />

life who you are, what you stand for<br />

and all the perfect reasons a customer<br />

should come and visit. New entrant<br />

Good Grocer NZ ritually posts about<br />

what’s new, fresh, tasty, the view of the<br />

store, or customers having a good time.<br />

It doesn’t matter what type of pictures<br />

you take, as long as you take relevant and<br />

appealing ones. These appealing pictures,<br />

posted regularly, will convince your social<br />

followers that your physical location is<br />

worth the visit.<br />

5. Show off your best asset - your<br />

employees and your partners<br />

People like to see other people. Show off<br />

these bright shining stars by employees’<br />

posting images of them having a<br />

good time and/or put up profiles of<br />

each individual and bring to life their<br />

personalities.<br />

Give your social followers a look at<br />

the types of people responsible for<br />

keeping the business going. This gives<br />

your physical location a warmer, more<br />

welcoming appeal that encourages<br />

increased foot traffic.<br />

6. Encourage social reviews.<br />

Take advantage of the people who have<br />

already visited you. You can do this in your<br />

store by making signs that encourage<br />

visitors to post images and descriptions<br />

of their experience or through other<br />

communications you may have. Another<br />

option is to do this online, by making a<br />

post that asks your followers to recount<br />

their most recent in-store experience.<br />

Try to be original in your phrasing and<br />

respond to the people who have both<br />

good and bad things to say.<br />

7. Share and retweet your fans.<br />

Nothing breeds brand loyalty like shares<br />

and retweets. If you see a customer post<br />

something positive about your physical<br />

location, share or retweet it and thank<br />

them for their positive feedback. Doing<br />

this regularly naturally encourages more<br />

feedback from your in-person customers<br />

but also shows off the fact that you<br />

appreciate your customers and makes your<br />

physical location more visible.<br />

Using social media is not hard – it<br />

just requires courage, consistency,<br />

commitment and most importantly<br />

relevant and interesting content. Be brave<br />

and bold. Try different things. Attract those<br />

moths to your flame. And if all else fails, a<br />

picture of a cute dog will always work. ▀<br />


* Juanita Neville-Te Rito<br />

is the founder of retail<br />

specialist consultancy,<br />

The Retail Collective.<br />

With more than 25<br />

years’ experience in<br />

the retail sector, and<br />

a personal passion for<br />

shopping, she is full<br />

of insights that can<br />

transform the brand<br />

experience provided by retailers at every level.<br />

Visit www.retailgeek.co.nz for more or follow her<br />

on Twitter: @JuanitaNeville or Instagram:<br />

@juanitanevilleterito<br />

The Idea Collective has launched a new collaborative<br />

installation with oDocs EyeCare at the Museum of<br />

Transport and Technology (MOTAT) in Auckland.<br />

An ongoing MOTAT exhibition, the Idea Collective is<br />

designed to celebrate New Zealand’s vibrant innovation<br />

culture by matching up visionaries, artists and<br />

entrepreneurs to create installations across five pavilions.<br />

oDocs was paired with New Zealand film director<br />

Armagan Ballantyne and her partner Jon Baxter to create<br />

a visual installation that would draw public attention to<br />

eye health and the work of oDocs.<br />

The oDocs’ collaboration has resulted in a giant eye that<br />

the audience can peer inside to see how the eye works.<br />

The eye is watching a video which begins to deteriorate<br />

in front of the audience in line with the symptoms that<br />

would be suffered by a macular degeneration patient.<br />

“As a visual artist, I’m so passionately in love with my<br />

sight, I can’t imagine being without it,” said Ballantyne<br />

at the launch event on 7 July. “The Idea Collective<br />

matched me and Jon with oDocs. We spent some time<br />

hanging out, found out what they did and looked at the<br />

space available. It didn’t take us too long to come up<br />

with the idea - we knew it had to be an eye. We wanted<br />

something the audience could really experience, that<br />

would make them think about their own sight and<br />

consider the impact of blindness.”<br />

oDocs EyeCare won an innovation award last year for<br />

their exciting work around smartphone-based eye test<br />

apps. They noted that of the 285 million people suffering<br />

from blindness and vision impairment worldwide, 80% of<br />

those cases were preventable and 90% of those were in<br />

developing countries. oDoc’s aim is to use its technology<br />

to make eye tests accessible, affordable and sustainable,<br />

and to compliment the work around low vision already<br />

being carried out in developing countries.<br />

Innovation really happens easily in New Zealand, there<br />

is a maker culture here, but the story is often started but<br />

not realised,” said oDocs’ CEO Hanna Eastvold-Edwins.<br />

“We’re a lucky start-up to have the momentum we do.<br />

The pavillions provide patrons with an interactive<br />

experience so they become part of the artistic process<br />

Buchanan Optometrists sold<br />

Alain Brideson and Hanna Eastvold-Edwins from oDocs with visual artist<br />

Armagan Ballantyne (right)<br />

New Zealand is rallying around us to give us that critical<br />

mass we need to get out and into the market.”<br />

New Zealand is smaller than most markets and oDocs<br />

needs this community support to succeed, she added.<br />

“We’re not trying to replace optometry. But there has<br />

been a 50% rise in diabetes globally and only a 2% rise<br />

in ophthalmology. The model needs to change. There<br />

aren’t enough trained staff in developing countries…our<br />

screening model can, ultimately, help reduce the number<br />

of people who may unnecessarily lose their sight.”<br />

The Idea Collective is open at MOTAT daily from 10am<br />

to 5pm. ▀<br />

The Idea Collective have a large space at MOTAT with six exhibits and a break out area<br />

Hallertau Brewery were one of the sponsors at the launch event, attended by artists, industry<br />

specialists and representatives from the Idea Collective and MOTAT<br />

Buchanan Optometrists in Christchurch has been bought by Matthews Eyewear Eyecare. Based in Riccarton,<br />

and formerly in the CBD, Buchanan Optometrists was owned and operated by Ian Buchanan from 2006.<br />

“After the earthquakes, we decided to relocate our family to Adelaide,” says Ian Buchanan. “I was running<br />

the practice remotely, and now we have settled in Tauranga.”<br />

Buchanan recently became a partner at Mt Maunganui Specsavers, which spurred on the sale of the business he<br />

had been overseeing remotely since 2013.<br />

“The sale was completed in May and it’s been a smooth transition. The long-term staff have retained their jobs<br />

and the business has rebranded to Buchanan & Matthews Optometrists.”<br />

Matthews Eyewear Eyecare, now has nine stores across the North and South Island, including practices in<br />

Hamilton, Wellington, Kapiti, New Plymouth, Nelson and Blenheim. It remains a family-owned business with each<br />

practice having its own local flavour and a commitment to high quality eye care. Unfortunately, Philip Matthews<br />

was not available for comment at the time of going to press. ▀<br />

6 NEW ZEALAND OPTICS <strong>Aug</strong>ust <strong>2016</strong>.indd

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<strong>Aug</strong>ust <strong>2016</strong>.indd<br />





