Dec 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 

DECEMBER 2016 

www.essilor.co.nz 

Clear vision and comfortable 

posture for digital activities 

THE SOLUTION FOR MODERN 

PRESBYOPES’ DIGITAL NEEDS

OUR EXPANSION… 

YOUR CAREER GROWTH 

A MUTUAL OPPORTUNITY 

As the Specsavers network of 370 New Zealand and Australian stores continues to 

experience significant growth, opportunities abound in metro and regional locations 

for career focussed optometry and dispensing professionals. 

For those taking a fresh look at what Specsavers offers as a working 

environment, the scale and format of our store locations continues to evolve 

with exciting results for our partners, our teams and our patients. Take 

Specsavers Ringwood as an example, recently recognised at the Australian 

Retail Awards as the outstanding retail design project of the past year. It is 

more than double the size of its previous location in the same shopping centre, 

with six consulting rooms, 12 dispensing desks, a contact lens teaching zone 

and four pre-testing rooms. Its investment in the latest retail and optometric 

technology is exemplary, offering a glimpse of the future. 

And now, as we look to the next phase of growth, we want to talk to you 

about our plans – and hear about yours. Our growth really can be your 

opportunity, whether you are looking at a store partner or an employed role - 

at every level of experience. 

To get the conversation started, contact Chanelle Coates on 0800 717 350 or by email on chanelle.coates@specsavers.com 

Retail 

Store Design 

Award 

2016 

Retail 

Employer 

of the Year 

2015 

Overall 

National 

Supreme Winner 

2015 

ANZ Customer 

Service Excellence 

Award 

2015 

Franchise 

Innovation 

Award 

2015 

NZ Franchise 

System of 

the Year 

2014 

Retail 

Innovator 

of the Year 

2014 

Multichannel 

Retailer 

of the Year 

2014 

Roy Morgan 

Research 

No. 1 for eye tests 

2014 

FCA International 

Franchisor 

of the Year 

2014 

FCA Social 

Responsibility 

Award 

2014 

2 NEW ZEALAND OPTICS December 2016

Waiting times: a national problem 

BY JAI BREITNAUER 

Senior ophthalmologists are welcoming the 

national publicity achieved by the story that 

some South Island patients are going blind as 

a result of waiting times for follow-up care. 

“We had discussed this situation with the minister 

of health in March 2015 and no action has occurred 

from government,” says Royal Australian and New 

Zealand College of Ophthalmologists (RANZCO) NZ 

President Dr Stephen Ng. “For us, it’s a chance to 

highlight it’s a national problem. All DHBs are under 

the same pressure. All DHBs have large numbers 

of follow-up appointments that are delayed to the 

point where it is becoming a huge clinical risk. The 

people on the waiting list who are reported to have 

gone blind in Invercargill, well we all know of cases 

where this has happened in other DHBs.” 

Dr Ng says the issue finally came to light after two 

ophthalmologists, one from Nelson Marlborough 

DHB and one from Southland, placed patients on 

the local risk register. Usually, these occurrences 

are reported to a local manager in the DHB, but 

by placing them on the register they were picked 

up by the Health, Quality and Safety Commission 

and included in the commission’s Learning from 

adverse events report. The report, published on 

10 November, highlighted the rise in reported 

ophthalmology-related events to 44 this year, 

and the resultant risk of vision loss from too long 

waiting times. The national media coverage resulted 

from a RANZCO press release issued just prior 

to the report, which renewed calls for an urgent 

government review of waiting time targets. It 

highlighted the case of “KB” – a 23-year-old who 

was diagnosed with glaucoma and, due to the lack 

of timely follow-up, was left blind in one eye and 

needing urgent surgery to save the other eye. 

“This year, Southern and Nelson Marlborough 

DHBs both reported a number of individual 

ophthalmology events, including a delay in followup 

appointments. The Commission commends 

these DHBs for showing leadership in this reporting. 

These DHBs are currently reviewing these events 

and will make improvements based on the 

findings,” said commission chairman Professor Alan 

Merry. 

“This is a prompt for other DHBs to look closely 

at their ophthalmology services to ensure people 

are being seen in a timely manner, with high-risk 

patients prioritised.” 

Targets putting pressure on services 

Dr Ng believes the solution to this problem is 

greater than can be handled at a local level. 

“The health targets for seeing new patients need 

adjustment [which needs to be done at government 

level]. At present every DHB is required to have 

patients that are referred for specialist appointments 

to be seen within four months. That means those 

people get in the door, but those who have already 

been seen and need follow-up care get less priority. 

They end up in this delayed follow-ups cohort that is 

building up and building up because of the pressure 

to get [new patients] in the front door – it means the 

follow-ups are just being shut out.” 

The aging population, increased diabetes and 

the success of treatments for other eye conditions 

have resulted in a larger number of people needing 

ongoing ophthalmology care, explains Dr Ng. 

“This is an expected part of the baby boomer 

generation that everyone has been talking about 

for years – it’s here and now. It’s exacerbated by the 

fact the government has targets for new patients 

and surgery that don’t take into account the huge 

number of people requiring chronic care for the rest 

of their lives.” 

Dr Graham Reeves, a consultant ophthalmologist 

with Counties Manukau and new Eye Institute 

doctor (see story p16), agrees. “This is not 

necessarily an isolated problem. New Zealand has 

an ageing population with chronic eye disease [and] 

once diagnosed, you need to care for those patients 

for the rest of their lives.” 

Dr Reeves notes this task in itself is difficult under 

current conditions, but the Ministry of Health has 

120-day maximum wait time guidelines for surgery 

which (as well as the guidelines for new referrals) is 

shifting the focus away from the patients who need 

care the most, he says. 

“We have to focus on new surgical patients, 

mostly cataracts, to avoid being penalised. Other 

patients suffer the consequences because we can’t 

keep up. We don’t have enough doctors or physically 

enough space. 

“There’s no easy answer, but it’s difficult when 

priority is being placed on patients who may not 

be going blind. Having cataracts is traumatic, but 

completely reversible, while delays in the treatment 

of those with other conditions can result in 

permanent blindness.” 

A question of community care 

Both Dr Reeves and Dr Ng want more focus to be 

placed on increasing resources around patients with 

conditions like glaucoma and AMD. 

“We need more ophthalmologists and we 

need more investment in training for nurses and 

optometrists to work alongside us in teams to deal 

with the huge numbers we’re seeing in every DHB,” 

says Dr Ng, adding he favours some form of allied 

community care. Dr Reeves says many of the clinics 

he works in are already running joint initiatives with 

nurses and community optometrists. 

In a world where ophthalmologists are 

collaborating more with optometrists and the 

scope of prescribing rights within the optometry 

industry have been extended, it seems logical to 

support the opportunity to offer additional training 

to optometrists to take on this increased role of 

community-based patient care. However, one 

source who did not wish to be named, says that 

in the past shared-care programmes have fallen 

over due to one important sticking point – money. 

The public system can’t support the current rate 

of pay of the average optometrist working at their 

current speed. It’s not financially sustainable in a 

sector that many feel is underfunded and stretched 

already, the source says. “Simply put, it’s cheaper to 

keep this level of eye-care in a public hospital.” 

Another issue is risk and who is responsible for 

it. An issue highlighted earlier this year when a UK 

optometrist was taken to court and found guilty 

after failing to spot a serious medical condition in a 

young patient, resulting in the patient’s death. 

“Many optometrists would still prefer the 

ophthalmologist to have responsibility as the main 

care giver,” the source says, highlighting training 

differences. “Many lay-people see an optometrist 

and an ophthalmologist as the same thing, but we 

do two very different jobs.” 

Representatives of RANZCO met with the chief 

medical officer on 15 November, together with 

representatives from nursing and optometry, to try 

to get to grips with the problem. 

“Allowing chronic eye conditions to advance 

unchecked, places a significant burden on the 

health service with more complex, time-consuming 

and expensive treatments required,” explains 

RANZCO president Dr Brad Horsburgh. “Studies 

show that, while the cost of treating chronic 

eye conditions and having regular check-ups to 

maintain eye health is minimal, the economic 

impact of treating and supporting a person who 

has lost their vision is substantial. The government 

could make cost savings in the long run by 

preventing blindness now.” 

A report, Social and economic cost of macular 

degeneration in New Zealand, launched at the time 

of going to press by Macular Degeneration New 

Zealand shows the cost of blindness due to macular 

degeneration is around $216.6 million a year, which 

vastly outweighs the cost of treatment to prevent 

people going blind in the first place, continued 

RANZCO. 

“RANZCO is really trying to concentrate on the 

needs of our patients, they’re the ones suffering 

under the system,” says Dr Ng. “We want to be at 

the forefront of trying to define solutions.” 

For more, see our new column “Eye on optics by 

Happy holidays! 

EDITORIAL 

Welcome to the last issue of the year and 

two exciting new columns. 

Eye on Optics by Chalkeyes pays tribute 

to that rascally business columnist Chalkie, who 

used to frequent the back page of infamous Kiwibattler, 

the Independent Business Weekly. Like 

Chalkie, the column is anonymous to allow the 

small group of regular, authoritative writers to 

share their well-considered views without fear of 

losing their jobs. 

Macular milestones, meanwhile, has been 

put together with MDNZ and trustee Dr David 

Worsley to highlight interesting macular 

research. This new, quarterly column augments 

the work of our wonderful monthly research 

columns Eye on Opthalmology and Focus on 

Research (thanks Hutokshi, Charles and Hussain, 

we really couldn’t do it without you!) 

What a year! Each month we find ourselves 

struggling to include all the happenings in 

our exciting industry and this month was no 

exception. Silmo, Visionz, ADONZ and the Eye 

Institute conferences have all vyed for space 

between a wealth of news and views. We hope 

you enjoy reading it all as much as we enjoy 

covering it for you! 

Have a fabulous holiday. We’ll be back with 

even more in our February issue. 

Cheers and a very Merry Christmas, 

Chalkeyes” on p27. ▀ 

Join us for a fantastic 

day at the track 

On Saturday 18th February 2017 

at Auckland Racing Club, Ellerslie 

Lesley Springall, publisher, NZ Optics 

Essilor launches Digitime 

Essilor has launched Varilux Digitime, a new 

range of occupational lenses for modern 

presbyopes, taking into account patients’ 

daily digital needs. 

The new addition to the Varilux range of 

progressive lenses (worn by more than 400 million 

people worldwide) will add a point of difference 

to your practice, explained Tim Thurn, Essilor’s 

director of professional services, speaking at Essilor’s 

Platinum Partner’s regional conference in Auckland 

last month. They are also far easier and simpler to 

understand and prescribe, compared with Essilor 

and Nikon’s older occupational lens offerings, 

Interview and Weblens, designed in 1998 and 2000 

respectively, well before smartphones, he said. 

Today’s digital devices have changed presbyopes’ 

visual and postural behaviour, with 70% of 45 to 65 

year olds saying they suffer from tired eyes and neck 

and shoulder pain - a common ailment as people 

stick their necks out and lean forward to read their 

screens more easily. 

It all comes down to how far away your screen is, 

said Thurn, with research by Essilor showing that 

people have very variable distances of preferred 

screen usage. A person’s average eye distance to 

their desk computer is 63 cm, but the range varies 

from between 38cm and 88cm, a whopping 50cm 

variation between users. 

The distance between eyes and device should be measured 

Thus in addition to normal progressive 

measurements, to maximise the effect of Digitime, 

Essilor requires the patient’s preferred eye distance 

from their desktop computer to be measured. 

Without this, the lens manufacturing process will 

default to the 63 cm average, which works, but not 

as well as when the actual device distance is known, 

stressed Thurn. 

Varilux Digitime comes in Near, Mid or Room 

variations, with the first focusing on near vision 

CONTINUED ON P4 

Join us for a fantastic 

day at the track 

On Saturday 18th February 2017 at Auckland Racing Club, Ellerslie 

Join us from 12 noon in the Guineas Room, where you will be treated to drinks on arrival and a 

delicious buffet lunch, plus much more. Witness the extravaganza of horse racing including the 

prestigious Avondale Cup and Avondale Guineas races. Enjoy a great day, while fundraising for 

Macular Degeneration New Zealand and their work in the Macular Degeneration community. 

A table of 10 package is $1,250 

(incl. GST) and includes: 

• Table in the Guineas Room for 10 guests, including 

drinks on arrival, buffet lunch, afternoon tea and 

cash bar 

• Entertainment throughout the day including 

tipsters, jockeys, celebrities and unique 

experiences 

• Opportunity to display product and branded 

pull-up banners in the Guineas Room for the day 

• Free carparking 

A Unique Experience is $100 (incl. GST) 

for 4 people for either option: 

1. Experience the Commentary Box 

2. Experience the Race Start 

Book now to be on the inside! 

