Sep 2016

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY
FOR OPTOMETRISTS AND EYE CARE PROFESSIONALS
PO BOX 106 954, AUCKLAND CITY 1143
Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz
SEPTEMBER 2016
NZOWA Visionz 2016
SUPPORTING
NEW ZEALAND’S
OPTICAL INDUSTRY
&Eduvisionz
LOW VISION, BUSINESS BEST PRACTICE,
COCKTAIL PARTY, GALA DINNER
Practical advice on running and managing a
successful retail business
Boosting your reach through social media
Health and safety: new laws and a St John’s first
aid course
A comprehensive look at all that’s new in low vision
Open to all professionals in the ophthalmic industry
A full industry exhibition with a broad range of optical
suppliers represented
Networking opportunities galore
14-16 October
Ellerslie Event Centre
Auckland
See inside for more and/or register online at www.nzowa.org.nz/conference

LAST FEW
PLACES
REMAINING
LAST CHANCE TO REGISTER
SCC5: ‘Collaboration – a new era in eye health’
BRISBANE CONVENTION & EXHIBITION CENTRE SATURDAY 10TH & SUNDAY 11TH SEPTEMBER 2016
SATURDAY CLINICAL EDUCATION SESSIONS –
OPTOMETRY-LED
Michael Yapp
Chief Staff Optometrist, Centre for Eye
Health, Sydney
A practical approach to diagnosing and
assessing Glaucoma suspects
Alex Gentle
Associate Head of Optometry School, School
of Medicine, Deakin University
Current best practice in ocular allergy
diagnosis and management
SUNDAY CLINICAL CONFERENCE –
OPHTHALMOLOGY-LED
Christolyn Raj
Vision Eye Institute, Consultant
Ophthalmologist, Royal Children’s Hospital
& Mercy Hospital, Melbourne
A series of clinical conundrums – adopting a
different perspective
Andrew White
Consultant Ophthalmologist, Westmead
Hospital, PersonalEyes practice, Sydney
Glaucoma and collaborative patient care
Richard Johnson
Principal Optometrist, Ophthalmology
Depart, Greenlane Clinical Centre, Auckland
Key features in presentation and
management of anterior uveitis
Jesse Gale
Senior Clinical Lecturer, University of Otago,
Consultant Ophthalmologist, Capital & Coast
District Health Board, NZ
Swolen optic discs
Daryl Guest
Clinical and Executive Director, Optometry
and Vision Sciences, University of Melbourne
Paediatric anterior eye therapeutics
Shelley Hopkins
Optometry, QUT Health Clinics, Brisbane
Assessing children
Nathan Walker
Ophthalmologist and Vitreoretinal Surgeon,
Outlook Eye Specialists and Gold Coast
University Hospital
Vitreoretinal surgery in 2016 –
the state of the art
Stuart Graham
Head of Ophthalmology and Visual Science at
Macquarie University’s Faculty of Medicine and
Health Sciences, Sydney
Glaucoma case studies
Geoff Sampson
Senior Lecturer, Deakin University
Impact of simulated refractive errors on
academic-related skills in children
Sunil Warrier
Private Practice Ophthalmologist and Ocular
Oncologist and Consultant at The Mater
Hospital, Brisbane
Ocular Oncology – master it, don’t miss it!
For full details on SCC pricing, CPD points and to register your place,
contact SCC Coordinator Gemma Robertson now on gemma.robertson@specsavers.com or +61 428 285 535.
2 NEW ZEALAND OPTICS September 2016

Leading the pack
FDA approved IOL first trialled in NZ
BY LESLEY SPRINGALL
EDITORIAL
It’s a bumper issue this month. We’ve been out and about finding out how
we’re leading the world in many areas. Check out the incredible story (this
page) about a potential new fix for myopia; or how we were the first to ever
implant the revolutionary Tecnis Symfony IOL – well Dr Dean Corbett was, but
we can bask in his shadow! We’re also leading our cousins across the ditch in
low vision technology (p24).
Plus, we’ve got everything you need to know about Visionz 2016 (p11 to 17),
an event not to be missed if you want to know what’s new for summer, and
we’re lucky enough to have been given a fascinating look into the world of our
only ophthalmological nurse practitioner (p9).
A huge thanks to all our very special contributors this month, who have gone
well beyond the call of duty and submitted fantastic stories and pictures on
Snowvision (sounds like amazing fun – p10), AUSCRS (p21) and the International
Orthoptic Congress (p24). We couldn’t do what we do without you, so thank you.
In everything we do, we try to make sure we serve all the industry’s
needs, whether you’re a student (the ball pictures on p23 are amazing), a
researcher, an optometrist, an ophthalmologist, nurse or practice manager,
and sometimes it’s not an easy balance. So we welcome your constructive
feedback as we strive to make NZ Optics bigger and better and more relevant
to all, whether you’ve been in the industry for generations or are just taking
your first tentative steps into the fascinating world of eyes. To this end we’ll be
asking for your feedback more formally over the coming weeks and we hope
you’ll be as frank with us as you can.
And finally, just a quick heads-up that next month we’ll be publishing our
very popular Dry Eye Special Feature, which is going to be even better than last
year’s thanks to the involvement of A/Prof Jennifer Craig (thanks Jennifer) and
other amazing people leading the way in dry eye on both sides of the Tasman.
With all that we’ve learnt, as far as we’re concerned, New Zealand is right up
there in the medals arena when it comes to eye health.
Yours proudly
The online ophthalmological world was
abuzz in August with news about the US
Food and Drug Administration’s (FDA’s)
approval of a new intraocular lens (IOL) being
heralded as a completely new class of IOL that
provides superior vision across a broad range of
distances.
To gain FDA approval, the Tecnis Symfony range
of IOLs – it also comes in four toric models – was
put through a barrage of international clinical
trials, the first of which were carried out at our
own Auckland Eye under the watchful care of
refractive surgery specialist Dr Dean Corbett.
The FDA approval of the Tecnis Symfony is
a big deal as it’s the final approval hurdle in
the development of what is an exciting, new
IOL design, says Dr Corbett. “The IOL has gone
ballistic in Europe and Australia as it genuinely
offers something new for patients.”
What makes the Tecnis Symfony unique is its
patented diffractive echelette (or blazed grating)
design feature, which extends the range of vision
the IOL affects, and its achromatic technology,
which corrects chromatic aberration for enhanced
contrast sensitivity (see Figures 1 and 2).
“The spread of a normal IOL is about
1.6 diopters, but the spread of Symfony is
Lesley Springall, publisher, NZ Optics
Fig 1. The novel pattern of light diffraction projected through the Tecnis Symfony IOL
Fig. 2. Tecnis Symfony corrects chromatic aberration with its patented achromatic technology
somewhere between 0.2 and 0.4 diopters,
depending on which study you read, so the
technology creates a more accurate lensfocusing
system,” says Dr Corbett. This provides
a real alternative to both monofocal and
multifocal IOLs especially as the Symfony’s
achromatic technology means the problems
with multifocal IOLs at night – with some
patients experiencing debilitating halos and
glare – is nowhere near as severe, he says.
“While IOLs have been the mainstay of cataract
treatment for many years, we continue to see
advances in the technology,” said Dr Malvina
Eydelman, director of the Ophthalmic and Ear,
Nose and Throat Devices Division at the FDA’s
Centre for Devices and Radiological Health, in a
media announcement heralding Symfony’s FDA
approval. “The Tecnis Symfony Extended Range of
Vision IOL provides a new option for patients that
may result in better vision across a broader range
of distances.”
Dr Corbett was asked by Abbott Medical Optics,
developer and manufacturer of Tecnis Symfony,
to undertake the first implant of the new IOL
more than four years ago, following his (and
Auckland Eye’s first) clinical trial on the AcuFocus
Kamra corneal inlay for presbyopia.
He says he’s been interested in presbyopic
surgery since undertaking one of the few,
approved refractive surgery
fellowships in Melbourne after
completing his ophthalmic training.
He also welcomes the opportunity
to study new technologies, so
introducing Auckland Eye to the
world of clinical trials was a natural
progression.
If money were no option, Dr
Corbett’s says the Tecnis Symfony
is by far his first choice for patients
requiring cataract (he prefers the
term, “lens replacement”) surgery as
there’s a wider refractive target to
hit and a far broader
overlap between the
near and far vision
targets. The result is a
superior range of vision
for the patient and far
less potential problems
for the surgeon. “It’s
a lens that can be
put into just about
anyone without being
concerned that it will
cause any problems,
which is way not the
case with a multifocal
lens.” ▀
Revolutionary keratoconus,
myopia treatment
BY LESLEY SPRINGALL
Auckland University researchers are in the last phase of a
study, before potential clinical trials, of a new eye drop
solution which can reshape and stabilise the cornea
making it a potential treatment for keratoconus and even
myopia.
Validating the research, the team behind the study – Associate
Professor Trevor Sherwin, Professor Colin Green and research
fellow Dr Carol Greene from the University’s Department of
Ophthalmology – were awarded a $150,000 Explorer Grant from
the Health Research Council (HRC) to take the work out of the
lab and into the field in a large animal study.
“Explorer Grants are unlike any of our other funding
opportunities,” says Professor Kath McPherson, HRC’s chief
executive. “They fund research that might seem ‘out there’,
but which actually has a very good chance of making a
transformative change to how we manage New Zealanders’
health. It might be high risk, but with that also comes the
potential for high reward.”
There’s more than six years of research behind this unique
study, says Dr Greene. “We have a completely fresh view
on how we could generate the cornea and potentially treat
keratoconus and possibly myopia.”
The team began by looking at how they could manipulate
cells in the cornea. “What we found was very unusual; we
found that every single cell in the cornea could be manipulated
so they acted like stem cells,” says A/Prof Sherwin.
Further studies revealed the ability to induce cornea cells
to return to their juvenile form and secrete a collagen, the
basis of the new drop formulation, which the team believe is
expressed during the development of
the cornea.
With sufficient laboratory data in the
bag, the team is now undertaking a
large sheep trial at Lincoln University.
Others involved include Auckland
University optometrist and researcher
Dr Stuti Misra, ophthalmology fellow
Dr James McKelvie, department head
Professor Charles McGhee, veterinary
ophthalmologist Dr Steve Heap,
Lincoln University researchers Dr
Hannah Lee and
A/Prof Jim Morton
and veterinary
surgeon Robin
McFarlane.
The large animal
study is critical
to knowing
whether the drops
can rebuild and
reshape corneas
in people, says
Prof. Green, and
the Explorer
Grant ensures the
quality and depth
of the study is
sufficient to take
it to the next level.
A/Prof Trevor Sherwin, Dr Carol Greene and Prof Colin Green
are undertaking cutting edge research that could help
combat myopia
“We are doing full tox (toxicity) testing as we go so by the time
we finish this study we should have something ready to go
into clinical development.”
It is very exciting, admits Prof. Green. “We are getting the
cells to lay down new collagen, so not just stiffen what’s
there (as in cross-linking) but thicken the cornea and stop the
disease progressing.” Using a hard contact lens, the cornea can
be reshaped, hopefully permanently, which could restore some
vision loss, he says.
A/Prof Sherwin says if it works, this will be the only regenerative
process for keratoconus and thus could significantly reduce
the chronic waiting list for donor corneas in New Zealand – 50%
are currently used to treat end-stage keratoconus. But the wider
implications of the treatment are on a different scale, he says.
“The technology is expandable to multiple tissue regeneration
indications with our second target being to treat those with
myopia.”
So far the work has been funded by the University, grants
and the commercialisation collaboration fund Return on
Science. With all patents now in place, the team is preparing to
talk to potential commercial partners. Initial study results are
expected by the end of this year. ▀
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September 2016
5/08/2016 12:58:25 PM
NEW ZEALAND OPTICS
3

News
in brief
SHOULD’VE – A UNIQUE TRADEMARK!
A trademark application filed with the UK Intellectual Property
Office in July by Specsavers’ for the phrase “should’ve” to protect its
well-known catchphrase has been approved. Commenting on the
completely unexpected approval, lawyers in the British media say
this could lead to similar moves by other companies. Third parties
have until the middle of October to raise objections.
OPHTHALMOLOGICAL DISORDERS MARKET RISING
The ophthalmological disorders market is set to almost double
from US$13.7 billion in 2015 to US$26 billion by 2022, according
to business intelligence provider GBI Research. A range of new
companies is expected to enter the market as the treatment space
is transformed by patent expiries and new product entrants,
with larger, more established companies losing dominance, said
Qaisrah Khalid, associate analyst for GBI Research. New company,
Ophthotech is forecast to overtake Roche in terms of total
revenue in ophthalmology by 2022 with their new age-related
macular degeneration (AMD) drug Fovista. This and other new
AMD products should help offset the impact of patent expiries
from some of the most commercially successful ophthalmology
products, including Lucentis, Eylea, and Alphagan, said Kahlid.
POKEMON GO CONTACT LENSES
John Hanke, CEO of Niantic,
maker of the popular Pokémon
Go game, said he wants fully
internet-integrated contact
lenses to allow players to
see Pokémon in the world
around them without a device
interface. Speaking in August
at the 2016 GamesBeat
conference in California,
Hanke, said he wanted to use
the game to drive players to
particular stores, public events,
and even parks that need a clean-up, as part of partner deals, that
make players a collective force – commercially, environmentally and
socially. The first step to which is having a player’s own Pokémon,
sat in their interactive contact lens, so they never leave the game.
FDA APPROVAL FOR NEW SCLERAL DEVICE
Advanced Vision Technologies has received FDA clearance for the
EyePrintPRO prosthetic scleral device utilising the proprietary
EyePrint Impression Process. The EyePrint Impression Process
creates an exact 3D model of the ocular surface which, in
combination with the EyePrint Designer (EPD) software, develops
a unique and precise scleral device for protection and optical
correction of the eye.
ORCAM ARRIVES DOWNUNDER
OrCam’s wearable tech for the vision impaired is now available in
Australia (and thus New Zealand) through assistive technology
provider Quantum Reading, Learning, Vision. OrCam MyEye uses a
small camera mounted on the wearer’s glasses frame to read any
printed text in the immediate environment and relay it to the user
via a discreet earpiece. It can also recognise the faces of individuals.
SILMO SYDNEY
The NSW health minister Jillian Skinner has accepted an invitation
to open Silmo Sydney on 9 March 2017. Organisers said Skinner’s
commitment to SILMO Sydney is a wonderful fillip to the event,
which underlines her commitment to the NSW state and national
optical industry and community. This is the second feather in the
cap of Silmo Sydney, which announced that Optometry NSW/ACT’s
conference Super Sunday will be held in tandem with the new
optical fair on 12 March 2017.
BROCCOLI BEST FOR AMD
Researchers at the Buck Institute for Research on Aging in California
boosted the potency of a broccoli-related compound by 10 times
and showed how it may be useful in the treatment of AMD. The
study, which was published in the journal Scientific Reports, also
highlighted how important lipid metabolism was in maintaining a
healthy retina.
NEW TREATMENT FOR GLAUCOMA
A micro-invasive glaucoma surgical (MIGS) device, CyPass Micro-
Stent made by Alcon, has gained FDA approval for use in patients
with non-severe primary open-angle glaucoma. Approval was
based on the Compass Study, the largest MIGS study to date with a
two-year follow-up for over 500 mild-moderate glaucoma patients
undergoing cataract surgery, which showed that 73% of those with
the implant had at least a 20% reduction in intraocular pressure.
Mike Ball, Alcon CEO, said the micro-stent will
provide a less invasive means of
lowering IOP than traditional
glaucoma surgery. The device
is designed to work by
enhancing the eye’s natural
drainage pathways while
only minimally disrupting the
tissue. ▀
Superstition can
affect eye tests
People having eye examinations may be affecting the results due
to a natural tendency to base their responses on past decisions,
suggests new research conducted at University College London
(UCL) and Stanford University.
The paper, co-authored by Professor Steven Dakin, the head of
optometry and vision science at the University of Auckland, who was
previously based at UCL’s Institute of Ophthalmology, was recently
published in the journal Proceedings of the National Academy of
Science. It demonstrates that people cannot avoid using their past
decisions to inform their current decisions, says Professor Dakin.
“Successfully adapting to our environment means we use
information about our past successes and failures to make better
decisions in the future. But sometimes the outcomes of past
experiences are not helpful and taking them into account leads to
worse decisions.”
Professor Dakin and his colleagues’ research shows it’s easier to
reinforce these tendencies than to break them down.
“We found that people’s choices are influenced by the success or
failure of past choices even where this history is irrelevant,” he says.
“For example, many people switch their decision following a failure,
even though such superstitious behaviour makes them perform
poorly. Our study shows that it’s a rigid response system. Even
when it’s not to your advantage, you can’t help but incorporate past
decisions in your decision making.”
The research found this tendency could be strengthened but
not weakened: existing biases could not be eradicated. Ways to
counteract this response, to make better measures of performance
such as when assessing vision at an eye clinic, are also presented in
the study.
“People’s irrational tendency to rely on their past decisions is
important because vision and hearing tests assume we are rational.
Without accommodating people’s individual biases, the test results
can look worse than they really are,” says Dr Dakin.
“We are now looking at children to see how prone they are to
biases, because you could argue either way that they might be more
Kiwi menswear company Barkers has been providing New Zealand men with
fashion-forward, classically tailored style since 1972. Now, in collaboration
with global experts in the eyewear industry and New Zealand optical
company Euro Optics, Barkers is launching its first complete eyewear collection.
“We saw eyewear as a natural progression for the Barkers’ brand,” says Paul
Biddle, Barkers’ general manager of merchandise and marketing. “Eyewear can be
an important element of a complete look and we wanted to offer New Zealand
men a good quality product. It was very important for us to find a partner that
could deliver the styles we want to offer at the highest quality.”
Barkers’ designers worked with Euro Optics on creating a range that would
appeal to New Zealand men through the styles created and the colours used,
says Biddle. “Once the initial design was completed, Barkers selected the best
global manufacturers to partner with to produce the eyewear.”
One major contributor to the range is Pascal Jaulent, founder of Face à Face,
a high-end French eyewear brand. Jaulent is now the lead designer
for Design Eyewear Group, which produces Face à Face, WOOW,
ProDesign and Inface.
Barkers’ optical collection is being launched in September,
while its new sunglasses collection will launch in October.
Both will be distributed by Euro Optics and will be
available to all independent optometrists, dispensing
opticians and specialist sunglass stores. The sunglass
collection will also be sold in Barkers’ 27 stores across
New Zealand.
Carl Doherty, Euro Optics’ general manager said,
“By combining this iconic New Zealand brand with
international industry know-how, we feel that Barkers
Eyewear will be a very successful range for all who
stock it. We are looking forward to bringing this to
market. The sunglass collection is easy to RX for
prescription sunglasses and Euro Optics will be
offering a special introductory package for optical
frames and sunglasses to trade customers including
a ‘Gift with Purchase’ promotion.”
Barkers’ optical frames will have an RRP of $249.00
to $290.00, while Barkers’ sunglasses will have an
RRP of $169. Both collections will be on display at
Visionz 2016 on Euro Optic’s stand. ▀
or less superstitious than adults…less superstitious because they
have less experience of the world or more superstitious because
superstition has a kind of adaptive value and is a default state for
the system.” ▀
GLAUCOMA SYMPOSIUM – SELLING FAST
Glaucoma New Zealand’s inaugural symposium,
and the only event in New Zealand dedicated to all
things glaucoma, is due to be held on 18 September
in Auckland. With a line-up of exceptional speakers
including Professors’ Helen Danesh-Meyer and Charles
McGhee, Associate Professor Jennifer Craig and Drs Mark
Donaldson, Shenton Chew, Sam Kain and Dean Corbett
among others, it is no wonder tickets are selling fast. The
team at Glaucoma NZ encourage any professionals and
students with an interest in glaucoma to register quickly
to avoid disappointment. Visit www.glaucoma.org.nz for
more information.
Barkers’ launches eyewear
www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand
For general enquiries, please email info@nzoptics.co.nz
For editorial and classifieds, please contact Jai Breitnauer, editor, on 022 424 9322 or editor@nzoptics.co.nz.
For advertising, marketing, the OIG and everything else, please contact Lesley Springall, publisher, on 027 445 3543 or lesley@nzoptics.co.nz.
To submit artwork, or to query a graphic, please email lesley@nzoptics.co.nz.
NZ Optics magazine is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times a year, by New Zealand Optics 2015 Ltd. Copyright is held by
NZ Optics 2015 Ltd. As well as the magazine and the website, NZ Optics publishes the annual New Zealand Optical Information Guide (OIG), a comprehensive listing guide that profiles the
products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The views expressed in this publication are not necessarily
those of NZ Optics (2015) Ltd.
4 NEW ZEALAND OPTICS September 2016