Before we delve into our next case I should<br />

make it known that shortly after my<br />

last column was published in May I was<br />

summoned to an urgent meeting with the<br />

NZ Optics editorial team. Disturbing reports<br />

had emerged of the readership falling asleep<br />

when perusing the contents of Speciality<br />

Contact Lens Forum. Admittedly, I was shocked<br />

that there were optometrists out there not<br />

captivated by weird rigid lenses like me. I was<br />

issued an ultimatum: inject some personality<br />

into my case reports or be shipped back to the<br />

penal colony across the Tasman as penance for<br />

the crime of dull writing. Jokes aside it is great<br />

to see the energy Lesley and Jai are putting into<br />

the magazine and I’m excited and grateful to<br />

help out in a small way as NZ Optics evolves.<br />

Naturally I apologise in advance for the glut of<br />

‘dad’ jokes and inappropriate puns that I now<br />

have free-reign to include in future missives.<br />

On to the optometry.<br />

We all know that the results of laser refractive<br />

eye surgery are becoming increasingly<br />

impressive. However, the reality is that despite<br />

the success of the initial surgery, zero refractive<br />

error is not a guarantee as the years continue.<br />

One report suggests that in a 2-13 year followup<br />

of LASIK patients only 64.8% of low myopes<br />

and 37.3% of high myopes remained within<br />

±0.50D of their attempted correction 1 . Not<br />

only can a cornea change shape over time but<br />

the onset of presbyopia can humble/anger<br />

the patient that expects the rest of their life<br />

to be devoid of optical aids. Unsurprisingly the<br />

typical post-LASIK patient is highly reluctant to<br />

return to their bespectacled former selves. This<br />

is where contact lenses come in.<br />

Traditionally I have found that even<br />

experienced optometrists are wary to meddle<br />

with a patient’s cornea that has already been<br />

permanently reshaped by our colleagues in<br />

ophthalmology. You wouldn’t re-glaze a cake<br />

created by a top chef would you? There are<br />

concerns about flap dehiscence, the structural<br />

weaknesses of a thinner cornea and perhaps a<br />

reluctance to incur the wrath of the patient’s<br />

eye surgeon should something go wrong,<br />

(“You put WHAT on my perfectly designed<br />

cornea?!”). Perhaps we should proceed with<br />

caution. Research shows that the central<br />

flap interface following LASIK has only 2.4%<br />

of the strength of normal stroma, while the<br />

peripheral margin is 10x stronger at 28% 2 .<br />

However, the general consensus is that the<br />

use of contact lenses in conjunction with<br />

lasered corneae is quite safe, as despite the<br />

histologically weakened interface LASIK flaps<br />

are quite robust. A fantastically designed<br />

study performed LASIK on the eyes of 18<br />

rabbits then ejected them from a fighter jet<br />

cockpit to see what happened. They concluded<br />

that ‘healed LASIK flaps...are stable when<br />

subjected to a rapid vertical ejection at nine<br />

times the force of gravity 3 . I would hazard a<br />

guess that this is more than most eyes endure<br />

with the use of a contact lens.<br />

Fitting standard contact lenses to a<br />

remodelled cornea is not always straight<br />

forward however. Frequently, following<br />

laser eye surgery, the corneal curvature falls<br />

outside the normal limits that off-the-shelf<br />

You wouldn’t reglaze a cake like this! My birthday treat in 2012<br />

soft contact lenses are designed for. By way of<br />

example I should divulge that I had a highly<br />

successful iLASIK surgery to both of my highly<br />

myopic eyes three years ago courtesy of Dr<br />

Trevor Gray and the team at Eye Institute.<br />

My refractive error was eliminated (but not<br />

my long axial lengths sadly, more on this in a<br />

future article) and I see a superb 6/4.8 unaided<br />

now with just a hint of astigmatism in my<br />

right eye. Needless to say I am one of the<br />

optometrists in the pro-LASIK camp. Prior to<br />

my surgery I was the best contact lens wearer<br />

I had ever met, with complaints of discomfort<br />

few and far between. At the launch of one of<br />

the fantastic new daily-disposables recently<br />

I popped a few -0.50D lenses in to test them<br />

out. Within five minutes they were in the bin.<br />

With every blink the vision would blur over, I<br />

had a noticeable foreign body sensation and<br />

the lens quickly dried out rendering it useless.<br />

Turns out my new 35D corneae did not take to<br />

kindly to a one-size-fits-all policy.<br />

Post-LASIK dryness can also be a factor when<br />

using a contact lens, even with a customised<br />

daily RGP (which can be an excellent option<br />

to mask corneal irregularities and fit the<br />

unusual bespoke cornea). Fortunately, we<br />

live in a realm of new technologies and their<br />

applications: It may surprise you that many<br />

post-laser refractive surgery patients with<br />

troublesome residual refractive error do very<br />

well when fitted with ortho-Keratology lenses.<br />

Cue the deafening sounds of aghastment.<br />

Fitting an already heathen device to a<br />

previously altered cornea? You must be mad!<br />

Indeed, in the main orthokeratology ‘bible’;<br />

John Mountford’s Orthokeratology: Principles<br />

and Practice published back in 2004, there is<br />

no mention of fitting ortho-K to the post-<br />

LASIK cornea (although John is working on<br />

a new edition which may address this). A<br />

pubmed search shows no articles about<br />

ortho-K on a post-LASIK cornea. Despite this<br />

many experienced ortho-Keratologists around<br />

the world practice ortho-K on the post-LASIK<br />

cornea with excellent results. I personally<br />

believe there is no more harm in fitting ortho-<br />

Keratology lenses to a lasered cornea than to a<br />

virgin example. It is the understanding of most<br />

orthokeratologists that the refractive effect of<br />

ortho-K comes about due to modification of<br />

the epithelial cells of the cornea, although the<br />

jury is still out in some circles. This OCT (Fig 1.)<br />

of a patient of mine using ortho-K lenses for<br />

high myopia illustrates this by showing the<br />

thinned epithelium centrally and thickened<br />

layer para-centrally. The stroma remains<br />

relatively uniform. In contrast all forms of laser<br />

refractive corneal surgery involve permanent<br />

modification to the stroma of the cornea.<br />

The mechanism of refractive change in<br />

these two modalities are mutually exclusive.<br />

In post-LASIK ortho-K the main challenge<br />

comes with designing the back surface of an<br />

orthokeratology lens to firstly fit the paracentral<br />

cornea safely and comfortably, and<br />

secondly remodel the central epithelium in a<br />

way to correct the refractive error. Let’s look at<br />

an example:<br />

A 67-year-old lady saw me due to the sudden<br />

appearance of flashes and floaters the previous<br />

weekend. Dilated exam revealed a benign<br />

posterior vitreous detachment. The woman<br />

had hyperopic LASIK carried out to both eyes six<br />

years before but she was having more trouble<br />

with her distance vision lately. She was also<br />

sick of using reading glasses. Unaided distance<br />

vision was only R 6/10 and L 6/12 and refraction<br />

revealed residual hyperopia of R +0.75/-0.25<br />

x 175 (6/5), L +1.50/-0.50 x 85 (6/5). Her<br />

topography confirmed her hyperopic LASIK with<br />

tangential maps showing a flatter para-central<br />

ring encircling a steeper central cornea (Fig 2.).<br />

Her left cornea was slightly steeper which was<br />

surprising given the higher hyperopic error.<br />

Given the foundations were essentially already<br />

in place hyperopic post-LASIK orthokeratology<br />

was offered to this patient. We chose to further<br />

steepen her cornea in a monovision set up, with<br />

her dominant right eye for distance<br />

and her left for near tasks.<br />

In these complex cases using<br />

topography-based lens design is a nobrainer<br />

for me. To marry the correct<br />

peripheral fit with the appropriate<br />

sagittal height and base curve for the<br />

desired refractive change with a trial<br />

lens would be time-consuming and<br />

inaccurate, even if such a post-LASIK<br />

hyperopic design set existed. Instead<br />

I plugged the patients topography<br />

into rigid lens simulation software<br />

EyeSpace (Innovatus Technology,<br />

Fig 3.) and designed a custom hyperopic<br />

ortho-K lens for each eye. Because the cornea<br />

is reasonably regular we can use a rotationally<br />

symmetrical lens to get a great fit. Of course<br />

with all hyperopic ortho-K the lens base curve<br />

is steeper than the existing corneal curvature to<br />

create additional plus power.<br />

One month later the patient was thrilled<br />

with her vision as she was no longer using<br />

reading glasses and seeing well at distance.<br />

Her right eye was seeing 6/6 N8 with a<br />

modest central steepening. Her left eye was<br />

6/15 N4 with an impressive 4.7D steepening<br />

in a well centred location (Fig 4.). Importantly<br />

she experienced no discomfort and her cornea<br />

was pristine with no trace of corneal insult.<br />

Unfortunately, not all post-LASIK refractive<br />

error is regular. Post-LASIK ectasia can be<br />

highly debilitating and severely limit the<br />

corrective options available. In some cases,<br />

highly customised ortho-K lenses can be<br />

used to remodel the irregularity and improve<br />

vision. A patient of mine in his mid-50’s had<br />

myopic LASIK done over a decade before but<br />

had developed severe post-LASIK ectasia in his<br />

right eye and moderate ectasia in his left eye<br />

since then. The better left eye had a variation<br />

of 7D of axial power along the 150 meridian<br />

leading to unaided acuity of 6/12 and a<br />

refraction of -1.00DS (6/6 with aberrations).<br />

This gentleman was very keen to explore his<br />

ortho-K options and we settled on fitting only<br />

the left eye with a custom myopic ortho-K<br />

lens. This had an aspheric back optic zone with<br />

a diameter to match the treatment zone of his<br />

myopic LASIK (Fig 5.).<br />

In these cases, interpreting the axial<br />

difference map can require some thought.<br />

Rather than creating a uniform degree of<br />

refractive change in the form of a ‘bulls-eye’<br />

that we are used to with simple myopic<br />

ortho-K, instead we are trying to create a<br />

post-ortho-K cornea that is more regular.<br />

This will decrease the aberrations in the<br />

optical system. You will see in the axial<br />

difference map (Fig 6.) that the ortho-K lens<br />

has succeeded in steepening the flat section<br />

of the cornea at axis 150 and flattening<br />

the steep section opposite this. The patient<br />

was seeing 6/6 unaided with only a quarter<br />

diopter of residual cylinder when using his<br />

lens. He commented that the halos around<br />

streetlights were much reduced, although<br />

not completely eliminated. His main gripe<br />

was that we couldn’t do the same treatment<br />

on his severely ectatic right cornea due to<br />

its ‘munted’ irregularity! Patients with other<br />

forms of irregular corneae such as forme<br />

fruste keratoconus can also be treated with<br />

ortho-K lens in a similar way (often with an<br />

inferior ‘tuck’ quadrant specific design) as<br />

long as the practitioner is mindful to monitor<br />

the cornea at each aftercare for signs of<br />

progression or insult.<br />

These cases highlight how versatile the<br />

practice of orthokeratology is these days. No<br />

longer is it reserved for simple myopia and<br />

it can be a great problem-solver for those<br />

particular patients that are determined to be<br />

spectacle-free! It is encouraging to know that<br />

when my LASIK goes kaput (as it is bound to,<br />

given my eyes’ record to date) I will have ortho-K<br />

up my sleeve to restore my super-vision.<br />

Tune in next time as I regale you with a story<br />

about the night we invented a revolutionary<br />

contact lens at the pub, and how it did not turn<br />

out to be quite as ingenious as we expected... ▀<br />

1. Dirani M, Couper T, Yau J, Ang EK, Islam FM,<br />

Snibson GR, Vajpayee RB, Baird PN. Long-term<br />

refractive outcomes and stability after excimer laser<br />

surgery for myopia. J Cataract Refract Surg. 2010<br />

Oct;36(10):1709-17.<br />

2. Schmack I, Dawson DG, McCarey BE, Waring GO 3rd,<br />

Grossniklaus HE, Edelhauser HF. Cohesive tensile<br />

strength of human LASIK wounds with histologic,<br />

ultrastructural, and clinical correlations.J Refract<br />

Surg. 2005 Sep-Oct;21(5):433-45.<br />

3. Goodman RL, Johnson DA, Dillon H, Edelhauser HF,<br />

Waller SG. Laser in situ keratomileusis flap stability<br />

during simulated aircraft ejection in a rabbit model.<br />

Cornea. 2003 Mar;22(2):142-5.<br />

Fig 1. Anterior OCT showing the thickness profile of the corneal epithelium in myopic<br />

orthokeratology. Note this well-fitted lens does not touch the cornea within the<br />

treatment zone.<br />

Fig 2. Our patient’s post hyperopic LASIK corneal topography showing the relatively<br />

steep central cornea R+L respectively.<br />

Fig 3. EyeSpace simulation, post-lens tear profile and the real lens on the left eye.<br />

Note the slightly irregular central tear profile due to the LASIK result.<br />

Fig 4. Axial difference map of the left eye showing the well-centred +4.7D<br />

topographical change.<br />

Fig 5. Our second patient’s EyeSpace simulation of his customised myopic ortho-K lens<br />

over his irregular post-LASIK left cornea.<br />

Fig 6. Axial difference maps showing our second patient’s irregular post-LASIK corneal<br />

topography in Exam A, the more regular post-ortho-K cornea in exam B and the<br />

unusual difference map showing how this patient’s cornea has been modified to<br />

decrease the aberrations due to his ectasia.<br />

* Alex Petty is a Kiwi<br />

optometrist who<br />

graduated from the<br />

University of Auckland in<br />

2010. He has an interest<br />

in specialty contact lenses,<br />

ortho-K and myopia<br />

control.<br />

8 NEW ZEALAND OPTICS <strong>Aug</strong>ust <strong>2016</strong>.indd

Let’s get digital<br />

Integration is the future of high street retail<br />

E Y E W E A R<br />


Warby Parker’s Green St store, NYC<br />


Journalists get invited to many interesting<br />

events, but one in particular piqued our interest<br />

in May. Held at the Sky Tower and hosted by<br />

Microsoft, the theme was Retail in the Digital Age.<br />

As a keen shopper and self-styled digital nerd,<br />

you can imagine I was front row and centre, and<br />

the keynote speaker was NZ Optics own itinerant<br />

business columnist Juanita Neville-Te Rito.<br />

“We’re seeing a significant time of change<br />

within the history of retail,” said Neville-Te Rito,<br />

addressing a small, but well-heeled audience of<br />

retail executives and business leaders. “Digital and<br />

its impact on retail is central to our business today.<br />

It’s the retail ‘new normal’.”<br />

Neville-Te Rito has worked in retail for more than<br />

25 years and is no stranger to change. But the level<br />

of disruption New Zealand in particular has seen<br />

in the last five years is unprecedented – and is best<br />

explained by acknowledging how painfully overused<br />

the word ‘disruption’ actually is – and it’s all<br />

down to new digital technology.<br />

“The retail future is literally in your hands,” said<br />

Neville-Te Rito, referring to the iPads, smartphones<br />

and tablets most people carry around with them<br />

these days. “The emerging customer is in a partial<br />

state of awareness at any given time. Their<br />

shopping journey is complex, influenced by social<br />

media and impacted by technology.”<br />

Omni-channel shopping<br />

Omni-channel shopping is an industry buzzword<br />

used to describe people who purchase using a<br />

complex network of devices, locations and apps.<br />

In reality, no shopper thinks to themselves: “I’m<br />

going omni-channel today”, we just buy to our<br />

own convenience - but that does not mean there<br />

isn’t any truth within the term.<br />

According to Neville-Te Rito the modern shopper<br />

is like a ping pong ball, following a non-linear<br />

path, and the digital layer adds complexity. They<br />

take advice on products from social media, they<br />

will shop for a cheap deal online while still in<br />

store, they want value balanced against product<br />

authenticity.<br />

What a demanding bunch!<br />

As I listened I found myself easily able to apply<br />

this logic to my experiences of shopping day-today,<br />

but how does this apply to optometry?<br />

In the optical world<br />

Optometrists, despite being healthcare providers<br />

at heart, have had to fully embrace their role as<br />

retailers in recent years. Over the last decade<br />

opening hours have extended, weekends have<br />

become another opportunity to do business<br />

and chains – both international and local – find<br />

themselves benefitted by positioning within<br />

malls. Flexibility and availability have become<br />

increasingly important to shoppers, as has<br />

affordability – both for eye care and for frames.<br />

Integrating digital is the next step for the<br />

optometrist already pushing the boundaries of what<br />

the consumer expects from their bricks and mortar<br />

operation. The best thing a retailer can do to make<br />

this work for them is put themselves in the shoes<br />

of their customers and think about the experience<br />

they might want to have both in-store and online.<br />

Are you easy to find, physically and digitally? Are you<br />

responsive? Is your information up to date?<br />

Taking the lead from overseas<br />

“Warby Parker Eyewear opened in the US six years<br />

ago,” said Neville-Te Rito. “Their brand is distinctive<br />

and hipster. They design and manufacture their<br />

own frames with the price point set at as little as<br />

US$99, including a prescription lens and shipping.”<br />

The company has seen a huge amount of success<br />

and much of that is down to where they have<br />

positioned themselves in the market.<br />

“They aren’t selling eyewear, they’ve established<br />

themselves as a tech-based lifestyle brand,” says<br />

Neville-Te Rito. “Their stores aren’t designed for<br />

efficiency; they offer a carefully crafted visual<br />

narrative. Around 85% of their shoppers have<br />

browsed online before going in store, but once<br />

they cross the threshold there is a strong human<br />

element – a member of staff greets you every time<br />

and everyone in the store is fully trained. Most<br />

employees are graduates.”<br />

Every product in the store is at eye level and<br />

the design of the store is streamlined to stop the<br />

customer feeling overwhelmed. Technology instore<br />

keeps things moving, with an easy to see board<br />

showing when appointments are, a photo booth<br />

that prints pictures of you in suggested frames and<br />

clear pricing. All the employees – called associates<br />

– carry tablets to facilitate assisting a customer<br />

and execute a fast, unobtrusive transaction<br />

anywhere in store.<br />

Examples like this clearly show that optometrists<br />

can’t think of their online presence and their high<br />

street presence as two separate entities – after all,<br />

the client doesn’t. They must find a way to meld<br />

the two together to the benefit of the customer<br />

and the bottomline.<br />

Having tech instore, having a strong social media<br />

presence, upgrading your POS hardware to offer<br />

more flexibility and opportunity to make a sale<br />

and keeping your website up to date are simple,<br />

but effective steps to take your business to the<br />

next digital level. Ultimately, your approach must<br />

be customer-first, and that customer increasingly<br />

comes paired with a piece of hand-held tech.<br />

“It’s hard to see through your belly-button,”<br />

says Neville-Te Rito. “You must uncover the retail<br />

ecosystem from the perspective of the shopper in<br />

order to connect with them.” ▀<br />

* *NZ Optics editor Jai Breitnauer has worked in marketing,<br />

PR and digital strategy in addition to her many years as a<br />

consumer and business journalist. She has contributed to many<br />

titles both here and overseas, including business publications<br />

NZ Retail and Idealog, before taking up her current role at NZ<br />

Optics. She is fascinated by the way technology affects small<br />

businesses, almost as much as she is fascinated by the way<br />

words affect people.<br />


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<strong>Aug</strong>ust <strong>2016</strong>.indd<br />