Individual tickets $140 (incl. GST). 

Earlybird tickets $125 (incl. GST) 

(before 31 December). 

Visit www.mdnz.org.nz to secure your tickets online. 

1 in 7 people over 50 will get Macular Degeneration. 

All funds raised on the day will gratefully go to support the Macular Degeneration community. 

To take up this opportunity, please contact Alice McKinley at 027 634 0495 or events@mdnz.org.nz 

December 2016 

NEW ZEALAND OPTICS 

3

News 

in brief 

NEW BRIEN HOLDEN AWARD 

The American Academy of Optometry (AAO) 

announced the establishment of the Brien 

Holden Humanitarian Award to honour the 

memory and work of the late great eye-care 

humanitarian, Professor Brien Holden. The 

new award, established by the Brien Holden 

Vision Institute and the Holden family estate, 

will be administered by the AAO and awarded 

annually to an individual or organisation who 

has made significant contributions to improve 

eye care within a country or region. 

NOVARTIS ALCON SALE? 

Drugmaker Novartis is considering selling its Alcon eye care division, 

chairman Joerg Reinhardt confirmed in an interview with Swiss 

weekly SonntagsZeitung. Alcon was bought from Nestlé in 2010 

after a lengthy series of deals totalling US$52bn as part of former 

CEO Dan Vasella’s vision to build a European healthcare giant. Since 

Vasella’s departure in 2013, Novartis has switched focus back to its 

prescription drugs and Sandoz generics business units, leaving Alcon 

to struggle, say commentators. “In the long run, the question arises 

as to whether we are the best owner for Alcon,” said Reinhardt. 

BETTER TESTS FOR HYPEROPES 

Research suggests noncycloplegic retinoscopy and the Retinomax 

autorefractor are better for detecting moderate hyperopia in 

children than other tests. The study, led by Dr Bruce Moore from 

the Massachusetts College of Optometry, screened more than 

4,000 three to five year olds for amblyopia, strabismus, significant 

cycloplegic refractive error and reduced visual acuity. 

AUSTRALIAN EYE-HEALTH REVEALED 

The results of the first Australian 

National Eye Health Survey were 

revealed on World Sight Day in 

October showing indigenous 

Australians are three time more 

likely to suffer from blindness 

and vision impairment than the 

non-indigenous population; and 

cataracts were the leading cause of blindness among indigenous 

Australians, while age-related macular degeneration was the 

main cause in the rest of the population. For more, visit www. 

vision2020australia.org.au 

ODOB FEE, PRACTICES REVIEWS 

The ODOB is conducting reviews of the 2017/18 fees and optometry 

scopes of practice. Consultation documents can be viewed on the 

ODOB website, www.odob.health.nz. Submissions are due by the 9 

and 23 December 2016 respectively. 

RANZCO UNDER FIRE 

Optometry Australia has criticised RANZCO’s Referral Pathway for 

Glaucoma Management released in August. The RANZCO guideline 

document “fails to reflect the diversity of optometry expertise 

and clinical circumstances and optometrists’ scope of practice, 

and diverges from current guidelines,” said Optometry Australia, 

in a statement released after consultation with the industry. 

“The RANZCO referral pathway was developed without advice 

from Optometry Australia, the professional organisation which 

represents the optometry profession in Australia, yet it seeks to 

advise our profession on patient care… Though RANZCO has every 

right to release referral pathways to its own members, it does 

not have authority to instruct the optometry profession on how 

patients should be managed or referred,” said national president 

Kate Gifford. 

PHARMAC PARTNERSHIP 

PHARMAC announced a new partnership with the Best Practice 

Advocacy Centre NZ, based in Dunedin, and the Goodfellow Unit 

of Auckland University, to support prescribing decisions and 

promote responsible use of medicines. The partnership will provide 

healthcare professionals with high-quality clinical information 

to enhance patient care and prevent the overuse or misuse of 

medication, said PHARMAC deputy medical director, Dr Bryan Betty. 

EXAGGERATED BLUE LIGHT CLAIMS CRITICISED 

UK high street opticians Boots and Vision Express have come under 

fire again in UK media for making allegedly exaggerated and bogus 

claims about the dangers of blue light from devices. Researchers 

for the BBC’s Watchdog programme (similar to Fair Go) found Boots 

staff are still misleading customers even after the Advertising 

Standards Authority banned Boots’ adverts last year. It was found 

there was no good scientific evidence to support the chain’s claims 

about their Protect Plus Blue lenses. 

DEXTENZA PASSES PHASE III 

Professor Brien Holden 

Indigenous populations have different eyehealth 

needs 

Ocular Therapeutix announced positive topline results from its 

phase III clinical trial of Dextenza (dexamethasone insert) 0.4 mg, 

for the treatment of post-surgical ocular inflammation and pain. 

The trial achieved statistically significant differences between 

the treatment group and the placebo group for the absence of 

inflammatory cells on day 14 and the absence of pain on day eight, 

respectively, said the company. ▀ 

CONTINUED FROM P3 

devices; the mid, near to intermediate devices; and Room, more 

intermediate and extended vision (the television across the room). 

The new lenses are aimed at new and existing presbyope wearers 

looking for a solution for the office, specific occupational needs and 

other activities; people whose head/body posture is causing them 

discomfort when they use their computers; or people whose hobbies 

and leisure activities (like needlework) require specific correction. 

The new lenses are available in all materials including Transitions 

photochromic lenses and all coatings, and are available to all. 

Sunglass deal for Essilor partners 

Also announced at the Essilor Platinum Partners roadshow is the 

company’s new promotion to encourage more practices to sell more 

prescription sunglasses, Sun2Max. 

Research (Essilor’s and others) shows there’s a massive opportunity to 

grow revenues by growing sunglass sales, said Guy Parbury, Essilor NZ’s 

business development consultant. 

Seasonality in sunglass sales is not so much driven by the seasons, 

but by the enthusiasm of practice managers when their new sunglass 

stock arrives, he said. “You can sell sunglasses through the year. 

Seasonality is driven by our behaviour, not our patients behaviour.” 

Practice owners should ask themselves: do we have the frames 

to sell? Do we display them well? Do we have the right offer? 

Do our patients know our offer? Do we offer it at the right time? 

Sunglasses should be displayed all year round and should be displayed 

prominently alongside other frames, and patients should be given a 

simple and very cost effective offer to encourage them to buy. This 

It’s been a big couple of months for Wanakabased 

practice Eyes on Ardmore, who unveiled 

its new brand, Ocula, on 24 November. 

“Eyes on Ardmore was recently remodelled in 

anticipation of the new name, bringing it in line 

with the new, modern concept,” said Danielle Ross, 

director and principal optometrist. 

A new, second practice under the Ocula name 

will be opening on 9 December in Queenstown, 

owned by Danielle Ross and eyewear specialist 

John Winstone, who acquired Bridgman and Dean’s 

Queenstown practice in November. All the patient 

records from Bridgman & Dean Queenstown are 

being transferred to Ocula. 

Drivewear becomes sportswear 

Younger Optics’ award-winning polarised photochromatic 

Transitions Drivewear lenses and plano sunglasses are flying 

off the shelf, not for driving, but for sports people, says the 

company, leading to a whole new consumer marketing campaign and 

a new focus. 

“Transitions Drivewear has been around for a few years now and it 

was originally developed as a driving lens, but what we’ve found over 

the last couple of years is that we are selling more and more to sports 

people,” says Craig Johnston, Younger Optics’ ANZ national sales and 

marketing director. 

The lens is proving particularly popular with fishermen, golfers and 

cyclists, so for the first time the company has launched a direct-toconsumer 

marketing campaign in several Australian golf, fishing and 

cycling magazines, many of which are also available in New Zealand. 

The consumer campaign is echoed in practices with free point-of-sale 

materials, such as window posters, counter cards and brochures so 

eye care professionals can offer their sporty patients an edge, says 

can either be at the end of their visit, after they’ve selected their new 

frames and lenses or, if this is too much information for them, when 

they come back to collect their new glasses, suggested Parbury. 

This simple offer, however, was not simple in the making with Essilor 

engaging a marketing consultancy and contacting all its preferred 

frame partners to tie together something that works. The result: 

with every pair of prescription glasses a patient buys from an Essilor 

Platinum Partner, that patient can also buy a pair of sunglasses, with 

exactly the same prescription, coatings etc. for just $249. 

All lenses include Crizal Sun UV for added UV protection, and have 

the Cancer Society NZ tick of approval. Excluded are more high-end 

sunglass frames, and it costs an extra $80 for patients to upgrade to 

polarised lenses. 

New point-of-sale and window display materials have been produced 

and are available now for any partner practice that wishes to give it a 

go. The one trial practice that had, at the time of presentation, grew its 

sunglass sales from a yearly average of 6% to 18% in one week and 22% 

in week two, said Parbury. “So why wouldn’t you give it a go!” 

For more marketing wisdom from the Essilor Platinum Partner’s 

roadshow, see February’s NZ Optics. 

Would you like Transitions with that? 

All change for Eyes on Ardmore 

Fisherman and golfers are opting for Transitions Drivewear to give them “an edge” 

With evidence showing that once people have tried photochromatic 

lenses, they tend to stay with them, Essilor is also offering its 

Platinum Partners the opportunity to encourage their patients to 

give Transition lenses a go by making Transitions free with EyeZen 

or Digitime lens from now until the end of the year! ▀ 

“Ocula exists to deliver an exceptional eyecare 

and eyewear experience, providing full-scope 

optometry, the latest diagnostic equipment and a 

range of exclusive eyewear brands,” said Ross. 

Eyes on Ardmore has been serving Wanaka since 

2001, with Ross acquiring the business in 2009. 

The company’s focus is on providing a high level 

of clinical expertise backed up by retail innovation 

and excellent customer service, said Ross. 

Reflecting this, Eyes on Ardmore’s team was 

the recipient of the prestigious Outstanding in 

Professional Services award at the inaugural 

Wanaka Chamber of Commerce Business Awards in 

November. ▀ 

PICTURE FROM CAMPAIGN 

John Winstone and Danielle Ross at the 

Wanaka Chamber of Commerce Business 

Awards 

Johnston. “That’s the whole concept behind the campaign, because 

that’s what our Drivewear lenses do, they enhance your vision, to give 

you that extra edge, make you that little bit better at what you do.” 

Younger’s free point-of-sale materials are available in New Zealand 

and if the consumer campaign is successful in Australia – which it’s 

looking like it will be, says Johnston – it’s very likely this will be rolled 

out in similar magazines in New Zealand. 

The new marketing drive also gives the company an opportunity to 

re-educate the market about Transitions Drivewear lenses as they are 

still unique, says Johnston. 

Transitions Drivewear lenses are the only polarised, photochromatic 

lenses that automatically change to three different colours, while 

darkening and lightening. 

“The lenses change colour for a reason. The colours are designed to 

enhance vision and increase your visual field depth. That’s why sports 

people have picked them up, because they enhance the colour of 

the ball, the undulations on a golf course, and give you better vision, 

blocking blinding glare, whether you’re cycling, fishing or whatever.” 

More and more ophthalmologists in Australia and the US are also 

prescribing them for their low vision patients, says Johnston. “They 

can’t increase their patients’ prescriptions, but by enhancing their 

vision through colour, they can enhance their vision and increase 

their depth of field.” 

According to the company’s marketing materials, “in bright sunlight 

Transitions Drivewear darkens up to a 90% tint with a dark brown 

colour to block intense light. While in overcast conditions, the lens 

lightens to an olive colour with a 63% tint allowing wearers to see 

more of their world. When driving or in mid-light conditions, the 

lens darkens or lightens to a copper colour with approximately 75% 

tint for excellent depth perception and enhanced contrast for visual 

quality and safety.” 

Developed with ophthalmologists and optometrists in the US, 

Transitions Drivewear combines Transitions’ photochromic technology 

and Younger Optics’ NuPolar polarisation. The lenses are available 

in 1.50 hard resin, high-impact polycarbonate and Younger’s Trilogy 

materials and come in a wide range of designs and prescriptions. ▀ 

To order the free point-of-sale material visit 

www.drivewear.com/ECP 

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. 