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NEW ZEALAND OPTICS
5

Bionic eye goes commercial
The bionic eye system, IRIS II, developed by
French company Pixum Vision, has been
awarded the CE mark. This 150-electrode
epiretinal implant features a design intended to be
explantable and upgradeable, and is now CE-mark
approved for people with vision loss from outer
retinal degeneration.
“The CE mark certification is a major step forward
for Pixium Vision and for retinal dystrophy patients
who have lost their sight,” said Khalid Ishaque,
CEO of Pixium Vision. “This recognition by an
independent expert body validates the longterm
multidisciplinary work that has resulted
in market approval of the IRIS II system. We
will continue to develop our bionic vision
systems with the aim to deliver improved
visual perception and help retinal dystrophy
patients lead more independent lives.”
The IRIS II features a bio-inspired camera
intended to mimic the functioning of the
human eye; an epiretinal implant with 150
electrodes, almost three times the number
of electrodes than the previous version; and
an explantable design – the electrode array
is secured on the retinal surface by a support
system that is intended to allow for future
replacements or upgrades.
Clinical trials are currently underway in Germany,
Austria and France. Moorfields Eye Hospital in
London received approval from the UK regulatory
authority MHRA to launch their own clinical trial
at the end of May. The focus right now is on IRIS II
as a solution for retinitis pigmentosa patients, said
the company, adding it was also working on an
implant for AMD patients. ▀
New doc for Timaru
Hawke’s Bay
ophthalmologist, Dr
Muhammad Khalid has
now filled the long-vacant role
of Timaru ophthalmologist for,
a presumably-much relieved,
South Canterbury District
Health Board (SCDHB).
Talking to NZ Optics in
August, shortly before
moving to Timaru to take up
his new role, Dr Khalid said
he was excited about the
new position and getting
back to being part of a small
community once again.
“My father was a GP in a
small town. I feel comfortable in and understand
smaller communities so I will enjoy being part of
one again.”
Dr Khalid says a smaller community offers a lot
more opportunities to get to know people and
to help solve a multitude of different problems,
problems you might not be exposed to from an
eye-health perspective as part of a larger team.
With three young children in tow (a girl and
two boys aged 13, 10 and 8), however, Dr Khalid
admits it was an important decision for him and
his wife, but they are all now looking forward to
the move. “You don’t go to small communities
like this to just work, you have to want to be a
part of the community.”
Dr Khalid has locumed in Timaru a few times
over the past year since his predecessor, Dr
Mike Mair’s retirement in July 2015. When
he mentioned to people at
SCDHB that he thought it
was a great place and was
surprised they hadn’t found
anyone to replace Mike, they
asked him to come in and
consider it.
SCDHB chief
executive Nigel Trainor,
talking to the Timaru Herald,
said having Dr Khalid meant
cataract surgery could once
again be performed at
Timaru Hospital and private
alternatives would now be
Dr Muhammed Kahlid at RANZCO NZ
available through the eye
in Dunedin in May
clinic.
“The search for an ophthalmololgist has been
extensive and during this time Dr Khalid was
able to provide support to South Canterbury
DHB as a locum doctor. We are delighted that
he liked what he saw and has decided to make
the move to Timaru permanent. He brings with
him extensive global experience and will be a
real asset to the community,” said Trainor.
Originally from Pakistan, Dr Khalid also
trained in Ireland and obtained his fellowship
in ophthalmology from the Royal College
of Surgeons of Edinburgh. He also has a
postgraduate degree in medicine from the
National University of Ireland in Galway
and a diploma from the European Board of
Ophthalmology. He moved to New Zealand with
his family in 2013 to be nearer to family in this
part of the world. ▀
RANZCO launches referral
guides; signs Specsavers MoU
The Royal
Australian
and New
Zealand College of
Ophthalmologists
(RANZCO) has
released the first of
a series of planned
referral guides for
optometrists and
GPs to help provide
more effective and
efficient patient
care pathways
and improve eye
health outcomes
for patients across
Australasia.
The first of the
referral guidelines,
looking at glaucoma
management, was
released at the beginning of August. Guidelines
on diabetic retinopathy and age-related macular
degeneration (AMD) are expected to be released
in the near future, with other indications to be
released later, following feedback.
In a statement RANZCO said these referral
guidelines do not favour and are not dependent
upon any one particular practice referral system
or methodology. “They simply provide a resource
which lays out a suggested referral pathway if
certain signs and/or symptoms are identified.
The aim is to ensure patients receive the best
care possible, in the most appropriate timeframe
and from the appropriate healthcare provider.”
The referral guidelines are based on peerreviewed
publications about best practice in
relation to referrals for symptoms and disease
areas. “That said, we recognise that what works
best in theory is not always what works best
in practice and so we will be assessing the
effectiveness and usability of the guidelines,”
said Dr Bradley Horsburgh, RANZCO president.
“We are all part of the eye healthcare system
and it’s important that we deliver that as
smoothly and effectively as possible for
patients.”
Dr David Andrews (RANZCO), Peter Larsen (Specsavers), Dr Bradley Horsburgh (RANZCO), Charles Hornor
(Specsavers) and Dr Russell Bach (RANZCO) celebrate the agreement between RANZCO and Specsavers
MoU with Specsavers
Though RANZCO stressed it is seeking feedback
from all optometrists, ophthalmologists and GPs
who use the new referral guidelines, to ensure
it gathers information quickly it has agreed
a Memorandum of Understanding (MoU), or
statement of intent, with Specsavers Australia
and New Zealand to run a two-year pilot
programme to gather metrics and data. “Given
the number of Specsavers optometric practices,
this pilot will allow us to efficiently gather data
to assess the effectiveness of the guidelines,” said
RANZCO.
“Working with Specsavers does not limit
the availability of the referral guidelines. The
guidelines will be promoted and made widely
available to all optometrists and GPs across
Australia and New Zealand.”
In a joint statement RANZCO and Specsavers
said both parties will share resultant data with
healthcare funding and management bodies
to shed greater light on eye health and broader
healthcare outputs.
“With a growing and ageing population in
both Australia and New Zealand we have a duty
to ensure that there is ingrained collaboration
between optometry and ophthalmology,” said
Peter Larsen, Specsavers’ optometry director.
“It is not enough to say we work together, we
actually need to set ourselves specific areas of
collaboration and measure the effectiveness
and efficiency of that collaboration. This
arrangement between Specsavers and RANZCO
does just that, the goal being superior patient
outcomes.”
Larsen said the first discussions with RANZCO
about using Specsavers’ ANZ network of
optometrists to proactively review the guidelines
took place in March. “And a meeting of minds
quickly emerged, leading to this MoU.”
RANZCO will be running training sessions on
the guidelines at the 2016 RANZCO Congress
in Melbourne in November for all optometrists
and GPs who wish to attend, while Specsavers
will be releasing more details about the MoU
and what it means in practice for Specsavers’
optometrists at its 2016 Clinical Conference in
Brisbane this month.
To download and review the first RANZCO
Referral Pathway for Glaucoma Management go
to: https://ranzco.edu/ophthalmology-and-eyehealth/collaborative-care/referral-pathway-forglaucoma-management
▀
How Pharmac makes funding decidions
Clinical advice from experts is the bedrock of Pharmac’s medicines assessments,
writes Medical Director Dr John Wyeth
Advice from clinical experts is an important
part of the Pharmac funding process.
There are multiple ways in which health
professionals provide input to our funding
decisions. From trained medical professionals on
Pharmac’s staff to experts on our specialist panels,
and members of our clinical advisory committees
and wider consultation, input from the medical
profession is central to Pharmac’s decisions on
medicine funding.
Our main clinical committee is the Pharmacology
and Therapeutics Advisory Committee (PTAC),
which has 21 subcommittees in clinical
specialities like cardiovascular disease, diabetes
and ophthalmology. The key skills of our clinical
committee members are reviewing and advising us
on the evidence for the use of medicines in a New
Zealand clinical setting.
We’re sometimes asked why we need to seek
advice on the evidence around medicines,
when a lot of this work is already undertaken
internationally. The answer is that we need to
clearly understand the way a new medicine might
be used in New Zealand. What are the currently
favoured treatments in New Zealand that we
are comparing the medicine under assessment
with? We need to know we are using the right
comparator in our assessment. Our advisory
committee members can help answer this
question, and they are also expected to use their
clinical networks and experience to provide advice
to Pharmac on all aspects of a medicine under
consideration.
All together, Pharmac has around 140 expert
doctors and other health professionals providing
formal advice on medicine funding applications – a
considerable resource.
Because New Zealand has a medicine funding
environment with a defined budget, we can’t
afford every medicine that is available on the
market, so choices have to be made. We know
there are high public expectations around
accessing the ‘latest and greatest’ medicines, but
we know in practice that these high expectations
around effectiveness of new medicines don’t
always play out. We need to carefully examine
the evidence and take a dispassionate view of
the medicines being looked at. We can’t spend
the same dollar twice, so we need to make sure
the choice we make is the one that gets the best
health outcomes for New Zealanders.
The main pathway to medicine funding is
through the Pharmaceutical Schedule. This
is the list of medicines funded for all eligible
patients. A medicine considered for Schedule
listing goes through a rigorous process
involving the assessment of clinical evidence,
pharmacoeconomic evaluation by Pharmac’s team
of health economists and negotiation with the
company that supplies the medicine. If we get
to the point of a provisional agreement with a
company, we then consult with the wider public.
What we want to know is what benefit any new
medicine has over and above the medicines that
are already funded on the Schedule – and what
will the additional cost of that benefit be?
Pharmac’s commercial skills can provide benefits
also. We’re hoping that’s the case with a process
we’re currently running, which emerged from
recommendations made by PTAC. Two anti-VEGF
agents are currently listed for use in DHB hospitals
for wet macular degeneration – bevacizumab
(Avastin) and ranibizumab (Lucentis). In reviewing
an application for another agent aflibercept, PTAC
recommended Pharmac run a commercial process
that might
lead to further
agents being
listed. That
process is now
underway.
Sometimes
people have
unusual clinical
circumstances
that might
mean a funded
medicine isn’t
right for them,
and there is
Dr John Wyeth
an unfunded
medicine that
is. Pharmac also has a process for assessing
individual patient applications for unfunded
medicines – the Named Patient Pharmaceutical
Assessment (NPPA) process. Pharmac receives
nearly 2000 applications a year under NPPA, most
of which are approved. NPPA isn’t a mechanism
to provide access to every unfunded medicine –
it aims to fill a specific need for some patients
whose clinical circumstances aren’t served by
medicines listed on the Schedule.
We encourage health professionals to get
involved in Pharmac funding processes and
have links with associations and societies. But
any clinician can be part of our consultation
database. We’d be happy to add you if you email
consultation@pharmac.govt.nz ▀
6 NEW ZEALAND OPTICS September 2016

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September 2016
NEW ZEALAND OPTICS
7

Focus
on Business
Five things to know about workplace
health and safety in the optics industry
The Health and Safety and Work Act
(HSWA) came into effect in April
2016. Since health and safety at work
is relevant for every individual in every
workplace, it is timely to find out how those
in the ophthalmic industry can be affected by
its provisions.
1. Your company is likely to be a PCBU
(Persons Conducting a Business or
Undertaking)
The name sounds deceiving but your
business will be a PCBU under the new
legislation, meaning it has the ’primary duty
of care’ to ensure, so far as is reasonably
practicable, the health and safety (H&S) of its
workers and that others are not put at risk by
its activities. This new terminology replaces
the previous “employer” obligations.
In essence every workplace is required
to meet a basic duty of care to its workers,
clients or customers and visitors to their
place of business, to ensure they are healthy
and safe during the time they spend on your
premises. You also owe a duty to ensure
that the H&S of members of public, and
those in the vicinity, are not affected by your
operations.
Importantly, there are penalties and fines
for PCBUs who fail to fulfill their duties
under the Act, and they don’t come lightly
(the maximum fine for Reckless Conduct for
a PCBU is $3 million, for an ‘Officer’ a $600K
fine or five years in prison or both, and for
an individual, a $300K fine or five years in
prison or both).
Pragmatically, if your business already has
H&S systems in place, the new legislation
won’t change much for you. There are new
definitions, new requirements for managing
overlapping duties with other PCBUs and
other refinements, however the changes
should mean a revision rather than an
overhaul of your current system.
2. Owners and managers are likely to be
‘Officers’
If you are the owner of your business, or in a
senior position eg. the managing director or
chief executive, then you are likely to be an
Officer under the Act. This means you have
some influence over policy or investment
decisions of the business and therefore need
to exercise due diligence to ensure that the
company (PCBU) is operated in such a way to
meet its H&S obligations.
Meeting your Officer obligations is more
than just having a H&S management
system in place. You need to understand
the risks involved in the business, and
take measures to ensure that the system
is in fact working, on an ongoing basis.
These form the basis of your due diligence
obligations. You cannot claim that you have
taken ‘reasonable steps’ after playing a
BY KIMBERLEY LAWRY
Dry eye: what’s new
passive role or merely taking an interest in
health and safety at work.
3. Size of your business is irrelevant – your
duties remain the same
Whether you are an eye care professional in
a solo practice or working with many others
in a large setting, you need to meet the
obligations in the Act. You can’t contract out
of the requirements and nor can you take
insurance to cover the penalties or liabilities.
The easiest way to ensure you comply is to
have a robust H&S system in place, and it’s
likely to be easier than you think to comply.
4. Understanding the risks – your company
hazard register is key
One of the key obligations is to understand
the risks involved in your business and to
have a plan in place to mitigate or control
those risks. Typically, this is achieved through
developing a hazard register and ensuring all
workers, contractors and other persons are
aware of any hazards that are present in your
business.
5. Have an H&S system in place and train staff
All workers have obligations under the act
and it’s the company’s responsibility to
ensure staff are inducted and trained into the
H&S system. This typically covers hazards,
workers involvement in hazard identification,
emergency procedures, reporting incidents
and accident and workers and the companies
H&S responsibilities.
Obviously this requires you to have a
system in place in order for you to train your
workers (and contractors who may work for
you). If you have something in place already,
it’s timely to review this in line with the
changes to the Act.
If you are starting out or yet to get
something in place then the time to start
this is now. The costs for non-compliance are
high and for most companies the initial H&S
investment to set up your system can be
offset by annual ACC levy savings.
If you want any support or help to help set
this up contact us on 0800 474 769 or
www.hrhealthandsafety.co.nz
ABOUT THE AUTHOR:
* Kimberley Lawry is
managing director of
HR Health and Safety
Limited – specialists
in supporting NZ
businesses to easily
navigate Health and
Safety and staff issues.
www.hrhealthandsafety.
co.nz
NZ Optics’ October issue will include a very special feature on dry eye with
all the latest thinking and research from New Zealand and overseas. Peerreviewed
and curated with the help of Associate Professor Jennifer Craig, New
Zealand’s own internationally-renowned dry eye specialist, and vice-chair
of the global initiative DEWS II (Dry Eye Workshop II), the feature will reveal
some of the cutting edge research going on in our own country and debate
some of the views held on dry eye through a number of carefully-selected,
contributed articles from some of New Zealand’s, and Australia’s, leading
thinkers on this hot topic.
If you care about dry eye and making sure you’re up to speed with all the
latest thinking, don’t miss NZ Optics’ October issue.
Movement-based eye tests
for children
Testing children’s eyes is tricky at the best of times,
but with non-verbal pre-schoolers it is almost
impossible.
“Specialists agree early intervention gives the
best chance of a good outcome in the treatment of
amblyopia,” says Dr Jason Turuwhenua, a research
fellow at the School of Optometry and Vision Science at
the University of Auckland. “But young children don’t
respond well to eye charts as they’re not familiar with
the letters, and it requires a subjective response they
aren’t able to give yet.”
Dr Turuwhenua is an engineer who became interested
in the application of engineering methods in resolving
vision problems. Along with vision scientist, Associate
Professor Ben Thompson they began working on
creating a system to accurately test the sight of young
children. In October 2015 they were awarded almost
a million dollars over two years in funding from the
Ministry of Business Innovation and Employment.
“Our system, which can be used for children as young
as two years, uses optokinetic reflex, an involuntary
motion of the eye that occurs when watching a moving
scene or pattern,” explains Dr Turuwhenua. “In our
system we envisage that a child would watch a screen
and we measure their eye movements – if they display
the reflex they would pass, and if they don’t display the
It can be easy to get stuck in a professional silo,
but research lead by physicist Dr Frederique
Vanholsbeeck is a reminder that no man – or
specialism - is an island. Her team, based in the
University of Auckland’s physics department, are
working on the development of new differentiation
tools in optical coherence tomography (OCT).
“OCT is a versatile and unique technique with
many applications,” explains Dr Vanholsbeeck. “But it
lacks discrimination in key areas. We are monitoring
chromatic dispersion and tissue stiffness and looking
at how new analysis and measuring techniques can
offer more accurate results to differentiate tissue or
detect early signs of diseases.”
Chromatic dispersion blurs the contours in
OCT images, making it hard to gain accurate
measurements of choroidal thickness. But by
combining sophisticated data analysis techniques
with a new optical laser, Dr Vanholsbeeck is aiming to
enhance the accuracy, and therefore the value of OCT.
“If you analyse the light after it has interacted
with tissue, you can extract information about your
sample such as its composition,” says the Brusselsborn
physicist who studied nonlinear optics as part
of her PhD before moving into biomedical imaging
and biophotonics. “We have a Marsden Research
grant [awarded November 2015] and a team of
five, including an optometrist, a post-doc and two
students as well as overseas collaborators. We
already have results and will be publishing our first
paper soon.”
The potential of this research goes beyond simply
improving OCT imaging systems. The results will
enable clinicians to look deep into their patient’s eye,
Dr Jason Turuwhenua
A/Prof Ben Thompson
reflex then it would be indicative of a problem that
requires further investigation.”
The work dovetails with research from Professor
Steven Dakin’s group in the same school, who have
worked with adults to show that the optokinetic reflex
mirrors people’s subjective experience of motion.
“Our findings show that eye-movement based tests
of acuity and contrast-sensitivity are valid substitutes
for tests relying on the patients’ own response.” says
Professor Dakin whose work will appear later this year
in the journal Scientific Reports.
Dr Turuwhenua notes that these tests could be
used to measure refractive error and his team are also
looking at the potential to develop an app. They are
aiming to have the test available for use in a clinical
setting within two years. ▀
Physics meets ophthalmology
Frederique Vanholsbeek is pairing physics and ophthalmology
leading to potential new therapeutic applications
globally.
If you’re a student interested in working with Dr
Vanholsbeeck, contact her by email; f.vanholsbeeck@
auckland.ac.nz or check out more about her research
group at www.biophotonics-newzealand.com ▀
Blue light crusade for Geoff Parker
Parker & Co optometrist
Geoff Parker has got
behind the new Essilor
campaign to promote their
Eyezen lenses, designed to
block out harmful blue light.
In a consumer press release,
he warns that strained
vision, headaches and sleep
deprivation are all linked to
high-energy blue light emitted
by flat screens.
“What we are seeing now is
that concentrated numbers of
hours spent in intensive screen
time while gaming, and even
long work days, are causing
noticeable symptoms in device
users,” he says in the release.
“Essentially, over-exposure to
that blue light - which occurs on the light spectrum
next to harmful invisible ultraviolet light - could
cause significant, long term damage”.
Also of concern is recent research showing 90% of
Geoff Parker from Parker & Co optometrists, is
supporting Essilor’s blue light awareness campaign
technology users are working
across multiple screens for
everyday activities, again
increasing their risk of harm
from blue light, he says.
“According to one study, 75%
of people who use two or more
devices simultaneously report
experiencing symptoms of
digital eye strain compared to
only 53% of people who use
just one device at a time. There
are strong suspicions that highenergy
blue light could cause
damage to the macula. That is
what is now being researched
globally.”
The consumer-facing
educational campaign, driven
by Impact PR on behalf of
Essilor, is aiming to educate younger people about
the potential dangers of blue light, while offering
Eyezen as one potential, modern solution. It was
launched in Australia and New Zealand in August. ▀
Photograph: Stephane Coen
8 NEW ZEALAND OPTICS September 2016