Wow, New Zealand. So far away! Why did<br />

you come all the way here?” I was asked a<br />

hundred times. Well, why not? Just look<br />

around…with a registration of 3,600 clinicians, more<br />

than 100 quick-fire sessions and over 450 posters,<br />

and the fact that the European Glaucoma Society’s<br />

(EGS) 12th Congress was being held in June in the<br />

picturesque city of Prague in the Czech Republic,<br />

why wouldn’t you come? It was with sheer delight<br />

that I was able to attend my first “confroliday.”<br />

In an impressive feat of organisation, the<br />

<strong>2016</strong> Congress was split into varying themes<br />

of glaucoma, intertwined with instructional<br />

courses (topics we could choose by heading to<br />

the allocated room) and poster sessions. Before<br />

getting into the serious stuff, there was an<br />

opening cocktail function where Professor Anja<br />

Tuulonen, European Glaucoma Society president<br />

from Finland, officially opened the event with her<br />

welcoming speech. This was followed by a show<br />

of traditional Czech dancers (think milkmaid-like<br />

outfits and throw in the occasional high-pitched<br />

squeal) who came bearing baskets of freshly-baked<br />

goods and left us with their welcoming smiles.<br />

Challenges in diagnosis and genetics<br />

The first session of the Congress focused on<br />

challenges in diagnosis. Professor Tuulonen<br />

highlighted the suffocation of healthcare systems<br />

due to over referral and outlined the increasingly<br />

popular use of macular GCC (ganglion cell complex)<br />

measurement and its particular advantage in eyes<br />

with PPA and tilted discs, in which a RNFL scan<br />

would present with artefacts. Professor Anders<br />

Heijl of Sweden further reminded us of proper OCT<br />

interpretation, including pitfalls and avoiding the<br />

common trap of “red disease”.<br />

Genetics of glaucoma followed with Professor<br />

Wallace Alward (USA) covering the genomewide<br />

association study (GWAS) which identifies<br />

Swept Source OCT Angiography<br />

RA:2804<strong>2016</strong>/CS<br />

susceptibility loci for open-angle glaucoma. Many<br />

more genes have been identified in the past<br />

decade. Specifically, myocillin mutations have<br />

been found to cause early-onset glaucoma with<br />

elevated IOP. This has also been found to cause<br />

almost all cases of autosomal dominant juvenileonset<br />

open-angle glaucoma. Arising from these<br />

genetic studies, there are targeted therapies in<br />

development. Phenylbutarate (PBA) in particular<br />

has been found to lower IOP in transgenic mice.<br />

Target pressures, palaces and pleasure<br />

It was a pleasure to once again meet Dr<br />

George Spaeth (USA) following his popular<br />

and philosophical talks at this years’ ANZGIG<br />

conference in Auckland. I chose to attend his<br />

instructional course titled What intraocular<br />

pressure is low enough?<br />

An important point to consider prior to<br />

commencing treatment is whether a disability will<br />

develop unless the patient is treated and that the<br />

patient chooses to be treated. “Don’t treat the IOP,<br />

it’s just a number,” Spaeth emphasises. “Treat the<br />

patient!”<br />

Dr Kulvant Singh (USA) chipped in with his<br />

views on target pressures, but said he refrains<br />

from writing target pressures in his clinical notes<br />

for legal reasons and because patients become<br />

overly fixated on it. Instead, Singh works with<br />

percentage reductions or by setting a range,<br />

which can be modified based on risks, benefits<br />

and the clinical course of the disease.<br />

That evening I headed to Žofín Palace – a neorenaissance<br />

building built in 1837, which has<br />

been a centre of cultural and social events and<br />

was the setting for the official congress dinner.<br />

Following some interesting entertainment and<br />

time on the dance floor with consultants from<br />

all over the world “letting loose”, I was ready to<br />

call it a night. My new-found consultant friends,<br />

however, would not have a bar of it and (let’s just<br />

say peer-pressure is my weakness) allowed me to<br />

experience Prague nightlife.<br />

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Court, scalpels and diagnostic pearls<br />

I arrived the following morning ready for the 8.30<br />

am start, but then wasn’t sure if it was the lack of<br />

sleep or if I had actually walked into a court room<br />

by mistake. The morning’s theme was Glaucoma<br />

Damage Progression and was a series of debates:<br />

fibres vs discs; MD vs VFI; and perimeter vs imaging<br />

device. These all made for some interesting points.<br />

Dr Boel Bengtsson (Sweden) argued her<br />

preference for VFI as is it is more centrallyweighted<br />

than MD, is less sensitive to cataract<br />

than MD and has an improved graphical display.<br />

Structural analysis (imaging) may prove more<br />

useful in monitoring moderate glaucoma and Dr<br />

Bengtsson stressed it has little use in advanced<br />

glaucoma. Also – and I agree with this, based on<br />

my own experience – it’s useful in patients who<br />

are unable to perform a visual field examination.<br />

A major interest of mine is the area of MIGS<br />

(minimally-invasive glaucoma surgery). A literature<br />

review I undertook in this area highlighted the<br />

safety and efficacy of many MIGS procedures<br />

when weighed up with higher-risk penetrating<br />

surgeries such as trabeculectomy. I have also seen<br />

the success of these first-hand within glaucoma<br />

clinics and although only a few MIGS procedures<br />

have long-term data available, there is definitely<br />

potential, which is quickly gaining traction both in<br />

New Zealand and overseas.<br />

Between lecture sessions we had time to wander<br />

the exhibition area, which included the usual<br />

promotion of the latest ophthalmological gadgets.<br />

The opportunity to put my name down for a wet<br />

lab, however, had me very excited and my colleague,<br />

Dr Divya Perumal, and I jumped at the opportunity<br />

to try a cutting-edge (literally) procedure on a<br />

porcine eye. CLASS (CO2 laser-assisted sclerectomy<br />

surgery) involves creating a scleral flap followed by<br />

laser to increase outflow through Schlemm’s canal.<br />

CLASS is used for management of medicallyuncontrolled<br />

open-angle glaucoma that offers<br />

efficacy comparable to trabeculectomy and nonpenetrating<br />

deep sclerectomy, but with superior<br />

10/21/15 12:07 PM<br />

safety. The wavelength of the laser is absorbed<br />

by water so the device’s cutting effect is halted<br />

when the dissection reaches the fluid perculation<br />

(three-year follow-up data is available).<br />

We also got to try our hand at implanting a XEN<br />

gel implant which essentially creates a shallow bleb,<br />

increasing subconjunctival outflow. The next stop<br />

was ECP (endocytophotocoagulation) laser, where<br />

the combined video-light-laser tip made it super<br />

easy to find, visualise and treat ciliary processes.<br />

Another new device, currently in clinical trials,<br />

measures IOP at any given time through the day.<br />

‘Eyemate’ is implanted within the sulcus during<br />

cataract extraction, which then sends an IOP<br />

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Courtesy of Dr. Carl Glittenberg, MD Karl Lansteiner Institute for Retinal Research and Imaging<br />

The inside of Žofín Palace during the Congress dinner<br />

Jason in his element having a go at the non-penetrating CLASS procedure<br />

Dr Divya Perumal and Jason (with Dr Ben Hoy in the background)<br />

measurement to a non-contact measuring device<br />

via a weak magnetic field. Measurements are also<br />

uploaded to a database and smartphone app,<br />

which can only be accessed by their doctor. The<br />

plastic implant itself is super-thin and flexible,<br />

measuring only 12mm in diameter.<br />

Pressure spikes<br />

On the topic of circadian monitoring, Dr Anastasios<br />

Konstas (Greece) presented on the Impact of<br />

24-hour monitoring in glaucoma care, and stated<br />

there is now comprehensive evidence that IOP<br />

readings every few months are not sufficient in<br />

the management of glaucoma and a single IOP<br />

measurement will miss a lot of IOP-related disease.<br />

Twenty four-hour monitoring isn’t always<br />

feasible, especially in a busy hospital glaucoma<br />

clinic, which churns through high numbers on<br />

a daily basis. Dr Konstas did however state that<br />

a water drinking test would replicate this quite<br />

well. Despite the apparent importance of peak<br />

IOP, Professor Luca Rossetti (Italy) concluded<br />

the mean and peak IOPs are both predictors for<br />

progression, and that the role of IOP fluctuation<br />

as an independent risk factor for progression is<br />

still debated. Furthermore, longitudinal studies<br />

on 24-hour contact lens IOP monitoring are still<br />

required to better understand their clinical value.<br />

Another instructional course I chose to attend<br />

was titled If it’s not glaucoma, then what is it? Dr<br />

Mark Moster (USA) outlined the need to consider<br />

neuro-ophthalmic disease in glaucoma patients.<br />

Why? Because IOP may be normal or elevated in<br />

both, visual field defects may be identical and<br />

cupping can occur in optic neuropathies. He<br />

quoted a study by our very own Professor Helen<br />

Danesh-Meyer from 2001 (proud New Zealand<br />

moment!) which found that cupping occurred in<br />

ischaemic optic neuropathy, specifically 92% in<br />

GCA and only 2% in NAAION. Typical optic neuritis<br />

presentations were highlighted and appropriate<br />

history taking specific to neurological disease was<br />

discussed. Though it’s not practical to scan every<br />

NTG patient, Dr Moster emphasised the need for<br />

an MRI in those with bitemporal loss, optic disc<br />

pallor, reduced colour vision and poor disc/field<br />

correlation. A CT scan is a good second choice.<br />

In conclusion<br />

Overall this was an enjoyable and well-organised<br />

conference which solidified my understanding of<br />

glaucoma. It was pleasing to see that we already<br />

practice most of what was covered, which goes to<br />

show that our very own glaucoma specialists are<br />

in agreement with those around the world and<br />

leaders in their field, many of whom I’m privileged<br />

to work with and learn from.<br />

The Congress further ignited my passion for<br />

glaucoma treatment, and what the future holds<br />

in terms of treatment and technology seems<br />

unimaginable – but it’s all happening right<br />

now. While diagnosis and treatment may prove<br />

difficult, on the contrary there is a lot of potential<br />

in the pipeline which will only make clinical<br />

practice easier. Until then, I shall leave you with<br />

a witty yet unfeigned quote by Professor Anja<br />

Tuulonen during the Challenges in Diagnosis<br />

session, which we can all relate to.<br />

“When you hear a noise in the bush, it’s up to the<br />

clinician to figure out if it’s a rat or a plastic bag.” ▀<br />

* Jason Dhana recently completed his MSc with a clinical<br />

specialisation in glaucoma, under Dr Dean Corbett. He splits<br />

his week between emergency and glaucoma clinics at Greenlane<br />

Hospital, and as a professional teaching fellow within the<br />

School of Optometry and Vision Science, University of Auckland.<br />

10 NEW ZEALAND OPTICS <strong>Aug</strong>ust<br />

1. Not for sale in<br />

<strong>2016</strong>.indd<br />

the US.<br />

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Clarity appoints Essilor<br />