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References: 1. Christensen M, Blackie CA, Korb DR, et al. An evaluation of the performance of a novel lubricant eye drop. Poster D692 presented at: The Association for Research 

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Lubricant Eye Gel. Presented at American Academy of Optometry 2011, Boston, MA. 3. Davitt WF, Bloomenstein M, Christensen M, et al. Efficacy in patients with dry eye after treatment 

with a new lubricant eye drop formulation. J Ocul Pharmacol Ther. 2010;26(4):347-353. 4. Aguilar A. Efficacy of a Novel Lubricant Eye Drops in Reducing Squamous Metaplasia in Dry Eye 

Subjects. Presented at the 29th Pan-American Congress of Ophthalmology in Buenos Aires, Argentina, July 7-9, 2011. 5. Geerling G, et al. The International Workshop on Meibomian 

Gland Dysfunction: Report of the Subcommittee on Management and Treatment of Meibomian Gland Dysfunction. IOVS. 2011;52(4):2050-2064. Alcon Laboratories (Australia) 

Pty Ltd. 10/25 Frenchs Forest Road East, Frenchs Forest NSW 2086. Distributed by Pharmaco (NZ) Ltd in New Zealand, 4 Fisher Crescent, Mt. Wellington , Auckland. Ph 0800 101 106. 

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5

Southern Eye opens 

new facility 

Southern Eye Specialists officially opened 

its new buildings at 128 Kilmore Street, 

Christchurch Central on 26 October. The 

evening opened with a blessing, followed by 

speeches from chairman, Dr Jim Borthwick, 

welcoming over 200 guests to the event, and 

Dr Allan Simpson, who made a donation to the 

neighbouring Otakaro Orchard community garden 

project on behalf of Southern Eye Specialists. The 

event was attended by local referrers, colleagues 

and members of the local community. 

Chrissie Dodds, Southern Eye Specialists practice manager, and the team from Cardiology Associates 

There are eight ophthalmologists working at 

Southern Eye, Drs Jim Borthwick, Sean Every, 

Allan Simpson, Rebecca Stack, Jo-Ann Pon, John 

Rawstron, Rob Weatherhead and Logan Robinson. 

All are New Zealand and fellowship-trained and 

experts in their respective fields. The practice has 

grown significantly over the last few years and 

it was becoming clear that larger purpose-built 

premises would be required in the future. 

The new rooms comprise three floors across 

two buildings in a new development at 128 

Kilmore Street, Central 

Christchurch. There is 

also increased parking 

for patients on site. The 

number of consultation, 

nursing and treatment 

rooms has been doubled, 

ensuring that patients 

are treated efficiently, 

quickly, and in comfort. 

There has also been 

significant investment in 

new equipment, ensuring 

that the new premises 

offer among the best 

treatment options to 

Christchurch and South 

Island patients. ▀ 

Guests gather outside the new building for the blessing 

Dr Jim Borthwick welcomes guests to the opening of the new building 

The building being blessed 

NZAO rocks New Plymouth 

In October the NZAO 

hosted their 86th annual 

conference at Novotel 

New Plymouth. Topics 

centred on therapeutic 

management and the role 

we play in the primary care 

setting. Approaches to 

clinical diagnosis and new 

areas of research were also 

discussed. 

NZAO president Callum 

Milburn welcomed attendees 

to open the conference, 

with a summary of the 

year so far and the recent 

developments for NZAO. I 

attended the conference as a 

representative of Wanganui 

Eyecare. As this was my first 

year, it was a great opportunity for networking within 

such a collegial atmosphere. 

The conferences took place over the weekend, 

structured as a series of lectures, seminars and 

interactive workshops. As the field of New Zealand based 

optometrist-prescribers grows, the State University of 

New York’s (SUNY) Dr. Mitchell Dul’s animated lecture 

series was certainly timely. In an environment where 

optometrists are more extensively involved in treatment 

than they are in New Zealand, it served an as insight into 

the direction we are heading. In keeping with the theme 

of community practice, a number of local optometrists 

further discussed community engagement. With 

presentations on various models, we were introduced 

to the idea of a union between hospital systems and 

community practices for the treatment of glaucoma. 

Our keynote speaker from Flinders University, Konrad 

BY JOHN BOYLE* 

(L to R) John Anderson, Tim Harrington, David Neil, Kathy Stone, A/Prof Rob Jacobs, Mike Frith, Peter Turner and Knox Laird 

Pesudovs, encouraged us to broaden our approach while 

making a clinical diagnosis. With a background in both 

general practice and academic settings, it was interesting 

to hear Konrad’s perspective on the deceptive and 

often insidious red eye. Workshops on Sunday featured 

discussions regarding glaucoma, binocular vision, low 

vision and courses from the NZ Red Cross on First Aid. This 

allowed us to gain first-hand experience with specialists 

in their respective fields. Plenty of time was set aside for 

questions and for a few contentious debates! 

Evenings were spent in conversation with other 

optometrists or specialists from across New Zealand 

and internationally. A highlight of Friday evening was 

inadvertently having my dinner paid for by a friend and 

colleague— thanks Rob! Saturday night’s annual formal 

dinner saw attendees dress up in their finest attire 

before sitting down to a three course meal. Stars of the 

evening were of course the 

retired boys’ at their reunion, 

where I was given some good 

humoured advice on love and 

romance, which can no doubt 

be attributed to 40-yearsexperience 

in the industry. 

With the night ending in no 

small amount of dancing and 

accompanied by karaoke, it was 

no surprise to see a few bleary 

eyed attendees at the following 

morning’s workshops. ▀ 

Keratoconus far more 

prevalent 

The world’s first keratoconus study 

in school children, the Wellington 

Keratoconus Study (WELKS), is just 

over half-way through and is already 

providing some insightful initial findings. 

In an update, released last month by 

the charity Capital Vision Research Trust 

(CVRT), which is conducting the study, 

it was announced that more than 1000 

Wellington teenagers in years 9 to 11 

have been screened for keratoconus since 

the study’s launch earlier this year. 

Initial findings show that compared 

to previous estimates keratoconus is 25 

times more prevalent in year 11s and 

nine times more prevalent in year 9s than 

previously thought. Of those diagnosed 

with keratoconus, 85% are male and 83% 

are of Maori descent. 

The WELKS study is being conducted 

with support from the Lions Club, local 

eye health specialists, Ford, Bowen 

Hospital and Alcon Vision Care. “The 

results from this study will have both 

national and international significance 

for the eye health of our young people,” 

said CVRT. 

CVRT study coordinator Janet Paget, 

in an article in the Dominion Post, said 

little was known about the prevalence 

of keratoconus, which was often only 

detected later in life when it was more 

difficult to correct. If keratoconus is 

picked up early it can be corrected with 

glasses, but if undetected can eventually 

cause blindness and require cornea 

transplants. “We are expecting to pick 

up at least one kid per school, possibly 

more.” The study is also picking up 

children who needs glasses or suffer from 

other eye problems. 

CVRT kitted out a specially-equipped 

van, complete with a Pentagram corneal 

topographer, to travel to participating 

secondary schools to screen year 9 

to 11 children as part of the study. St 

Catherine’s school principal Mary Curran 

told the Dominion Post it was a “winwin” 

having the research conducted at 

the school, with students receiving a 

thorough eye exam. “As long as it’s not 

interfering with their learning, why 

wouldn’t you?” 

The aim of WELKS is to identify 

patterns of keratoconus in its early 

stages of development, with the hope 

of developing longer-term best-practice 

screening and treatment solutions. The 

study should be completed by the middle 

of next year. ▀ 

For more information about WELKS, 

visit www.capitalvision.org.nz/ 

wellington-keratoconus-study-worldfirst-2015-2016. 

(L to R) Sidney Salek, Bill McClellan, Helen and Kinnear Johnson, Susan and Roger Apperley and Peter Stevenson 

6 NEW ZEALAND OPTICS December 2016 

John Boyle is a 22-year-old graduate 

from Auckland University, who joined 

Wanganui Eyecare earlier this year as 

a therapeutically-trained optometrist. 

He enjoys the slower pace and lighter 

traffic of Wanganui, as well as amateur 

dramatics and snowboarding. 

Dave Forrest (Lions Wellington), Rachel Cox (Research Manager, CVRT), Sandie McIntosh (Lions), Janet Paget (CVRT), 

Dr Reece Hall (CVRT board), Viv Forrest (Lions) and Prof. Tony Wells, CVRT founder

December 2016 NEW ZEALAND OPTICS 

7

SPECIAL FEATURE: VISIONZ 2016 

Visionz 2016 

BY GARY EDGAR, PRESIDENT OF NZOWA 

The business of vision 

This year Visionz was held at the Ellerslie Events Centre, Greenlane in Auckland. 

The facility at Ellerslie is so manageable and ticks all the boxes for our needs as 

a conference venue. The Visionz trade exhibition attracted 28 companies, a little 

down on the last exhibition in 2014, but still a good turnout. 

The trade exhibition was free to attend by anyone in the optical industry and was 

supported by Eduvisionz, comprising a special Low Vision meeting on the Friday and 

a practical, practice management conference on the Saturday and Sunday. Delegates 

reported they thought it was a great line up of speakers, covering great topics, making 

it a thoroughly enjoyable event. 

Other highlights included the new addition of a St John’s first aid course, open 

to all to attend. St John played an integral part in the conference with practical 

demonstrations on CPR. Essilor’s Guy Parbury won the CPR challenge with Berdette 

Garnett, from Pearson & Hooker, a close second. The course gave delegates the 

confidence to handle a real life situation. Certificates have been sent to all participants 

for your efforts over the four-hour course. 

NZOWA hosted a cocktail party on the Friday evening with a blind wine tasting. 

Participants had to correctly name the four types of wine and wine was given as prizes 

to winners Pene Fox and Stuart Whelan. 

Over the weekend we also had a prize draw for those who registered for the 

conference, plus a host of wonderful exhibitor prizes for delegates who took part in 

the “passport control” challenges. The early-bird registration draw, and the Nespresso 

machine, was won by Clitz-Simmi Chopra, while Darren Savage and Viv Deaker 

won the two $250 travel vouchers, and Michelle O’Hanlon scooped the $500 travel 

voucher. All winners were announced and celebrated at the Gala dinner on Saturday 

night, where ADONZ members, other delegates and exhibitors danced up a storm. 

Congratulations to all our winners, we hope you enjoyed your weekend here in 

Auckland. 

Delegate numbers were down 

compared to 2014 with 151 

registrations which, when combined 

with the 130 ADONZ conference 

delegates, meant a total of 281 

guest attendees. But given the 

buzz in the exhibitor room and the 

feedback on EduVisionz, I would like 

to personally thank my committee 

and all those involved for making 

this a successful weekend. 

Planning is now underway for 

the next Visionz in Auckland, in 

October 2018, and we welcome 

your feedback and views on what 

should be included and the format 

of the next event. 

Barbara Collins, NZOWA President Gary Edgar and Regan Hirst 

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8 NEW ZEALAND OPTICS December 2016 

OptiMed’s Robert Nyenkamp and Craig Norman 

The 2016 Eduvisionz programme offered as part of 

the NZ Wholesalers Association (NZOWA) biennial 

Visionz exhibition offered those who work in the 

optometry sector a unique opportunity to learn about the 

latest business trends, marketing techniques and industry 

focussed innovations. There was also lessons about dealing 

with complaints, a St John’s First Aid course, and information 

about picking the best team. 

The following is an overview of just some of the highlights 

from some of the key speakers: 

Juanita Neville-Te Rito, The Retail Collective 

Our own retail columnist Juanita Neville Te-Rito opened the 

Eduvisionz’ day with her talk on the fundamentals of retail 

marketing. “Retail is about the selling of products, services 

and experiences. The optometry industry straddles those 

three areas in a very unique way.” 

In order to deliver an engaging customer experience, you 

need to understand the shopper and their journey on the 

path to purchase, Neville-Te Rito told her audience. “The 

average human attention span is eight seconds and your 

ability to interact in a positive way within 

that timeframe is essential. Physical, 

virtual and digital experiences for the 

customer are also opportunities for sales. 

You have many touch points to connect 

with your customer.” 

Shoppers want to purchase on their 

own terms, she said, a retailer’s job is 

to solve that unmet need. “Shoppers 

want to touch, smell and feel. They don’t 

want cheap, but they want to make a 

good choice, and they want to make an 

emotional connection.” 

Neville-Te Rito said she felt the 

“eyewear category has lost its mojo.” 

“The days of the expert behind the 

counter are long gone, it’s about how 

the product makes me look and feel. The 

provider who can make me look and feel 

better will get the share of my dollar.” 

She finished by looking at three 

overseas businesses doing eyewear well. 