Meet the…nurse practitioner
There are 175 nurse practitioners (NPs) in New Zealand, but Carol
Slight is the only one working in ophthalmology. Jai Breitnauer
finds out more
I
meet Carol Slight on one
without having to involve
of her non-clinical days
anyone else, however, there
at Greenlane Clinical
are certain sub-specialities I
Centre where she is based
and, over a hot chocolate
at Muffin Break on campus,
discover just how busy
Carol’s life is. She runs
glaucoma clinics, uveitis
clinics, works alongside
several ophthalmologists
and also goes off-site to
assist at satellite clinics in
other parts of Auckland,
including Waitakere Hospital.
She has her own patients,
works largely autonomously,
and is required to participate
in 40 hours of continued,
professional development
education each year, and
is audited by the Nursing
Council every three years.
“It’s quite hard to become
a nurse practitioner,” Carol
admits, “It was a seven-year
process for me. Perhaps
Carol Slight is New Zealand’s only nurse practitioner in ophthalmology
feel more comfortable in, and
certain things I don’t do by
choice. For example, I don’t
give Avastin injections for
AMD patients although that
could always be a possibility if
I underwent the training and
audit process.”
Anything related to
narrow-angle glaucoma, laser
treatment or patients with
a complicated condition, or
who perhaps need surgery,
are also referred quickly to a
consultant if they end up in
one of her clinics, she adds.
“I have consultants I can
call on, and I have a lot of
support. It’s about buy-in, and
getting that comes through
cultivating trust. They know I
won’t push my boundaries.”
One of the biggest
challenges for Carol is her
that’s why there are so few of us.”
The role of nurse practitioner is relatively new. It was
introduced in 2001 to help ease patient waiting times and
manage an ever-increasing workload in our health care
system. Nurse practitioners are registered nurses who have
completed a masters in nursing, worked in an area at an
advanced level for at least four years and are registered
with the Nursing Council after an intensive portfolio
assessment and oral interview. Nurse practitioners are
registered in a specialist area, but still have a holistic
approach to the care of patients. They bridge a care-gap for
groups of patients who need expert assessment, but who
do not require a consultant.
“I’m a hospital-trained nurse who qualified in 1980 and,
apart from a few years out when I had my three children,
I’ve always worked within an ophthalmology setting,” Carol
says. “I wanted to further my skills, so I took a Masters of
Nursing, and part of my dissertation was looking at the role
an NP can play in relieving the pressure on waiting times for
glaucoma referrals within a defined scope.”
Carol qualified as an NP in 2007 and began practicing
in 2008.
The role of an NP is quite a lot more advanced than a
registered nurse, even for those working in specialist areas,
and Carol has made the job her own. But she stresses the
collaborative nature of the work she does and the unique
role she has.
“As an NP, I can assess, diagnose and prescribe within
my scope of practice. I see, and treat, a lot of patients – in
fact I probably see more uveitis patients through my clinic
than many junior doctors. But I also work very closely with
ophthalmologists and I learn a lot from them.”
Carol also says as a nurse practitioner you have to be both
confident in your skills and know where the boundaries of
your role end. This is important, not just for the safety of
patients, but also to maintain a good working relationship
with other healthcare professionals – some of whom may
not fully understand the scope and skills an NP has.
“I get referred the lower-risk patients, or patients who
are transferring from private to the public system. I do
initiate treatment under some circumstances, and it is
possible for me to see a whole patient episode-of-care
requirement for continuing education. As the only
ophthalmology NP in New Zealand, she finds her needs
aren’t necessarily catered for by current educational
programmes.
“At the RANZCO conference, I spent more time in the
doctors’ conference than in the nurses’ room,” admits
Carol, who was a speaker at the nurses’ meeting this year.
“I do get some additional funding to attend overseas
meetings and events, as I don’t always get what I need
from local programmes. I’ve previously been to the World
Glaucoma Congress in Hong Kong and Canada, and I’m
hoping to go to the International Ocular Inflammation
Society conference in Switzerland next year.”
Another issue Carol has to face is making sure other
professionals understand the full scope of her role,
although this is a journey all NP’s have to face, she says,
particularly when undertaking roles that traditionally have
been the domain of medics.
“As trailblazers we’ve all had to pave the way, but I
think we’ve all found it has run smoothest when we work
alongside someone more senior as a mentor.”
Carol says she’s grateful for the support she has had
within ophthalmology circles in Auckland. “The scope of
my role is increasing now, and also the understanding
of what I do is getting wider. I have recently worked
with ophthalmologists in other parts of New Zealand on
working groups looking at elective surgery prioritisation.”
Ultimately, the part of the job Carol most enjoys is its
personal nature; seeing patients regularly, helping them
and making connections.
“I had patients who were with me through the birth of
my first grandchild. These patients always ask how many
grandchildren I have now. My patients share things with
me as well. You make friends, build personal relationships,
and live through the highs and lows of their lives.” ▀
An apology: In our July 2016 issue we wrongly
described Carol Slight as a clinical nurse specialist in our
post-RANZCO coverage, instead of nurse practitioner:
ophthalmology. However, we are actually grateful for
this mistake that led us to meet Carol in person and learn
about her interesting and very individual role. Thanks for
your time, Carol.
Hong Kong Optical
Fair 2016
The 24th Hong Kong Optical
Fair will be held at the Hong Kong
Convention and Exhibition Centre
from 9-11 November 2016.
Organised by the Hong Kong Trade
Development Council (HKTDC) the 2016
Optical Fair is expected to feature more
than 760 exhibitors from across the
globe. It will include pavilions from the
Chinese mainland, France, Italy, Japan,
Korea and Taiwan and is supported by
the Hong Kong Optical Manufacturers
Association and Visionaries of Style.
Last year this popular international
optical fair, self-titled “Asia’s premier
optical fair”, attracted exhibitors from
25 countries, plus 220 brands from
22 countries in the Fair’s Brand Name
Gallery, and a record-breaking 14,7000
buyers from 99 countries. As well as
the Fair itself, the event also features
seminars, buyer forums, design awards,
networking receptions and eyewear
parades to promote industry exchange
and market intelligence sharing.
Brands attending this year include
Converse, Davidoff, Evisu, Kenzo, LGR,
Markus-t, Menrad, Morgenrot, Moscot,
Muzik, Quiksilver and Thom Browne
“The 24th Hong Kong Optical Fair will
once again draw the cream of the optical
world to the City. Opportunities abound
for sourcing the latest products from
quality suppliers, assessing the newest
trends and networking to strengthen
relationships within the industry,” said
organisers.
For more and to register visit:
http://hkopticalfair.hktdc.com/
dm/2016/landing/index_sem_
en.html?gclid=CK2NsrvJtc4CFQtvQod55gF-Q
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NEW ZEALAND OPTICS
9

Snowvision Down Under 2016
The 11th biennial Snowvision Conference,
which coincided with its 20th anniversary,
was held on 3-6 August in Queenstown.
Despite a gloomy forecast, the weather stayed
very good throughout, with plenty of snow and
excellent clear daytime conditions for the skiiers,
golfers and go-karters.
The keynote speaker this year was Dr Patricia
Modica, assistant clinical professor at The State
University of New York (SUNY), who specialises
in neuro-ophthalmic disease. She enlightened
delegates on such tricky topics as multiple sclerosis
and its possible triggers, the facial and cranial
nerves and their defects, and tips on in-practice
screening for neurological defects.
Melbourne “power couple” Professor Erica
Fletcher, from the Department of Anatomy and
Neuroscience at the University of Melbourne, and
Richard Lindsay, a fellow of the American Academy
of Optometry, each shared their knowledge in their
specialty topics, ocular anatomy and contact lenses
respectively. Erica, who has just won the Glen A Fry
Medal from the American Optometric Assocation,
gave some excellent talks on AMD assessment and
understanding the vascular supply to the eye so
we can more accurately diagnose ocular artery and
vein abnormalities and their consequences. Her
clinical seminar on OCT interpretation of retinal
disease was also outstanding, using case histories
to demonstrate diagnosis and management of
difficult conditions. Husband Richard Lindsay is a
specialist contact lens (CL) practitioner and clinical
academic. He talked to us about paediatric CL
fitting and how to troubleshoot rigid and soft toric
CL issues.
New Zealand keynote speakers Associate Professor
Jennifer Craig and husband Dr Simon Dean
delivered a lecture and a workshop respectively
on blepharitis and dry eye which, as usual, were
extremely well received. By training optometrists
to perform the correct up-to-date diagnostic tests
to analyse the ocular surface, there should follow
improved confidence and success in managing this
often frustrating group of conditions.
Auckland ophthalmologist Dr Shanu Subbiah
had a heavy workload with two talks and three
workshops. Shanu has fellowships in anterior
segment, cataract, and medical retina. He gave a
Wellington optometrist, Inhae Park shares her
scholarship report
Linton Dodge from CR Surfacing and Grant Watters congratulating
Beatrice Tan for taking the most scenic go-kart route
BY GRANT WATTERS*
talk and a seminar on pragmatically approaching
the management of glaucoma, with some very
interesting case histories. Shanu’s other, excellent
talk was on the ocular side effects of systemic
medication, often overlooked, especially if a
patient is on multiple drugs. Shanu also ran two
popular, hands-on workshops on gonioscopy/3-
mirror lenses and BIO, with the help of Dr Simon
Dean and fellow speaker Richard Johnson.
Richard, the current head optometrist for
Greenlane Eye Clinic, shared some weird and
wonderful general clinical case histories and ran
the iconic pathology quiz (previously
delivered by Associate Professor Gordon
Sanderson for 20 years), so Richard had
big shoes to fill! No problems there,
with Richard balancing important
clinical pearls with a lively, and often
humorous, delivery. The quiz winner was
Jane Ludemann with her co-practitioner,
Greg Nel, coming a close second. They
were closely followed by Jo Arthur, with
only four points out of a possible 60
separating the top three places.
Well-known professor of public
health at AUT, Grant Schofield, gave
two fantastic talks on metabolic
disease and nutrition. He helped
delegates understand the pathways
leading to cardiovascular disease,
obesity and diabetes to name a few, as well as
offering ways that sufferers could adjust their
diet and lifestyles in manageable ways to help
themselves. Grant’s research is pointing towards
a new balance between sugar, carbohydrate and
fat intake, whilst acknowledging there needs to
be more understanding of individual’s different
requirements in these areas.
The final invited speaker was Dr Hong Sheng
Chiong, an ophthalmology registrar based in
Dunedin and founder of oDocs EyeCare. Hong
reminded us of the statistics on preventable
vision loss in the third world. He and his team
have created a set of inexpensive ophthalmic
examination tools which allow clinicians to
perform mobile eye examinations in various
clinical settings. oDocs is currently looking for
funding for expansion.
Gary Crowley and Annette Powell
Keynote speaker Dr Patricia Modica
Dr Simon Dean, speaker (and photographer) ready
for action
Greg Nel (left) with another delegate and Hoya’s Stuart Whelan
With morning lectures from 6.30-9.30am and
afternoon workshops from 4.00-7.00pm, the middle
of the day was free for skiing and other activities.
For the first time, the Snowvision CLC-sponsored ski
race was held at the Remarkables. This change of
venue went smoothly, apart from a bus break-down
coming home (argghhh no brakes!).
The winning ski team (including
the evergreen Hamish Caithness)
was “Team Hurricane”, edging out
“House Stark”. The fastest male
skier was Tim Eagle (sporting an
impressive “go faster” beard) and
fastest woman skier was Martina
Fellmann. Alex Petty celebrated his
return to New Zealand with the
fastest snowboard run.
This year the ILS-sponsored golf day,
organised by Glenn Bolton, was held
at the iconic “Hills” course, home of
our own New Zealand Open. In cold,
but clear conditions Michael Brown
edged out Francis Hassan with only
four Stapleford points between them
over 18 holes. All-rounder Hamish
Caithness won the prize for the best
drive to the green.
The second biennial CRSsponsored
Go-Kart championship
held at Highlands Raceway in
Cromwell had a successful title
defence by Liam Crowley. The racing
was so close that only one second
per lap separated first from last
in the final. Runner up was Sacha
Sergiew, with Thomas Zerk a close
third.
The organisers would like to
sincerely thank their sponsors for
helping make Snowvision happen,
and continue! OIC and the Way
family have been on board all the
way through as has Graeme Curtis
from CLC. Hoya again sponsored
the opening cocktail function as
they have done now for many years.
Special thanks also to Glenn Bolton
from ILS, Linton Dodge and Sacha
Sergiew from CR Surfacing and
EuroOptics.
See you in two years!
Dr Simon Dean, Kerry Bennett, Tim Eagle, Jill Harrison and Mark Humphries
Middle and right, speakers Professor Erica Fletcher and Richard Lindsay
* Grant Watters is a qualified TPA optometrist, co-owner of
Mortimer Hirst in Auckland and one of the organisers of
Snowvision
Special thanks too to Dr Simon Dean and Greg Nel who kindly
took on the role of press photographers for NZ Optics for this
year’s Snowvision event.
ILS Golf Day: (L to R) Mark Humphries, Andrew Oorschot (ILS’ accountant), Stuart Whelan,
Glenn Bolton, Phil Matthews, Hamish Caithness, Peter Dick, Michael Brown, Francis Hassan
Snowvision 2016
scholarship recipients
In this its 20th anniversary,
the organisers of
Snowvision acknowledged
founding trustees David
Robinson and Hamish
Caithness of the Snowvision
Charitable Trust. The Trust
funds, with the support of
the New Zealand Association
of Optometrists (NZAO), up
to three sponsorships each
year for two optometrists
and one final year student
to undertake four weeks of
clinical study at the State
College of Optometry at The
State University of New York
(SUNY). To date the Trust has
sent about 40 New Zealand
optometrists to New York.
Past winners are required
to each give a brief talk
about their scholarship
experiences at the biennial
Snowvision event and
they are always extremely
enthusiastic about their
experiences, said Snowvision
organiser Grant Watters.
The Snowvision scholarship
recipients for 2016 were
Brent Hooker from Napier,
who’s scholarship is funded
by the NZAO, and Jacob
Benefield of Palmerston
North. Final BOptom year
student, Oliver Munro, won
the student scholarship. ▀
Dr Shanu Subbiah conducting a workshop Glenn Bolton from ILS congratulates golf winner Michael Brown Trustee Dave Robinson congratulates Alex Petty for being the fastest Snowboarder
10 NEW ZEALAND OPTICS September 2016

SPECIAL FEATURE: VISIONZ 2016
What’s on at Visionz 2016
The biennial conference, organised by the New Zealand Optical Wholesalers
Association (NZOWA) and run in tandem with the Association of Dispensing
Opticians (ADONZ), is being held on Friday 14th to Sunday 16th October at the
Ellerslie Events Centre in Auckland.
This year Visionz 2016 will include a comprehensive, one-day low vision conference
on Friday 14 October as part of a targeted educational programme for optometrists,
practice managers and other optical staff, all in addition to New Zealand’s own,
popular industry showcase.
As well as low vision, Visionz – or EduVisionz (the educational side of the event) – will
also focus on the business of optometry with speakers addressing the commercial
aspects of running a business in today’s competitive environment; health and safety in
the workplace, including the opportunity to take part in a St John’s first aid course; the
pros and cons of social media and whether a practice can benefit from incorporating
a social media platform into its marketing strategy; and picking the best team and
getting it right from the start.
Visionz and Eduvisionz, as well as being held in conjunction with ADONZ’s annual
conference, will also incorporate the International Opticians Association (IOA) annual
meeting, which is being hosted for the first time in New Zealand.
And don’t forget the social side: a Visionz ‘Happy Hour’ has been organised for late
on the Friday afternoon and then there’s the popular Gala dinner on Saturday night.
Sign up now at http://nzowa.org.nz/em-registration
Welcome to Visionz 2016
BY GARY EDGAR, PRESIDENT OF NZOWA
Welcome to Visionz & Eduvisonz, the biennial New
Zealand industry exhibition and educational
seminars.
Also a big welcome to members of the NZAO, ADONZ,
NZOWA and members of the International Opticians
Association (IOA) who are visiting from overseas, and are
looking forward to joining us to further their knowledge
and to network with their colleagues.
Whether you are here in Auckland for the Friday low vision
seminar or the educational seminars over the weekend or
the level 1 St John First Aid Course (Saturday), this year’s
Visionz weekend includes the latest in fashion eyewear and
technology that will impress.
Our exhibitors will make your trip worthwhile. They have
worked hard for months preparing for this event so you can
experience the best from your wholesalers.
The Friday evening cocktail party, hosted by the NZOWA,
should be fun with a blind wine taste of various New
Zealand wines. While the Gala Dinner hosted by ADONZ
should be a sell out on the Saturday night.
We will have the passport control again, just answering
a few questions on the exhibitors’ products could see you
flying away with travel prizes and gift vouchers and product
donated by the wholesalers themselves.
There’s even prize draws just for registering.
We hope you enjoy the weekend,
catching up with friends and
networking with colleagues.
When you support Visionz/
Eduvisionz 2016, you are
supporting your industry.
I look forward to welcoming
you in all in October.
Kind Regards
Gary J Edgar
NZOWA President
Gary Edgar, president of NZOWA
Meet the
speakers
There’s a great line up of
23 speakers at this year’s
event, across both the Low
Vision and EduVisionz
programme. NZ Optics
caught up with five of them
to find out a little more
about them and what they
do before we meet them on
the day.
Tell us about being a LinkedIn influencer?
Back in October 2013, I was asked to join the
first 150 LinkedIn Influencers worldwide as the
‘business voice’ of New Zealand. I know there are
people better qualified for the role, but since I’d
developed a relationship with the LinkedIn APAC
team, they knew me and so I readily agreed,
who wouldn’t? It gave me a great platform to
publish long-form opinion stories and enabled
me to grow my network of followers to over
400,000. I share posts and tips on developing
digital marketing as well as just being nicer, a
bit friendlier in business, something I feel there
can be a lack of. So I’ve made the most of the
opportunity and am grateful for the exposure.
Why is social media and digital
marketing so important for businesses
these days?
Digital marketing is huge now, it’s hard to think
of a time when we didn’t have it, but there are
LINDA COLES,
SOCIAL MEDIA EXPERT, BLUE BANANA
still many companies not using it, which is crazy.
Why wouldn’t you want to develop an audience
that are interested in what you do so you can
deepen that relationship with them, and create
some super fans, those that think your product
or service is the bees knees? It’s also a great
way to establish feedback and develop word-ofmouth
marketing, and it’s relatively cheap to do,
not to mention easily measurable.
What are the challenges for optometry
businesses?
I don’t see there are any more challenges for
optometry than any other business. The simple
way to create great content is to figure out what
your audience wants to hear and deliver that
in such a way they want to share it – simple.
Nothing is new; it’s just a bit different than
putting an advertorial together for the local
paper, but this way you get to measure its
success. Optometry is not a barrier to doing great
social media!
Impression FreeSign ® 3
Fully individualised progressive lenses based on 3 unique Rodenstock technologies with option of a separate near refraction.
Individual Lens Technology
Reduces aberrations by taking into account the
interaction between the patient’s facial anatomy,
the frame and the lenses.
Allround
For everyday use
Expert
Preferencing Intermediate - near
Reduction of the aberrations of a progressive
lens by changing near cyl and axis in according
with effective near astigmatism and listings law.
Option of personal EyeLT to include a separate near
refraction.
?
Choice of 3 set designs or fully individualized
lens – allowing you to position the aberration
wherever you want on the lens.
Active
Preferencing distance
Individual
Design your own lens
For more information, speak to your Rodenstock Account Manager or visit www.rodenstock.com.au
ROD082 Impression Freesign3 Insight HPC.indd 1
September 2016
11
NEW ZEALAND OPTICS
7/06/2016 3:49 PM

SPECIAL FEATURE: VISIONZ 2016
MIKE BRUNEL,
CONSULTANT AND AUTHOR
ELAINE SILK,
PRACTICE BY DESIGN
Tell us briefly about your
career?
I left New Zealand to play rugby
in Australia in my teens, got into
sales, then travelled to Europe, like
most Kiwis do, for a few years.
I arrived back in New Zealand
and applied for a position at the
local radio station selling radio
ads. I loved it. After managing
numerous radio sales teams, I
then co-founded NRS Media, a
successful media consultancy
company. Over the last 20
years we have established six
international offices in Sydney,
London, Atlanta, Toronto,
Cape Town and Bogota. With
staff close to 200 people, our
products and services are sold
in 32 countries, in 11 languages
and we have sales in excess of
$300 million a year. We sold the
company to staff and a private
equity company in 2015.
What’s your favourite
campaign and why?
I was awarded a prestigious
media award for raising money
to fund an expedition to Mt
Everest. The campaign itself was
to put three climbers on the top
of Mt Everest: Rob Hall, Gary
Ball and Peter Hillary. Rob Hall,
the expedition leader knew I
represented a number of radio
stations, so he approached my
company with an intriguing idea:
he wanted to broadcast live, back
to our network of radio stations,
on his way to the top of Mount
Everest via satellite phone. Both
the idea and the technology were
quite innovative at the time. The
challenges were quite difficult, and
I will share some of those at m my
presentation.
What challenges do you think
the optical industry face?
Retail is challenging, with
technology and the shift in the
buying criteria changing. Business
owners will win the customer by
positioning themselves as experts.
Authority marketing is becoming
a real trend and takes business
owners out of the price war
and back into talking solutions.
Optometrists are nicely positioned
to take advantage of this trend.
Tell us briefly about your career
so far?
Some hazy years spent at art
college cumulated in a job with a
graphic design studio and, under
the UK Display Screen Equipment
regulations, a compulsory eye exam,
where I met an optometrist who
owned a small group of independent
practices. This introduction to
the world of optometry and my
subsequently becoming a Federation
of British Dispensing Opticians
(FBDO) qualified DO, fused my
passion for creative design with an
understanding of the needs of an
optometry practice and culminated
in me launching my company
Practice by Design.
Why is practice layout so
important?
Optometry practice design is the
art of creating desire for the visual
solutions you provide; elevating its
value by creating an environment that
engenders a receptive mood. Effective
design involves everything your
patient sees, hears, smells, touches
DRI OCT-1 Triton Series
Swept Source OCT now with OCT Angiography
Essilor
With the demands of the modern world many adults are
living with some kind of eye strain including tired eyes,
blurred vision and dry eye. A recent study showed all
users of digital devices – regardless of age, type of device
or frequency of use - feel the same discomfort, related
to the difficulty of reading small characters and screen
brightness. For younger users, the main discomfort is
screen brightness, while for older users, it is the effort
required to decipher small characters.
See. Discover. Explore.
Feeder vessels in a CNV with GA
as they move through the space you
have created. The sensory cues your
patients absorb reinforce messages on
a deep, unconscious level and the look
and feel of the practice leads them to
form conclusions and expectations
about quality, value and trust in your
practice.
What recent trends are you
seeing in practice design?
The desire to elevate eyewear to
a status akin to jewellery has led
to some stunning practice designs
where the frames really are the
centre of attention, with advances
in lighting allowing designers to
highlight the intricate features of
frames. I am also intrigued by the
movement towards more consumercentric
interiors where the needs
of the patient come first. This has
softened and created a more playful
approach to practice design where
the floor plan brings the optometrists
forward, helping to eliminate the
divide between the retail and clinical
functions, creating an open flow and
atmosphere.
What is a key challenge for
optometry practices?
In the US, blindness ranks among
the top four “worst things that could
happen to you” alongside cancer,
Alzheimer’s disease and HIV/AIDS.
When designing an optometry
practice, it’s important to ensure
the practice creates a reassuring
and welcoming atmosphere to
alleviate stress. In the current optical
marketplace, you have to provide a
great patient experience on the clinical
side and a great retail experience on
the eyewear side. It’s up to you to make
your practice their best choice.
To meet these new visual needs, Essilor has designed a
new category of lenses for a connected life. This all-new
range of ophthalmic lenses provides a correction for each
reading distance required by digital devices, relaxes users’
eyes and protects them against the potential dangers of
blue-violet light.
Meet us on ADONZ stand 3 to discuss the features and
benefits of EyeZen lenses and play the EyeZen challenge to
win fantastic prizes!
Swept Source OCT Angiography
OCT Angiography image taken with a Topcon OCT Triton
Courtesy of Dr. Carl Glittenberg, MD Karl Lansteiner Institute for Retinal Research and Imaging
DRI OCT Triton Plus
Multi-Modal Imaging
The Topcon Swept Source DRI OCT-1 Triton Series 1 features a 1 micron, 1050nm light
source with a scanning speed of 100,000 A Scans/Sec., providing multi-modal fundus
imaging.The DRI OCT-1 Model Triton rapidly penetrates all ocular tissue without being obscured by
media opacity or hemorrhage. See you at AAO Booth 3732.
Color FA FAF OCT-A
1. Not for sale in the US.
First combined anterior and posterior
swept source OCT
Triton
For more information visit, newsgram.topconmedical.com/tritonangexport
DRI OCT-1 Series
Extremely fast scanning speed
100,000 A/Scans second
Retinal Journal 1021r1.indd 1
Swept Source OCT now with OCT Angiography
1050nm invisible wavelengths penetrates
Cataracts and Haemorrhages
10/21/15 12:07 PM
See. Discover. Explore.
Feeder vessels in a CNV with GA
RA:28042016/CS
OCT Angiography image taken with a Topcon OCT Triton
Courtesy OCT of Dr. Angiography Carl Glittenberg, MD image Karl Lansteiner taken Institute with for a Topcon Retinal Research OCT and Triton Imaging
Courtesy of Dr. Carl Glittenberg, MD Karl Lansteiner Institute for Retinal Research and Imaging
The Topcon Swept Source DRI OCT-1 Triton Series 1 features a 1 micron, 1050nm light
source with a scanning speed of 100,000 A Scans/Sec., providing multi-modal fundus
imaging.The DRI OCT-1 Model Triton rapidly penetrates all ocular tissue without being obscured by
media opacity or NZ hemorrhage. ) 0508 See you DEVICE at AAO Booth (338 3732. 423)
sales@device.co.nz
www.device.co.nz
Color FA FAF OCT-A
1. Not for sale in the US.
12 NEW ZEALAND OPTICS September 2016
For more information visit, newsgram.topconmedical.com/tritonangexport