Clarity 20/20 has appointed Essilor to assess,<br />

repair and replace glasses covered under<br />

Clarity’s insurance programme, and to put<br />

together their cost-effective Snappa frame and<br />

lens package, both offered through participating<br />

independent optometrists.<br />

The new agreement, which came into force in<br />

June, should speed up and simplify the process<br />

of assessing and repairing a patient’s glasses,<br />

says Robert Cormack, director of Clarity. “Essilor is<br />

recognised as one of the leading lens suppliers in<br />

the country … and most independents will have<br />

dealings with Essilor as well as other lens suppliers.”<br />

Unlike some mainstream insurance companies,<br />

Clarity’s policy provides comprehensive likefor-like<br />

cover and does not divert patients away<br />

from their practice, says Cormack, so Essilor will<br />

be responsible for sourcing lenses from other<br />

companies as and when required.<br />

Chris Aldous, senior manager at Essilor NZ, says<br />

Essilor is happy to have Clarity 20/20 on board as a<br />

customer and confirmed Essilor will be supplying<br />

frames and lenses on a like-for-like basis.<br />

Matt Marquis, Clarity’s national sales<br />

development manager, says appointing Essilor is<br />

NZAO <strong>2016</strong><br />

Registrations are now open for the New<br />

Zealand Association of Optometrists (NZAO)<br />

86th annual conference at the brand new<br />

Novotel New Plymouth from 14-16 October.<br />

The three-day conference includes a packed<br />

education programme on the Friday and the<br />

Saturday, and a glaucoma workshop, low vision<br />

seminar and binocular vision workshop on the<br />

Sunday. Keynote speakers include Professor Mitchell<br />

Dul from the US, Dr Kathleen Watt from the<br />

University of New South Wales and Professor Konrad<br />

Pesudovs from<br />

Flinders University<br />

in Adelaide.<br />

Professor<br />

Mitchell Dul<br />

is director of<br />

the Glaucoma<br />

Institute and<br />

professor at the<br />

SUNY College of<br />

Optometry at the<br />

State University<br />

of New York. He<br />

will be speaking<br />

NZAO <strong>2016</strong> Conference keynote<br />

Professor Mitchell Dul from the US<br />

about his 20-<br />

year experience<br />

Lab-grown RGCs expand<br />

research opportunities<br />

A<br />

new<br />

series of studies have shown that retinal ganglion<br />

cells (RGCs) can be generated from patient-specific induced<br />

pluripotent stem cells, allowing them to serve as an in vitro<br />

model for pharmacologic screening and pathophysiology studies.<br />

Commenting on the studies in Ophthalmology Times, Dr Jason<br />

Meyer, associate professor of biology at Indiana<br />

University, and co-author of the paper Ohlemacher<br />

SK, et al. Stem Cells. <strong>2016</strong>;34:1553-1562, said<br />

the results could facilitate drug-screening<br />

studies and characterise the pathogenic<br />

mechanisms of disease progression<br />

in optic neuropathies. “It is not<br />

unreasonable to think about<br />

using these patient-specific<br />

cells as a source of spare parts<br />

to repopulate the retina.<br />

However, success in that<br />

area involves overcoming<br />

a number of hurdles in<br />

terms of demonstrating<br />

that the cells survive,<br />

integrate, and function<br />

post-transplantation.” ▀<br />

all about<br />

Clarity’s<br />

aim to help<br />

practices<br />

provide the<br />

best service<br />

possible to their patients, ensuring they keep<br />

coming back time and time again.<br />

“We want the assessment, repair or replacement<br />

of a patient’s glasses to be a really seamless<br />

process. The primary function of Clarity is to<br />

glue patients to a practice; to keep independent<br />

patients in independent optometry. Appointing<br />

Essilor makes the process of repairing or replacing<br />

a patient’s glasses quicker and easier, which is<br />

what’s important for both the patient and the<br />

practice, so that’s what we’re trying to do.<br />

“Clarity allows practices to offer a unique high<br />

value point of difference in their local market,<br />

making the practice the hero in their patient’s<br />

eyes. This helps to maintain and enhance the<br />

relationship between the practice and their<br />

patient, causing the patient to become a<br />

loyal advocate instead of being vulnerable to<br />

competitors.” ▀<br />

of glaucoma and why<br />

optometrists need to be<br />

treating it.<br />

Dr Kathleen Watt is clinical director for the School<br />

of Optometry and Vision Science at the University<br />

of New South Wales. She has a background<br />

in orthokeratology and is currently working<br />

on pathways to eye care for asylum seekers in<br />

Australia. Dr Watt will be discussing ortho-K and<br />

myopia, binocular vision and ortho-K infection.<br />

Professor Konrad Pesudovs is foundation<br />

professor of optometry and vision science at<br />

Flinders University in Adelaide. His main areas<br />

of research are identifying abnormalities to<br />

establish a diagnosis, the longitudinal strategy<br />

required for management of therapeutic cases and<br />

assessing a cataract and identifying optical quality<br />

metrics predictive of visual performance in eye<br />

disease. His presentations will focus on thinking<br />

therapeutically, assessing cataract patients and<br />

diagnosing red eye.<br />

A first aid course is being included in the <strong>2016</strong><br />

NZAO conference programme again to enable<br />

delegates to refresh their first aid skills from two<br />

years before. The conference dinner will be held on<br />

the Saturday night. To register visit<br />

www.nzao.co.nz/NZAO-conference-registration ▀<br />

Focus on<br />

Eye Research<br />

Glaucoma<br />





Journal of Glaucoma <strong>2016</strong>; 25:623-628<br />

Review: The aim of this review was to estimate<br />

the number of treated glaucoma patients with<br />

end of life visual impairment and blindness, and to<br />

determine the factors associated with this.<br />

This study involved a systematic literature search in<br />

relevant databases on end of life visual impairment<br />

and was conducted in 2014. A total of 2574 articles<br />

were identified, of which 5 were on end-of-life visual<br />

impairment and included in the review.<br />

All studies had a retrospective design. A<br />

considerable number of glaucoma patients were<br />

found to be blind at the end of their life with<br />

24% experiencing unilateral and 10% bilateral<br />

blindness. The following factors were associated<br />

with blindness: (1) baseline severity of visual field<br />

loss: advanced stage of glaucoma or substantial<br />

visual field loss at initial visit; (2) factors influencing<br />

progression: fluctuation in intraocular pressure (IOP)<br />

during treatment; presence of pseudoexfoliation,<br />

poor patient compliance, higher IOP; (3) longer time<br />

period: longer duration of disease and older age<br />

at death because of longer life expectancy; and (4)<br />

coexistence of other ocular pathology.<br />

Comment: This review indicates that a significant<br />

proportion of glaucoma patients still become blind<br />

despite our current treatment modalities. Hence<br />

further prevention of blindness in glaucoma patients<br />

is needed. This could be achieved by identifying<br />

patients at an earlier stage of disease as well as<br />

addressing the risk factors outlined above where<br />

possible. Patients at risk for glaucoma-related<br />

blindness need to have a very low target IOP and<br />

need to be closely monitored to prevent glaucoma<br />

progression.<br />





Ophthalmology <strong>2016</strong> – Article in Press<br />

Review: The purpose of this study was to evaluate<br />

the clinical efficacy of a topical Bimatoprost ocular<br />

insert. This is a silicon ring (Fig 1. and Fig 2.) that<br />

provides a slow release of Bimatoprost. A parallelarm,<br />

multi-centre, double-masked randomised,<br />

controlled trial was performed and included 130<br />

patients with either open angle glaucoma (OAG) or<br />

ocular hypertension (OHT).<br />

Patients were randomised to receive the<br />

Bimatoprost insert plus artificial tears twice daily or<br />

a placebo insert plus Timolol 0.5% twice daily for 6<br />

months after a screening washout period. Diurnal<br />

IOP measurements were obtained at baseline,<br />

weeks 2, 6 and 12, and months 4, 5, and 6.<br />

The primary end point assessed was the mean<br />

change from baseline in diurnal IOP between the<br />

2 groups. A mean reduction of -3.2 to -6.4 mmHg<br />

was observed in the Bimatoprost arm compared<br />

Fig 1. The Bimatoprost ocular insert<br />

Fig 2. A patient with the device in place<br />


with -4.2 to – 6.4 mmHg for the Timolol arm over<br />

6 months. Adverse effects were consistent with<br />

bimatopost or Timolol exposure and no unexpected<br />

adverse effects were observed.<br />

The authors concluded that a clinically relevant<br />

reduction in mean IOP was observed over six<br />

months with the Bimatoprost ocular insert and<br />

that seems to be safe and well tolerated. Larger<br />

confirmatory phase III studies are planned.<br />

Comment: This Bimatoprost ocular insert appears<br />

to be a safe, well-tolerated and clinically effective<br />

new delivery device. If confirmatory studies<br />

demonstrate a similar efficacy, the insert may<br />

provide an alternative to daily eye drops and hence<br />

would be ideal in patients who with poor adherence<br />

to therapy or find application of topical eye drops to<br />

be difficult.<br />





Ophthalmology <strong>2016</strong> – article in press<br />

Review: The purpose of this study was to evaluate<br />

the Icare HOME device for use by glaucoma patients<br />

for self-tonometry. A prospective performance<br />

evaluation of a medical device was performed<br />

and included 189 participants with glaucoma or<br />

suspected glaucoma.<br />

Participants had standardised training and had to<br />

be able to use the Icare HOME device independently.<br />

Those certified obtained 3 IOP measurements<br />

using the HOME device, and these were compared<br />

with measurements obtained from Goldmann<br />

applanation tonometry (GAT) by a clinician. The<br />

agreement between the devices was used to assess<br />

precision.<br />

Out of the 189 participants, 18 were ineligible to<br />

take part in the study. Forty-four (25%) participants<br />

could not complete the study due to difficulty using<br />

the device or failing the certification process. For<br />

those that were able to participate, the Icare HOME<br />

and GAT measurements agreed within 5mmHg in<br />

116 of 127 participants (91%). The mean difference<br />

between Icare HOME and GAT was -0.33 mmHg (SD<br />

3.11 mmHg). No adverse events were reported.<br />

Fig 3. The Icare HOME device<br />

Hence not all participants could learn to use the<br />

Icare HOME device, but for those that could, most<br />

were able to obtain measurements similar to those<br />

obtained by GAT.<br />

Comment: Although not all patients are able to use<br />

the Icare HOME device, in those that can it appears<br />

to be a safe, affordable and reliable method of selftonometry.<br />

The Icare HOME may have the potential<br />

to address an unmet need by providing more<br />

frequent IOP measurements in a patient’s daily life<br />

and hence information relating to their diurnal IOP<br />

variation. Clinical applications also include helping<br />

to identify patients at greater risk of glaucoma<br />

progression (wider fluctuation in IOP) as well as a<br />

patient’s response to treatment. ▀<br />


* Dr Hussain Patel<br />

(MBChB, MD, FRANZCO) is<br />

an ophthalmologist based<br />

at Auckland’s Eye Surgery<br />

Associates and senior lecturer<br />

in ophthalmology with<br />

the New Zealand National<br />

Eye Centre, University of<br />

Auckland. He has a special<br />

interest in glaucoma, and is<br />

actively involved in glaucoma<br />

research, supervision of<br />

research fellows and teaching.<br />

<strong>Aug</strong>ust <strong>2016</strong>.indd<br />



with<br />

Prof Charles McGhee<br />

& A/Prof Dipika Patel<br />

Series Editors<br />

Preoperative risk assessments to reduce<br />

cataract complications<br />


Cataract surgery is highly successful but<br />

complications do occur and internationally<br />

studies report an overall complication rate of<br />

approximately 5%. Although not all complications<br />

lead to poor outcomes, the occasional severe<br />

complication can be blinding. With over 30,000<br />

cataract surgeries performed each year in New<br />

Zealand, even a small percentage of moderate<br />

adverse outcomes adds up to hundreds of patients.<br />

Numerous factors increase the risk of a<br />

complication during and after cataract surgery.<br />

Unfortunately, many of these factors are intrinsic<br />

and unavoidable but prior identification of these<br />

risk factors may allow optometrists and ophthalmic<br />

surgeons to appropriately advise patients.<br />

Subsequently, it may be possible to take appropriate<br />

perioperative precautions and adjust intraoperative<br />

techniques to try to reduce these risks.<br />

Corneal opacity<br />

One of the most apparent risk factors on slit-lamp<br />

examination is corneal scarring or haze. If the<br />

opacity is sufficient to obscure fine iris detail on<br />

slit-lamp examination, it may prove problematic<br />

during surgery. To maximise the red reflex during<br />

surgery to facilitate capsulorhexis, the eye may<br />

be manipulated into a better position and the<br />

background or direct co-axial microscope light may<br />

be altered to minimise backscatter of light from<br />

the cornea and cataract. In very severe cases of<br />