• Kite, a British boutique who 

approach the selling of eyewear like 

shoes. The company makes shopping 

tactile and fun, said Neville-Te Rito. Staff 

are relaxed and friendly and there is no 

pressure, no hard sell, just the chance to 

try on the goods and make a choice. Kite 

also offers style advisors and a kiosk with 

a multi-touch display for taking selfies in 

their frames. 

• Walby Parker, a US-based boutique 

chain, that’s built around the mobileenabled 

shopper who researches 

online, but wants to touch and feel the 

merchanside. “Don’t copy them,” says 

self-confessed Walby Parker fan Neville- 

Te Rito. “Just get into the space where 

you are asking yourself ‘how do I define 

my customer experience’. Think about 

customer flow and their pain points and 

you will find your bit of magic.” 

• Toyshades, a UK-based, design-led 

eyewear brand aimed at millennials 

with a clear focus on fashion, is a great 

example of “sticky engagement’” she 

said. The company’s simple, stylish range 

of eyewear is available online and as a 

concession in the high street fashion 

chain Top Shop, and it frequently provides 

specials, new ranges and promotions to 

draw the customer in. 

7/11/2016 2:33:13 PM 

Neville-Te Rito ended with the following advice: be 

uncomplicated, distinctive and communicate that message 

clearly to our customers. 

Mike Brunel, author, speaker and lifelong sales 

person 

Any man who walks into a room with an ice axe immediately 

has your attention. That was the first lesson salesman and 

entrepreneur Mike Brunel had for the audience as he stood 

there wielding the aforementioned lethal weapon, which 

once belonged to Kiwi climber Rob Hall. 

“We are all in sales. We just don’t know it,” said Brunel. 

“You need to change the way your staff view sales.” 

To illustrate the point, he recalled how he and Rob Hall 

presented an idea to Unilever to fund an expedition to 

Everest. Hall wasn’t a salesman, but he was so passionate 

about his cause Unilever supported him to walk seven 

mountains. Sales is about telling an authentic story that 

makes a connection with your customer, said Brunel. 

His tips included knowing your product back to front. 

“You’re being researched every day (on the internet), so 

when someone comes into the store you need all the 

answers to solve their problems and look professional.” Also 

there’s been a shift in buying criteria – people are buying a 

solution to a problem, but it’s emotional too, he said. “They 

want to feel good. Glasses are an accessory, an emotional 

item. We want to be able to see, but that’s the necessity 

aspect. The only way you can overcome price is to position 

yourself as an expert. Optometrists have been doing that all 

along – they have my files, I trust them.” 

Brunel also implored the audience to own the one 

kilometre around their store: letter boxes, text messages, 

social media – focus on your immediate locale and dominate 

that market, he said. “The theory is that only 6% of people 

are ready to buy right now – you need to be in front of them 

when they are ready to buy. Connect with your client on a 

regular basis.” 

Now imagine a man walks through your door who has 

been in the desert for 60 days, he said. “You give them a 

drink of water first, but do you stop there? No, because they 

will also want a shower, some new clothes and some food. 

You should always be thinking about the upsell; what are 

your customer’s unmet needs?” 

Brunel is also a big fan of openness in businesses. “Tell 

your staff everything except what the other person gets 

paid. And have regular, short meetings with at least one 

team meeting each week.” He suggests regular one-on-one 

sessions with staff, getting your staff to sell to you, and a 

Friday night social event to help lift staff engagement. 

Linda Cole, Blue Banana 

Author of many books about social media, including Learn 

marketing with social media in 7 days and Start with hello, 

a book about networking, Linda Coles is a specialist in 

raising a company’s digital profile for free, or very cheap. 

Most people are full of questions, she said. “Do you need 

a social media presence? Which one? How much will it cost 

in time and money?” Social media is important, because it 

gives us a soap box from which we can raise our profile. 

“Online, its warts and all – people can see what’s behind 

the brand. But this isn’t necessarily a bad thing. You just 

need to keep your brand in front of your consumer’s 

eyeballs. Pick a strategy and deliver. It doesn’t have to be 

big or fancy, but you have to implement it consistently. For 

example, is it to deliver wacky content? Then keep serving 

it up.” 

The aim, she said, is to “go viral” – the holy grail of free 

marketing. “The things that catch on are the things that 

make people’s pulse change. If it makes you cry, excited, 

happy, smile or laugh then it is making your pulse change 

and you should share.” 

Although she cautioned about too much content that 

makes you cry. Humour works best, she said. “When a 

brand makes you smile, people perceive that brand as more

Clare Martin, Judith McKinlay and Janice Batty 

Christine Doorman and Pene Leadbeater 

Maui Jim’s Mark Buist and Rob Garrett 

General Optical’s Koenraad Groot and Pablo Hurford 

Anne and Michael Warner and Vineet Chauhan 

Trish Orr, Jill Stackhouse, Dianne Goodridge, Jackie Merritt and Caron Bowe 

courteous and competent.” 

Cole recommended starting with developing a 

Facebook audience as good “bang for your buck”. 

But know who you are talking to; is it the blue 

rinse brigade or the hipsters? Figure out what 

their problem, need or desire is and how you can 

fulfil it. 

“Useful tips work well, like how to keep glasses 

clean or fun eye care. They’re very sharable. 

Video content is very engaging; you don’t have to 

make it, but can share it from other people…Just 

remember to get your logo in there somewhere!” 

The best time to post on Facebook, said Coles, 

is between 6pm and 9pm, and get your team 

involved in generating new and interesting 

posting ideas. You don’t even have to be there 

to post, you can schedule posts using Hoot Suite 

or Facebook’s own built-in function, and you can 

promote (or “boost”) posts for as little as $5 a day. 

“Can you afford it?” said Coles. “It’s more a 

question of can you afford not to?” 

Jackie Merritt, Deborah Warn, Shelley Endicott, Louise Green and Mark Collman 

Bruce Keighley, Nicola Dunn and Carl Doherty 

Elaine Silk, Practice by Design 

Nelson-based Elaine Silk helps practices with 

interior design, but it’s not just about the chairs 

you choose or where you put your reception desk, 

she said as she went on to explain the principles 

of sensory design, and stores that use all five 

senses to engage the customer. 

“This is the touchy-feely stuff, literally….When 

a patient enters a practice, they stop and pause. 

This is the decompression zone and they will be 

seeing, smelling and touching.” 

Back in the 1970s, a group of psychologists got 

really excited about being able to measure the 

way a sensory experience affects emotions. This 

laid the foundation for using sensory design in 

business, she explained. 

“The nose is easily bored. If there is a nice 

smell, it will subdue it, but nasty smells won’t go 

away. Your practice has a smell and if you’re not 

controlling it, you’re missing out.” 

Research by Nike, where they constructed two 

identical stores, but scented just 

one of them, showed an 84% 

increase in sales in the scented 

store. Silk also noted that 

Langham hotels have a signature 

scent it’s had designed that 

unites the whole hotel group. 

“You don’t want it to be 

overwhelming though,” Silk 

cautioned. “Plants can be a 

good solution, as they not only 

exude a subtle, natural scent, 

but brighten the atmosphere.” 

One Sydney-based study, she 

shared, showed productivity 

increased 12% when plants were 

introduced in the workplace. 

“Often you don’t know where 

smell stops and taste starts,” 

said Silk, adding that something 

as simple as offering a branded 

chocolate with a cup of coffee 

can have a big impact on a 

customer. It’s a personal touch 

and they begin to associate a 

taste with your practice, she said. 

A review of 157 studies 

looking at the impact of sound 

and music demonstrated, 

overwhelmingly, that people like 

music being played as well. The 

beats per minute also affects 

people’s pulse rates, with loud 

and fast music proven to weaken 

self-control (think Hollister’s 

European stores which are a 

bit like nightclubs). Practice 

managers may want to focus 

on more relaxing music to put 

customers at ease, said Silk. Placing the speakers 

around the periphery of the waiting room and 

up high will make the room feel larger, which 

also helps decrease the perception of wait times. 

Ambient ‘pink noise’ can be used in the consulting 

rooms for privacy, masking conversation. A useful 

tool if space is an issue, she said. 

Touch is also important, said Silk. “The sense of 

touch creates warmth and a sense of ownership 

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or belonging. Locked frame bars are a problem, as 

the customer needs to interact with the frames.” 

The final sense to cover is vision. Make sure your 

chairs aren’t worn out, your carpet isn’t stained, 

your glass is clean, pens aren’t chewed, she said. 

“Customers make a subconscious decision in 90 

seconds based on vision. And 52% of customers 

don’t return to a store because of aesthetics.” 

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9

SPECIAL FEATURE: VISIONZ 2016 

Visionz 2016: what’s new 

The New Zealand Wholesalers Association 

(NZOWA) had a good turnout on the 

exhibitors’ floor at the Ellerslie Event Centre 

in October, with more than 24 companies and 

organisations taking stands. The following is a 

snapshot of what was on offer and what was new 

from some of the main exhibitors. 

Essilor 

Ramana Mallavarapu and Bolle’s Sandy Caddy 

Distributed by: 

Essilor NZ’s marketing director Kumuda Setty and 

her team were asking delegates to take the Eyezen 

challenge, designed to highlight issues around 

digital eye strain affecting many people between 

20 to 40 years of age. Essilor’s Vision Foundation 

also had a stand highlighting their achievements 

this year and seeking support for its communitybased 

programme in 2017. Setty said she was 

pleased with the number of optometrists who 

had volunteered their time to be a part of the eye 

screening programme. 

OptiMed 

Robert Nyenkamp and Craig Norman from OptiMed 

were keen to show-off their new wall-mounted 

column table, perfect for the smaller practice or 

clinicians who see a lot of patients with mobility 

aids. The table has no legs, instead a column is 

mounted against the wall of the examination room. 

The table’s height is adjustable with a clear space 

underneath making it perfect for wheelchair users. 

General Optical 

General Optical’s new team Koengraad Groot 

and Pablo Hurford were proudly showing off 

the new Columbia range, which is also new to 

General Optical. The tough, outdoorsy eyewear 

range, made in collaboration with Flexon (another 

General Optical brand specialising in highly flexible 

materials) is made in Portland, Oregon by the 

Columbia Sportswear Company, a leader in the 

outdoor gear industry for more than 40 years. 

“It’s got a bit of brand following here because 

Columbia’s so well known for its gear, like puffer 

jackets,” said Hurford. 

Also attracting attention was General Optical’s new 

Dragon and Nike ranges. “Nike is huge for us, it’s very, 

very popular in New Zealand and it’s increasing all 

the time.” New to the range is the cute, but tough, 

Nike Kids range, which is also proving popular, as is 

the sun Rx programme, added Hurford. 

Independent Lens Specialists (and Shamir) 

ILS was proudly showing off its Progear Sportshades 

range, which have been designed from the ground 

up with input from professional athletes to be a 

high-performance prescription product, explained 

director Glenn Bolton. 

The Shamir sales team were also on hand to 

phone: 09 443 0072 

email: tim@oic.co.nz 

Device Technologies’ Ryan Heggie and Diego Sonderegger flank CR Surfacing’s Linton Dodge 

explain the new partnership between ILS and 

Shamir (see NZ Optics’ November issue), which 

expands ILS’ lens offerings. “Customers are really 

pleased because Shamir hasn’t had a fitting 

lab that was as well-equipped as ours is,” said 

Bolton. Shamir products now available via ILS 

include the digitally-designed Autograph3 lens 

and its Glacier Plus range. 

Albie Hanson, formerly of Lensworx, now 

ILS, was also at Visionz to explain how ILS is 

now running the Kodak Lens Vision Centre 

programme (see NZ Optics’ October and 

November issues) across the country. 

In other news, ILS’s popular magnetic 

Chemistrie Sunlenses clip-ons, which are custom 

made to fit virtually any frame, has introduced 

Chemistrie Blue to cut out blue light. 

Euro-Optics and Elegance in Eyewear 

Central to the Euro-Optics stand was its new 

range, produced in collaboration with iconic 

Kiwi menswear brand, Barkers. “This is our first 

chance to show the full collection all at once,” 

said general manager Carl Doherty. “It’s been 

really well received by the market so far. We’ve 

had a lot of interest and a lot of good feedback.” 

Doherty said as the new Barkers Eyewear range 

is a direct collaboration, Euro-Optics has some 

direct influence over the design. “So if people 

have demand for a particular style or element 

they need, like if they need a bigger bridge for 

bigger guys, then we can look at integrating that 

into new releases. We have tried to make sure 

the range has some statement pieces as well as 

some good selling, classical shapes and colours 

that really appeal to New Zealand men.” 