EURO OPTICS LTD +64 9 573 5791
S
September 2016
NEW ZEALAND OPTICS
13

SPECIAL FEATURE: VISIONZ 2016
KAREN BAIRD
HR CONSULTANT FOR HUMANKIND
JOHN SAYWELL, CEO, RPM RETAIL
What are some of the typical HR challenges for a small
retail/healthcare business?
A challenge we see a lot of is dealing with poor performance.
Often discussions aren’t held early enough, due to time
pressures on the manager or concerns about how to handle it
or what to say. As the business grows, there also tends to be a
strain on the processes, especially around who is doing what.
Regularly keeping on top of this and catching concerns early
through honest conversations really helps to prevent these
concerns from growing and potentially blowing up further down
the track.
What does Humankind offer businesses too small for
their own HR manager?
A mistake that many small businesses make is thinking that
because they are small there is no need to think about HR.
Reality is, small to medium-sized businesses need just as much,
if not more support than larger companies. We take an approach
that allows you to only use us when needed. We review your
documents and processes and advise you on risks and current
opportunities.
As well as an
initial review,
we help you
understand
the essentials,
making sure
your policies and
employment
agreements are
up to date, you
understand the
latest Health
and Safety
requirements
and, when
issues occur,
we help you
and your teams
through the
processes.
What is your background?
I qualified as a pharmacist then managed
and owned pharmacies and sunglasses
stores in Auckland and Christchurch for 10
years before starting the consulting and
software firm RPM Retail in 2002. Our RPM
Business Intelligence software is used by
over 500 retailers in NZ and Australia to
benchmark store performance, provide
stores with a KPI scoreboard and deliver
actionable daily insights and alerts to store
managers, head office staff and suppliers.
In 2013 RPM merged with Montage
Business Intelligence – a consultancy firm
whose customers include NZ’s leading
agribusinesses, utility companies and a
number of DHBs.
Are optometrists retailers or
healthcare providers?
Both, and the relative percentage of these two components
varies from practice to practice. More importantly however, the
common theme across these two parts of the business is the
one-to-one relationship with customers or clients.
BTP International and Rodenstock
There are exciting things happening on the BTP stand at
Visionz 2016 this year, including the presence of Nicola
Peaper, professional services, Rodenstock Australia, who
will be speaking at ADONZ on the topic of Maximising
Multifocals: Intermediate and Near.
The BTP stand will also feature the Rodenstock
Lens display competence centre as well as the newly
launched Frame and Lens companion range consisting
of German-quality frame and lenses, designed to make
the dispensing of premium quality spectacles easy for
practices.
We will also be running a promotion that will give
attendees the chance to win up to $100 in gift vouchers,
so be sure to visit us on the BTP stand to find out how.
How can retail science help
businesses blossom?
Business models are being disrupted
more rapidly than ever as the
information revolution changes the way
goods and services are delivered. I have
a simple approach that relies on three
simple steps: measure, plan, act. Because
good plans can’t be made without
knowing where you are now, gathering
data is the first step. Then, once plans
have been translated into new activities,
it is vitally important to measure
results so actions can be fine-tuned or
redesigned. Customer behaviours can be
understood through the measurement
of transactions, particularly if data from
a large number of stores or outlets is
combined for benchmarking purposes.
In my role as a retail scientist, I help
businesses to interpret their data to find patterns which show
what works and what doesn’t so their performance can be
continuously improved.
OptiMed
OptiMed represent quality, value and innovation with
our new diagnostic products offering very exciting
additions to our range for 2016. On display at Visionz
we will have the Eidon Wide Field Confocal Scanner,
plus other innovative imaging technology. Our supply of
pharmaceuticals and consumables can be ordered online
or by calling our friendly customer services team (see
our ad in this issue of NZ Optics for contact details). Our
slogan “OptiMed, Servicing All Your Ophthalmic Needs”
defines us as a company where service is our strength
and focus.
Robert and Craig invite you to come and view our booth
to discuss your interests, have a coffee and chat or just to
enter our competition.
We invite you to experience the EyeZen Challenge
at ADONZ conference Booth No 3
WIN Fantastic prizes !
www.eyezen.co.nz
00303_Eyezen_NZOpticsAd_APR16.indd 1
14 NEW ZEALAND OPTICS September 2016
8/04/2016 11:24:05 AM

NZ
0800 447 272
EYESRIGHT.CO.NZ
September 2016
NEW ZEALAND OPTICS
15

SPECIAL FEATURE: VISIONZ 2016
Best of the rest
Other speakers include NZ Optics’ own,
itinerant business columnist, Juanita Neville-
Te Rito, writer and speaker Tanya Unkovich,
Nicola Peaper of Rodenstock Australia and Stu
Allan of Optics NZ. The Low Vision programme
includes speakers such as Professor Stephen
Lord, a senior principal research fellow at
Neuroscience Research Australia in Sydney, Dr
Alan Johnston, a former Reader and Associate
Professor in the Department of Optometry
at the University of Melbourne, plus Dr Mike
O’Rouke from Tauranga Eye Specialists, who
carried out the first Australasian CentraSight
surgery earlier this year, and John Veale, founder
of the Lighthouse Vision Trust and director of the
Low Vision Clinic at Burwood Hospital.
ADONZ and IOA at Visionz 2016
The Association of Dispensing Opticians of New
Zealand (ADONZ) National Conference will be
held from 9am Friday 14 to Sunday 16 October at
Ellerslie Event Centre, Auckland in conjunction with the
2016 Visionz show.
In a New Zealand first, ADONZ is also playing host
to the International Opticians Association (IOA)
Convention from Thursday 13 to Friday 21 October; the
ADONZ conference contains the educational portion of
the convention and then delegates will enjoy the sights
of the North Island of New Zealand.
International speakers at this year’s conference
include: Elaine Grisdale, head of professional services
and international development at the Association
of British Dispensing Opticians (ABDO), who returns
following her popular sessions at last year’s conference
in Hamilton; Fiona Anderson, ABDO president, who
will share her knowledge of paediatric dispensing;
Barry Duncan, ABDO head of policy and development
who will discuss why
professionalism and
commercialism work;
and Julien Porte, head
of sales, Asia & Pacific
Tanya Unkovich
for Morel Lunettes who
will discuss Frames.
Other speakers
include Samantha
Bennett, Asian, migrant
and refugee health gain
manager for Waitemata
and Auckland DHBs;
Nicola Anstice and
Samantha Simkin
from the University of
Auckland; Auckland
ophthalmologists Dr
Justin Mora and Dr
Trevor Gray; ODOB’s
Lindsey Pine; Vineet
Prof. Stephen Lord
Fiona Anderson, ABDO president joins
colleague Elaine Grisdale at ADONZ
National Conference this year
Chauhan and Gordon Stevenson from Essilor NZ;
orthoptist Carly Henly; and behavioural optometrists
Grant Dabb and Evan Brown.
Given the presence of delegates from the IOA, other
programme highlights include a series of State of the
Nation reports from other countries represented.
For more and to register visit: http://conference.
adonz.co.nz
SPECIAL FEATURE: CCLS Conference
Independent Lens Specialists (ILS)
At Visionz, Independent Lens Specialists (ILS) will be launching the Chemtech
range of Readymade specs with “Blue Control” lenses. Designed to be more
comfortable for patients that require a simple readymade script with the added
benefit of protecting their eyes from the high-energy blue light from digital
screens and devices.
Plus, come and see the new Progear Sportshades, a high-quality sports range
of glasses designed from the ground up for prescription lenses. This product
can be custom-made to suit the patient. Matching the Sportshades with our
Alpha Sport/Outdoor Progressive makes an unbeatable sport and outdoor
combination. Visit us on booth #60.
Euro Optics
Euro Optics will have a number of new product releases on display at Visionz.
The just released Bakers Eyewear collection will be displayed, including an
optical collection and easy RX sunglass collection. Be sure to check out this new
range and the great sales package on offer. The Adidas range will feature the
new Adidas originals optical frames in metal and plastic and new additions to
the Adidas performance sunglass collection, which can also be used in sun-rx
packages. The collections of Inface, Danati and Italia Independent will also be
on display highlighting the latest releases.
Elegance In Eyewear will be highlighting the new custom-built displays
Silhouette now offer along with the latest releases in all segments of full-rim,
semi-rimless and rimless products.
Be sure to pop into the stand and get your chance to spin the wheel to take
advantage of special prizes on offer when you place an order.
Eyes Right Optical
Eyes Right Optical is proud to introduce you to Prodesign’s Danish Heritage
collection. This is a modern eyewear collection, design-influenced by Danish
architecture and furniture from the golden age of the 1940s and ‘50s, with
subtle references to the Viking era like the logo emblem, which is based on
the Viking symbol for everlasting. Prodesign has turned it into a chiseled icon
signifying the craftsmanship that goes into every frame Prodesign make.
Come and check out all the latest products from Eyes Right Optical at Visionz
2016 – see Face à Face, Koali, ÖGA, Kensie, Dana Buchman, Timex, TMX and, of
course, Prodesign Denmark, including its latest Danish Heritage collection!
24 ChemTech frames and 1 free display
ChemTech has been newly redesigned by
Eyenavision to offer a readymade solution
to help ease digital eye strain. Lightweight,
fashion reading glasses now feature our
prescription quality lenses with a proprietary
coating to combat the blue light emitted by
screens, tablets, smartphones, and other
digital devices.
• Clear 1.56 index lenses with a special
anti-reflective coating that filters blue light
• Reduces glare, improves contrast and focus
without distorting colors or images
• Available in plano and single vision
intermediate distance power from +0.25 to
+3.00
Showcase your ChemTech products in
our new ChemTech POP display! Each
ChemTech frame includes a box, cloth,
case, and eyewear lanyard.
eyenavision.com
$12.50 per ChemTech VISIT US Frame ON STAND #60
TO REGISTER
We invite you to
register online at
www.nzowa.org.nz/conference
Visionz
2016
TM
888-321-3939
Distributed by:
phone: 09 443 0072
email: tim@oic.co.nz
16 NEW ZEALAND OPTICS September 2016
8 NEW ZEALAND OPTICS May 2016

Making the most of Auckland
There’s always
something
exciting
happening in the
City of Sails and
October is a great
month to enjoy
some outdoor
activities. Here are
our top picks:
1 Devonport – take a ferry
from the waterfront and find
yourself in the beautiful North
Shore suburb of Devonport.
With its heritage buildings and
bunting, you might mistake it
for Kensington in the 1950s and
there’s a large choice of eateries.
2 Da Vinci Machines exhibition
– a collection of beautifully
crafted replica machines, based
on the drawings of visionary
Leonardo da Vinci, will be on
display until Sunday 16th October
at the Museum of Transport and
Technology (MOTAT), Western
Springs. Many of the exhibits
are hands on – and many would
never have actually been made
by da Vinci himself, but modern
techniques have allowed us to
realise his dreams.
3 Lunchtime concert series –
Held on Friday 14th October,
1 – 2pm, at the University of
Auckland music theatre on
Symonds Street. These free,
public performances are a great
way to spend your lunch hour.
4 Sky jump – for the adrenalin
junkies among the delegates.
Ascend the Sky Tower and then
leap off in a controlled freefall of
192 metres back to street level.
Not your thing? Then why not
just enjoy afternoon tea and the
view from Sky Tower’s Orbit 360
restaurant.
5 Dinner at The Stables –
Elliot Stables just off Queen
Street offers an eclectic dining
experience, perfect for big
groups. With a selection of
different outlets to order from,
table service and a bar, grab a
few colleagues and catch up over
a good meal.
6 Something else? – For those
with a little more time, there’s
wine tours on Waiheke, a train
trip up Rangitoto, a chance to see
native birds on Tiritiri Matangi
or our sea life, up close and
personal, at Kelly Tarlton’s Sea
Life Aquarium, and it’s always
fun to stroll down Federal Street
to Aotea Square, stopping for a
wine on the way.
General Optical
General Optical (GenOp) is proud to announce it has extended its
partnership with Tritan Imports to deliver all of the GenOp brands across
New Zealand. Come say hello to Koenraad Groot and Pablo Hurford at the
GenOp booth at Visionz 2016 and explore some of our brands, like Calvin
Klein, Diane Von Furstenberg, Dragon, Nike, Salvatore Ferragamo, Skaga
and many more!
Device Technologies
Device Technologies is pleased to be representing exciting new equipment
during the Visionz 2016 conference, including TearScience’s Lipiview II and
Lipiflow complete solution suite to treat meibomian gland dysfunction and
Topcon’s ergonomic and time-saving devices designed to help the modern
optometry practice. Topcon’s technology suite includes the CV-5000
Computerised Vision Tester; the computerised Lensmeter; the TRK-2P 4-in-
1; the 5-in1 KR-1W Wavefront Analyzer with the combined technologies of
wavefront aberration, corneal topography and autorefraction; the latest
generation sensor LED video slit lamp; the swept source (with OCT-A) and
spectral domain anterior and posterior OCTs; as well as a full range of
chairs and stands. Plus, we also have the new Captiv8+ for better patient
communication.
Ophthalmic Instrument Company (OIC)
OIC look forward to welcoming you onto our stand at Visionz. We will have
the Nidek RS-330 DUO on display, which combines high-resolution retinal
photography with optical coherence tomography (OCT). Also on show
will be the Nidek RS-3000 Advanced SLO based OCT, which includes OCT
Angiography. The latest release from Nidek is the compact HandyRefK,
a highly portable, handheld auto refractor/keratometer, which also has
an opacity measurement function for imaging and quantifying cataracts
with central and peripheral opacity indexes. Come and try the new Nidek
TONOREFIII, which combines auto refraction/keratometry, non-contact
tonometry and pachymetry into a single compact unit, saving on space
and improving patient flow through the practice. There will also be a large
range of optical supplies and equipment on display - a solution for all your
practice requirements - so come and have a chat with us.
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The program comes with
visual merchandise and a
dispensing kit for easy up
selling and marketing.
New styles and exciting
new brand Cole Haan
launching SS 2016/17.
Check out our
stand at VisionZ
2016 Auckland
Pablo Hurford
New Zealand Account Manager
P: 0800 141 444
M: 022 412 5044
E: phurford@genop.co.nz
W: www.generaloptical.co.nz
September 2016
NEW ZEALAND OPTICS
17

RANZCO appointments
The Royal Australian and New Zealand
College of Ophthalmologists (RANZCO) has
elected Associate Professor Mark Daniell to
be their new president.
A/Prof Daniell is a senior consultant ophthalmic
surgeon and the current head of the corneal
service at the Royal Victorian Eye and Ear Hospital
in Melbourne. He is the founding chair of the
ANZ Corneal Society, medical director of the Lions
Eye Bank and also head of surgical research at the
Centre for Eye Research Australia. He previously
served on the RANZCO Board for 10 years, most
recently as vice president.
As RANZCO president, A/Prof Daniell says his
focus will be on advancing ophthalmology as a
profession, enhancing professional standards and
advocating for eye patients in the medical system.
“RANZCO plays an important role in improving
eye health outcomes for people across Australia
and New Zealand, and further afield, by ensuring
the highest possible standards of ophthalmology
training and representing the interests of people
with eye health problem. As president I aim to
build on the important work that we have done
in improving people’s eye health and further
RANZCO’s position as a leading provider of
medical education and professional and patient
advocacy.”
Outgoing RANZCO president, Dr Bradley
Horsburgh said, “As vice president, Mark was
dedicated to furthering the objectives of
the profession and the patients who rely on
ophthalmology. He was an enormous support
to me in my role as president and I am confident
that his expertise, determination and drive will
make him an excellent and successful president.”
A/Prof Daniell will serve as president elect until
the RANZCO Congress in November when Dr
Horsburgh stands down.
New censor-in-chief
In other news, Auckland Eye’s Dr Justin Mora
has been appointed censor-in-chief at RANZCO.
New Bailey Nelson practice
Australian-based Bailey Nelson have
continued their expansion in New Zealand
by opening a fourth outlet in Takapuna,
Auckland. The new store, or boutique as they
prefer them to be called, opened its doors in July.
Other Bailey Nelson boutiques are in Ponsonby,
Auckland, Wellington and Riccarton, Christchurch.
“The Takapuna store was really driven by
customer demand,” says JC Hinsley, NZ country
manager for Bailey Nelson. “People visiting our
boutique in Ponsonby would ask us, ‘when will
you come to the North Shore?’ Takapuna is a
great, developing location and we are looking
forward to being part of the local vibe.”
Bailey Nelson launched in Australia in September
2012, originally just selling frames at the Bondi
markets before moving into bricks and mortar
stores and full optometry services. It keeps costs
low by manufacturing its own products, allowing
the company to provide glasses, plus lenses and
coatings, for as little as $125.
“We source our materials globally, our acetate
Bailey Nelson Takapuna has a vintage beach theme
Previously the chief examiner, a role he has held
for five years, Dr Mora was elected to his new
position on 23 May.
“I have thoroughly enjoyed my job as chief
examiner but this new role has far greater scope
as it encompasses all the education programs of
the College,” said Dr Mora. “I can’t pretend I’m
not a little anxious about the amount of work
it will entail but I am looking forward to the
challenge.”
The role means Dr Mora will be the head
of education for RANZCO and responsible for
training programme selection, the training
itself, accreditation of training hospitals,
assessment of overseas trained ophthalmologists
and continuing education for the 1200
ophthalmologists in Australia and New Zealand.
Dr Mora was also made a director of RANZCO
and takes on both posts from September. ▀
A/Prof Mark Daniell will take up the reins at RANZCO
from November
is sourced from Mazzucchelli in Italy, and we
work closely with our manufacturers,” says
Hinsley. “We design in-house to create ranges
with what you could call vintage futurism, but
we prefer ‘classic with a twist’ with new frame
ranges released regularly.”
The company now has 20 stores in Australia, he
says. “Our hallmark is to provide a professional
rather than clinical optometry service, blended
within a retail environment.”
This retail environment is something Bailey
Nelson spends a lot of time thinking about, says
Hinsley, with each store having a cohesive feel
while still maintaining a local flavour.
“Our Ponsonby store is all about dark wood and
features celebrating the craft behind creating our
eyewear, while our new Takapuna boutique has
a more relaxed, beach-chic vibe, with surfboards
and a clean, vintage flavour,” says Hinsley. “We
like to take inspiration from the local area and we
see each of our boutique designs as a part of the
community.” ▀
Results of global myopia survey
The full results of a global
survey into myopia
management will be
presented at the first ever British
Contact Lens Association Asia
(BCLA) event this month.
More than 1,000 eye care
practitioners from across the
world were asked about their
views on the increasing rates of
myopia in children, and their most
frequently prescribed myopia
management strategies and their
relative effectiveness. Practitioners
were also asked their reasons
for prescribing conventional
spectacles when myopia control
strategies are available.
Results reveal that eye care practitioners are
generally aware of a range of different methods of
myopia control.
In a statement promoting the event, BCLA
keynote speaker Professor James Wolffsohn said,
“Unsurprisingly, concern was the highest among
eye care professionals in Asia, where myopia
is most prevalent. However, regardless of their
geographical location, practitioners correctly
GenOp NZ appointment
General Optical (GenOp) announced that
Tritan Imports, a distributor of action
sports gear based in Mt Maunganui, will
represent the entire GenOp portfolio and look
after GenOp’s New Zealand customer base. Tritan
has been distributing Dragon sunglasses to the
New Zealand market for the past seven years,
so it was an obvious choice to take on the full
portfolio of brands, said Paul Jones, GenOp’s head
of sales and marketing.
“In the last seven years, Tritan has delivered
exceptional customer service while taking the
BY STEVE STENERSEN & SUE KAIN
Professor James Wolffsohn
It is with much sadness that we are writing this
obituary for our special friend, Dr David Wilson.
We met David back in the mid-90s while
ADONZ was negotiating with the Open Training
and Education Network (OTEN) to deliver David’s
dispensing optician’s course to New Zealand. This
allowed New Zealand to have access to OTEN,
their resources, and a group of brilliant teachers.
What started as a professional relationship very
quickly became a personal friendship with David,
his wife Jan and their son Andrew.
David was a very clever man. He was also
extremely humble and always happy to share
his knowledge with anyone who asked for
his help. This is evident within ADONZ where
David personally taught more than half of the
members. The rest will have, at some stage in
their career, attended one of the many lectures
David wrote and presented to New Zealand.
David not only taught dispensing opticians,
he taught optics to optometrists and
ophthalmologists in Australian universities. He
was regarded as a world class lecturer, lecturing
throughout the globe with the Brien Holden
Vision Institute.
In 2012 David received his PhD after three and
a half years of study and research. Part of his
PhD involved a feasibility study on the viability
of using donated second-hand glasses in low
socio-economic countries. After proving it was less
expensive to use ready-made or cheap single vision
glasses, he received threats from prison inmates
whose job it was to sort the donated spectacles.
Each year at ADONZ conference there is a
dress up theme. David always embraced this
and participated each year. One particular
year David got a whisper he was going to be
court marshalled for being an Australian. The
punishment was to perform the Haka in front
of everyone. When the time arrived David took
his punishment good naturedly. He stood front
and centre on stage, dressed as Dracula, and led
the Haka perfectly. What no one knew was that
David had practised the Haka to perfection. He
knew the words, the meaning of the words, the
stances, facial expressions, and all the actions.
identified orthokeratology,
pharmaceutical agents and
outdoor activity as the most
effective methods to slow down
myopia progression.
“Nevertheless, two thirds of
practitioners would still only
consider conventional glasses
or contact lenses for correcting
their myopic patients, citing
increased cost (35.6%), the lack of
convincing information (33.3%)
and unpredictable outcomes
(28.2%) as the main setbacks.”
A survey in Hong Kong,
indicated that orthokeratology
was the most commonly known
treatment for myopia control
in children. Although parents were receptive to
the use of orthokeratology for myopia control in
children, however, the survey also showed they
were conservative with the use of contact lenses
for myopic correction only, with safety cited as the
major concern.
Full results will be presented during the inaugural
BCLA two-day conference in Hong Kong from 13-14
September. ▀
Dragon brand to new
heights. We know they’ll
do the same for our full
portfolio of eyewear and
lenses.”
Tritan chief executive
Koenraad Groot has
appointed Pablo Hurford
Pablo Hurford, GenOp’s
new NZ account manager
as GenOp’s account manager to focus entirely on
GenOp’s New Zealand customer base. Hurford
has an extensive background in retail sales
management and will be based in Auckland. ▀
Obituary: Dr David Wilson
19/12/1954 – 21/07/2016
After that effort he
earned his “Honorary
Kiwiship”.
Since 1995, the
Dr David Wilson
contributions David
has made to dispensing
opticians in New Zealand is, in our opinion,
unsurpassed. In that time he helped set up
OptiBlocks and remained on the management
team until he passed away. Each time OptiBlocks
moved premises David was always there to help
pack, transport, and unpack the equipment in
the new premises. He attended every conference
for 22 years, except one, when he was in hospital
receiving treatment. He wrote and delivered
lectures and CPD articles for New Zealand DOs
every year. He researched legislation and attended
Board meetings on behalf of our industry. The
most amazing part is that it was done in David’s
own time, and mostly at his own expense.
David had a great sense of humour. He loved
a good laugh and did not mind if it was at his
own expense. He enjoyed recalling stories, often
where he was the butt of the joke. One story
in particular involved drilling holes in a bench
for a hand edger. David had “taken control” of
measuring the placement of holes for edging
machines. He carefully measured several times
the holes that were to be drilled. Unfortunately
David had turned the machine upside down
to take the measurements. The finished holes
ended up a mirror image of what was required
with the placement being reversed.
One of David’s passions was writing. He spent
most of his time writing, or reviewing other
authors’ work while employed with Brien Holden
Vision. He wrote a style guide (17 versions) to
ensure each author wrote the same way and
allowed the text to flow between authors.
David was the main author for two text books,
Practical Optical Dispensing and Practical Optical
Workshop. These were both updated last year.
It was hoped David would write material for the
new dispensing optician’s course in the pipeline.
David’s death is a terrible loss and the New
Zealand industry will never quite be the same
without him. He was a special friend who we will
miss forever. ▀
18 NEW ZEALAND OPTICS September 2016