scarring, an external light pipe may occasionally<br />

be useful to illuminate structures tangentially to<br />

enable a safe capsulorhexis.<br />

White/dense/mature cataracts<br />

A dense cataract can present multiple problems<br />

during surgery. The large lens may create positive<br />

pressure and tension on the capsule and may<br />

significantly shallow the anterior chamber. The<br />

anterior capsule is also very difficult to visualise over<br />

a white or brunescent cataract, increasing the risk of<br />

a capsule tear or irregular capsulotomy.<br />

The view of the capsule can be improved using<br />

tissue staining e.g. Vision Blue (trypan blue<br />

ophthalmic solution) injected into the anterior<br />

chamber and washed out after it has stained the<br />

anterior capsule blue (Fig 1.). Furthermore, a dense<br />

cataract will require more phacoemulsification<br />

energy than a soft lens. Since total ultrasound<br />

energy can be associated with postoperative<br />

corneal oedema and intraocular inflammation, a<br />

phaco-chop technique that generally requires less<br />

energy may be preferable. 1<br />

Fig 1. Intraoperative photograph during capsulorhexis - anterior lens<br />

capsule stained with Vision Blue over congenital white cataract.<br />

Fuch’s endothelial corneal dystrophy<br />

(FECD)<br />

Other risk factors may be more subtle. Individuals<br />

with mild FECD may be asymptomatic or unaware<br />

of minor changes in vision. However, patients with<br />

FECD are at greater risk of corneal decompensation<br />

and need to be aware of the possible longer-term<br />

consequences such as a corneal transplant. Thus<br />

all corneas need to be examined carefully for signs<br />

of FECD eg. guttata and increased pachymetry<br />

(Fig 2.). A preoperative central corneal thickness<br />

12 NEW ZEALAND OPTICS <strong>Aug</strong>ust <strong>2016</strong>.indd<br />

(CCT) greater than 620µm is associated with<br />

an increased probability of requiring a corneal<br />

transplant following cataract surgery and for each<br />

10µm increase beyond 620µm, the odds of corneal<br />

decompensation increase by 1.7 times 2 .<br />

Damage to the compromised endothelium may<br />

be prevented by reducing the flow of fluids in<br />

the anterior chamber during surgery and using<br />

a ‘soft-shell’ technique (a dispersive viscoelastic<br />

device coats and protects the endothelium<br />

while a cohesive viscoelastic deepens the<br />

anterior chamber and maintains the working<br />

space) 3 . Furthermore, torsional rather than<br />

longitudinal phacoemulsification can reduce the<br />

dissipated ultrasound energy, thereby minimising<br />

endothelial injury 2 .<br />

Pseudoexfoliation syndrome<br />

Pseudoexfoliation is associated with a significant<br />

number of problems in cataract surgery, including<br />

poor pupillary dilation, zonular weakness<br />

leading to zonular dialysis or lens dislocation<br />

with vitreous loss, postoperative intraocular<br />

pressure spikes, capsular phimosis, cystoid<br />

macular oedema, prolonged inflammation, and<br />

corneal decompensation. However, the white/<br />

grey dandruff-like material mostly on the pupil<br />

margin and anterior lens surface, indicative of<br />

pseudoexfoliation, can be easily missed on casual<br />

slit-lamp examination, especially with an undilated<br />

pupil (Fig 3.). Peripupillary iris transillumination<br />

and pigmented pupillary ruff atrophy may also<br />

provide clues of underlying disease.<br />

With prior knowledge of these risk factors the<br />

patient can be better-informed and surgical<br />

planning can be modified, eg. lower anterior<br />

chamber irrigation rate, insertion of a capsular<br />

tension ring, augmented pharmacological and/<br />

or mechanical pupillary dilation (synechialysis, iris<br />

hooks). Hydrodissection and hydrodelineation of<br />

the cataract can cause further downward stress<br />

and zonular compromise, thus should be performed<br />

carefully. A zonule-friendly phaco-chop technique<br />

and a gentle two-instrument rotation of the nucleus<br />

are also helpful. It is also useful to work in the central<br />

anterior chamber with copious viscoelastic, avoiding<br />

the friable capsular periphery and shallowing of the<br />

anterior chamber. Towards the end of the surgery,<br />

thorough removal of viscoelastic is important in<br />

minimising significant postoperative IOP spikes 4 .<br />

Phacodonesis<br />

Phacodonesis is the tremulousness or subtle<br />

movement of the lens with eye movements,<br />

which may occur due to a previous eye injury,<br />

pseudoexfoliation or other causes of zonular<br />

compromise or lens subluxation. Phacodonesis may<br />

be detected by asking the patient to move their eye<br />

quickly from side-to-side and up-and-down while<br />

the clinician observes the eye on the slit-lamp. The<br />

patient may also be asked to look directly ahead<br />

while the clinician gently strikes the upright of<br />

the slit-lamp head support 2-3 times (obviously<br />

warning the patient beforehand). The transmitted<br />

energy through the head/chin rest may produce a<br />

flickering lens reflex or frank movement.<br />

Similar adjustments can be made to surgical<br />

techniques as previously highlighted in<br />

pseudoexfoliation to reduce stress on the zonules<br />

and also plan for additional techniques such as<br />

sutured capsule tension segments or rings.<br />

Anaesthetic<br />

Generally, contemporary cataract surgery is<br />

performed under regional (peri-bulbar/sub-<br />

Tenon’s anaesthesia [STA]) or topical (drop/gel)<br />

anaesthesia, with or without low-level oral or<br />

intravenous sedation. A larger volume regional<br />

anaesthesia may increase the intraocular pressure<br />

and shallow the anterior chamber, occasionally<br />

making surgery a little more difficult. Since an<br />

incision is required in the infero-nasal conjunctiva<br />

for STA it may be associated with subconjunctival<br />

haemorrhage, that on occasion may be extensive.<br />

Although not sight-threatening and self-resolving<br />

over 7-14 days, the dramatic appearance may<br />

Fig 2. Slit-lamp photograph showing corneal endothelium with guttata<br />

in Fuch’s endothelial corneal dystrophy.<br />

Fig 3. Slit-lamp photograph of white/grey pseudoexfoliative material on<br />

pupil margin.<br />

be unsettling for patients and relatives. Topical<br />

anaesthesia may avoid any injections but requires<br />

adequate patient cooperation, as the eye is able to<br />

move much more freely during the procedure.<br />

Therefore, preoperative assessments should<br />

include potential language barriers, anxiety<br />

levels, ability to lie flat for up to 30 minutes,<br />

head tremors, and antiplatelet/anticoagulant<br />

medications that may predispose to bleeding.<br />

Systemic medications<br />

Oral Doxazosin and similar alpha-blockers used<br />

for prostatic and urinary symptoms are associated<br />

with intraoperative “floppy iris syndrome” – the<br />

iris billows and has a tendency to prolapse through<br />

the surgical incisions whilst the pupil progressively<br />

constricts during surgery. This can lead to extremely<br />

complicated surgery and extensive iris damage.<br />

Unfortunately, these issues are not resolved by<br />

simply stopping the medication prior to surgery.<br />

Thus ophthalmologists may need to consider a<br />

number of strategies including: creating longer<br />

corneal incisions and maintaining the anterior<br />

chamber depth to prevent peripheral iris prolapse;<br />

augmented pharmacological pupil dilation (e.g.<br />

intra-cameral phenylephrine); and mechanical<br />

dilation/iris stabilization (e.g. iris hooks or rings).<br />

Inflammation<br />

Intraocular inflammation such as chronic anterior<br />

uveitis that is not entirely quiescent should<br />

generally be controlled and stable for around six<br />

months before embarking on cataract surgery.<br />

Perioperatively, patients may require an increased<br />

dose of corticosteroid or other immunosuppressive<br />

therapy to reduce the risk of significant<br />

postoperative inflammation and flare-ups.<br />

Risk stratification<br />

Complication rates generally decrease with<br />

increasing experience of surgeons 5 . Thus, it is<br />

imperative that cases are allocated appropriately,<br />

especially in teaching hospitals where there is a<br />

vast range of surgeon experience. Preoperative<br />

risk stratification systems have been devised to<br />

assess the risk of complications for individual<br />

patients. They may help minimise complications<br />

by identifying and allocating the higher risk cases<br />

to appropriate surgeons in a standardised manner.<br />

In a recent study in Auckland, two preoperative<br />

risk stratification systems were evaluated – one<br />

system devised by Muhtaseb et al 6 and another<br />

system used in the Buckinghamshire NHS Trust.<br />

Each system takes into account different risk factors<br />

and a final risk score is calculated by adding up the<br />

risk factors in each case (Table 1). Subsequently,<br />

the Muhtaseb system was implemented to assist<br />

allocation of cases to registrars, fellows and<br />

consultants and further analyses are underway to<br />

examine the impact on complication rates.<br />

It is imperative that risk factors are identified and<br />

documented preoperatively for such cataract risk<br />

stratification systems to work effectively. Apart<br />

from allocating cases to appropriately experienced<br />

surgeons, they support surgeons of all levels to<br />

take precautions in order to reduce complications.<br />

It also allows practitioners involved in preoperative<br />

assessments to focus discussions on specific risks<br />

with individual patients, which is critical in providing<br />

the best quality of cataract surgery, and most useful<br />

in postoperative management. ▀<br />

Table 1. Preoperative risk factors as per the Muhtaseb and<br />

Buckinghamshire risk stratification systems for cataract surgery.<br />


Age (years) >88 1<br />

Ametropia (>6 D of<br />

myopia or hyperopia)<br />

Axial length -<br />

Brunescent/white/<br />

dense/total cataract/no<br />

fundus view<br />

1 -<br />

80-90 years 1<br />

90+ years 2<br />

26mm 1<br />

>30mm 2<br />

3 3<br />

Corneal scarring 1 -<br />

Diabetic retinopathy - 1<br />

Fuchs endothelial<br />

dystrophy<br />

- 1<br />

Only eye - 1<br />

Oral alpha-receptor<br />

antagonist<br />

Phacodonesis 3<br />

Pseudoexfoliation 3<br />

-<br />

Doxazosin 1<br />

Tamsulosin<br />

or similar<br />

Posterior capsule plaque 1 -<br />

Posterior polar cataract 1 -<br />

Previous vitrectomy 1 1<br />

Shallow anterior chamber<br />


Grand Rounds part II<br />

Dr Penny McAllum, Kathryn Bierre, Jill Mottram and Olga Hammond<br />

The second instalment in the Eye Doctors<br />

series of Grand Rounds was held at<br />

Ormiston Hospital, Botany Junction on 8<br />

June. Sponsored by Bausch + Lomb, the event<br />

saw a gathering of local optometrists to hear<br />

presentations by Drs Andrew Riley, Shuan Dai,<br />

Penny McAllum and Mark Donaldson.<br />

Wound healing<br />

Keynote Speaker Dr Andrew Riley opened with<br />

a look at wound healing in the eyelid area. He<br />

talked about how complex the healing process<br />

is, considering the skin is made up of so many<br />

different types of tissue that we still have a lot to<br />

learn about.<br />

There are four typical stages of healing:<br />

haemostasis is the immediate response,<br />

with inflammation over the next 0-4 days,<br />

proliferation and/or granulation over 4-21 days,<br />

with remodeling taking up to two years. Dr Riley<br />

described cleaning a wound, removing loose<br />

sutures, topical or oral antibiotics and offered<br />

five examples of abnormal wound healing and<br />

suggested responses. Infection is possibly the most<br />

common problem. Wound breakdown can occur<br />

if there is tension on a wound or a poor healing<br />

response. Pyogenic granulomas are relatively<br />

common vascular lesions but are misnamed as<br />

they are neither infectious nor granulomatous, but<br />

an excessive healing response. They can be treated<br />

with local steroids or removal. The use of topical<br />

preparations to reduce the appearance and size of<br />

scar tissue can also be useful.<br />

New optometry<br />

certificate for CLs<br />

The importance of blurred vision<br />

Dr Shuan Dai offered his insights on when blurred<br />

vision needs to be investigated urgently. He noted<br />

that sometimes patients confuse double vision<br />

with blurred vision, and how important it is to<br />

ascertain if it is monocular or binocular. He talked<br />

about the case of a 21-year-old male who, suffering<br />

from headache and anxiety, was prescribed antidepressants.<br />

A few months later he began to suffer<br />

from blurring vision. It was recommended by his<br />

referring eye specialist, that the anxiety medication<br />

be stopped and his vision appeared to improve. At<br />

first it seemed obvious it was a simple medication<br />

side-effect, however, four months down the track<br />

the patient again presented with blurred vision,<br />

headaches and a slow pupil response to light.<br />

His slightly reduced vision couldn’t be improved<br />

with refraction and his optic nerves were swollen.<br />

An urgent MRI scan showed a large pineal gland<br />

tumor causing obstructive hydrocephalus which<br />

was likely the cause of his initial symptoms.<br />

Dr Dai emphasised that we should have a low<br />

threshold to refer for further investigations for<br />

any person with sudden onset of double vision<br />

or unexplained blurring vision, especially among<br />

younger patients.<br />

Who needs crosslinking<br />