Euro-Optics is also offering a Barkers’ Optical 

Starter pack to independents, which includes 

$40 Barkers’ promotional gift cards for patients 

who buy a Barkers’ frame and $20 for sunglasses, 

which was proving very attractive, he said. 

On the stand was also Silhouette’s new range 

from its younger, urban lifestyle brand Neubau, 

which is going to be incorporating more natural, 

recyclable materials into its frames and packaging. 

There was also a new range from Inface, part 

of the Design Eyewear Group, which has a 

great entry level price deal, said Doherty. While 

Silhouette is re-positioning the brand for a 

younger demographic with the help of a new, 

attractive marketing campaign. “The design 

element will always remain on lightweight and 

rimless frames, but with different interpretations 

of that,” said Doherty, with new styles entitled 

“urban fusion” etc. reflecting the new positioning. 

Finally, Italia Independent have released 

some metal frames with just standard glazing, 

making them not so restrictive to use; new flat 

sunglasses, which are right on trend now; and the 

latest Adidas Originals range, including a “really 

well-priced” sunglass range,” said Doherty. 

BTP International 

BTP International’s busy stand had an extra hand 

at Visionz in the form of Chris Hanley, national 

sales manager for De Rigo Australia, representing 

BTP’s new upmarket De Rigo brands - Chopard, 

Furla, Dunhill, Lanvin and Escada (see full story 

p11.). 

Also taking pride of place was Rodenstock’s 

frame brands, including Porsche, and 

information about its high quality lens system. 

Rodenstock’s Nicola Peaper, a speaker at the 

EduVisionz conference who explained multifocal 

lens technology, was also present to help Visionz 

attendees understand multifocals and how 

to choose what’s best for your patient. BTP’s 

Trish Orr said there had been a lot of interest 

in the lenses, while Peaper said optometrists 

and dispensing opticians are best to familiarise 

themselves with a couple of lens systems and 

manufacturers as customisation is key in the 

independent market to really make a difference 

to your patients. 

BTP’s other brands include Ogi (see p 18.), 

Seraphin, Bon Vivant and Red Rose from Ogi 

Eyewear; Area 98’s La Matta and Kaos; and Nova 

Rx sunglasses (for more see the OIG). 

Eyes Right Optical 

The launch of the Face à Face 16/17 sunglasses 

collection, as worn by Catherine Zeta Jones, was 

a priority for Trish Bloxham and her team. With 

100 pieces in the collection, all of which bring 

the highlights from the optical range into the 

sunglasses frame design, there was plenty to 

showcase. Eyes Right also had the new collection 

by ProDesign on display, a vintage-inspired range 

called Danish Heritage. 

Phoenix Eyewear 

Kate Sylvester 

With the lead up to summer, Phoenix Eyewear’s 

main focus at Visionz was its new prescription 

sunglass ranges from CAT, O’Neill, William Morris 

and its new brand Ben Sherman, which are all in 

the entry-level prescription sunglass programme 

(see p4.) with Essilor, said Mark Collman. “Then 

we’ve got our Kate Sylvester premium brand, 

which sits above that, but they are all prescriptable 

styles, which has been our major focus.” 

New brand Ben Sherman was attracting a lot 

of attention, especially with its clever “button” 

and fabric-design detailing. Visionz is ideal for 

introducing new brands as it allows you to see a 

lot of people quickly and modify your purchasing 

to suit what the customers want, rather than 

what you think they want, he said. 

On the stand were also all the wonderful new 

styles from William Morris released at Silmo 

Paris this year (see NZ Optics’ November issue), 

which were also attracting attention. People 

are getting braver, said Collman, especially with 

colour, though this takes a little while sometimes 

to filter out to the more rural regions. 

Sales of O’Neill sunglasses are also going well, 

he added, “because they are colourful, bright, 

lightweight and they are polarised, so lots of nice 

aspects there for younger people who want a 

good solution.” While the thinner acetates and 

round frames from Carter Bond, sister brand to 

the wonderfully colourful Jono Hennessy, were 

also proving to be a hit. 

Device Technologies 

Device Technologies’ Diego Sonderegger 

said given the increasing interest and use of 

OCT-Angiography (see this month’s Eye on 

Ophthalmology, p24.), there’s been a lot more 

interest in the company’s new Swept Source DRI 

OCT Triton SS from Topcon. 

Also attracting interesting was Topcon’s CV- 

5000, a computerised vision tester offering the 

latest features in automated refraction. “The 

great thing about this, is it’s all automated,” 

said Vision Team product manager Ryan Heggie. 

“So it takes an optometrist from standing and 

leaning to control the manual refractor heads 

in front of the patient’s face, to sitting down, 

at their desk, using the touchscreen one-dial 

control to digitally control the lenses. So it’s a 

great relief for neck and shoulder pain.” 

The CV-5000 also includes an LCD visual acuity 


chart and easily interfaces 

with an optometrists’ other 

technologies, including 

the patient database, so 

everything is automatically 

inputted and saved where 

it needs to be, said Heggie, 

plus the price has come 

down. “So it’s now getting 

great momentum as it’s a 

lot more affordable.” 

The big news on the stand, 

however was the launch 

into New Zealand of Frey’s 

automated perimeters. The 

Frey product range covers 

the entire spectrum of visual 

field test technologies, 

from complete testing to 

data analysing systems. The 

technology behind Frey’s 

perimeters is born from the 

high-performance automotive industry, so it’s proven, long-lasting and 

durable, and its affordable, said Sonderegger. The perimeters come in 

three different sizes from the portable version, weighing just 9kg, to 

the top AP-300 model, incorporating an extensive range of strategies, 

fields and test parametres. 

CR Surfacing 

Sharing a stand with Device Technologies was CR Surfacing as 

both are members of the Optical Alliance, a professional business 

development and loyalty programme designed to support 

independent optometrists. General manager Linton Dodge said 

the alliance has been in operation for more than four years and is 

working well, providing customers with good package deals for 

equipment and lenses, for example, as well as referrals for those 

involved in the Alliance. 

CR Surfacing’s stand featured Shaw lenses, designed by Dr Peter 

Shaw in Canada in response to spectacle-induced anisekonia; Satin 

Blue coating to combat harmful blue-light from the sun and LED 

screens to help relieve sore and tired eyes; and the Signature Anti- 

Fatigue ST, a specially-formulated free-form lens, also designed to 

sooth hard-working eyes, and now available in a stock lens format 

with the added protection of Satin Blue. 

Optique Line 

Bob Graham from Optique Line was keen to show off the company’s 

increasingly popular Mersey Beat house brand. Paying homage to the 

signature fashion of the early 1960’s music scene, combined with a 

fresh, contemporary twist on design and manufacturing processes, 

the new range showcases the best traits of the current vintage style 

trend at a very affordable price. 

Bollé and Serengeti 

St John’s demonstrating the lighter side of saving lives 

Growth in Bollé and Serengeti’s prescription sunglass programme 

has been amazing, said Sandy Caddy, the brand’s New Zealand 

business manager. “We’ve been in the programme three years and it 

is just going from strength to strength.” 

Having Bollé and Serengeti authentic lenses helps create more 

choice for patients, she said. “We run the European programme… 

generally everything is back within two to three weeks, and it’s easy 

to use the website portal. New Zealand has really embraced it.” 

Caddy was also keen to communicate the breadth of the brands 

script range, which is one of the largest at +6 to -8 and up to a -4 cyl. 

“So we exceed a lot of those parametres, so for those who are a bit 

tricky we’ve got options and solutions.” 

Fashion-wise, matt finishes and mirrored glasses are very much on 

trend, said Caddy, especially coloured mirrors and a return to more 

‘80s and ‘90s-inspired looks. 

Bollé is also promoting its sports solutions (it’s even released a high 

performance cycling helmet), which are proving to be increasingly 

popular with consumers, she added. “So it’s an opportunity to grow 

where the market is growing…because the technology has just 

improved so much, so it’s pretty exciting really.” 

De Rigo and BTP in NZ 

New Zealand high-end frames 

distributor BTP International 

introduced a number of new 

international frame brands at Visionz 2016 

after agreeing to become the agent for 

Italian company De Rigo in New Zealand 

earlier this year. 

On show were stunning examples from 

the latest ranges of some of De Rigo’s 

flagship brands including Chopard, Furla, 

Dunhill, Lanvin and Escada. Chris Hanley, 

national sales manager for De Rigo 

Australia, was also on hand to present the 

frames and support their launch (re-launch 

in the case of Chopard) into New Zealand. 

Hanley said he approached Trish Orr from 

BTP to become the company’s distributor 

in New Zealand for some of De Rigo’s 

higher-end brands as she’s already wellknown 

and established in the market in 

this field and carries a number of similar, 

but different, compatible brands. 

Though most of the brands are new to 

New Zealand, one is not new to Orr as she 

looked after the very high-end Chopard 

account many years ago when she worked 

at Eyeworld. She says she’s delighted to be 

able to represent Chopard again and to have 

expanded her portfolio with some of De 

Rigo’s other brands. “These are all famous 

international brands…so it’s very exciting to 

take on these new brands. We are known for 

point-of-difference and high quality product 

so it was really the way to go.” 

Orr says all the new De Rigo brands 

work well with BTP’s other brands, 

which are also all high quality, especially 

Rodenstock (maker of Porsche frames) and 

Rodenstock’s high quality lenses. “So it 

seemed like the right marriage for us. We 

also just love fashion, so we love to have 

the connection with high quality product. 

It really is eye jewellery.” 

Chopard, particularly, is well-known for 

its eye-jewellery credentials, incorporating 

precious jewels, rhinestones and 22 

carat gold plating to create a timeless 

and elegant collection, a 

reputation enhanced by its 

annual sponsorship of the 

Cannes Film Festival. It even 

makes the coveted Palme 

d’Or trophies. 

De Rigo is one of the 

largest family-run optical 

manufacturing companies 

in the world. Founded in 

1978 by brothers Ennio and 

Walter De Rigo as a small 

company of artisans working 

in Belluno in Northern Italy, 

it’s brands are now sold 

in 80 countries through 

15 companies and more 

than 100 independent 

distributors. Other De 

Rigo brands include Police, 

Loewe, Nina Ricci and 

Zadig&Voltaire. 

The company strengthened 

BTP’s Trish Orr, wearing Chopard’s elegant opera-inspired palladium readers, and De Rigo’s Chris Hanley at Vsionz 2016 

Chopard’s “Happy Diamonds” 

its position in the Asia Pacific region earlier 

this year by acquiring its major Australian 

distributor L’Amy Australia in September. 

Former L’Amy managing director Mark 

Holloway is now managing director of the 

new subsidiary, which operates officially 

under the name De Rigo Vision Australia, 

based in Sydney. In a statement at the 

time of the purchase, De Rigo CEO Michele 

Aracri said, “Australia is a key market for 

our consolidation in Asia Pacific, one of 

the most dynamic economies of the area 

360˚ 

From Furla’s 2017 sun range 

with impressive potential. This investment 

is another step forward in the wholesale 

level of the De Rigo Group.” He said having 

a direct Australian subsidiary means De 

Rigo would now be “well placed to respond 

quickly to customer’s needs, especially 

relating to sales, marketing and aftersales 

services”. 

There was so much great stuff at Visionz and 

ADONZ 2016 that we were unable to fit it all 

in, so coverage of the Low Vision conference 

day will be in our February 2017 issue. Ed. 

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Gary Edgar, NZOWA president (centre) presenting the Visionz 2016 best stand award, as judged by Visionz 2016 MC, former TVNZ presenter, 

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11

SPECIAL FEATURE: VISIONZ AND ADONZ 2016 

ADONZ 2016 

The ADONZ 

Annual 

Conference 

was a great success 

with a raft of varied 

and interesting 

lectures. With the 

NZOWA trade fair 

held alongside 

our weekend, we 

enjoyed the best of 

both stimulating 

educational 

presentations and 

products and services 

that enhance our 

industry. Over the 

past few years we 

have valued the 

lectures provided by 

the Association of 

British Dispensing 

Opticians (ABDO) 

and it was especially 

BY PEGGY SAVAGE, ADONZ PRESIDENT 

ADONZ president Peggy Savage and speaker Julien 

Porte from Morel France 

pleasing to have the International Opticians Association (IOA) 

convention delegates attend our conference. 

Our AGM was held on the Friday. My presidency was extended 

for a further year; Donald Crichton will continue as vice president; 

while the executive consists of Vineet Chauhan, Lynette Hunter, 

Lucie Single and Andy Willmott. It was a little disappointing that 

AGM attendee numbers were down slightly this year, however, 

the executive is very excited about our future and the education 

requirements, along with ensuring we keep pace with an ever 

changing industry. 