NACBO 2016 – Seeing Beyond Illusion
BY EVAN BROWN*
The Australasian College of Behavioural
Optometrists National Annual Conference
provides an outstanding opportunity to gather
great clinical pearls and this year was no exception.
Ten Kiwi’s managed to attended the conference
and listen to this year’s speaker, Dr David Cook,
a pioneer in using 3D movies in strabismus
treatment and a 35-year veteran of vision therapy
from the US. David discussed his experience and
methodology, what works consistently for him in
the non-surgical management of strabismus and
amblyopia, the importance of prescribing lenses
and individualised vision therapy programmes.
David had been to Auckland with much of this
programme in April 2013 (Kiwis beat the Aussie’s
again), but like most learning opportunities,
you get more the second time around;
previous experience allowing more insight and
understanding about the message being conveyed.
If you are interested in strabismus and amblyopia
treatment and have not had an opportunity to
listen to David, I recommend you line up for one
of his seminar’s in the USA, which he holds on a
regular basis.
ACBO’s National Annual Conference is also a
celebration, ending a two to three-year process
for those vision therapists and optometrists who
have chosen to extend their skills and knowledge
base by becoming certified in Vision Therapy and/
or becoming a certified Fellow of the College. Nine
vision therapists completed their comprehensive
practical vision therapy course journey, begun in
February 2015, this year, including Kiwi optometrists’
Noel Templeton, Sally Blohm and Cindy Tsai.
The ACBO practical vision therapy programme
is designed to meet the needs of vision therapists
and optometrists looking to diversify and meet the
needs of more patients by providing gold-standard,
Kiwis tapped to pen CL “bible”
The sixth edition of Contact Lenses, the
international textbook considered “the
bible of all things contact lenses” involves a
record number of Kiwi contributors.
Joining Auckland optometrist Kerry Atkinson,
the sole Kiwi contributor for the last five editions,
are Associate Professor Jennifer Craig, optometrist
Grant Watters from Mortimer Hirst, and South
Island optometrist Michael Curtis.
It’s a great honour, says A/Prof Craig, who is
writing the dry eye and tear film chapter with Dr
Laura Downie, from the University of Melbourne.
“Dry eye has moved on enormously … we’ve
learnt a lot since the last edition (2007). So it’s
wonderful it continues to be updated so students
get a contemporary textbook.”
Watters and Curtis are updating the chapter on
Cosmetic and Prosthetic Contact Lenses, while
Atkinson has already filed his updated chapter
on Patient Management.
The approach to patient management has
changed considerably since he first wrote on the
subject in the early 70s, he says. “It’s changed
from a paternalistic approach to a far more
participatory approach.”
The book is edited by Tony Phillips, associate
professor at Flinders University, Melbourne, and
Lynne Speedwell, head of optometry, clinical &
academic, at Great Ormond Street Hospital for
Children in London.
Editing the chapters is an “exercise in
masochism,” laughs Atkinson. “Tony’s wife
threatened to divorce him three editions ago!”
Atkinson, who is also a professional teaching
fellow at Auckland University, was involved
in the original group of authors from City
of London University. “Tony Phillips and I
were members at that stage. Our head of
department, (Professor) Robert Fletcher wanted
it and so it took off from there.”
With A/Prof Phillips’ move to Australia and
Atkinson’s return to New Zealand, the number
of antipodean contributors have grown
significantly. “It is exciting. Australia and New
office-based vision therapy. The programme
provides relevant theory and understanding on
the development of vision problems and options
for management. This is balanced with a strong
practical experience, which focuses on delivering
therapy techniques to maximise results. ACBO
now offers the programme in New Zealand and
the first group, with 16 optometrists, began
in February this year in Auckland. The second
workshop is scheduled for October.
More information on the ACBO Practical Vision
Therapy programme, the Optometric Extension
Programme (OEP) and OEP VT for strabismus and
amblyopia can be found on the ACBO website:
www.acbo.org.au/professionals/menu/events ▀
* Evan Brown is a certified behavioural optometrist with
specific interest in visual dysfunctions related to learning and
paediatric optometry. He is co-lecturer for the ACBO Practical
Vision Therapy Programme and clinical co-director for the NZ
Special Olympics Healthy Athletes Opening Eyes Programme.
Zealand have a
depth of contact
lens knowledge
that often isn’t
acknowledged
because we are
just a pimple at
the Pacific Ocean’s
bottom, but the
Australasian system
has been producing amazing academics from
Brien Holden’s time onwards.”
Contact Lenses is used by undergraduates
and teaching staff, and as a “great reference”
book for post graduate optometrists and others
interested in contacts lenses globally, says A/
Prof Craig, who admits using the book herself at
University.
Described as “a definitive reference work on
contact lenses for optometrists, dispensing
opticians, ophthalmologists and contact lens
practitioners,” it is due to be printed this year. ▀
New ACBO
Fellows
Auckland-based optometrist Evan
Brown and Victoria-based optometrist
Connie Tsang completed the ACBO
fellowship process and were presented
with their certificates at the end of July in
Sydney at the Phantom of the Ocular NACBO
2016 Dinner, a fabulous black tie evening
generously sponsored by CR Surfacing.
New Zealand now has three ACBO
practicing fellows, Richard Shanks, Grant
Dabb and Evan Brown, for colleagues to make
referrals too for binocular vision dysfunction,
oculomotor dysfunction, visual perceptual
developmental delay affecting learning and
neuro-optometric rehabilitation following
acquired brain injury. Evan Brown and
fellow New Zealand-based optometrist Niall
McCormack are also fellows of the Americanbased
College of Optometrists in Vision
Development (COVD).
For optometrists interested in the path
to fellowship with ACBO, the study camp
for intake this year is 22 and 23 October in
Melbourne. Refer to ACBO’s website for more
information. ▀
Connie Tsang and Evan Brown are made fellows of ABCO
12th Annual Scientific Conference
11th Annual Scientific Conference
Join us for an exciting new education format
Margaret Lam, is our 2015 International Invited
CONFERENCE for Optometrists, Lecturer, she Dispensers a highly sought-after & Staff speaker at
CONFERENCE Saturday afternoon conferences November throughout 5th the – Asia-Pacific Workshops and only is an
owner/optometrist of a small group of successful
Dispensing Optician
Sunday full day November 6th – Conference only
independent optometry practices in Sydney,
Conference
Sunday
collectively called “theeyecarecompany”.
and
Jason Holland is our 2016 International
8 th November 2015Invited Lecturer, Margaret's he is a practice-enhancing highly sought-after lectures will include:
Optometry Conference
8.00am - 5.00pmspeaker at conferences throughout the
Sunday
• Ocular therapeutics and contact lenses - two peas in a pod
Asia-Pacific and is a busy clinician from
6th November 2016
• From Little Things, Big Things Grow - Practice Growth Strategies
Venue:
Brisbane with a passion for expanding
8.00am - 5.00pm
• Update on keratoconus management: optimal care guidelines
Waipuna Hotel & shared-care responsibilities
for keratoconus
for
patients,
glaucoma
CL management of keratoconus
Conference Centre, and ocular surface disease patients.
1/2 day workshops
and working with ophthalmologists
58 Waipuna Rd,
Saturday PM Mt Wellington, Auckland
5th November 2016
Registrations:
Registrations:
Registration:
Phone. 09 522 2125 Fax. 09 522 5770
Venue:
Phone 09 522 Email. 2125 conference@eyeinstitute.co.nz
Fax 09 522 5770
8.00am - 8.30am
Waipuna Hotel & Light Meal & Beverages
Email conference@eyeinstitute.co.nz
Register Online. eyeinstitute.co.nz/optometry
Conference Centre provided Register Online eyeinstitute.co.nz/optometry
for your 2015/2016 CPD Credits
58 Waipuna Rd
BOOK NOW!
Mt Wellington Auckland
for your
(including
2016/2017
Therapeutics)
CPD Credits
(including Therapeutics)
BOOK NOW!
Thanks to our Conference Sponsors:
Thanks to our Conference Sponsors:
GOLD SPONSORS
GOLD SPONSORS
SILVER SPONSORS
CORNEAL LENS
CORPORATION N.Z. LTD
ideas into practice
SILVER SPONSORS
BRONZE SPONSORS
September 2016
NEW ZEALAND OPTICS
19

Focus on
Eye Research
Thyroid eye disease, epiphora,
and ptosis after ocular surgery
CHUNDURY RV ET AL. ORBITAL RADIATION
THERAPY IN THYROID EYE DISEASE
Ophthal Plast Reconstr Surg 2016; 32:83-89
As the role of supportive therapies such as selenium
and biologic agents in the treatment of thyroid eye
disease (TED) continue to evolve, orbital radiation
therapy (ORT) is a longstanding, but contentious
mode of medical treatment of TED. This review
considered a wealth of existing data, and its
shortcomings, in an effort to understand the role of
ORT in TED.
A dose of 20Gy delivered to each eye in 10 fractions
over 10-12 days is common, but different sources of
radiation, classification schemes and compounding
effects of adjunctive glucocorticoid use means
that comparisons between studies is challenging.
This paper considers all the available data as a
whole and concludes that between 50-90% of mild
moderate TED patients treated with ORT will have
some improvement in motility, proptosis and clinical
activity when it is given early in the disease. ORT may
also help prevent vision-threatening complications
such as compressive optic neuropathy. The beneficial
effect of ORT can be enhanced with concomitant use
of glucocorticoids. Re-irradiation has been used with
some success, however there is little data regarding
safety and efficacy.
Much data exists to demonstrate ORT is safe in
patients without predisposition to retinopathy.
Patients with retinopathy risk factors, particularly
severe hypertension and diabetes may be at higher
risk. The risk of cataract development appears very
low.
The theoretical increased risk of brain and bone
malignancy has not been observed in large
retrospective studies with long-term follow up,
although some still limit the use of ORT to patients
greater than 30-35 years because of this concern.
The authors concluded that although ORT is rarely
used as a first-line agent, it is a safe option in the
armamentarium available for management of active
TED.
MANSUR C ET AL. EVALUATION AND
MANAGEMENT OF CHEMOTHERAPY-INDUCED
EPIPHORA, PUNCTAL AND CANALICULAR
STENOSIS, AND NASOLACRIMAL OBSTRUCTION.
OPHTHAL PLAST RECONSTUCT SURG 2016; JULY
(EPUB AHEAD OF PRINT).
Epiphora is a recognised adverse effect of chemo
therapeutic agents whose extent is probably
under appreciated by both ophthalmologists and
oncologists.
This elegant literature review identifies various
agents known to cause epiphora, the mechanisms
and appropriate management paradigms.
Most commonly associated are 5-Fluorouracil
(5-FU) and Docetaxel which cause dose dependent
epiphora in up to 50 and 64% of patients
respectively; this is reversible with prompt
treatment. The agents are secreted in tears, and
appear to cause canalicular, lacrimal sac and
nasolacrimal duct fibrosis.
A trial of corticosteroid with probe and syringe
appears effective in cases of low dose or short-term
treatment, but patients receiving high frequent
dose 5-FU or docetaxel, silicone stenting at the
first sign of recurrent or progressive canalicular
stenosis can prevent irreversible canalicular scarring.
Unfortunately, prophylactic topical corticosteroid
have been proven to be ineffective.
Other agents less commonly found to cause
epiphora secondary to nasolacrimal obstruction
included radioactive iodine (I-131), which at high
doses is preferentially taken up by nasal tissue.
Females and those over 45 years old were more
likely to develop epiphora.
F-1, an oral drug composed of tegafur (pro-drug of
5-FU) and oteracil, as well as mitomycin C (MMC),
also cause stenosis of the lacrimal drainage pathway
at the punctum, canaliculus or distal nasolacrial
duct. Onset of effect is within three months.
Interestingly MMC is often used to prevent fibrosis
DR JAMES SLATTERY*
of the lacrimal drainage system after surgery.
Epiphora is the second most common side effect
of Imatinib. Unlike other agents, the mechanism
is via hypersecretion and mechanical blockage of
puncta by conjunctivochalasis coupled with pump
dysfunction secondary to periorbital oedema.
Practitioners must be aware of stenosis or
obstruction of the lacrimal drainage system as
a possible adverse effect of these agents. Early
recognition and appropriate treatment may obviate
the need for more invasive and complicated
surgical treatment and so evaluation of drug
type, and thus likely cause of epiphora, with
prompt appropriate referral is critical.
GODFREY K. BLEPHAROPTOSIS FOLLOWING
OCULAR SURGERY: IDENTIFYING RISK FACTORS
Curr Opin Ophthalmol 2016;27:31-7
Ptosis is common following ocular surgical
procedures. Nearly one third of acquired ptosis is
postsurgical. This literature review attempts to
identify the incidence of this poorly understood
complication post ocular surgery, and shed light on
its likely contributing factors.
Cataract surgery is the most commonly performed
ocular surgery and randomised prospective studies
document the incidence of post cataract ptosis
to be somewhere around 6-12%. Use of a bridal
suture in addition to an eyelid speculum nearly
doubles the risk. The incidence is similarly around
10% post refractive surgery, such as laser in situ
keratomileusis as well as trabeculectomy, as
documented in the collaborative initial glaucoma
treatment study (CIGTS). Adjuvant use of
mitomycin C (MMC) increased the risk. There
are documented cases of ptosis following serial
intravitreal injections of anti-vascular endothelial
growth factor and steroid, but appropriately
powered studies are lacking.
Ptosis can be caused by interruption to any of
the delicate structural and functional relationships
of the eyelids although levator dehiscence is likely
the common denominator. Several studies recognise
individual patient anatomy to confer highest risk of
postoperative ptosis and it is probable that patients
with tenuous levator attachment and subclinical
ptosis are at highest risk. Operative time may play a
role but there is no consensus in the literature.
Theories such as a tight speculum reducing blood
flow to the levator muscle, horizontal eyelid stretch
and contraction of orbicularis against speculum
causing dehiscence have been postulated, or
that compression of myoneural or myovascular
structures contributes. Myotoxicity from local
anaesthetics has also been suggested, but has not
been validated in the literature.
Risk can be minimised with use of topical
anaesthetics and avoidance of bridal sutures and
specula where possible. If a speculum is required,
using the shortest possible horizontal arm and
reduced vertical eyelid displacement should be
considered. Studies have shown disposable specula
are significantly less stiff than reusable ones, which
may reduce the risk.
Even with optimum technique, ptosis can still occur
and this should be discussed during informed
consent. Repair is possible with high rates of
success but requires an additional surgical
procedure. ▀
ABOUT THE AUTHOR:
* Dr James Slattery holds
an MBBS, PhD, B Sci
(Biomed), and is an
oculoplastics fellow
at the University of
Auckland. He trained
in Adelaide, South
Australia.
Labour of love with touch
of madness
BY SIMON ESKOW
What would inspire someone who
doesn’t know French to create the first
translation of a 450-page book written
in that language?
“I’ve got no bloody idea,” says Dr Philip
Polkinghorne, who accomplished that very task,
laughing. “It’s the stupidest thing I ever did.”
Polkinghorne, who describes his grasp of French
as “absolutely useless”, finished the impressive
task of translating Le Decollement de La rétine:
pathogénie, traitement – or Detachment of the
retina: pathogenesis, treatment – in mid-2015. The
400-page tome was authored by the pioneering
Swiss ophthalmologist, Jules Gonin (1870-
1935), who discovered through detailed clinical
observation that the retinal tear was the cause,
and not the result, of retinal detachment, contrary
to prevailing theories of the time.
“People had done all sorts of hocus pocus
before that time,” Polkinghorne says. “But Gonin’s
was the first, if you like, thought-out, scientific
approach to the problem.”
Polkinghorne, a surgeon with Auckland Eye
and an associate professor at the University of
Auckland, embarked on his translation after
spotting a copy on the University of Auckland’s
head of ophthalmology Professor Charles
McGhee’s bookshelf. Polkinghorne has been a
member of the international Club Jules Gonin
for 20 years and was surprised to see a copy
of the original French version as relatively few
are in circulation. Despite the linguistic barrier,
Polkinghorne borrowed the copy, scanned the
400 pages to a PDF file and converted it to Word,
and began the page-by-page, word-by-word
translation, using “a whole lot of search engines”.
In the first section, Gonin details the history of
ophthalmological theories of retinal detachments,
with critique and a presentation of his own theory.
“People did some crazy things for retinal
detachment,” Polkinghorne says. “For example
they cut holes in the iris and injected all sorts of
things into the eye like mercury and cyanide, and
under the conjunctiva.”
The latter section of the book describes
treatment for retinal detachment and Gonin’s
approach using thermocauterisation.
The whole project took Polkinghorne more than
a year.
“I think it took me about 10 hours per page. Once I
got into it, I couldn’t stop. It became an obsession.”
Professor Jules Gonin - brilliant but divisive
A/Prof Philip Polkinghorne says translating Jules Gonin’s book became
an obsession
Translation was hampered by the fact that Gonin
wrote one hundred years ago, which means some of
his French is antiquated. Furthermore, Polkinghorne
had to determine the meaning of outmoded
technical terms by their context. The French word
for “vitreous”, for example, was translated in
search engines as “glass”. Another example was
a term translated as “electro-coagulation”, which
Polkinghorne knew to mean “diathermy.”
Modern technology and hard work carried
Polkinghorne only so far.
“Sometimes it was impossible for me to work it
out, so, I talked to a lot of French speakers,” he says.
A particular difficulty arose from determining the
unit Gonin used in measuring IOP.
“He was obviously talking about the pressure
of the eye but it wasn’t mm Hg (millimetres of
mercury), but a symbol that I had no clue what it
meant.”
Among his French speaking consultants were
Associate Professors Gordon Sanderson and
Ivan Goldberg. It was A/Prof Goldberg who put
Polkinghorne in touch with a glaucoma subspecialist
in France, who revealed the symbol to
represent mm of H2O.
“A lot of people helped me with those difficult
translations.”
Mind you, other difficulties still remain, says
Polkinghorne, such as identifying some of the
drugs Gonin references, which went under trade
names from companies long-gone.
Polkinghorne’s efforts took him as far as London
to visit Dr Richard Keeler, a self-styled archivist
with a large collection of books, photographs
and other material covering the history of
ophthalmology. Dr Keeler supplied Polkinghorne
with a rare image of Gonin from a pamphlet about
a presentation Gonin made to the Oxford Club at
the height of the doctor’s career in the early 1930s.
The pamphlet had misspelled Gonin’s name,
perhaps because Gonin was well-known to have
had a somewhat bumptious relationship with
many of his peers.
“There were people who said he was despicable.
He certainly wasn’t the world’s nicest man,” says
Polkinghorne. “In his book, he calls people the
most outrageous things. He names the people and
calls them charlatans. Known figures! So he did
take on people. So people did the exact same thing
back to him.”
An electronic version of Polkinghorne’s
translation is likely to be posted on the Club Jules
Gonin website. Polkinghorne says he plans to print
a small number of copies himself. ▀
OSO Congress double bill
The Orthokeratology Society of Oceania
(OSO) will be holding its 12th Congress
from Friday 23 to Sunday 25 September at
the Surfers Paradise Marriott Resort & Spa, Gold
Coast, Australia. This year, for the first time,
OSO will also be hosting the 5th Congress of the
International Academy of Orthokeratology.
OSO, which covers New Zealand, Australia
and some parts of the South Pacific, has been
around for quite some time, says Hamilton
optometrist Jagrut Lallu, one of the OSO
Congress’ organising committee. “As new
groups began to spring up globally, they decided
to come together annually to share their
knowledge and expertise. This year is the first
time this global meeting has come to Oceania.”
This is an event not to be missed for anyone
interested in orthokeratology, says Lallu. “This
is a big meeting. We normally have around
200 delegates at our biennial congress, but
because of this international meeting we are
expecting many, many more. Oceania does a lot
of research into ortho-k, but we are expecting
delegations from China, the USA, Europe, Russia
and South Africa – literally, all over the world.
It’s the first time we’ve hosted it and to have
this many global experts in one location is
pretty special.”
The three-day event will include workshops
around fittings, scleral lenses, trouble shooting
and a beginners boot camp among other things,
plus Friday night drinks with the speakers and a
Saturday night gala dinner.
There is still time to register, and a full rundown
of the programme is available, online at
www.osa.net.au ▀
20 NEW ZEALAND OPTICS September 2016