Dr Penny McAllum talked about corneal<br />

collagen crosslinking for keratoconus, focusing<br />

on who needs it and who doesn’t. She noted<br />

that crosslinking has become a widely-used<br />

and effective treatment for keratoconus<br />

patients, but it is not suitable or helpful for<br />

everybody. Only those with mild or moderate<br />

keratoconus, that shows signs of progressive<br />

deterioration, require treatment. The treatment<br />

works by combining riboflavin and UVA light<br />

to induce free radical production, resulting<br />

in a strengthening of the cornea by inducing<br />

more bonds within the collagen fibrils and<br />

adjacent collagen fibrils. The Dresden protocol,<br />

which involves removing the central 8mm of<br />

the epithelium before applying the riboflavin<br />

solution, is the most commonly used and<br />

proven method. However, it is time consuming,<br />

painful and cannot be used on a patient<br />

with extensive corneal thinning, explained<br />

Dr McAlllum, adding that other alternatives,<br />

such as transepithelial crosslinking, rapid<br />

UVA treatments and new types of riboflavin<br />

solution, show promise. Dr McAllum noted that<br />

the earlier crosslinking is performed, the more<br />

sight there is to save. With this in mind, she<br />

said she is happy to perform the procedure on<br />

children as long as progressive keratoconus is<br />

demonstrated. After the procedure the patient<br />

can expect pain for the first one or two days<br />

and some blurring of vision for up to three<br />

months. Some patients experience haze for up<br />

to a year, but vision often improves slowly over<br />

1-2 years due to flattening of the cornea.<br />

Dealing with ICE<br />

Dr Mark Donaldson presented “Summer ICE” –<br />

two cases of irido corneal endothelial syndrome,<br />

presented to him on consecutive balmy Februaries,<br />

where normal endothelial cells are replaced with<br />

abnormal migratory cells.<br />

Evidence supports a herpes virus aetilology<br />

for at least some cases of ICE. Patients afflicted<br />

with ICE have reduction in vision from corneal<br />

opacification and disruption of the normal iris<br />

architecture. Glaucoma is a major complication,<br />

which is a secondary elevation in pressure arising<br />

from abnormal epithelial cells migrating over the<br />

trabecular meshwork. For cases with glaucoma,<br />

surgical treatment is invariably required.<br />

The first case study was a 54-year-old female<br />

who presented in February 2015 with mild blurring<br />

of vision, noticeable on waking, in her right eye,<br />

which resolved over over the space of an hour.<br />

The IOP of her right eye elevated from 24 mmHg<br />

on presentation to 35 mmHg on full medical<br />

treatment within 10 months. The second case<br />

was of a 32-year-old woman who presented in<br />

February <strong>2016</strong> presenting to her optometrist with<br />

glare affecting her right eye. Anterior segment<br />

OCT scanning clearly showed thickening of the<br />

posterior cornea in both cases, assisting greatly in<br />

the diagnosis. The glare was caused by stray light<br />

entering the eye through correctopia and tracts<br />

of iris atrophy. The first case, which had no iris<br />

abnormality, was Chandlers syndrome; the second,<br />

essential iris atrophy – both sub-types of ICE.<br />

Grand Rounds – where next<br />

The next Eye Doctors Grand Round will be held<br />

on 21 September at Novotel, Greenlane. All<br />

optometrists are welcome to attend. ▀<br />

Dr Andrew Riley, Yvette Beatie from sponsors B+L and Dr Shuan Dai<br />

Selina Phuah, Lily Chang and Beverly Payne<br />

Ascot Clinic (09) 520 9689 - Botany Junction (09) 277 6787<br />

The Australian College of Optometry (ACO)<br />

has launched a new post-graduate level<br />

course for optometrists wishing to learn<br />

more about speciality lenses and advanced lens<br />

fitting.<br />

Gary Filer, Heather Laird and Naomi Meltzer<br />

Presenters for the Certificate in Advanced<br />

Contact Lenses (ACO-CACL) course include<br />

Professor James Wolffsohn, deputy executive<br />

dean of the School of Life and Health Sciences EyE DOctORS GRAND ROUNDS<br />

GRAND ROUNDS - <strong>2016</strong><br />

at Aston University in the UK; Associate<br />

Professor Richard Vojlay from Melbourne; CCLS<br />

<strong>2016</strong><br />

We look forward to seeing you.<br />

Australia president Jessica Chi, ACO’s Dr Adrian<br />

Bruce and more.<br />

Offered as a flexible, remote learning syllabus<br />

the certificate will feature a practical local clinical<br />

21st September - Novotel, Ellerslie<br />

experience placement within Australia and/or<br />

New Zealand and should be completed within<br />

No registration fee . cPD points available<br />

the recommended four to six-month time frame.<br />

“In-depth study is a great opportunity<br />

Visit our website for more details.<br />

for optometrists who have a real interest<br />

in a particular area to gain an extensive<br />

understanding in their field of expertise,”<br />

said Jolanda de Jong, ACO’s general manager<br />

of professional development. “It clearly<br />

Dr Andrew Riley<br />

Dr Mark Donaldson<br />

demonstrates to patients that their optometrist<br />



has been motivated to undertake study and<br />

is up to date with current best practice and<br />

Dr Penny McAllum<br />

Dr Shuan Dai<br />

knowledge.” ▀<br />

EYE 0765<br />



Health in the<br />

cloud<br />

Leading New Zealand health organisations<br />

have welcomed the Ministry of Health’s<br />

official acceptance of Microsoft’s Trusted<br />

Public Cloud services for advancing the country’s<br />

electronic health service capabilities.<br />

In an announcement on 8 July, Microsoft New<br />

Zealand confirmed Microsoft’s core cloud services<br />

Azure, Office 365 and Dynamics CRM Online,<br />

have met the Ministry’s requirements for storage<br />

of personal health information.<br />

Barrie Sheers, the managing director for<br />

Microsoft NZ, says the Ministry of Health’s<br />

decision to accept the use of Microsoft’s public<br />

cloud will be transformative for the eHealth<br />

agenda in New Zealand.<br />

“New Zealand’s health tech industry is today<br />

worth $1.3 billion to the local economy and our<br />

country significantly punches above its weight<br />

on the international stage with health tech<br />

innovation. With leading exporters like Orion<br />

Health, and more than a hundred other smaller<br />

independent software vendors, the health tech<br />

sector in New Zealand is one that continues to<br />

grow and provide burgeoning opportunity for<br />

export to the fast growing global health market.”<br />

Scott Arrol, chief executive of New Zealand<br />

Health IT (NZHIT) says his organisation is fully<br />

supportive of the Ministry of Health’s decision to<br />

accept Microsoft’s cloud services.<br />

“I am delighted by this news as it further<br />

supports the ability for health providers and<br />

digital partners to utilise advanced technologies to<br />

enable the delivery of enhanced services to New<br />

Zealanders. At the same time, the Microsoft cloud<br />

will provide another important platform with<br />

which to operate their business models, develop<br />

and deploy innovative solutions for the local and<br />

international markets and advance this country’s<br />

ability to be a leader in the delivery of high quality,<br />

responsive and personalised health outcomes.”<br />

New Zealand health providers currently<br />

using Microsoft’s cloud services include Ryman<br />

Healthcare, Orion Health, St John’s Ambulance<br />

Service and Plunket. The services are also used<br />

by IT solution providers for the health sector,<br />

including Datacom, Stratos, Volpara, McKesson<br />

and Intergen.<br />

Christchurch-based Gabe Rijpma, senior<br />

director of Health and Social Services Asia<br />

at Microsoft, says that with the advent of<br />

personalised medicine, genomics, intelligent<br />

sensors, advanced diagnostics and laboratory<br />

tests, data usage by health organisations will<br />

increase as the sector builds ever more advanced<br />

models of the human body.<br />

“Being able to process all this data, store it,<br />

analyse it and make intelligent predictions on<br />

the results will usher in a new era of healthcare<br />

that will radically transform the way care is both<br />

diagnosed and delivered.” ▀<br />

www.eyedoctors.co.nz<br />

<strong>Aug</strong>ust <strong>2016</strong>.indd<br />



Truth, lies and statistics<br />

I<br />

recently received a Survey Monkey survey<br />

from one of the BIG FOUR contact lens<br />

companies.<br />

This one dealt with marketing and data<br />

collection by contact lens companies and<br />

sought to determine our perceptions on such<br />

things.<br />

I am generally happy to complete surveys<br />

and have done many in my time. Sometimes<br />

they drive you nuts and may take 15 to<br />

20 minutes to complete. I find that rather<br />

tedious. Some surveys offer to pay me<br />

US$15.00 and then send me a bank cheque.<br />

When you try cash it in it takes weeks to clear<br />

and the bank charges are often greater than<br />

the amount you receive. Fortunately my bank<br />

has offered to waive the bank fees when they<br />

see how ridiculous it is – when I would have<br />

to pay $25.00 to get $15.00 meaning it costs<br />

me $10.00 to do the survey! A recent survey<br />

offering me US$15.00 had a condition that I<br />

now had to complete an American W-8 tax<br />

form in order to receive the payment. I don’t<br />

like filling in forms at the best of times so I<br />

kindly declined. I did suggest that this was<br />

nonsense and if they could find a way to pay<br />

me without form filling I might consider it. I<br />

got no response.<br />

We can thank terrorism and money<br />

laundering for such over the top ludicrous<br />

form filling for trivial amounts of money,<br />

never mind the hassles we all have at airports<br />

these days.<br />

I’ve done quite a few surveys from<br />

companies wanting to launch a new lens,<br />

product, drug or solution. They seek to<br />

determine what we think a good name would<br />

be for their new product. Some of the names<br />

they come up with are ridiculous with just<br />

a few that make sense. You have to list and<br />

grade your preferences, sometimes among<br />

twenty names and as you drill down they ask<br />

more and more questions and cross-check<br />

your answers. It all gets rather silly and is a<br />

time wasting irritation.<br />

That said, I once did a survey for a market<br />

research company employed by a world<br />

leading contact lens company. They even had<br />

images of the boxes of lenses and the name<br />

they were thinking of. It was obvious to me<br />

who the company was and I immediately<br />

contacted colleagues in said company telling<br />

them how pleased I was to see that they were<br />

launching a silicone hydrogel lens. My local<br />

contacts were somewhat in the dark, but it<br />

didn’t take long for their top people in the<br />

USA to make contact, wondering how the hell<br />

this guy in ‘Nuzillin’ knew about their secret<br />

lens. It was all rather interesting I must say.<br />

My View<br />

At any rate let’s get back to the recent survey<br />

I referred to. Among other things the survey<br />

was asking if we thought that contact lens<br />

companies should market their brand directly<br />

to consumers.<br />

Of course they should and of course they<br />

do. All one needs to do is take a look at<br />

YouTube to see what marketing some of the<br />

companies do in the US, EU, Asia, Japan etc.<br />

Of course when I am seeing a patient I<br />

always recommend the lens that’s best for<br />

them. Even if they did ask for a lens they had<br />

seen advertised, it would not necessarily be<br />

the one that I prescribe.<br />

We are now in the 21 st Century and<br />

marketing rules. The survey also asked<br />

questions about companies being involved in<br />

social media. Again of course they are: social<br />

media is now making traditional marketing<br />

look staid and old fashioned and if one believes<br />

what you see and read, this is where it’s at.<br />

They also asked if we had issues with<br />

companies data mining and obtaining<br />

patient information via social media and<br />

apps. I don’t believe you can stop companies<br />

getting patient data and contact details, as<br />

the patients (consumers) voluntarily provide<br />

that information. The way I see it is that<br />

modern youth are very free with their privacy<br />

and details, much like the hippies were in the<br />

‘60s with free love! I have not promoted CL<br />

company apps to my patients but I see that<br />

there may be some positives, like improving<br />

compliance and providing reminders. I simply<br />

tell my patients who battle to remember<br />

when to change lenses to programme a<br />

reminder into their smartphone. Of course<br />

having the majority of my in-range patients in<br />

dailies avoids many of these issues.<br />

Privacy<br />

I avoid providing contact lens companies with<br />

any patient details apart from their name<br />

on orders. They do not get their address,<br />

DOB, phone or email. In the old days in my<br />

practices – before the internet - we used<br />

to have a multipage self-carbon order pad<br />

with tear offs, so the order that was faxed/<br />

posted/delivered to the companies simply<br />

had a patient reference number and nothing<br />

else. (We had been stung once or twice by<br />

companies who had tried to contact our<br />

patients directly and thus had learned our<br />

lesson decades ago). These days with privacy<br />

acts and so on it is even more important for<br />