ADONZ is open to suggestion for the proposed David Wilson 

memorial trophy/award. He was sorely missed at conference, 

however we were greatly appreciative that Jan came to our Gala 

Dinner, which was an evening shared with the NZOWA and a 

great success. It appears the older DOs have a learned stamina for 

dancing the night away compared to the young’uns who have yet 

to hone this skill! 

See you next year. 

ADONZ 2016 National Conference 

– “All things Kiwi” 

The Association of Dispensing 

Opticians of New Zealand (ADONZ) 

held their 2016 national conference 

at the Ellerslie Events Centre. The 

conference opened to the resonance of Poi 

E, a quintessential Kiwi song that summed 

up the conference theme ‘All things Kiwi’. 

In a New Zealand Herald poll in 2014 we, 

as Kiwis, identified ourselves as friendly, 

having a can-do attitude, and being 

laid-back. These three great traits were 

personified in the wonderful conference 

delegates of ADONZ 2016. Ellerslie was 

buzzing with colleagues meeting, friends 

reuniting, stimulating discussion, and 

a fabulous trade-show with an array of 

frame, lens and instrument companies 

represented. This was the backdrop for a 

variety of great speakers to inform, inspire 

and entertain the delegates. It was an 

honour, as an optometrist, to be a part of 

the ADONZ conference as both a speaker 

and delegate. 

Stephen Caunter, the business training 

manager of ANZ Bank, was first to the bat 

discussing how customer complaints can 

improve business. He gave a comprehensive 

and highly entertaining presentation 

with practical examples of dealing with 

unsatisfied customers. We were then off 

for a quick trip around the ‘globe’ with 

the lovely tour guide, Elaine Grisdale. 

Elaine is the current head of professional 

services and international development 

at the Association of British Dispensing 

Opticians (ABDO). The anatomy overview 

was informative and well-linked to day-today 

situations that dispensing optician’s 

encounter. 

The next speakers covered the full range 

of ages and appealed to them all, much 

like Country Calendar. Dispensing tips were 

given for challenging paediatric patients 

as well as problem solving in multi-focal 

wearers. I had the privilege of presenting on 

paediatric visual impairment in Aotearoa, 

a topic close to my heart. Nicola Peaper, 

the professional services manager of 

Rodenstock Australia, spoke on maximising 

multifocals for distance and near. Through 

her presentation Nicola took us back to 

some of the basics of dispensing including 

appropriate measurements and the impact 

these have on the final lens design. 

After a day of learning we were put to 

the test with an evening of nibbles and 

wine tasting, New Zealand wine of course, 

with winners receiving prizes from the 

conferences sponsors. It was a wonderful 

cocktail party that caused the Bachelor NZ 

to pale in comparison. 

The next day began with the main 

lecture hall being filled with the wonderful 

presentation skills of Dr Trevor Gray, a 

refractive-cataract surgery and corneal 

surgery specialist. Trevor eloquently covered 

the interesting topics of ‘cataracts – is there 

now a cure’, ‘adenoviral conjunctivitis’ and 

‘demodex and the eye’. All three topics 

were discussed with much interest over the 

BY SAMANTHA SIMPKIN* 

ADONZ keynote speakers, ABDO’s Fiona Anderson, Barry Duncan and Elaine Grisdale 

following delicious morning tea treats and 

coffee. Running concurrently with Trevor’s 

talk was a Paediatric Dispensing Workshop, 

which I chose to attend. The workshop 

was overseen by the multi-talented, 

Fiona Anderson who is the current ABDO 

president, a passionate dispensing optician 

and a member of too many boards to begin 

listing. Fiona’s excitement for educating 

others was evident from the moment she 

entered the room. Real-life cases were 

presented with an ensuing small group 

discussion, then feedback time to the session 

as a whole. Many interesting prescriptions 

were shown which stimulated dialogue 

between colleagues. Fiona encouraged 

taking the time to research challenging 

cases, understand your clients, and learn 

to say ‘no’ when needed, all to ensure our 

patients get the best outcomes possible. 

This session made me consider the multiple 

options of dispensing for high prescriptions 

and possible techniques to employ to 

maximise visual and cosmetic results. It is 

much like the All Blacks scoring a try, the 

main goal is to get over the line, but if you 

can make it look good you will have fans for 

life, just ask Dan Carter and Julian Savea! 

Staying in the sport theme, Dr Nicola 

Anstice a senior lecturer in the School 

of Optometry and Vision Science at the 

University of Auckland, highlighted the 

importance of outdoor time for children. 

Nicola presented a thorough and concise 

review of the extensive literature on myopia 

control modalities and reiterated the 

growing importance of this in optometric 

practices as myopia continues to increase. 

This was a timely reminder of the 

importance of the right correction in myopia 

control and the role dispensing opticians 

play in communicating with the optometrist 

and patient. From the wonderful New 

Zealand accent of the local Dr Nicola Anstice 

we moved to the lilting French accent 

of Julien Porte, from Morel France, who 

discussed frames. Julien took us through the 

process of designing a frame, from the artist 

to deciding material to final production. 

He also took the time to review important 

features of the different materials used for 

frames, aspects we should be considering as 

we select spectacles for our patients. 

After lunch we came back to New 

Zealand with a session on ‘Knowledge risk 

management within an optometry practice’ 

by Vineet Chauhan and ‘Understanding and 

responding to migrant health services in 

New Zealand’ by Raj Singh. Following this 

was one of my personal highlights of the 

conference, three presentations from the 

effervescent Carly Henley, an orthoptist 

from Greenlane Clinical Centre. Carly wins 

the prize for the most animated presenter 

of the conference, her enthusiasm for her 

work is contagious! Carly spoke on ‘Nobody 

loves you when you are down and out’ 

(strabismus), ‘To see or not to see – that is 

the question’ (amblyopia), and ‘practical 

magic’ (prism). A trio to rival Sol3 Mio. 

Next came L&P, Lindsey Pine, Optometrists 

and Dispensing Opticians Board registrar, 

who covered the important information 

on practising legally and within scope. She 

was followed by Essilor’s Gordon Stevenson 

on the importance of prescription safety 

eyewear, a hard topic with our ‘she’ll be 

right’ Kiwi attitude. Gordon reminded us of 

the incidence and preventability of a lot of 

eye injuries. A review of correct dispensing 

techniques of safety frames and lenses was 

appropriate as the sun peaked through the 

clouds and Summer began to feel close. 

The venue and delegates transformed 

into their gala dinner best for the Saturday 

evening. The ball room was decked out with 

Kiwiana; flax, paua, and the quintessential 

buzzy-bee toy. It was a night of dancing, 

dinner and drinks with of course some Dave 

Dobbyn thrown in! 

The delegates reassembled, more 

quietly this time, for the final morning of 

conference on Sunday. We were provided 

with a morning of strabismus, Shaw lenses, 

professionalism and the secret life of lenses. 

These fascinating topics were covered by an 

abundance of talent. Firstly, Dr Justin Mora, 

a paediatric ophthalmologist who relished 

showing videos of strabismus surgery and 

articulate the complexities of strabismus. 

Evan Brown, optometrist (TPA, FCOVD) 

covered the intricacies of aniseikonic 

corrections with Shaw lenses. Grant Dabb, 

another optometrist (FACBO), illuminated 

the amazing impact lenses have on function 

including visual space, motor function and 

perception. 

The variety and range presented at this 

conference was comparable to that Kiwi 

icon, the Kiwi Burger, an interesting mix, 

that results in all who try it being satisfied. 

It was an absolute privilege to be able to 

attend a dispensing optician conference 

as an optometrist, it was an excellent 

conference that comprised all the best 

bits of being Kiwi. To all the organisers, 

delegates and ADONZ, I would like to say 

thank you and ka pai! ▀ 

Samantha Simkin and Anthony Simpson 

* Samantha Simkin is a therapeutically-qualified 

optometrist currently pursuing her PhD in the 

Department of Ophthalmology at the University of 

Auckland. 


December 2016 NEW ZEALAND OPTICS 

13

Focus on 

Eye Research 

Crosslinking, keratoconus and herpes 

BY DR RASHA ALTAIE* 

CORNEAL COLLAGEN 

CROSSLINKING IN CHILDREN 

WITH KERATOCONUS (J AAPOS 

2015;19:228-232) 

This study reports on the visual, 

refractive, and tomographic 

outcomes of corneal collagen 

crosslinking (CXL) in paediatric 

patients with keratoconus (KC). 

A total of 25 eyes of 14 patients 

(11 males) were included. Mean 

age at surgery was 16.2 years 

(range, 13-18 years). 

The following parameters 

were analysed: astigmatism; 

maximum-, minimum-, meankeratometry 

values (Kmax, 

Kmin, and Kmean, respectively.) 

and thinnest corneal depth. 

All patients had CXL in theatre 

with epithelium off. Follow up 

intervals were at three months, 

six months and one year for all 

patients and at two and three 

years where available. Changes 

in Kmax, as described by Koller 

and colleagues, were defined as 

Kmax regression (>1 D decrease 

in Kmax), Kmax stabilisation (1 D increase in 

Kmax). The results showed 

at one year, compared with 

preoperative Kmax values, five 

eyes (20%) showed regression; 

13 eyes (52%) stabilisation; and 

seven eyes (18%) progression. 

There was a significant reduction 

in the mean thinnest corneal 

area from baseline (473.6 ± 

37.68 mm) to six months (424.55 

±70.2 mm), but this recovered 

at one year (452.82 ±53.5 mm). 

There were no significant 

postoperative complications. 

This study showed that CXL is 

safe in kids, and CXL effectively 

stabilised uncorrected visual 

acuity, refractive indices and 

keratometry values at one year, 

while improving best-corrected 

visual acuity. 

The author policy is to treat 

paediatric KC following initial 

diagnosis, rather than to wait 

for documented progression. 

This study highlights the 

importance of early treatment of 

KC in children, which we highly 

recommend. 

PAEDIATRIC KERATOCONUS IN 

A TERTIARY REFERRAL CENTRE: 

INCIDENCE, PRESENTATION, 

RISK FACTORS AND TREATMENT 

JOURNAL OF REFRACTIVE 

SURGERY 2016; 32(8):534-541. 

Keratoconus (KC) is rare in 

children, however it seems 

to progress faster and to be 

more advanced at the time of 

diagnosis than adults. This study 

highlights the importance of 

early detection of KC in children. 

Also it reports the incidence, 

clinical presentation, risk factors 

and treatment outcome of 

paediatric KC. The author reports 

on the incidence of paediatric KC 

in children among patients with 

keratoconus of all ages during 

five years (2010-2014). 16,808 

patients were examined, and the 

incidence of paediatric KC was 

0.53%. 

Decreased visual acuity was 

the most frequent complaint at 

initial presentation, in addition 

to allergic conjunctivitis, hydrops 

scar (mistaken as bacterial 

keratitis scar) and family history 

of KC. All eyes received corneal 

cross-linking treatment and 

16 eyes received additional 

intra-corneal ring segment 

implantation. Other treatment 

modalities have also been 

used like implantable collamer 

lens (ICL). The authors set a 

nomogram for the treatment 

of KC in kids, depending on the 

initial best correct visual acuity, 

ability to tolerate contact lenses, 

anisometropia and presence of 

corneal scaring. 

The study concludes the 

importance of suspecting KC in 

children with a positive family 

history of KC, poor correct 

distance visual acuity, high 

astigmatism and/or history of 

eye rubbing and allergic eye 

disease with reduced visual 

acuity. The disease has a fast 

progression rate. Therefore, no 

time should be lost between 

diagnosis and treatment. 

EPIDEMIOLOGY OF HERPES 

ZOSTER OPHTHALMICUS, 

RECURRENCE AND CHRONICITY 

OPHTHALMOLOGY VOLUME 

123, NUMBER 7, JULY 2016 

This is a retrospective 

epidemiological study, with the 

aim to describe the prevalence 

of herpes zoster ophthalmicus 

(HZO) and risk factors for its 

recurrence and chronicity. 

All the medical records of 

patients, whom were diagnosed 

with HZO from January 2010 to 

December 2014, were reviewed. 

A total of 90 patients were 

included in the study with mean 

age at initial presentation, of 

68±13.5 (range of 27-95 yrs); the 

peak age was 60-69 years. The 

author of the study describes 

the presenting ophthalmic 

manifestation in HZO, 

conjunctivitis or episcleritis as 

the most common presentations, 

followed by uveitis and epithelia 

keratitis. All these patients were 

monitored for recurrence of HZO. 