AUSCRS 2016
BY DIVYA PERUMAL AND NOOR ALI*
We had the recent opportunity to be
selected for the Advanced Trainee
Programme at the Australasian Society
of Cataract and Refractive Surgeons’ (AUSCRS’)
annual conference. The conference was held at the
beautiful Sheraton Mirage in Port Douglas, Cairns
from 20-23 July, 2016 and provided an opportunity
to reflect on the latest knowledge and scientific
developments in cataract and refractive surgery.
The programme began on a high note with
a session on post-training career progression,
getting started with refractive surgery and a casual
discussion session on cataract surgical complications
and challenging cases. At end of the day we were
rewarded with a wet lab session on iStent insertion.
The opening ceremony to welcome the 20th year
of AUSCRS fit well with the 2016 theme – Mission
Impossible: 20 years of innovation-20 years of
success – all guests were attired in the AUSCRS ‘Rock’
black T-shirts and sunglasses. “Mission Impossible
secret agents” and AUSCRS’ co-founders, Professor
Graham Barrett and Dr Rick Wolfe, arrived in
motorcycle suits to fireworks and the music of the
Ragdolls, the local AUSCRS band! After the glitz and
glamour of ushering in the evening, we had the
honour of sitting down with Professor Barrett and
speaker Dr Oliver Findl, president of the Viennese
Society of Ophthalmology, over coffee and cake to
discuss any surgical dilemmas we had.
This extraordinary conference had a great list of
overseas speakers and much to offer. The following
is just a selection of some of the highlights.
Dr Eric Donnenfeld, the national medical director
of TLC Laser Eye Centres in the US, provided an
overview on the surgical approach to traumatic
cataract: always assume that the posterior capsule
is torn until proven otherwise; consider a peribulbar
block; close the corneal laceration first; and keep
sutures away from visual axis, he said. He also
suggested using air in the anterior chamber to stop
aqueous leak, tissue glue to close the laceration, if
necessary, and vision blue to visualise the capsule.
Other key learnings included visco-dissection and
bimanual to aspirate a soft cataract, considering
the possibility of a posterior capsule tear and using
triamcinolone to visualise the vitreous.
Dr Damien Gatinel, from the Fondation
Ophtalmologique Adolphe de Rothschild in Paris,
showed the audience the effect of ‘rainbow glare’
in LASIK patients and its management with a 10 to
20-micron ablation with PRK or excimer laser.
While in his presentation on The role that
intracranial pressure plays in glaucoma, Dr John
Berdahl demonstrated the association between
intracranial pressure and IOP, and suggested that
IOP is a surrogate for the translaminar pressure
difference. He also postulated that cupping is due
to the posteriorly directed force generated by the
translaminar pressure difference.
We were exposed to various forms of multifocal
IOL during this conference, including bifocal
and trifocal IOL. The general theme is to never
over-promise the capacities of these lenses, that
preoperative workup needs to be normal, the
surgeon needs to be confident using the lens
platform and always discuss the effects of glares
and halos around lights at night and dusk.
Dr Michael Assouline suggested that keratoconus
is a retinal pathology! His novel concept suggested
keratoconus, which is related to a VSX1 mutation,
causes bipolar cell dysfunction, which leads to
a dysregulated emmetropization process. The
abnormal emmetropization mechanism causes
corneal weakening and steepening, which leads to
keratoconus.
MIGS (minimally invasive glaucoma surgery) was
also a major interest at AUSCRS. The rationale of
MIGS use has been suggested as a way to reduce
medication dependence and the risks of invasive
glaucoma surgery as it targets the site of greatest
resistance (ie. juxtacanalicular tissue). The iStent
data by Australian ophthalmologist Dr David
Manning showed iStents reduce IOP modestly,
while reducing medication usage significantly, was
safe and did not worsen glaucoma.
Dr Karl Stonecipher, medical director of TLC
Greensboro in North Carolina, shared his cases of
YAG vitreolysis. Potential complications include
cataracts from lens trauma and retinal tears.
While the annual AUSCRS “underwater chat”
session alluded to concerns about the use of
intracameral vancomycin association with
haemorrhagic occlusive retinal vasculitis and
the discrepancy in the access to toric IOL across
the world, which is mostly related to regional
differences in reimbursements. Australia appears
to have a higher rate of uptake compared to most
other countries.
Dr Barrett suggested using a surgical induced
astigmatism ‘SIA’ value of 0.1D if one is unsure of
Professor Graham Barrett opens AUSCRS 2016 with the mission
“who dares to achieve 20/20 vision wins!”
AUSCRS pays tribute to Tom Cruise in a lively panel discussion
their individual calculated SIA.
While in his talk, Perfect prediction, Dr Andreas
Pallas from Switzerland considerd the use of a fourth
generation formulae, Barrett’s Universal Formula
II, Haigis and Hill RBF, lens thickness and ‘white to
white’ to improve IOL target accuracy in short eyes.
His study challenges the previous belief that Hoffer-Q
and Holladay-2 are more accurate in short eyes.
Dr Donnenfeld’s talk on intraoperative
abberometry revealed the benefits of this
technology, including measurement of the
true refractive power of the cornea, the ability
to incorporate surgically-induced astigmatism
into surgery, allowing compensation for ocular
cyclotorsion, and accurate measurement of the
visual axis for IOL placement.
Dr Wolfe suggested that > 0.50DC astigmatism is
a surgical complication and that partial astigmatic
correction (ie. limbal relaxing incisions and steep
axis incision) is of limited value. The best method
to correct for astigmatism is toric IOLs, he said, but
he doesn’t agree with astigmatism as a method to
correct presbyopia. His “recipe for success” includes
using IOL Master K-readings and the Barrett Toric
- Perfect 3 dimensional control of
every intravitreal injection
- Single handed sharps safety
- The only intravitreal injection system
compliant with international legislation
on the use of sharp safe devices
- Streamlined workflow
The Sheraton Mirage, venue of AUSCRS’ Mission Impossible
Calculator, choosing the lowest possible astigmatic
aims (even if the axis flips) and using a 2.2 x
2.2mm temporal incision and advanced alignment
techniques.
Dr Anton Van Heerden, of the Royal Victorian
Eye and Ear Hospital in Melbourne, challenged
current belief that Hoffer Q was best for short
eyes, Holladay 1 in medium eyes and SRK/T in long
eyes. His study, found that the T2 formula is more
accurate compared to the SRK/T formula over the
entire axial length range in medium-long eyes,
and less accurate in long eyes. Holladay 2 is nonsuperior
compared with other older formulae when
lens thickness is not measured and the Barrett
Universal II was the most accurate formulae in eyes
greater than 22mm.
Dr Bruno Trindade suggested treating
pseudophakic presbyopia with a monocular pinhole
intraocular implant (XtraFocus implant), a sulcus
IOL designed by Morcher, which can also be used to
manage irregular corneal astigmatism. The concept
is based on the idea that a pinhole increases depth
of focus and reduces the blur circle on the retina. Dr
Trindade’s study showed no difference in contrast
sensitivity pre-op and post-op and an improvement
in spectacle independence. These lenses allow
transmission of infrared wavelength and OCT and
ultra-wide field retinal imaging.
Sydney ophthalmologist Dr Alina Zeldovic
presented her findings on current practices on
antiviral prophylaxis for cataract surgery. She
found most clinicians wait for HSV keratitis
inactivity for 3-6 months, use antivirals for seven
days pre-op, with more than 90% using oral
acyclovir 400mg BD (although Valaciclovir and
Famciclovir have better bioavailability and can be
used on a daily dosage), and that most clinicians
did not change their post-op steroid regimen.
AUSCRS was indeed a very entertaining
conference. with speakers dressing up in military
uniforms to diving suits to reflect sub-themes.
There were many debates, including laser refractive
surgery and femtosecond assistant cataract surgery,
with some very frank discussions that challenged
speakers. The Casino Royale-themed conference
dinner was very special, with martini glasses,
Russian roulette tables (compete with AUSCRS chips
and red lighting) and plenty of dancing!
In summary, this is a conference not to be missed.
This was our first AUSCRS conference and will
certainly be one we look forward to next year. ▀
* *Divya Perumal is a fourth year ophthalmology registrar in
Auckland, prior optometrist and mother of two-year old toddler,
Dhilan. Her interests include glaucoma and cataract surgery.
While Noor Ali is a third year ophthalmology registrar in
Auckland. Her interests include medical retina and cataract
surgery. She is also a keen baker and runner.
is now available in procedure packs
Contact Toomac Ophthalmics for a demonstration mark@toomac.co.nz
info@salarsurgical.co.uk
Drs Divya Perumal and Noor Ali at AUSCRS 2016.
September 2016
NEW ZEALAND OPTICS
21

with
Prof Charles McGhee
& A/Prof Dipika Patel
Series Editors
Orbital side effects
of prostaglandin
analogues
Prostaglandin analogues (PGA) are
topical PGF2a agonist drugs frequently
recommended by glaucoma experts as first
line therapy in patients with newly diagnosed
glaucoma or ocular hypertension. The popularity
of these drugs arises from their potent intraocular
pressure lowering effect, once-daily dosing and
paucity of systemic side effects noted to date.
Local side effects including iris pigmentation,
hypertrichosis, conjunctival and eyelid skin
hyperaemia are well documented, however more
recently, observations in monocular users have
revealed a novel constellation of ocular adnexal
changes attributable to topical PGA therapy.
As early as 2004, upper eyelid sulcus deepening
and involution of dermatochalasis in three
patients who were unilaterally treated with
bimatoprost was reported 1 , and several years later
enophthalmos was described in eyes treated with
the same medication 2 .
Multivariate analysis confirms current PGA use
is associated with a significantly increased risk
of periocular changes 3 . The full constellation of
changes includes deepening of the upper eyelid
sulcus, resolution of dermatochalasis, loss of
inferior orbital fat pad, upper lid ptosis with
levator dysfunction, lower lid retraction and
enophthalmos, and has been collectively referred
to as prostaglandin associated peri-orbitopathy
(PAP).
Reliable and reproducible measures of
enophthalmos and lid position exist, however there
are no such objective quantitative methods that
cover PAP changes as a whole, and variations with
age, gender and race make analysis across studies
difficult. The mainstay of diagnostic evaluation
relies on clinical examination of the periocular area
with or without photos supported by inter-observer
agreement. Hence diagnosis tends to be subjective,
and this is relevant in patients with mild PAP, but
severe glaucoma patients may choose to continue
with their PGA medication.
Whilst changes are most obvious in patients
using PGA’s unilaterally, large cross-sectional
studies confirm PAP to be clearly associated with
PGA application among bilateral users as well 4 .
Studies have demonstrated an overall frequency of
PAP to be as high as 93% in PGA users 5 . Drug type
is an independent risk factor with bimatoprost and
travoprost most strongly associated with adnexal
changes followed by latanoprost. This may be due
to the higher concentration of the active agent in
The 4 days of Optics
23 - 26 September 2016
LIVE THE EXPERIENCE
22 NEW ZEALAND OPTICS September 2016
JAMES SLATTERY* AND BRIAN SLOAN
silmoparis.com
Right sided PAP. Note the prominent hypertrichosis and lash ptosis,
lid margin inflammation and tendency to lid retraction
Age-related fat atrophy can be very severe, and in this case is
restricted to the fat of the superior orbit. Note the eye is white,
the lashes are normal in number and position, and the lid margins
are uninflammed.
the bimatoprost formulation, or a more potent
effect on its receptors.
Periorbital fat atrophy
A commonly studied feature of PAP is deepening
of the upper lid sulcus (DUES). Whilst reported in
several races, the most extensive work has been
performed in Japanese glaucoma patients.
Inoue et al 6 , retrospectively investigated
the frequency of DUES in a group of Japanese
glaucoma patients and reported frequencies of
60%, 50% and 24% of bimatoprost, travaprost
and latanoprost respectively. They found drug
type to be an independent risk factor. Prospective
studies in a Japanese population switched from
latanoprost to bimatopost reported a frequency
of 60%, and a much earlier onset of effect than
previously thought with the incidence maximal at
three months 7 .
Longer duration of bimatoprost was significantly
associated with higher scores of ocular adnexal
involvement, but longer duration of latanaprost
and travaprost were not 1 . PAP can occur at any age,
but has a higher incidence with increasing age,
and greater hyperopia 7 .
These changes are potentially reversible
with 85% of affected patients in one study
demonstrating some improvement within two
months after being changed back to latanoprost 8 ,
and another group showing partial or complete
reversal of DUES in three to eight months 5 .
While not reported as frequently as DUES,
relative enophthalmos of 1-3 mm and loss of
inferior orbital fat are common findings in studies
relating to PAP 3,4,5,9 .
The mechanism by which PGA produce
deepening of the upper lid sulcus and loss of
inferior orbital fat pads is likely attributable to
alteration of periorbital fat metabolism. This
theory is supported by diagnostic imaging
studies, with reversible periorbital fat atrophy in
PGA treated eyes noted on MRI in patients who
developed PAP compared with untreated eyes 9 .
FP prostanoid receptor activation inhibits
pre-adipocyte differentiation in several cell lines
including cultured human orbital tissue, which
are then prevented from expressing adipocyte
specific genes 2 . A controlled study taking preaponeurotic
fat biopsies from patients using
various PGAs demonstrate that mean adipocyte
density of bimatoprost and travoprost treated eyes
was significantly higher than in untreated eyes,
indicating the volume of lipid per cell was reduced
in PGA users 10 , and basic in vitro research reveals
bimatoprost has the most significant inhibitory
effect on adipose differentiation and intracellular
lipid accumulation, and latanoprost the weakest 12 ,
consistent with clinical findings.
Reinforcing this theory is the propensity for
drug absorption into periocular tissues from
administration of PGA. Animal studies have shown
eyelid specimens to contain more than 2000 times
higher concentrations of bimatoprost compared
with aqueous and more than 16 times iris and
ciliary body 11 .
Abnormalities in lid position
Large cross-sectional studies as well as retrospective
case reviews of monocular PGA users have
demonstrated PGA use to be associated with upper
lid ptosis and reduced levator function in up to
45% of patients. A less robust finding is lower lid
retraction 3,5 .
The mechanism of ptosis and levator muscle
dysfunction is speculative and may be related to
a variety of aetiologies. A mechanism of disinsertion
of the levator from the tarsal plate has
been postulated; an alternative option is that low
grade dermatitis and erythema of the lid tissue
causes tightening and a stiff, ptotic upper lid that
resists superior displacement 3,5 .
A much smaller but quantitative monocular
study by Rabinowitz et al 13 noted a significant
rate of upper lid malposition including a number
of patients with upper lid ptosis, as well as
demonstrating a non-significant trend towards
upper lid retraction. Like several other studies
they too noted a significant rate of lower lid
retraction, which would be consistent with their
upper lid findings.
There are no studies to date demonstrating
improvement of ptosis post cessation of
PGA use and given the inconsistent findings,
comprehensive studies are needed to elucidate the
nature of lid position effects of PGA use.
Lid margin changes
Trichomegaly and increased skin pigmentation are
well recognised and the former has been known to
contribute to lash ptosis, which can be severe 4,14 .
Recent series have now demonstrated that
structural changes to the lid margin are equally
prevalent 4 , with a reduction in the thickness of
the upper and lower lid margins and tightening
of the lid margin. These changes were observed
to contribute to trichiasis in multiple patients
4,5
. A case of spontaneous globe subluxation in a
thyroid orbitopathy patient post-commencement
of travaprost that spontaneously resolved postcessation
exists and was suspected to be due to
tightening of the lid margin 4 .
PGA users also demonstrate increased
rates of marginal blepharitis and meibomian
gland dysfunction (MGD) with coexisting
tarsoconjunctival fibrosis and mild cicatricial
ectropion 4 .
Of those who could discontinue their PGA in this
series, many showed improvement of lid margin
features, with objective improvement in trichiasis
and subjective improvements in ocular irritation.
Several cases of reduced eyelid inflammation
and resolution of cicatricial ectropion, and the
previously mentioned case of resolution of
spontaneous eyelid subluxation lend support to
the theory of reversibility of PAP 4 .
Conclusion
PGA’s are effective for the treatment of glaucoma,
but cause pervasive and significant structural
changes of periorbital soft tissue in a high
proportion of patients. These changes may occur
within months of starting treatment. They are
most common and severe in patients treated with
bimatoprost, followed by travaprost and then
latanoprost.
Abnormalities of upper and lower lid margin, lid
and canthal malposition, cicatricial ectropion and
trichiasis are recognisable. Blepharitis and MGD
may contribute to ocular surface irritation and
discomfort as well as exacerbate lid malposition.
Tight eyelids may interfere with applanation
measurement, surgical access to the superior
globe, and enophthalmos may lead to unnecessary
orbital imaging.
The early changes of PAP may be difficult for
The same patient before (above) and after (below) trial cessation
of PGA. Note the skin inflammation causing cicatricial ectropion
in the upper picture, which completely resolves. Also note the
marked conjunctival hyperaemia, which also resolves.
the patient to appreciate. Patients are often on
bilateral treatment and while PAP changes occur
within months they occur gradually. Glaucoma
patients also tend to be elderly and may normally
expect prominent periorbital bony architecture
demarcation, sunken appearance of the globe and
hollowing of the periorbital area. It is therefore
important that clinicians identify these changes,
as they may otherwise remain unrecognised until
much more severe.
We recommend baseline photographs with
periodic comparison for all patients receiving
these medications. The soft tissue effects of
PGA may be at least partially reversible in some
patients, so alternative therapy, or changing to
latanaprost from one of the more potent PGA’s
should be considered in affected patients. Surgical
intervention should be deferred until it is clear that
the changes are irreversible or are progressive. ▀
References
1. Peplinski LS, Albiani Smith K. Deepening of lid sulcus
from topical bimatoprost therapy. Optom Vis Sci 2004; 81:
574–7.
2. Filippopoulos T, et al. Periorbital changes associated with
topical bimatoprost. Ophthal Plast Reconstr Surg 2008;
24: 302–7.
3. Shah M, et al. A cross-sectional survey of the association
between bilateral topical prostaglandin analogue use and
ocular adnexal features. PLoS One 2013;8:e61638.
4. Custer PL, Kent TL. Observations on Prostaglandin
Orbitopathy. Ophthal Plast Reconst Surg 2016; Vol. 32,
No 2.
5. Kucukevcilioglu M, et al. Prostaglandin associ- ated
periorbitopathy in patients using bimatoprost,
latanoprost and travoprost. Clin Experiment Ophthalmol
2014;42:126–31.
6. Inoue K, et al. Deepening of the upper eyelid sulcus
caused by 5 types of prostaglandin analogs. J Glaucoma
2012;
7. Aihara M,et al. Incidence of deepening of the upper eyelid
sulcus after switching from latanoprost to bimatoprost.
Jpn J Ophthalmol 2011; 55: 600–4.
8. Sakata R, et al. Recovery from deepening of the upper
eyelid sulcus after switching from bimatoprost to latanoprost.
Jpn J Ophthalmol 2013;57:179–84.
9. Jayaprakasam A, Ghazi-Nouri S. Periorbital fat atrophy-An
unfamiliar side effect of prostaglandin analogues. Orbit
2010; 29: 357–9.
10. Park J, et al. Changes to upper eyelid orbital fat from use
of topical bimatoprost, travoprost, and latanoprost. Jpn J
Ophthalmol 2011; 55: 22–7.
11. Woodward DF, et al. Pharmacological characterization of a
novel antiglaucoma agent, bimatoprost. J Pharmacol Exp
Ther 2003; 305: 772–85
12. Choi HY, et al. In vitro study of antiadipogenic profile of
latanoprost, travoprost, bimatoprost and tafluprost in
human orbital preadipocytes. J Oculo Pharmacol Ther
2012; 28:146-52
13. Rabinowitz MP, et al. Unilateral Prostaglandin-Associated
Periorbitopathy:A Syndrome Involving Upper Eyelid
Retraction. Ophthal Plast Reconstr Surg 2015; 31(5) 373-8
14. Casson RJ, Selva D. Lash ptosis caused by latanoprost. Am
J Ophthalmol 2005 May; 139(5):932-3
About the author
* James Slattery MBBS,
PhD, B Sci (Biomed) is an
oculoplastics fellow at the
University of Auckland.
He completed his
ophthalmology training in
Adelaide, South Australia.