you to make sure patient data is retained and<br />

not shared.<br />

These days some companies offer to ship<br />

contact lenses direct to the consumer. It’s not<br />

something I’m happy with and have never<br />

used such systems.<br />

The paranoid conspiracy theorists reckon<br />

that contact lens companies are building<br />

databases of contact lens wearers so<br />

that they can send the consumer/patient<br />

marketing info and potentially cut out the<br />

optometrist and supply lenses directly. I<br />

doubt that this is likely to happen. Contact<br />

lens companies know on which side their<br />

bread is buttered. Let’s face it optometrists<br />

are the gatekeepers and prescribers of the<br />

bulk of contact lenses in the world. Some<br />

are prescribed by ophthalmologists (like in<br />

France) and dispensing opticians and others<br />

with contact lens prescribing licences (like<br />

we see in the UK, US and Canada) but this<br />

is not the bulk of prescribing. If contact lens<br />

companies start direct selling to patients and<br />

bypassing contact lens practitioners then I<br />

suspect that contact lens market penetration<br />

would drop significantly: practitioners will<br />

stop proactively prescribing lenses. We have<br />

seen some major legal battles in the US<br />

where certain online contact lens retailers<br />

and others with vested interests have tried<br />

to alter legislation to make contact lenses<br />

freely available without prescription. They<br />

seek to dumb down contact lenses to generic<br />

non-medical commodities. There are also<br />

moves afoot to allow for kiosks that ‘examine<br />

eyes’ and spit out a CL or spectacle Rx. That’s a<br />

discussion for another day.<br />

Bias?<br />

Some surveys ask leading questions and<br />

require ‘forced choices’. I’m generally not<br />

happy with responding to such items. Thus<br />

I avoid completing such surveys as I believe<br />

they provide biased and skewed data and<br />

statistics. Some allow for an ‘other’ option<br />

and allow you to add comments: In my<br />

experience, when I have tested such options<br />

to see if they are read by asking for an email<br />

response, I never get one so deem it to be a<br />

waste of time.<br />

At any rate these are my views on some<br />

of the questions that are being asked. I’d be<br />

interested to see what this survey’s results<br />

show, if they are ever shared. I would probably<br />

have broken down respondents by age: I’m<br />

sure we would see quite skewed data as we<br />

did in Brexit recently with massive differences<br />

in perceptions between the younger and older<br />

generations.<br />

I reckon younger practitioners are much<br />

more accepting of social media, TV marketing<br />

and advertising than older practitioners but<br />

of course I could be wrong.<br />

Truth, lies and statistics eh? ▀<br />

Getting behind MD awareness<br />

The recent <strong>2016</strong> Macular Degeneration New<br />

Zealand (MDNZ) Awareness week was a success<br />

based on a marked increase in the turnout<br />

to national seminars and phone calls to MDNZ for<br />

further information.<br />

The week-long campaign from 23-<br />

29 May continued the Association’s<br />

strong focus on the benefits of early<br />

intervention and use of the easy-touse<br />

Amsler Grid.<br />

Phillippa Pitcher, MDNZ general<br />

manager, said there has been<br />

a steady increase in awareness<br />

around the benefits of early<br />

detection through regular eye<br />

examinations, especially where a<br />

relative has been affected by MD or<br />

there has been a history of smoking.<br />

MDNZ managed a greater reach<br />

through a more strategic approach<br />

to the use of social media and the<br />

willingness of 10 New Zealanders<br />

to share their personal stories in<br />

the hope that people would take<br />

heed of symptoms and act quickly<br />

to preserve their vision, she said.<br />

“Recent statistics supplied to<br />

MDNZ show our continued focus<br />

on the benefits of early detection<br />

and smarter use of communication<br />

Good diet for MD<br />

New Zealanders are set to benefit from new<br />

research identifying optimum weekly diets for<br />

preventing age-related macular degeneration<br />

(AMD) – New Zealand’s leading cause of blindness.<br />

Dr Graham Wilson, ophthalmologist and clinical<br />

director at St George’s Eye Care in Christchurch, is<br />

investigating what New Zealanders need to eat to<br />

help prevent AMD and minimise the progression of<br />

the disease for those who already have it.<br />

A range of New Zealand-specific<br />

dietary scenarios will be identified<br />

along with the associated cost.<br />

There is also potential to model<br />

Maori, Asian and Pacific Island<br />

diets. It is the first time that<br />

macular degeneration research of<br />

this nature has been carried out in<br />

New Zealand.<br />

“It is well documented that<br />

improvements in diet, for<br />

example increasing intake of<br />

green leafy vegetables, fish and<br />

nuts, can reduce the risk of AMD<br />

progression in those with early<br />

signs of the disease,” says Dr<br />

Wilson, who is undertaking the<br />

research project alongside his<br />

brother Dr Nick Wilson, professor<br />

of public health at the University<br />

of Otago.<br />

“We aim to take it one step<br />

further by modelling the perfect<br />

New Zealand diet. The results will<br />

be very applicable to the average<br />

Kiwi, providing real, tangible<br />

information to help prevent<br />

the disease and minimise its<br />

progression.”<br />

Research will be carried out by<br />

accessing a University of Otago<br />

database that identifies nutrient<br />

channels is making a difference. This year we were<br />

able to directly access nearly 242,000 people, over<br />

the age of 60, who use Facebook through our use of<br />

a ‘Humans of New York’ approach. Those 10 personal<br />

stories, from people from all walks of life, really<br />

helped us to get the message out<br />

there in a positive way.”<br />

Awareness was also built up<br />

through a series of interviews<br />

on the main media channels<br />

with MDNZ trustee Dr Andrew<br />

Thompson, MDNZ chair Dr<br />

Dianne Sharp and supporter Dr<br />

Jim Borthwick. There was also<br />

digital signage in 21 shopping<br />

malls around the country and four<br />

outdoor billboards in Auckland.<br />

Pitcher said the uptake and<br />

support of the campaign by<br />

optometrists and ophthalmologists<br />

throughout the country was<br />

amazing.<br />

“Many took out advertisements<br />

in their local papers, arranged<br />

competitions where, for example,<br />

winners received a free eye check,<br />

and sent out MD information to<br />

their clients via their mailing lists.<br />

New look online for VOSO<br />

New Zealand charitable trust Volunteer<br />

Ophthalmic Services Overseas (VOSO) has a<br />

brand new website with content contributed<br />

by all the current and some former trustees.<br />

In a statement the organisation gave special thanks<br />

to former trustee Malcolm McKellar, who dreamt of<br />

a website that would both increase public awareness<br />

of the charity as well as provide an online platform<br />

for the public to donate directly to VOSO. “We would<br />

also like to thank former secretary Ravi Dass who<br />

secured the domain name and provided many of the<br />

great photos on the site,” said VOSO secretary and<br />

Auckland-based optometrist Kylie Dreaver.<br />

The website was kindly built by The Drop’s Mark<br />

Dromgoole, nephew of retired optometrist Colin<br />

Beckwith. The organisation was also keen to thank<br />

its main financial supporters the NZAO, RANZCO<br />

and the University charitable trust, and Air New<br />

Zealand, which helps the organisation with its cargo<br />

requirements, as well as all the optometrists and<br />

ophthalmologists who have personally supported the<br />

MDNZ Awareness takes pride of place at Vivian<br />

Edgar in Te Puke<br />

This support helped us greatly to<br />

spread our message far and wide.” ▀<br />

VOSO trustee and retired Thames optometrist Hywel Bowen at work for VOSO<br />

organisation over the last 30 years.<br />

This year VOSO has a combined surgical and<br />

optometry trip to Tonga, an optometry trip to Samoa<br />

and has sent surgical supplies to Fiji, where limitations<br />

in IOLs have led to reduced cataract surgeries being<br />

performed. For more about VOSO’s activities, visit the<br />

new site at www.voso.org.nz. ▀<br />

levels and costs of common New Zealand foods. Linear<br />

programming techniques will be used to optimise the<br />

nutrients for AMD prevention across a range of diets,<br />

including those constrained by cost.<br />

The benefits are not limited to eye health, says Dr<br />

Wilson.“What is good for your eyes is also good for your<br />

heart and in preventing certain types of cancer. The<br />

research findings will also be applicable to prevention<br />

of other diseases.” ▀<br />




We require a star team player who also thrives in an autonomous<br />

environment. If you have an eye for detail and organisation, have<br />

a passion for eyewear and fashion and enjoy the sales challenge<br />

then we would love to discuss the position with you further.<br />

Hours include a late night and some Saturday work on a rostered<br />

basis.<br />

Email your CV to Kristine on kjensen@eyesofhowick.co.nz or<br />

phone 0274824477.<br />


Chair stand, vertometer, slit lamp and other accessories for sale.<br />

Please email bdclworks@gmail.com for further equiries.<br />

14 NEW ZEALAND OPTICS <strong>Aug</strong>ust <strong>2016</strong>.indd

Calling innovators!<br />

Essilor has launched<br />

their international open<br />

innovation challenge to<br />

develop scalable solutions for<br />

measuring refractive errors<br />

in populations with poor<br />

access to eye healthcare. The<br />

announcement, made from<br />

Essilor’s French headquarters on<br />

30 June, is calling for interested<br />

parties to come forward with<br />

ideas around the challenge.<br />

Called the See Change<br />

Challenge, Essilor is seeking<br />

innovative solutions that can<br />

improve the lives of 2.5 billion<br />

people by facilitating access<br />

to vision care. Specifically, the<br />

See Change Challenge aims to uncover low-cost,<br />

easy-to-use and scalable solutions that can be<br />

used by primary vision care providers in developing<br />

countries and low socio-economic areas to<br />

accurately measure eye refractive errors.<br />

“Innovation has always been a cornerstone of our<br />

mission to improve lives by improving sight,” said<br />

Hubert Sagnières, chairman and chief executive of<br />

Essilor International. “Today we are widening our<br />

field of exploration to ensure we meet the vision<br />

needs of the 7.2 billion people in the world. We<br />

are excited to use the open innovation model to<br />

discover new solutions that have the potential to<br />

transform the lives and economic futures of lowincome<br />

populations through improved access to<br />

vision care.”<br />

Essilor is appealing to startups,<br />

universities, app developers,<br />

vision scientists, optometrists,<br />

engineers and all individuals<br />

and organisations to bring their<br />

multi-disciplinary expertise to<br />

develop innovative refraction<br />

solutions. Be that a new piece of<br />

hardware, a new piece of software,<br />

a smartphone app or something<br />

entirely different, the aim is to use<br />

these solutions to speed up the<br />

delivery of vision care in poorer or<br />

more isolated regions by enabling<br />

more people to be easily trained to<br />

become primary eye care workers.<br />

Up to five winners of the first<br />

phase of the Challenge will<br />

receive €25,000 and the opportunity to enter<br />

the second phase of the Challenge, where an<br />

additional €100,000 is up for grabs for the two<br />

final winners. Essilor will also potentially support<br />

the final winners with development contracts to<br />

help them to build and scale up their solution.<br />

Of the 4.5 billion people who need vision<br />

correction, only 1.9 billion actually correct their<br />

eyesight. More than 2.5 billion people still live<br />

with uncorrected poor vision and its social and<br />

economic consequences, and 95% of them live in<br />

developing countries where they lack awareness of<br />

the impact of poor vision and access to basic vision<br />

care solutions.<br />

For more information, or to get involved, visit<br />

www.essilorseechange.com ▀<br />

NZOWA launches website in<br />

time for Visionz <strong>2016</strong><br />

The New Zealand Optical Wholesalers<br />

Association (NZOWA) has launched its<br />

long-awaited website www.nzowa.org.nz<br />

detailing members, their contact details and the<br />

products they offer.<br />

The website also carries details about NZOWA’s<br />

biennial conference Visionz, which is being held<br />

this year from 14-16 October at the Ellerslie Event<br />

Centre in Auckland.<br />

Registration is now open for Visionz <strong>2016</strong><br />

and anyone wishing to attend can also register<br />

through the new NZOWA site. The three-day event<br />

encompasses a comprehensive industry exhibition,<br />

an educational conference (EduVisionz) focusing<br />

on low vision (see story in June’s issue of NZ<br />

Optics) and practice management, including: tips<br />

and advice from a successful retailer’s perspective;<br />

managing people; preparing your business for sale;<br />

handling complaints; and boosting your profile<br />

through social media. Another theme is health<br />

and safety given the recent changes to the health<br />