Also the clinical course of the 

disease was defined as acute 

and chronic. Chronic disease was 

defined as active disease that 

requires antiviral therapy or antiinflammatory 

therapy (or both) 

for more than 90 days from the 

initial presentations. 

The recurrence rate was up 

to 25%. Of note, most of the 

recurrence occurs in immune 

competent patients, white race, 

male gender, with no history 

of HZO vaccination during the 

follow up. 

Interestingly, several ocular 

findings on initial presentation 

increased the risk of recurrent 

disease. These risk factors 

included ocular hypertension 

and uveitis. 

Similarly both these two factors 

increased the risk of chronicity as 

well, but after adjusting for age 

and gender, ocular hypertension 

was the main risk factor for 

both recurrence of HZO and its 

chronicity. 

In conclusion this study 

highlights the risk factors for 

recurrence (or chronic course 

of HZO) as well the role of 

vaccination and oral antiviral 

therapy to reduce the chance of 

recurrence of HZO. ▀ 

ABOUT THE AUTHOR: 

* Dr Rasha Altaie is an 

ophthalmologist with particular 

interest in pterygium surgery, 

paediatrics, cornea and cataracts. 

After training in Ireland she received 

advanced clinical fellowship and 

sub-specialty training in cornea and 

anterior segment reconstruction, and 

paediatric ophthalmology at Auckland 

University. She is currently working as 

a specialist in the public sector with 

Counties Manukau DHB and as well as 

privately at the Milford Eye Clinic. 

Record attendance 

for DOCC 

A 

record 

37 budding ophthalmologists attended the Dunedin 

Ophthalmology Clinical Course (DOCC) this year. The course, run 

by the Ophthalmology Department at the Dunedin School of 

Medicine from 31 October to 11 November, is an intensive, two-week 

residential course for New Zealand and Australian medical graduates 

in their final years of the RANZCO training programme. Running since 

1998, the course has been specially-designed to prepare registrars 

sitting the RANZCO Advanced Clinical Examination (RACE) on their 

journey to become fellows of the Royal Australian and New Zealand 

College of Ophthalmologists (FRANZCO). 

“The RANZCO RACE is a frightening prospect for most eye registrars,” 

said Gisborne ophthalmologist Dr Graham Wilson, an Otago University 

senior lecturer and course speaker. “The DOCC course is totally 

dedicated to helping them pass.” 

Dr Wilson praised course manager Sally Boult, who he says has 

everything running “super smoothly”, and the Dunedin Hospital Eye 

Department team – Drs Logan Mitchell, Casey Ung, Harry Bradshaw 

and Mary Jane Sime and Associate Professor Gordon Sanderson – for 

“the massive amount of organising and planning” needed to make the 

course such a success. 

This year’s course involved 21 speakers addressing a number of subspeciality 

topics, each with clinically-orientated interactive modules, 

seminars and case presentations, followed by a number of mock 

written and Objective Structured Clinical Examinations (OSCEs). New 

lecturers this year included Drs Rob Jones and Antony Bedggood, from 

Nelson and Christchurch respectively, and Ben LaHood from Adelaide. 

Ruth Ferraro, RANZCO’s new deputy CEO and head of education, 

also attended one day of lectures and, together with Dr Justin Mora, 

course lecturer and newly-appointed RANZCO censor-in-chief, hosted 

the registrars at a reception on behalf of RANZCO, where Dr Mora 

encouraged them to continue to support the work of the College once 

the all-consuming RACE was behind them. 

Of the record 37 attendees on this year’s course, five were New 

Zealanders and 32 were Australian. 

DOCC 2016 attendees with RANZCO’s Ruth Ferraro (bottom left) 

SPONSORED FEATURE 

Hill-RBF installed 

in Gisborne 

The Hill-RBF method represents a new 

approach in IOL calculation, based on 

pattern recognition, data interpolation and a 

validating boundary model, for improved accuracy 

and confidence with IOL power prediction. 

The first Hill-RBF Calculator has just been 

installed at Kiwi Eye in Gisborne on Dr Graham 

Wilson’s Lenstar LS 900, an all-in-one cataract 

planning platform offering unique dual zone 

keratometry. This is the first installation in New 

Zealand, although some Kiwi ophthalmologists 

have already been accessing the Hill-RBF 

Calculator on-line. 

With the heightened emphasis on cataract surgery 

being a refractive procedure for many patients, the 

drive to optimise the formulas used to determine 

IOL selection has also revved up. We have been 

fortunate to have access to two new formulas over 

the last couple of years – the Olsen and the Barrett. 

The Hill-RBF Calculator is likely to be another 

incremental improvement on both formulas. 

Dr Wilson said: “It is exciting to be able to offer 

this new technology to patients and optimise 

their post phaco-refractive outcomes. The Hill- 

RBF Calculator is very cool – utilising artificial 

intelligence and being a continuously updated 

‘big data’ exercise.” 

Background on the Hill-RBF Calculator 

Lenstar with T-Cone and monitor 

The Hill-RBF Calculator is a joint project with 

the RBF (Radial Basis Function) Calculator 

physician team, Haag-Streit in Switzerland and 

US mathematical computing software firm 

Mathworks. 

The Hill-RBF Calculator is an advanced, selfvalidating 

method for IOL power selection 

employing pattern recognition and sophisticated 

data interpolation. It has been optimised for 

use with the Haag-Streit Lenstar, using optical 

biometry for all axial measurements and high 

density autokeratometry. 

Radial basis function IOL power selection 

performs the same for short, normal and long eyes. 

Based in artificial intelligence, this methodology 

is entirely data driven and free of calculation bias. 

This approach also employs a validating boundary 

model, indicating when it is performing within a 

defined area of accuracy. 

The fundamental advantage of pattern 

recognition for selecting an IOL power is achieved 

through the process of adaptive learning – the 

ability to learn tasks based solely on data, 

independent of what is previously known. Current 

methods limit possibilities to situations that are 

already understood. This method is also selforganising, 

meaning that it has the ability to create 

its own organisation, or representation of data. 

Such an approach is well-suited to the complex, 

non-linear relationships that make up many 

aspects of the human eye. 

Unlike static theoretical formulas, this approach 

will be an ongoing project and continuously 

updated as a “big data” exercise. The greater 

the number of surgical outcomes that are fit 

to the RBF model, the greater the overall depth 

of accuracy. In its present form, the Hill-RBF 

Calculator has been optimised for biconvex IOLs 

from +6.00 D to +30.00 D. 

The Hill-RBF method is now part of the Haag- 

Streit LENSTAR EyeSuite biometry software. 


Eye Institute conference highlights 

BY JASON DHANA* 

Giving up a sunny Sunday in November 

is usually a question requiring much 

deliberation, but when it coincides with Eye 

Institute’s annual conference, the answer for 177 

optometrists was obvious. 

Once again held at the lakeside Waipuna Hotel 

in Auckland’s Eastern suburbs, the conference 

covered the common, the rare, the new, and handy 

tips such as closing wounds with super glue! 

Probably to prevent us from having a Sunday 

snooze, the format comprised rapid quick-fire 

sessions, as well as speaker panels for opportunities 

to submit questions. This year’s International 

keynote speaker was Dr Jason Holland, an 

optometrist based in Brisbane. Dr Holland is 

passionate about shared-care responsibilities for 

glaucoma and ocular surface disease patients. He 

opened the morning with his lecture titled ‘Show 

me the light – MGD & IPL’, which touched on 

meibomography and meibomian gland expression, 

and successful cases following treatment with 

intense pulsed-light (IPL) devices. 

During the morning, Dr Trevor Gray enlightened 

us on the latest advances in implantable contact 

lenses (ICLs), specifically highlighting the benefits 

of the new Aquaport ICLs, while Dr Peter Ring 

detailed clues to the diagnosis and the protean 

causes of unilateral proptosis, as well as diagnosis 

and long-term management of retinoblastoma. 

Although potentially life-threatening conditions 

are less commonly encountered in optometric 

practice, they do happen, and accurate and 

thorough assessment is crucial in preventing 

misdiagnosis. Signs of unilateral proptosis include 

a hyperopic shift, tethering of the inferior rectus 

and an IOP difference greater than 4mmHg 

between the eyes. These should also alert the 

clinician to rule out thyroid eye disease, which is 

the most common cause of unilateral proptosis. 

Commonly encountered in optometric practice, 

foveal pathologies were covered by Dr Peter 

Hadden. A useful piece of information to pass onto 

patients is that approximately half the patients 

with an epiretinal membrane will remain stable, 

while half will worsen. Vitreomacular traction 

is commonly seen on OCT and Dr Hadden spoke 

Trish Collins and Noel Templeton Nicola Dunn, Gary Edgar and Bruce Keighley Chloe Lovell, Hadyn Treanor and Angeline Ng 

Teresa Flanagan and Selina Phuah 

about the chances of progression to a retinal hole 

and assessment, based on quick and easy OCT 

measurements. The rule is the vitreous will break 

free from the macula if the adhesion is less than 

200µm, while those greater than 600µm will lead 

to stronger adhesions and pulling on the macula. 

This of course can lead to a macula hole, either 

lamellar or full-thickness in nature. Simple tests 

to differentiate these when an OCT is out of reach, 

include the Watzke-Allen test or our trustworthy 

Amsler grid. 

Dr Adam Watson introduced us to Tacrolimus 

ointment. Tacrolimus works well for inflammatory 

conditions such as AKC, VKC and dry eye. Some 

evidence exists on treatment for SLK, and 

prophylaxis for graft rejection as well. As expected 

of any quality conference, the topic of glaucoma 

for optometrists was strongly covered. Dr Holland 

highlighted that half of glaucoma patients are still 

undiagnosed and that a ‘normal’ IOP in turn does 

not make a disc ‘normal’ – a very important point in 

Dr Peter Hadden, Darryl Eastabrook and Michael White 

my experience and opinion. One can almost ignore 

(but still measure) IOP, and instead undertake a 

careful disc assessment without any bias from 

whether IOP is normal or elevated. Because (as we 

know) glaucoma does exist without elevated IOP. 

Dr Holland went on to cover the outcomes of the 

Advanced Glaucoma Intervention Study (AGIS) and 

the Ocular Hypertension Treatment Study (OHTS), 

reporting that thinner corneas lead to a higher risk 

of progression and being aware of the numerous 

causes for short-term IOP fluctuations. As well as 

IOP, patients may also perform visual fields with 

great variability. According to the NHMRC guidelines 

(2010), it is recommended that two to three visual 

field tests per year are performed to detect change. 

Dr Graham Reeves covered the EAGLE study, 

which concluded favouring clear-lens extraction for 

angle closure, either with or without elevated IOP. 

This is already a frequently-performed procedure 

in cases of angle closure in New Zealand. Professor 

Helen Danesh-Meyer also shared her always 

Optrex’s Ernest Tobia with Laura Crosby 

Dennis Oliver, Chris Earnshaw and Younus Bhikoo 

well-received glaucoma wisdom with us, stating 

that the role of IOP in glaucoma is evolving and 

that NTG as a discreet entity does not exist. She 

presented studies which revealed that 40-60% of 

glaucomatous patients have IOP within the normal 

range. Interestingly, the association between disc 


Thank you 

Please mark your calendars for 

next year’s series 

for attending Eye Institute’s Seminars, Workshops 

and 12th Annual Conferences this year. 

Seminars 23rd May, 22nd August 2017 

Conference 4th and 5th November 2017 

Register online or email: 

conference@eyeinstitute.co.nz 

Eye Institute 2015.indd 1 



15 

20/11/14 4:18 PM


Aaron Mirkin, Susie Partington and Tony Devcich 

haemorrhages and NTG are debatable according 

to numerous studies. With regard to patient 

education, patients may wonder how or why 

they have developed glaucoma when they have 

a normal IOP, unlike their friend/relative who has 

glaucoma with elevated IOP. Professor Danesh- 

Meyer likes to explain glaucoma to her patients in 

that it is “a disease of pressure sensitivity”, where 

the IOP in that particular eye may be too high for 

that particular optic nerve. I find this a quick and 

useful tip which patients easily understand. 

Gingko biloba is a well-known and thoroughlyinvestigated 

neuroprotector. It has been shown 

to relax vasospasm and acts as an antioxidant. It 

can however thin blood and even though a JAMA 

study showed no adverse effects on patients 

taking blood thinners, it’s probably best to discuss 

management of these particular patients with 

their GP prior to commencing treatment with 

gingko biloba. Importantly, a rare yet significant 

side effect of prostaglandin analogues, which I 

have seen in my patients, is orbital fat atrophy. 