Eyeball 2016:
Dilate another day
Jennifer Sylvester, Martijn Van Der Most and Robin Birch from
Eye Institute
The Ball committee (L to R) Tomo Konishi, Huimin Dai, Divya Anthrape, Sean Mahendran, John Kwak, Priyagna Patel, Nikita Govender, Kylie
Mann, Lexia Ahkit, Harpreet Singh, Nick Stuhlmann and (bottom front) Kishan Mistry.
A
glittering date in the diary, Saturday
30 July, saw the Hilton on Auckland’s
waterfront play host to 196 optometry
students, faculty staff members and industry
guests to celebrate this year’s BOptom graduates.
Organised by the Eyeball Committee, a
separate group from the NZ Optometry Student
Society (NZOSS), the red-carpet event had a
James Bond theme with prizes for the best
dressed and a raffle. Eye Institute optometrist
Martijn Van Der Most was also on hand to
take formal photos. The event was sponsored
by Specsavers, Luxottica, Eye Institute, NZAO,
OptiMed, OIC, the Corneal Lens Corporation,
CooperVision and Eyeline Optical.
“It was great to see everybody enjoy
themselves on the night and very rewarding
to see our hard work appreciated,” said ball
committee president, John Kwak. “The ball
committee really came together, and we
definitely had a lot of fun.” ▀
Emma Gee and Hirdesh Nair from OPSM
Xxxx
Raya Yamashita, Mano Pihema and Shannon Wallis
Laura Matthews (dressed as Bond), Vincent Tang, and Sophie Leang
The poker chips from Casino Royale (L to R) Andy Ho, Ryan Chan, Gunnika Gill, Soojah Lee, Aaron Chin, Jonathan Albert, Jaole Chen.
The staff rocking Moonraker; Zoe Smith, Kristine Hammond, Jason Dhana,
Kathrine Sands, A/Prof Rob Jacobs, Bhav Solanki and Lisa Silva
Davina Patel, Alice Kah and Cassandra Mensah
Fine arts student Francesca Sie with friends Jason Kumar, Mary Rush and Cassandra Payawal.
Amy Young, Jason Dhana, Huria Rahimi, Jessica Lat, Anh-Dao Le and Leslie Tien
Joseph O’Gorman, Lauren Curd, Kayleigh Aspeling and Ken Turner Risa Suh, Yun Jung Shim, Jamie Lainson and Harpreet Singh Best dressed winner Kishan Mistry with alter ego, Indie Silva and Ollie Smith (aka Jaws)
September 2016
NEW ZEALAND OPTICS
23

International Orthoptic
Congress 2016
BY MIRIAM LANGESLAG-SMITH*
RANZCO & Specsavers?
In this modern, commercial
world we are seeing ever more
collaboration between large
groups, commercial operations,
medical-insurers and so on.
The AA collaboration with
Specsavers offering ‘free eye tests’ for
AA members and the similarly free
eye exams being offered by OPSM to
Southern Cross medical insurance
members are good examples.
There are various other such things
promoted by loyalty schemes and so
on. In some parts of the world it is
even more complex with a variety of
players involved. Some professions
are also being ‘controlled’ by either
being in an affiliated provider
scheme or not. Ophthalmology too
has had such arrangements ‘forced’
on it. In recent times we have seen
Southern Cross ‘forbid’ its members
from having femtosecond aided
cataract surgery, to the point that if
a patient elected to have this option
done - at their own cost - they were
then told the medical insurer would
not cover any of the cataract surgery!
This is in my view crazy and smacks
of being unjust and unfair and one
wonders if there are vested interests
or political issues at play? It makes
no difference to their cost if the
patient elects to have what they may
deem a more advanced option to
their surgery. This has led to some of
the groups who shelled out on such
advanced equipment literally having
a million dollar white elephant
wasting valuable theatre space. One
group even sent their laser unit back
to the provider.
I don’t like being economically
forced to have to ‘choose’ a certain
provider of medical services, which
may not be my first choice or the
best choice, simply due to financial
considerations. When I joined
Southern Cross that was not one of
the conditions but now it is being
forced on me. Of course the insurers
will tell you that this is to keep costs
under control but there’s more to it
than that.
As we know loyalty schemes are
designed to make us more inclined
to deal with certain companies
that reward us for our loyalty. It can
certainly lock one in. It does in some
cases have benefits but at other times
it can make it more hassle or cost
more to stay with say a certain airline.
I don’t agree with such control
of relationships and the proposed
RANZCO-Specsavers collaboration
(see news story p6) will not
likely foster or enhance good
relations between optometry and
ophthalmology.
Although RANZCO mentions
Specsavers as the largest group
in retail optometry they do not
represent the majority. All told
OPSM commands about one third
of the optometry market with
independents another third and
Specsavers also about one third.
I believe RANZCO have made a
mistake in how they went about
this initiative, as it should have been
inclusive of the whole profession. I
do note RANZCO’s point of it being a
good test vehicle for their scheme as
Specavers run pretty much the same
systems throughout their network
of ‘stores’. Surely that should have
been a clue to RANZCO as they are
talking about high level medical
collaboration not retail business that
takes place in stores?
There are many independent
practitioners who I believe could
have made an excellent contribution
to this process and their speciality
practices may in fact have been a
better vehicle to gather the valuable
data, which is what RANZCO claims
to be seeking.
Although the collaboration does
not seem to be a commercial
arrangement – and they do state that
the referral guidelines and education
are open to all optometrists – it still
does not sit well with the people I’ve
had feedback from.
At any rate I gather there are moves
afoot to create a more level playing
field and potentially we may see
some alterations to this proposal
over the next while.
It’s also been interesting to note
that Specsavers have tried to
trademark the word ‘Should’ve’ as
used in their clever ‘Should’ve gone
to Specsavers’ advertisements (which
is already trademarked). Some people
think this is ridiculous and that they
are unlikely to succeed. ▀
Acuity chart for AMD
A
team
of researchers from
Ulster, Moorfields Eye Hospital
and Auckland have developed
a new acuity chart to detect early
signs of macular degeneration, called
the Moorfields Acuity Chart.
With age-related macular
degeneration (AMD) still the leading
cause of sight loss in Western
countries, having an easy to use,
early detection test will result in
much better outcomes for AMD
patients. Until now letter charts
have not been consistent or sensitive
enough to give an early diagnosis or
to monitor progress.
The research team, which included
Professor Steven Dakin from the
School of Optometry and Vision
Science at the University of Auckland,
worked on the new acuity chart. The
chart uses letters built up from fine
black-and-white stripes, as previous
research showed these ‘high-pass’
letters are more equally readable
than standard letters, but also that
they appear to vanish altogether
when they are too small to be
recognised.
In a study published in the British
Journal of Ophthalmology, the
sensitivity of the Moorfields Acuity
Chart was compared with the
standard test in 80 AMD patients
and 38 people with normal vision.
The results showed the Moorfields
chart was more reliable from one
test to the next for people with
AMD, but not the participants with
normal vision.
Sir Peng Tee Khaw, director of
the NIHR Moorfields Biomedical
Research Centre said, “This marks
a significant advancement in our
ability to diagnose vision loss arising
from the leading cause of sight loss
in industrialised countries. This is
exciting for us all as improved testing
methods lead to better diagnosis and
treatment development.” ▀
From the 27 to 30 June 2016, 700 members of the
International Orthoptic Association (IOA) from 42
countries met in Rotterdam in the Netherlands to share
their research, knowledge and experiences in and around
the world of orthoptics at the XIIIth International Orthoptic
Congress. Among the attendees were three orthoptists from
New Zealand: Karen Fyles from MidCentral District Health
Board, Gisela Rademaker from Timaru Eye Clinic and myself,
Miriam Langeslag-Smith from Counties Manukau Health.
The Congress is held every four years and is attended not
only by orthopists, but also ophthalmologists, researchers
and educators, fitting with the theme, “Bridging Worlds”
where bridges between the different fields related to
orthoptics are being built.
This year the Congress was held at De Doelen International
Congress Centre in the heart of Rotterdam. Rotterdam is a
dynamic city with a lively cultural scene and long maritime
history, and the largest cargo port in Europe. The near-complete
destruction of Rotterdam’s city centre during World War II has
resulted in a varied architectural landscape. On a more personal
level, Rotterdam is the city where I started my working career
as an orthoptist many moons ago. It was great to be back in
familiar surroundings although in an ever-evolving city like
Rotterdam a lot had changed since I worked here.
The first day of the Congress started with an education
session for attendees who are educating orthoptics students,
residents, medical students or other ophthalmic personnel,
and two workshops. The first focused on the change in the
personal and professional identities of orthoptists across
the world, demonstrating that many orthoptists now have
expanded roles in their practices. The first orthoptist to be
accredited to perform intravitreal injection is an example
of this. The second workshop was about assessment and
intervention in cerebral visual impairment in children.
The following three days were filled with three invited
symposia from IOA partners: the International Paediatric
& Strabismus Council; the International Strabismological
Association; and the World Society of Paediatric
Ophthalmology and Strabismus. There were 76 oral
presentations, 20 rapid-fire poster presentations and 84
posters divided into 12 different themed blocks, with themes
such as binocular vision, low vision, technology in eye
disease, strabismus and neuro-ophthalmology, just to name
a few. I had the privilege of presenting in the amblyopia block
on Amblyopia improves more than just visual acuity, which
included results of a study I conducted as part of my master’s
degree at the University of Auckland. I also had two posters in
the theme block Expanding orthoptic practice, one with Carly
Henley from Auckland DHB who unfortunately was unable to
attend the Congress.
The Congress was completely paperless. All delegates
had free WiFi access and were encouraged to download a
Welcome to the XIIIth IOA Congress in Rotterdam
CentraSight training in NZ
CentraSight, the ground-breaking macular
degeneration treatment that inserts a tiny telescope
into a patient’s eye, now has a formal point of
contact in New Zealand - specialist low vision consultant,
Naomi Meltzer.
Meltzer, based in Auckland and a former partner at Barry
and Beale optometrists for 30 years, says she’s always
had a special interest in low vision. She took a diploma
in rehabilitation at Massey in 2009 to help her low vision
patients and, while she was on the course, met Paula
Daye, the outgoing CEO of the NZ Foundation of the Blind.
Together they set up the Sight Loss Services Charitable
Trust, to provide information, equipment and support to
New Zealanders with low vision and their families, and to
promote better understanding of low vision in the wider
community. She also helped establish the NZ Association of
Optometrists’ accreditation for optometrists in low vision,
which became available earlier this year.
Today Meltzer runs a specialist low vision practice, Low
Vision Services, and it was while she was contacting low
vision specialists in the UK that she was put in touch with
Graham Brown, director of CentraSight.
“I’d heard of CentraSight through Rodney Stedall, one of
the optometrists already trained to do assessments in New
Zealand.” says Meltzer. “Graham was going to be in New
Zealand, to be present at (Tauranga ophthalmologist) Mike
O’Rourke’s first CentraSight operation, so we arranged to
meet.”
From that initial meeting, Meltzer entered the UK-based
training programme to become an optometrist qualified to
assess and rehabilitate patients.
“The success of the treatment is reliant upon a rigorous
screening of candidates and good post-operative
rehabilitation, as well as excellent communication between
the surgeon, the patient and the low vision optometrist,”
she explains. “Once they’ve had the implant, the patient
needs to be trained to use their implanted eye for detail and
their other eye for getting around. It’s not for everyone.”
designated congress app on their smartphones or tablets,
which showed which presentation or event was going on in
real time. There was even the ability to add your own notes
on the online presentations.
Overall the presentations were of a high calibre and covered
a wide variety of subjects. There were many highlights for me,
too many to name here, but one that did stand out was the
need for consistency around the world in naming orthoptic
disorders. People naïve to visual experiments respond very
differently to “visual experts” therefore we should not be
using orthoptic/optometry students as a control group in
ophthalmology research.
Not all the presentations were on new and novel research,
which was good as they confirmed previous findings,
refreshed subjects and brought forward knowledge that over
the years may have gone to the back of our minds.
Although the orthoptist market is still very small, 13 exhibitors
took part in the Congress, many displaying novel products.
These included a redesigned picture visual acuity chart, a
new strabismus test, electronic amblyopia treatment glasses,
research and examination equipment and children’s glasses.
Besides the very interesting presentations, there was also
time to relax and socialise. The social side of the Congress
was, as always, a great opportunity to catch up with
colleagues, old class mates and friends from around the
world. The welcome reception, VIP reception and Congress
dinner at St. Laurenskerk, or Great Church of Rotterdam, plus
the lovely buffet lunches with ample Dutch delicacies, were
the perfect times to do just that. For the very keen, there was
even a morning run through Rotterdam on the third day.
The next IOA Congress will be in June 2020 in Liverpool in
the UK. It would be great if we can have more New Zealand
orthoptists attending this very worthwhile and inspiring
Congress. If you can’t make it to Liverpool, perhaps you can
make it to Lisbon, Portugal in 2024. ▀
*Miriam Langeslag-Smith is an orthoptist with Counties Manukau DHB.
While Meltzer wasn’t
the first optometrist
to qualify – Rodney
Stedall from Paterson
Burn Hamilton was the
first and Lynley Smith
from Langford Callard
in Tauranga the second
– it became clear to
CentraSight she was well
set up to be the contact
point for the whole of
Australasia and assist
Naomi Meltzer
with the training of other
teams in this part of the world.
“My experience in low vision, plus the fact I already have
a dedicated low vision practice and an 0800 number for
people from all over the country to phone for advice, made
me the ideal candidate for this role,” says Meltzer, who is
going to be helping CentraSight train other optometrists for
the CentraSight programme. “But I am in touch with both
Rodney and Lynley, and we are continuing to learn together.”
The CentraSight surgery isn’t a switch that suddenly turns
on good vision, warns Meltzer. “There’s a lot of work to be
done both before and after the operation to rehabilitate the
patient and their motivation, as well as additional health
concerns, travel and finances all have to be considered. But
for those patients who fit the criteria, CentraSight offers the
ability to recognise family members’ faces, read a book and
see other detail, which they may not have been able to do
for a long time, either at all or without magnification.” ▀
If you are an optometrist with a patient you’d like to refer
for assessment, or you are interested in finding out more
about training yourself, you can contact Naomi Meltzer
by calling 0800 555546. CentraSight surgery is currently
offered by Mike O’Rouke at Tauranga Eye Specialists and
Dr Stephen Guest at Hamilton Eye Clinic. The equipment is
distributed by Toomac.
24 NEW ZEALAND OPTICS September 2016

To Fiji and back again
Karen Moulton shares a laugh with nurses at the Pacific Eye Institute
BY KAREN MOULTON*
At the end of May, I had the opportunity to
spend a week at the Pacific Eye Institute in
Suva, Fiji, as part of a Specsavers and Fred
Hollows Foundation outreach trip.
The Pacific Eye Institute is an initiative of The Fred
Hollows Foundation, which runs a postgraduate
course in eye health and refraction aimed at
trained nurses around the Pacific. The course helps
nurses learn and develop skills in refraction and in
identifying eye disease to take back to their own
countries. Ultimately the course is all about helping
local communities to become more self-sufficient
in eye care: a lack of skilled nurses (let alone
optometrists and ophthalmologists) is a big issue
in the Pacific region and something the Pacific Eye
Institute is helping to address with this programme.
On my trip I was accompanied by David Kim,
a new graduate from New South Wales, and, a
month later, a second Specsavers duo replicated
our trip - one “experienced optometrist” and one
“graduate programme optometrist” went on each
trip, as part of a competition for optometrists run
inhouse at Specsavers.
Our role for the week was to assist and supervise
the students doing the refraction and eye health
practical. The students – all nurses - were from
Fiji as well as other countries around the Pacific
such as Samoa and Tonga. Many of the students
had moved from their home towns and countries,
sacrificing time with their families and loved ones.
Having been to Fiji last year on an outreach
with a different organisation, this was a great
opportunity to see another part of the country
and witness first-hand the great work of The Fred
Hollows Foundation. The students were friendly
and dedicated to learning new skills to take back to
their own communities. It was also pleasing to see
previous graduates becoming tutors for current
students.
From my own point of view, I wanted to help
out and pass on my knowledge in a country and
a region where eye care is not as developed as it
is in New Zealand. On a practical level developing
trained nurses to refract and identify eye diseases
seems much more sustainable than having
optometrists intermittently visit the islands, treat
people and then leave. It means each community
is less reliant on international assistance and can
help themselves more.
Of course, it is not perfect either and that can
often be put down to isolation and cost, especially
when it comes to prescriptions - they only have
ready-made prescriptions there, so once home, the
nurses have to look at a prescription and decide if it
will be okay with ready-made prescription glasses.
But the whole initiative is a big step forward and by
spending time at the Pacific Eye Institute, you get
to see first-hand how improving vision can change
a person’s lifestyle and independence. Getting
involved like this, you also feel a real sense of
accomplishment to train local professionals so that
they can go on to help their entire communities.
I had a great time on the trip sharing our skills
and dealing with all the friendly staff, students
and patients. The only regret would be that a week
was not long enough! I am looking forward to one
day returning again or even travelling to one of
the other countries in the Pacific to see how the
students are using their new skills in their own
communities. ▀
* *Karen Moulton is a Specsavers optometrist in Mt Maunganui.
In the past 12 months Specsavers’ stores in
New Zealand and Australia, through in-store
fundraising direct with customers, have raised
more than A$350,000 for The Fred Hollows
Foundation.
Specsavers will be running another competition
in December to January for Specsavers
optometrists who wish to help and gain
experience at the Pacific Eye Institute in 2017.
Rodenstock introduces FreeSign
German lens and eyewear
manufacturer Rodenstock
has introduced its latest,
highly adaptable, lens design
into New Zealand, heralding it
as its “best progressive lens” and
the “best sales tool” for patients.
Rodenstock’s Impression
FreeSign 3, the result of more
than five years of research
and development, allows
optometrists to offer a fullyindividualised
progressive
lens, based on three unique
Rodenstock technologies,
tailoring the lens to the patient’s
lifestyle.
Rodenstock’s patented Eye Lens
Technology (EyeLT) technology
- that can calculate individual
aberrations for any gaze direction
depending on the pupil size -
reduces aberrations by taking
into account the interaction
between the patient’s facial
anatomy, the frame and lenses,
allowing individual solutions for patients, the
company said in a statement. “Progressive lenses
with EyeLT open up a new dimension of vision and
make it possible for you to see more and sharper
up close.”
Impression FreeSign ® 3
Fully individualised progressive lenses based on 3 unique Rodenstock
technologies with option of a separate near refraction.
Allround
For everyday use
Active
Preferencing distance
Individual Lens Technology
Reduces aberrations by taking into
account the interaction between the
patient’s facial anatomy, the frame
and the lenses.
Expert
Preferencing Intermediate - near
Individual
Design your own lens
?
With FreeSign, three lens types are available
alongside the Individual option – Active, Allround
and Expert, each suited to different patient
Reduction of the aberrations of a
requirements, progressive lens such by changing as distance near cyl viewing individualized lens and – allowing wide you to
and axis in according with effective position the aberration wherever you
vision zones. near astigmatism ▀ and listings law. want on the lens.
For more information, speak to your Rodenstock Account Manager or visit www.rodenstock.com.au
ICHOM conference highlights
The International Consortium for Health
Outcomes Measurement held its
conference in London on 16-17 May. It
brought together more than 800 healthcare
professionals from more than 40 countries. The
opening speaker, ICHOM President Christina
Akerman, talked about global progress toward
value-based healthcare, Fareed Mirza from
Novartis Foundation discussed outcomes
Rodenstock introduces FreeSign lenses to New Zealand
Option of personal EyeLT to include a
separate near refraction.
Choice of 3 set designs or fully
measurement in low and middle income
countries, while Boston Consulting Group’s Rich
Lesser focussed on the importance of delivering
value-based healthcare in the private sector.
The next ICHOM conference will be held in
Boston in late 2017. ▀
If you’d like to see some of the video sessions
from the ICHOM conference, visit NZ Optics
Facebook page for more.
Innovative health ideas wanted
Health Minister Jonathan Coleman has
issued a call to clinicians to submit
innovative ideas on healthcare.
“Clinicians have an insider’s view of where
innovation can be applied to improve healthcare
services,” said Dr Coleman in a statement issued
at the end of July. Dr Coleman is a qualified
medical doctor.
“Each year the Clinicians’ Challenge encourages
health professionals to find ways technology
can solve problems they face in their day-to-day
practice, as well as making a difference to the
health of New Zealanders.
“Effective use of information and technology
solutions can also enable patients to be more
involved in their own healthcare and can
ensure clinicians have access to a fuller range of
information, helping to improve patient care.”
The Clinicians’ Challenge is a joint initiative by
the Ministry of Health and Health Infomatics
New Zealand (HiNZ).
Last year’s winner in the active project category
was the oDocs Eye Care initiative (see NZ Optics,
December 2015), a world-first innovation that
allows people with sight-threatening conditions
to be diagnosed using a smartphone, making
basic optometry services accessible and
affordable to people living in remote areas.
This year’s Clinicians’ Challenge has two
Dr Jonathan Coleman
categories: a new idea yet to be developed; and
an innovative system or solution already in place
that’s having a positive impact on patient care.
The winner in each category will receive a grant
of $8,000. The results will be announced at the
2016 HiNZ conference in November.
Entries can be submitted at www.hinz.org.nz
until 12 September 2016. ▀
September 2016
NEW ZEALAND OPTICS
25