and safety legislation. This includes a St John’s first<br />

aid course, which will be open to practice owners,<br />

managers and staff and NZOWA members and<br />

staff.<br />

Visionz has been very successful in the past and<br />

has received extremely positive feedback from<br />

attendees so the NZOWA is very pleased to be able<br />

to offer this event to the optical sector again, said<br />

Gary Edgar, NZOWA president.<br />

“NZOWA is putting this event on to bring the<br />

industry together. It is an opportunity for practice<br />

owners and their staff to gain new ideas and<br />

skills to enhance their performance and elevate a<br />

practice’s retail image.”<br />

The low vision conference will run on the Friday<br />

and the practice management programme for<br />

practice owners and staff will run on the Saturday<br />

and Sunday. A Visionz cocktail party will be held on<br />

Friday evening starting at 5:15pm. CPD points are<br />

being applied for. For more visit www.nzowa.org.<br />

nz/conference or email enquiries@nzowa.org.nz ▀<br />

Alcon promotes More Prize<br />

Time in practices<br />

Alcon began rolling<br />

out the second<br />

phase of its directto-consumer<br />

advertising<br />

and marketing campaign<br />

for its Dailies Total 1<br />

contact lens brand<br />

in Australia and New<br />

Zealand on 10 June.<br />

The multi-channel<br />

campaign builds on<br />

the success of the first<br />

phase of Alcon’s “More<br />

Contact Time” campaign,<br />

which launched in<br />

October 2015 and was designed to raise consumer<br />

awareness of contact lenses to drive more patients<br />

into practices to request a contact lens trial.<br />

The second phase of the campaign is designed<br />

to target the core demographic for daily<br />

disposable contact lenses who look for contact<br />

lenses comfortable enough to wear all day and<br />

into the evening, said the company. “The locally<br />

photographed <strong>2016</strong> campaign has refreshed<br />

visuals and was created to engage and connect<br />

with the target demographic.”<br />

The campaign includes ads in key women’s<br />

magazines, social media and digital advertising<br />

and a host of in-practice material. Alcon is also<br />

Key visuals from the second phase of Alcon’s consumer campaign<br />

encouraging practices to take advantage of its<br />

in-practice promotion, the Dailies Total 1 More<br />

Prize Time competition, which runs from June<br />

to September. Prizes include six or 12-month<br />

supplies of Dailies Total 1, GoPro Hero action<br />

video cameras, Fitbit Blazes, iPad Pro’s and a<br />

A$2,000 luxury designer voucher.<br />

“Our <strong>2016</strong> integrated campaign has been<br />

designed to continue to support you by driving<br />

new and existing contact lens patients in-practice<br />

to trial Dailies Total 1. The More Prize Time<br />

competition targets our key demographic and<br />

will give patients an extra incentive to visit your<br />

practice,” said the company. ▀<br />

Style-Eyes<br />

Colourful eyewear<br />

Are your customers afraid of wearing colourful<br />

frames? Sometimes I’ll look at a customer’s<br />

outfit and think, “I love their style - I can sell<br />

them something bright and fun!” Yet after<br />

a long selection process they chicken out<br />

and choose a black or tortoiseshell frame.<br />

How can we help our customers access their<br />

adventurous side?<br />

I asked my spectacle-wearing friends about<br />

their opinions on colourful eyewear.<br />

Anthea says, “I think there is the perception<br />

that you need a bold or daring personality<br />

to wear colourful or otherwise stand-out<br />

eyewear, but in my experience they just<br />

become part of your face or your style if they<br />

are your everyday pair.”<br />

I like to tell customers that while spectacles<br />

are a medical device, they’ve also got an<br />

opportunity to buy jewellery for their face, so<br />

they may as well make the most of it.<br />

Skin tone<br />

“I have always wanted to get coloured frames<br />

but when I go to try them on, none of them are<br />

the right shade for my face.” Anya<br />

There are some people who insist that certain<br />

skin tones only suit certain colours. You’ll hear<br />

things like, “Oh you’re an autumn – try these<br />

green frames.” I’ve never completely understood<br />

the point of Seasonal Colour Analysis and it only<br />

really ‘works’ for white skin. Anyway, this kind of<br />

rule is meant to be broken! Instead of spending<br />

time trying to work out what ‘undertone’ means,<br />

just encourage your clients to try some frames<br />

on – if they like the colour and feel that it suits<br />

them, then that’s a win.<br />

Proof of breaking this rule comes from my<br />

friend Deb who said, “I love colour[ful] frames<br />

and, surprisingly, can wear colours that I didn’t<br />

think I could – like red, purple, pink…” It just goes<br />

to show that if someone is curious about colour,<br />

playing dress-ups in store with frames is the best<br />

way to discover something new that suits.<br />

How do we solve Anya’s case? She stuck with<br />

neutrals and tortoiseshell in the past, but she<br />

thinks that deep emerald green would suit<br />

her and will look for that next. All she needs is<br />

some encouragement.<br />


Phone 09 486 4372 or Fax 09 486 3936<br />

info@eyesurgeryassociates.co.nz or<br />

Dr Patel at: patel@glaucoma.co.nz<br />

www.eyesurgeryassociates.co.nz<br />

For more personalised eye care<br />

talk to Dr Hussain Patel<br />

Consultant Ophthalmologist<br />


Eye Surgery Associates are a Southern Cross Health Society Affiliated Provider<br />

Matchy-matchy<br />

“It hasn’t stopped me, but outfit co-ordination<br />

is a consideration. Whether glasses “go” with<br />

your overall style or wardrobe.” Anthea<br />

If customers are concerned about frames<br />

matching clothes, I talk with them about the<br />

colour wheel, which explains the relationship<br />

between different colours and tones, and how<br />

things don’t always need to match to work.<br />

(See www.colormatters.com/color-anddesign/basic-color-theory<br />

for more about this.)<br />

If we’re going by complementary colours for<br />

example, and the customer says they wear a lot<br />

of green, then purple frames are a great match.<br />

For some people who have to wear suits<br />

or uniforms, eyewear is one of the only<br />

opportunities they get to express their<br />

personality through attire. Have a chat to your<br />

customers about how they have to dress for<br />

work and use this as a starting point for your<br />

frame recommendations.<br />

I also use colour as an opportunity to sell a<br />

second pair. If someone is drawn to a colourful<br />

frame, but is concerned about matching their<br />

clothes, I suggest getting a black, grey, brown/<br />

tortoiseshell, or metal frame as a safe second pair.<br />

Every dispenser I know asks their customers<br />

the same question: “How many pairs of shoes<br />

do you have? More than one? Then shouldn’t<br />

you have more than one pair of glasses?”<br />

Trends<br />

Last month, Louise Sceats of Jono Hennessy<br />

told NZ Optics that blue is on-trend, and we’re<br />

certainly seeing many shades of blue in current<br />

frame collections. I’ve also noticed dusky pink<br />

and rose gold metal features in a lot of ranges.<br />

Looking for some inspiration? A few of my<br />

favourite, colourful brands are l.a.Eyeworks,<br />

Theo, Anne et Valentin and Andy Wolf.<br />

And here’s a weird fact for you if all else fails:<br />

Hot pink goes with everything. ▀<br />

* Jo Eaton is an optical dispensing student at RMIT. Originally<br />

from Wellington, Jo became interested in eyewear after<br />

discovering she was myopic at the age of 14. In 2008, many<br />

years after deciding to make unusual glasses her ‘thing’,<br />

she founded eyewear fashion blog ‘Eye Heart Glasses’. When<br />

she’s not immersed in the world of spectacles, she works in<br />

digital marketing, DJs, volunteers for community radio and<br />

is a director of feminist music organisation LISTEN.<br />


Glaucoma Specialist / Refractive Cataract Surgery<br />

General Ophthalmology / Acute & Emergency Eye Care<br />

Available throughout Auckland<br />

and also in Hamilton<br />

<strong>Aug</strong>ust <strong>2016</strong>.indd<br />







We are looking for a passionate Dispensing Optician / Optical<br />

Assistant to join our family.<br />

In this role you will offer an amazing eye care experience by<br />

providing exceptional customer service with honesty, care and<br />

absolute attention to customer needs.<br />

We offer a great working environment with continuous support<br />

and professional development opportunities.<br />

To be successful in this role you will:<br />

- Have a friendly, natural and consultative approach to selling<br />

- Be confident, enthusiastic and motivated to succeed<br />

- Have excellent communication and sales skills<br />

- Be a versatile team player<br />

Experience as a Dispensing Optician or Optical Assistant is<br />

preferred.<br />

If you are not yet qualified, we will provide the opportunity and<br />

support to qualify as a dispensing optician.<br />

This position is full time, based in Hamilton and/or Cambridge<br />

and requires some Saturday work.<br />

To apply:<br />

Please email your CV and a cover letter to sandri@patersonburn.<br />

co.nz<br />



Specsavers Invercargill has an exciting opportunity for an<br />

optometrist to take up either a permanent or block position in their<br />

practice.<br />

The practice itself is lead by 2 dedicated store directors and a team<br />

of experienced and passionate employees, who have a strong<br />

reputation within the local community. It has two test rooms, a<br />

dedicated pre-test area, 5 dispensing desks and a loyal patient<br />

database.<br />


You may be aware that Invercargill is the capital of the Southland<br />

region of New Zealand, and the gateway to some of the country’s<br />

most beautiful scenery, cultural attractions, nature reserves and<br />

parks, as well as a city life with lively cafes, restaurants, and bars.<br />

What you may not be aware of is that Invercargill is located an<br />

hour and half from some of the best skiing and snowboarding in<br />

the world – and not only that - free use of an exclusive chalet is<br />

on offer to the optometrist that joins this team!<br />



We are looking for an experienced dispensing optician to join<br />

our three room practice at Specsavers Sylvia Park. This is a<br />

great opportunity to work in a central location in Auckland.<br />

Competitive Salary and bonus package based on experience.<br />

Great training opportunities available through Specsavers on<br />

management and leadership. Specsavers experience is not<br />

essential. Please email Ryan Mahmoud at dir.sylviapark.nz@<br />

specsavers.com or call 021 166 5899.<br />



AcuityKit has a comprehensive range of digital eyecharts for eyecare<br />

professionals. Ideal for low vision and domiciliary work.<br />

Visit our website www.acuitykit.com or email john@acuitykit.com<br />

Paterson Burn Optometrists is one of the largest independent<br />

optometry practice groups in New Zealand. We are totally<br />

independent and Waikato owned and we've maintained our<br />

independence in the ever changing environment of New Zealand<br />

optometry. Our core purpose is to improve people's lives by<br />

providing the best visual solutions available. Paterson Burn<br />

Optometrists value respect, integrity, accountability, enjoyment,<br />

continuous improvement, freedom for initiative and teamwork.<br />


ON PAGE 14<br />

If you would like to;<br />

* Further develop your clinical skills and practice within a setting<br />

that sees a variety of pathology cases<br />

* Tear up the ski slopes (or observe from the chair lift – your<br />

choice!) by having free use of a chalet on your days off<br />

* Find out about the attractive package and sign on bonus that is<br />

on offer<br />

* Find out how Specsavers can support AUS optometrists to work<br />

in NZ and financially support the earning of your annual CPD<br />

points<br />

Then please contact Carly Parkinson on +61478201057 or carly.<br />

parkinson@specsavers.com for a confidential chat today!<br />




SATURDAY 10 TH & SUNDAY 11 TH SEPTEMBER <strong>2016</strong><br />

Join 500 optometrists (including more than 100 non-<br />

Specsavers optometrists) at this year’s SCC for two days<br />

in September – for one of Australia and New Zealand’s<br />

premier optometry CPD and networking events.<br />

Visit spectrum-blog.com for more info<br />


With growth continuing, our store teams are currently<br />

seeking optometrists to fill permanent roles in the following<br />

NZ practice locations:<br />

North Island • St Lukes<br />

• Kerikeri • Taupo<br />

• Masterton • Tauranga<br />

• Mt Maunganui • Te Rapa<br />

• Pakuranga • Wanganui<br />

• Palmerston North • Wellington<br />

• Paraparaumu CBD South<br />

• Rotorua • Whakatane<br />

South Island<br />

• Dunedin<br />

• Invercargill<br />

• Shirley<br />

We are currently also seeking experienced dispensers for a<br />

variety of our New Zealand stores.<br />

Alternatively, if you’re interested in a move to Australia -<br />

either short or longer term, talk to us for the lowdown on<br />

possible locations in all states.<br />

A trip to SCC as our guest could be the perfect way to see<br />

what's on offer.<br />

To find out more and to explore the T&C'S associated<br />

with this industry-wide offer, contact Carly Parkinson<br />

on 0800 717 350 or carly.parkinson@specsavers.com<br />

– or visit spectrum-blog.com<br />

16 NEW ZEALAND OPTICS <strong>Aug</strong>ust <strong>2016</strong>.indd<br />


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