Style-Eyes
Treasure hunting: vintage
eyewear
When I started my blog, I closely followed the
other few glasses blogs in existence. One was a
vintage eyewear blog from Germany. It was then
that I fell in love with my first pair of vintage
frames. Coral-pink and black Cazal 312 from
1980, the same year I was made. I eventually
found a deadstock pair on eBay and snapped
them up at half the price I was expecting.
Wearing vintage eyewear can help you stand
out from the masses in this era where so many
frames look so similar. It’s a great way to find
shapes, colours and styles not currently in stores.
‘Deadstock’ means that the frame was
never sold and is unworn, in the condition
in which it would have been originally
sold, but it was removed from sale
due to being out of date. Sometimes
great collections of frames like this get
unearthed from storage somewhere and
end up for sale.
Who’s hunting?
I have found other vintage enthusiasts, even
more obsessed than I am. Davon Ford runs
online store In Search Of (www.insearchofshop.
com). I first interviewed him several years ago
as he was just starting his collection. He said, “I
started collecting in college after a friend had
given me a pair of vintage Porsche Design 5623
frames.” This collection grew to the point of him
opening In Search Of three years ago. I noticed
him call some frames his ‘grail’ frames which I
liked - very Indiana Jones!
I caught up with him again and asked him
what he was currently hunting. “My current grail
is the Cazal 634 in the Grey Amber colourway,”
he said. “For me a frame achieves grail [status]
when I’ve hunted for it more than a year and I
haven’t been able to find it… they start to feel
damn near impossible to find and it makes you
truly appreciate the frame once you find it.”
Rose from Che Eyewear in Melbourne chooses
to stock deadstock vintage eyewear alongside
new eyewear from the likes of Karen Walker and
Seraphin. She told me how this came about:
“We had a lot of deadstock of our own and
realised that current trends were reflective of
our own deadstock. We went on a little hunt
for more pieces and all of a sudden we had an
extensive range. I love anything vintage, and
therefore it was easy for vintage eyewear to
become a passion.”
Rose’s requirements for stocking vintage
Casanova SC 8
Cazal 254
BY JO EATON
frames are that, “Our vintage pieces must be
new. I don’t deal with anything second hand.
Style is important and quality, of course.”
I bought the 1980s Martin Wells frames
(pictured in the Style-Eyes header) from Rose
two years ago and they are a firm favourite.
If you make the decision to sell deadstock
vintage eyewear alongside the new frames in your
collection, check out eBay and Etsy. They make it
so much easier to find good quality frames.
Current trends
1950s/60s-style Mad Men-inspired thick acetate
frames are no longer the vintage style to hunt.
Nor are the gigantic 1980s-style plastic frames.
There is a fashion school on the same campus
as Optical Dispensing at RMIT, where I study.
I’ve noticed the impeccably-dressed fashion
students are opting to wear 1990s-inspired wire
rim frames. Gold is especially in. Davon agrees,
“When I first started, the outrageous Cazal,
Alpina, and other giant ‘80s frames were all the
rage. Now all these years later smaller frames
with detail are the rage. Like Jean Paul Gaultier,
Cartier and Ralph Lauren.”
I asked Davon if he’d noticed current brands
borrowing from the classics. Without naming
names, he said, “New brands borrow heavily
from the past... I’ve seen older brands just
straight up steal a frame from the past, slightly
change the design and colours, and then just
release it as their own.”
Get inspired
Instagram is a great source of inspiration for
your treasure hunt. I recommend following
Davon @frame_gawd for starters. Others
to follow include @carettavintage, @
forgotteneyewear, @oedipus.spex and @
vintz_shop.
If you’re interested in stocking new frames
with a vintage style twist, rather than
deadstock, Cazal are still making frames that
look just like they always have, as are Linda
Farrow and Cutler & Gross.
Affordable Australian brand Bailey Nelson are
just starting to open stores in New Zealand. (See
story p18). They’ve got a great example of the
wire rim trend in their Harrison frame.
What I love about vintage eyewear is that you
can be almost guaranteed to find something
truly unique. Google Casanova’s Simbolismo
series if you don’t believe me! ▀
* Jo Eaton is an optical dispensing student at RMIT. Originally
from Wellington, Jo became interested in eyewear after
discovering she was myopic at the age of 14. In 2008, many
years after deciding to make unusual glasses her ‘thing’,
she founded eyewear fashion blog ‘Eye Heart Glasses’. When
she’s not immersed in the world of spectacles, she works in
digital marketing, DJs, volunteers for community radio and
is a director of feminist music organisation LISTEN.
Marcolin 7023
Taxi St 1
Photographs by Davon Ford
Ogi release two new
collections
US-based Ogi Eyewear have released
two new collections of optical frames
designed “to inspire”.
Firstly, under their Seraphin banner, is The
Barrymore for women. A feminine, handcrafted
acetate frame available in four colours.
With a vintage flair, including Seraphin’s
trademark fleur-de-lis temple tip emblem,
this collection offers a combination of
elegance and durability under the ‘neoclassical’
design umbrella.
The second release, under the Ogi designer
label, is the 7161 Heritage Collection for men.
Handcrafted from three layers of premium
acetate and polished for a gloss finish, these
frames feature tortoiseshell temples, fastened
to the frame by robust triple-barrel hinges.
There’s silver dual-pin detailing to register a
Frame Fashion
Week launched
Eyewear is getting its own Australasian
Fashion week, Frame Fashion Week,
designed to inspire interest in high
fashion frames. The event, which will
comprise ten experiences, including an
optical and a buying group conference, a
retail window competition and an Eyewear
through the ages expo, will run from 1 – 10
July in Sydney, in the Premier Brands area of
the biennial ODMA Fair.
“Frame Fashion Week have chosen our
event, ODMA 2017, as one of their key
showcase events,” said Finola Carey, chief
executive officer of ODMA.
Carey said she does not feel enthusiasm is
waning for industry events, and was pleased
with the way the market embraced this
year’s O-Show. “The key is to deliver events
in response to demand from our customers.
We are working to make ODMA 2017
what the exhibitors and visitors want – a
weekend of shopping with a bit of fun and
entertainment thrown in for good measure.”
Billed as Australia’s contemporary eyewear
festival, Frame Fashion Week aims to
celebrate the relationship between great
eyewear and high fashion. “There will be
a great deal for visitors from New Zealand
to see and do to ensure that the trip is
worthwhile from a business perspective,”
said Sue Dight from event organiser Touring
Enterprises.
ODMA chair Robert Sparkes said, “We are
thrilled at the development of Frame Fashion
Week. The eyewear industry is projected
to exceed US$165 billion by 2022 and we
can only see this relationship with fashion
growing. Frame Fashion Week is a valuable
addition to the industry visiting Sydney,
ensuring this period in July is a must-attend
for the optical industry.” ▀
The Barrymore for women by Seraphin (Ogi)
The 7161 Heritage for men by Ogi
certain vintage-inspired quality. Designed in a
soft rectangular shape, the 7161 is available in
a range of neutral colour options.
Ogi is distributed by BTP International
Designz in New Zealand. ▀
BLACKFIN – New
launch at Silmo
Blackfin’s new autumn/winter 2016-17
collection will be previewed at Silmo Paris
from 23 to 26 September.
The new designs, a mix of spectacle frames and
sunglasses, showcase rounded shapes and unisex
designs such as the model Saint Martin, featuring
a double-arched bridge with curvaceous lines in
two-tone colouring. With either a natural or satin
titanium finish, this model has high-tech appeal
contrasting with the 1980s inspired shape.
All Blackfin frames are made of titanium and
beta-titanium with Swordfish temple tips, and
are made following the neomadeinitaly precepts,
a new all-Italian production model that cares
not only for the product, but for the people who
produce it.
Blackfin is distributed in New Zealand by Beni
Vision. ▀
Blackfin Saint Martin frame, looks great with sunglasses lenses too
UK optom convicted
of manslaughter
In the first case of
its kind in the UK,
locum optometrist
Honey Rose, 35, has
been convicted of
manslaughter at
Ipswich Crown Court.
Rose, who qualified
as an optometrist
in India and took
additional exams
allowing her to
practice in the UK
in 2010, failed to
identify that the optic
discs at the back of
eight-year-old Vincent
Honey Rose, convicted of
manslaughter
“Vinnie” Barker’s eyes were swollen – a symptom of
undiagnosed hydrocephalus. Barker collapsed and
died five months later.
The routine eye exam took place in 2012, and
although Rose claimed to have had difficulty
examining the boy due to his photophobia, a retinal
photograph taken before the eye exam clearly shows
the swelling, suggesting bilateral papilloedema.
During the trial Jonathan Rees QC, prosecuting, said
this “would have been obvious to any competent
optometrist” and should have led to an urgent
referral to treat “a life-threatening condition”. He
referred to Rose’s conduct as “criminal”.
Jurors took just over two hours to find Rose guilty
of manslaughter. Sentencing was set for 25 August.
Speaking to the BBC, Detective Superintendent
Tonya Antonis from Suffolk Police said: “If this case
makes the optometry profession reflect on their
practices and review their policies to prevent it
happening to anyone again, or encourages other
parents to take their children to get their eyes tested
with the knowledge that any serious issues would be
picked up, then it will be worthwhile. ▀
26 NEW ZEALAND OPTICS September 2016

RECEPTIONIST/OPTICAL RETAIL
ASSISTANT - TAKAPUNA
At Haydon Optometrists we are passionate about Fashion
and Quality. We are an independent practice in Takapuna
that is committed to providing our clients with the best –
be it service, advice, fashion eyewear or lens technology.
Central to this commitment is our exceptional staff. We
have an opportunity for a receptionist/optical assistant,
who can provide service that, matches our commitment
to quality. This role will be 2 days per week+ alternate Saturdays
and with a requirement to provide leave cover when
required. This is a job share position.
If you have receptionist or the retail experience we require
and if you can fit into an exceptional team, we want to
hear from you.
If this sounds like you please email your CV to sharon@
haydons.co.nz or call 021 0374800
JOIN US FOR
YOUR PERSONAL INVITATION
BRISBANE CONVENTION & EXHIBITION CENTRE
SATURDAY 10 TH & SUNDAY 11 TH SEPTEMBER 2016
Join 500 optometrists (including more than 100 non-
Specsavers optometrists) at this year’s SCC for two days
in September – for one of Australia and New Zealand’s
premier optometry CPD and networking events.
Visit spectrum-blog.com for more info
MORE CLASSIFIEDS ON PAGE 28
OR JOIN US FULL TIME...
With growth continuing, our store teams are currently
seeking optometrists to fill permanent roles in the following
NZ practice locations:
North Island • Rotorua
• Kerikeri • St Lukes
• Masterton • Tauranga
• Pakuranga • Wellington
• Palmerston North CBD South
• Paraparaumu • Whakatane
South Island
• Dunedin
• Invercargill
• Shirley
We are currently also seeking experienced dispensers for a
variety of our New Zealand stores.
Alternatively, if you’re interested in a move to Australia -
either short or longer term, talk to us for the lowdown on
possible locations in all states.
A trip to SCC as our guest could be the perfect way to see
what's on offer.
To find out more and to explore the T&C'S associated
with this industry-wide offer, contact Carly Parkinson
on 0800 717 350 or carly.parkinson@specsavers.com
– or visit spectrum-blog.com
Optique Line goes Kiwi
Australasian frames designer and distributor
Optique Line has launched a dedicated
New Zealand website for its New Zealand
customers.
Founder John Nicola said it was something the
company had been wanting to do for a while.
“It was important for us to provide our New
Optique Line unveil’s new Kiwi-focused website
Zealand customers with a streamlined online
experience. So we designed a single e-commerce
platform where our entire catalogue of product is
instantly accessible, including the highest quality
images, frame specifications and exclusive online
specials for New Zealand stores.”
Trumpeted with a press release titled, “We are
officially Kiwi,” the new website, which went live in
July, has been specifically designed to make online
ordering easier for Optique Line’s Kiwi customers
with easy to use navigation, a quick search
function for favourite frames, Zoomify, a one-page
checkout process and online exclusive specials and
clearance items. The new site also incorporates an
online blog and e-newsletters for those registered.
“We are dedicated to the New Zealand
independent optometry industry; supporting
continued growth and stability,” said Nicola. “It is
our mission to stay at the forefront of innovation,
seeking and introducing modern methods to assist
our retailers with improved efficiency, knowledge
and passion.”
Optique Line’s brands include Stepper,
Convertibles, Aura Flex, Gemini, Paparazzi and the
just-launched, UK-1960s music-inspired Mersey
Beat range.
E Y E W E A R
MERSEYBEATEYEWEAR.CO.UK
Optique Line also changed its company name to
reflect its full New Zealand status to Optique Line
NZ Ltd from the Australian Optique Line NZ PTY
Ltd. Existing subscribers to the old website will
need to update their online login details and reset
their passwords, said the company. ▀
Aussie optoms work 36hrs/wk
The Australian Institute of Health and
Welfare’s Eye health workforce in Australia
reports that the average working week for
Aussie optometrists is just 36 hours.
The report, which was designed to document
the occupations around eye health and profile
the workforce, was published at the end of
May and offered a number of insights on the
profession. It also noted that nearly 12 million
Australians, or 54% of the total population, have
reported suffering from one or more long-term
eye conditions (Australian Bureau of Statistics
2011-12 National Health Survey).
Demographic changes
In 2014, half of all Australian optometrists were
women, with an average age of 42 years. The
average age of optometrists in outer regional
areas was 44 years, and was lowest in major
cities at 41. In 2006, the highest average age had
been 50 years in remote and very remote areas,
and the lowest had been 39 years in major cities.
Less than 1% of optometrists were of Indigenous
background.
While optometrists in outer regional areas
worked the highest number of hours per
week on average in 2014 (38 hours), those in
major cities worked the least (just 36 hours).
Ophthalmologists worked the longest hours
among eye-health professionals, at 42 hours per
week, and occupational therapists worked the
least (31 hours).
A growth industry
The Australian eye care workforce grew by nearly
25% between 2006 and 2011, driven by a boom
in optical dispensers (a 37% increase) and is now
around 11,000 people. The Australian population
grew by almost 29% over the same period. Wages
for optometrists increased by 2% from 2011. The
report also found an increase in those working
in optometry as employees, with 89%, or 4,337
out of 4,885 employed in 2014 – an 8% increase
from 2011.
By 2011, 10,916 people worked in the eye
health workforce, the latest year for which
data was available for most of the eye health
professions. The majority were optometrists
or optical dispensers, with 37% or 4,034
being optometrists and 41% or 4,481 optical
dispensers. The 2011 workforce also included
828 ophthalmologists, 674 orthoptists, 651
optical mechanics, 158 orientation and mobility
specialists and 90 occupational therapists
specialising in eye health. ▀
Editor’s note: Grant Hannaford, the former vp of
the Australian Dispensing Opticians Association,
has challenged the number of practicing DO’s
in the report. Hannaford claims there are
approximately 2,400 qualified optical dispensers
in Australia, not 4,481. The confusion seems to be
the result of industry deregulation.
Does this ring true for you? Send us an email at
editor@nzoptics.co.nz so we can build a picture of
the New Zealand optometrist’s working week.
SHOP ONLINE NOW!
Get the latest models exclusively at
(NZ) 0508 678 478 optiqueline.co.nz
September 2016
NEW ZEALAND OPTICS
27

MORE CLASSIFIEDS INSIDE
ON PAGE 27
DISPENSING OPTICIAN /
OPTICAL ASSISTANT
PATERSON BURN OPTOMETRISTS HAMILTON
& SURROUNDS
We are looking for a passionate Dispensing Optician / Optical
Assistant to join our family.
In this role you will offer an amazing eye care experience by
providing exceptional customer service with honesty, care and
absolute attention to customer needs.
We offer a great working environment with continuous support
and professional development opportunities.
To be successful in this role you will:
• Have a friendly, natural and consultative approach to selling
• Be confident, enthusiastic and motivated to succeed
• Have excellent communication and sales skills
• Be a versatile team player
Experience as a Dispensing Optician or Optical Assistant is
preferred.
If you are not yet qualified, we will provide the opportunity and
support to qualify as a dispensing optician.
CALLING ALL OPTOMETRISTS FROM
AUSTRALIA AND NEW ZEALAND!
Specsavers Invercargill has an exciting opportunity for an
optometrist to take up either a permanent or block position in
their practice.
The practice itself is lead by 2 dedicated store directors and a
team of experienced and passionate employees, who have a
strong reputation within the local community. It has two test
rooms, a dedicated pre-test area, 5 dispensing desks and a loyal
patient database.
WHY SPECSAVERS INVERCARGILL?
You may be aware that Invercargill is the capital of the
Southland region of New Zealand, and the gateway to some
of the country’s most beautiful scenery, cultural attractions,
nature reserves and parks, as well as a city life with lively cafes,
restaurants, and bars.
What you may not be aware of is that Invercargill is located an
hour and half from some of the best skiing and snowboarding in
the world – and not only that - free use of an exclusive chalet is
on offer to the optometrist that joins this team!
If you would like to;
• Further develop your clinical skills and practice within a
setting that sees a variety of pathology cases
• Tear up the ski slopes (or observe from the chair lift – your
choice!) by having free use of a chalet on your days off
• Find out about the attractive package and sign on bonus that
is on offer
• Find out how Specsavers can support AUS optometrists to
work in NZ and financially support the earning of your
annual CPD points
Then please contact Carly Parkinson on +61478201057 or carly.
parkinson@specsavers.com for a confidential chat today!
OPTOM PLATE FOR SALE
The personalised plate OPTOM is for sale after 18 years. Asking
price is $3000+GST or make an offer. Additional fees apply to
change or remove message and have the plate made.
Contact stuart.warren@nzoptom.co.nz
OPTOMETRIST - QUEENSTOWN
We currently have an exciting opportunity for an Optometrist to
join our Specsavers store in Queenstown on a permanent basis.
Surrounded by majestic mountains and the beautiful crystal
clear Lake Wakatipu, the tranquillity and natural beauty of
Queenstown is the perfect destination for a lifestyle full of
adventure, exploration or relaxation.
The region is renowned for its four distinct seasons, spectacular
scenery and world class activities and attractions .Whether
you’re an adrenaline junkie, food or wine connoisseur, skier or
snowboarder, fisherman or enjoy hiking - there is something
for everyone.
This is a small practice which consists of a team of 5, including the
2 dedicated directors, who have a strong reputation within the
local community. This store is located in a high socio economical
area, which is only a 5 minute drive from the ski fields.
We pride ourselves on providing exceptional service to our
customers. This is achieved by support you will receive by our
Retail Staff and Optical Dispensers, to ensure every customer
receives the highest quality treatment possible.
If you are interested in this opportunity or may know someone
within your network, please contact Aaron Irvine direct via email
dir.queenstown.nz@specsavers.com or call 021 0374800
Whether you are looking for new staff, to sell your practice or buy
some equipment, NZ Optics classified page connects you.
For all your advertising needs email
Lesley@nzoptics.co.nz or
(for classifieds only) do it online at
www.nzoptics.co.nz
This position is full time, based in Hamilton and/or Cambridge
and requires some Saturday work.
To apply:
Please email your CV and a cover letter to sandri@patersonburn.
co.nz
Paterson Burn Optometrists is one of the largest independent
optometry practice groups in New Zealand. We are totally
independent and Waikato owned and we've maintained our
independence in the ever changing environment of New Zealand
optometry. Our core purpose is to improve people's lives by
providing the best visual solutions available. Paterson Burn
Optometrists value respect, integrity, accountability, enjoyment,
continuous improvement, freedom for initiative and teamwork.
DISPENSING OPTICIAN
HAVELOCK NORTH
Grant & Douglas Optometry & Eyewear are seeking a qualified
Dispensing Optician (or someone who is currently training to be
a Dispensing Optician). We are a busy independent Optometry
practice providing excellent eye care and eye wear solutions
tailored to our customer’s individual needs.
This role will be based mainly in our Havelock North practice
however you may occasionally be required to work in our
Hastings practice.
This is a great opportunity for a confident, versatile individual
who has the following attributes:
• Experience in customer service with a proven track record for
a high level of customer satisfaction.
• Excellent communication and sales skills.
• Shows initiative, is reliable and honest.
• Strong computer literacy.
• Good standard of personal presentation.
• Able to work cohesively and productively within a team.
Monday to Friday, approx 30 - 40 hours per week (Negotiable)
Please email your CV and cover letter outlining your skills and
experience to Anna Byers abyers@grantanddouglas.co.nz
D/O TO COVER MATERNITY LEAVE
We require a dispensing optician for a one year fixed term
contract to cover maternity leave in sunny Gisborne. Hours and
days worked flexible, either part time or full time. Contact either
Steve Stenersen or Sue Kain (06) 867 5465, 027 486 7540, or
steve@sko.co.nz
Thinking of selling your practice - we have buyers
Considering buying - we’ll give you all the options
OpticsNZ specialises in optometry practice sales,
we've helped dozens of Optometrists buy and sell their practices
For more information contact Stuart Allan on: 03 546 6996
027 436 9091 stu@opticsnz.co.nz www.opticsnz.co.nz
• Locum Service
• Recruitment Services
• Practice Brokering
• Business Consultants
28 NEW ZEALAND OPTICS September 2016