This is reported to take effect within 6-12 months, 

particularly with bimatoprost. 

As the conference came to a close, Dr Simon 

Dean spoke about his dark-horse product, which he 

carries around in his first-aid kit – cyanoacrylates, 

or superglue. A tale emerged about how Dr Dean 

had closed a wound secondary to ‘surfboard versus 

head’, which was a definite Bear Grylls moment for 

him. Non-toxic and self-sloughing after a few days, 

cyanoacrylates such as Dermabond and Histacryl 

have a slower setting time compared to your 

run-of-the-mill commercial superglue, due to their 

longer-chained chemical structure. Glue is a great 

Alex Petty testing out OptiMed’s equipment with Robert Nyenkamp 

alternative to sutures, says Dr Dean, especially 

when managing patients who aren’t the easiest to 

suture – kids. 

As usual, Eye Institute delivered a top quality 

conference and I look forward to their 2017 CPD 

events. In the meantime – I’m off to my local 

Bunnings to stock up my first-aid kit. ▀ 

* Jason Dhana is an optometrist in ophthalmology, Greenlane 

Clinical Centre, and a Professional Teaching Fellow in the School 

of Optometry and Vision Science, University of Auckland. 

Vipti Harry and Yvette Beattie 

Jyotika Lal, Selina Phuah and Maria Pais 

Practical workshops focus on OCT 

Eye Institute extended its annual conference 

this year to include two afternoon workshops 

the day before the main Sunday optometrist 

and DO conferences. Both were practical, 

discussion-focused workshops that took a slightly 

different look at the pros and cons of optical 

coherence tomography (OCT), including the 

different products currently on the market and 

their use in diagnosing glaucoma. 

Each workshop ran for about one and a half hours 

and the 90 or so delegates who attended – about 

50% of which had OCTs and 50% didn’t, but were 

considering buying them – could choose which one 

to go to first or second as they were repeated. 

Optical coherence tomography 

The OCT Workshop was run by Eye Institute Drs 

Peter Hadden, Trevor Gray and (new appointee – see 

Dr Graham Reeves 

joins Eye Institute 

Dr Graham Reeves has joined the Eye 

Institute after relocating to Auckland at 

the beginning of this year and becoming 

one of the consultant ophthalmologists with 

Counties Manukau District Health Board. 

Born in Palmerston North, Dr Reeves went to 

medical school in New Zealand, but completed 

his ophthalmology training in the UK before 

returning to Wellington in 2012 to undertake a 

glaucoma fellowship with Professor Tony Wells. 

Previously with Capital Eye Specialists in 

Wellington, Dr Reeves, who is a glaucoma and 

cataract specialist, says he moved to Auckland to 

take up an “exciting opportunity” with Manukau 

SuperClinic to help their recently beefed-up 

glaucoma treatment service. 

Dr Reeves joined two other new appointees 

on the glaucoma team, Drs Shenton Chew and 

Jim Stewart, who all joined within about two 

weeks of each other. Having made the move and 

knowing several of his Eye Institute colleagues 

from his training days, he says he was delighted 

to be offered the opportunity to join the Eye 

Institute. “I am very excited to be adding my 

skills and experience to the great team at the Eye 

Institute.” 

The move to Auckland is not a new one, as 

Dr Reeves spent six months here in 2003-2004 

and says he’s enjoying the cultural and sporting 

activities Auckland is offering him and his young 

family. ▀ 

Eye Institute Dr Graham Reeves 

separate story) Graham Reeves. This covered the 

different types of OCT: the original time-domain 

(TD) OCT, which is somewhat eclipsed today by 

spectral-domain (SD) OCT as it offers far higher 

resolutions (1μm to 3μm axial resolution vs 10μm 

with TD-OCT) and scans per second (at least 20,000 

compared with TD’s 400), and Swept-source OCT 

(SS-OCT; DRI-OCT made by Topcon), which is the 

latest milestone in retinal and choroidal imaging. 

“Every machine has a role,” said Dr Gray. “But TD 

has largely been superseded by SD, which is clearly 

the technology here to stay.” While Swept-Source 

is still a bit too highly priced, so is probably more 

for specialists in public hospitals until the price 

becomes more affordable. Dr Gray recommended 

http://eyewiki.org/, the American Academy of 

Ophthalmology’s online Eye Encyclopaedia as “a 

great resource” for optometrists who really wanted 

to compare the different technologies. 

Dr Hadden tackled the technical aspects of 

OCT, why they are called OCTs and how they 

work and then explained how he used OCT 

to study “the amazing sub-cellular anatomy” 

of the retina and some of the pitfalls of OCT 

analysis. While Dr Reeves looked at other 

clinical uses for OCT, particularly diagnosing 

glaucoma – a tricky business even with the latest 

equipment. He admitted he had been interested 

in the technology enough to visit Spectralis 

OCT manufacturer Heidelberg’s head office in 

Germany, of his own volition and at his own 

expense, but (laughing) officially disclosed how 

the company had given him a couple of teddy 

bears for his kids! 

In summary, OCT makes early detection of 

anything and everything far easier, said Dr 

Gray. While having an accurate and detailed 

baseline from which to work from aids any future 

diagnoses, said Dr Reeves. “It’s all about getting 

to really know your machine; how it scans, 

what it scans each time, so you can really see 

comparisons between the scans over time. But no 

machine is infallible.” 

Other tips, especially for diagnosing glaucoma, 

included: use the power of progression analysis; 

actively search for artifacts; be aware of normal 

variants; find the scleral spur with anterior 

segment OCT; and always evaluate and treat 

new technology with a high degree of healthy 

scepticism. “This machine has no brain, so you 

need to use your own,” ended Dr Reeves. 

Practical aspects of 

diagnosing glaucoma 

The other workshop ‘Practical 

aspects of diagnosing 

glaucoma’ was chaired by 

Eye Institute’s Dr Shanu 

Subbiah and featured guest 

speakers Drs Jason Holland, 

from Brisbane, and Jay 

Meyer, originally a US-based 

ophthalmologist and now 

a fellow of the Department 

of Ophthalmology at the 

University of Auckland. 

Dr Subbiah proved an 

amusing and interactive chair 

describing in no uncertain 

terms why he used to hate doing gonioscopy, but 

why there’s really no alternative. “Anterior OCT is 

a great communication tool, but gonioscopy is still 

the gold standard.” 

Both Dr Subbiah and Dr Meyer provided tips on 

how to get the best iridocorneal angles and why 

this can be, and sometimes cannot be, helpful 

in diagnosing glaucoma; the dos and don’ts 

and controversies surrounding PIs (peripheral 

iridotomies, the preferred laser procedure in New 

Zealand for treating narrow angles) and whether 

even treating narrow angles works. 

Dr Meyer says OCT is important as a diagnostic 

tool as it’s the only provider of objective 

information, a quantitative assessment of the 

inner retina, while all the other tests – indirect 

fundoscopy, visual field testing, stereo disc photos 

and disc drawings – are all subjective. But there are 

“still many potential confounders” in OCT when 

it comes to diagnosing glaucoma and glaucoma 

progression, including: 

• Unrepresentative normative databases (did 

you know the data for most OCTs is based on a 

sample of just 200 to 500 cases, making accurate 

breakdown by sex, age, ethnicity and/or region 

somewhat inaccurate?) 

• Poor quality images 

• Atypical nerves 

• Measurement and segmentation errors, and 

• Masquerading conditions 

Dr Holland stressed the importance of taking 

more than one scan, especially if you’re concerned 

about anything amiss or unexplainable on 

How, what and why for DOs 

For the second year, Eye Institute ran a second 

conference parallel to the main conference 

for dispensing opticians. This covered a 

number of topics including how to identify 

dangers, what makes something dangerous and 

why and when red flags should be waved. 

Dr Peter Hadden’s first session looked at ‘Flashes 

and floaters – what’s dangerous, what’s not?’ He 

noted he had only ever had one migraine, which 

was characterised not by a headache but by partial 

vision loss and the presence of an unusual visual 

aura. These symptoms are the most common 

visual disturbance, but can be indicative of far 

more serious conditions like brain cancer, so should 

be checked out if they are sudden or different to 

normal. Good triage of the patient – often done over 

the phone – is the gateway to the best treatment, 

he said. 

Later that morning, Dr Hadden discussed the 

refractive consequences of vitreoretinal surgery, 

looking at combined cataract and vitreoretinal 

surgery and how post-operatively patients can find 

a big change in their vision, beyond the obvious 

benefits of the cataract removal. Many patients 

can find themselves with a new astigmatism 

or may need glasses to correct a new refractive 

error. The benefits of removing a cataract far 

out-weigh these consequences but, he explained, 

it was important to understand all the methods 

employed for correcting them. 

Dr Simon Dean gave an informative talk 

about the therapeutic uses of tissue glue in eye 

surgery. He noted tissue adhesives are now in 

widespread use and can aid the reduction of 

surgical time while also speeding up patient 

recovery. Cyanoacrylates, fibrin glues and the 

common-all-garden Steri-Strips are some examples 

of these adhesives. Being aware of the benefits 

Glaucoma and OCT workshop speakers Drs Jason Holland, Jay Meyer and Shanu Subbiah 

the first scan. If you have access to different 

machines, it’s also helpful to do another scan on 

another machine to test the first one’s accuracy. “I 

encourage multiple tests as diagnoses are only as 

good as the raw data you’re getting.” 

The most important thing, however, is to 

think, he said, to use your judgement and your 

experience and to not wholly trust the data you 

get from any OCT scan. 

As to which OCT, the speakers agreed each 

machine has different pros and cons and while 

they said some were better than others, this was 

also affected by price, especially if every add-on is 

an additional expense. 

Dr Holland said when buying, optometrists 

should look for simple reporting functions, not 

pages and pages of data, which can be confusing 

and difficult to find and assess progression. The 

capabilities of SD-OCT are also rapidly advancing 

with 3D imaging, reproducible registration and 

advanced segmentation algorithms of macular 

and optic nerve head regions. A review of the 

evidence to date, said Dr Holland, suggests retinal 

nerve fibre layer (RNFL) remains the dominant 

parameter for glaucoma diagnosis and detection 

of progression, while initial studies of macular 

and optic nerve head parameters have shown 

promising results. But simply taking regular disc 

photos for comparison is also important. 

In both workshops, chairs Drs Gray and Subbiah 

stressed that feedback from all delegates is more 

than welcome to hone subsequent workshops 

next year. ▀ 

See more on OCT-A on p24. 

and limitations of these adhesives is essential to 

good post-operative care, he said, before running 

through a few case studies drawing the audience’s 

attention to the importance of keeping a would 

bacteria-free for fast healing and good cosmetic 

recovery. 

Dr Nick Mantell welcomed the audience back 

from morning tea with a look at refractive laser 

surgery and who is suitable. He noted this field 

is continuously evolving and as a result the 

criteria for assessing patient suitability is also in 

a state of flux. Astigmatism, corneal thickness 

and dry eye are all issues which might restrict 

patient suitability, but he described a number of 

circumstances under which these patients might 

be accepted. 




Dr Adam Watson looked at eyelashes. He 

discussed what is a normal eyelash and the role 

eyelashes have as the first level protectors of 

our ocular surface, before moving on to what 

can go wrong. Demodex, blepharitis, styes and 

madarosis (eyelash loss) are some common 

conditions patients might present with. Dr 

Watson then shared various management 

options and things to watch out for. 

The next two sessions were adapted talks 

from the main conference. Key note speaker 

Dr Jason Holland, a specialist optometrist 

from Brisbane, opened with his talk, ‘Show me 

the light – a look at the science, mechanisms 

and evidence behind IPL in the treatment of 

meibomian gland dysfunction and dry eye 

disease’; while Dr Trevor Gray tackled the issues 

and changes with implantable contact lenses 

(ICLs) noting he had personally performed 

more than 1,200 ICL procedures to date. Dr 

Gray also reviewed the latest international 

papers relating to ICLs, the new Aquaport ICL 

design and the different approaches to shared 

post-operative care required for ICL patients. 

Dr Peter Ring wrapped up the early-afternoon 

session with his look at the evolution of 

intraocular lenses (IOLs). Up until about 60 

years ago, all patients were aphakic following 

cataract surgery. So the insertion of the first 

intraocular lens in 1950 permanently changed 

expected outcomes for cataract surgery 

patients. However, it wasn’t until they were 

re-designed in 1975 that they finally found an 

accepted place among cataract surgeons, he 

said, before discussing newer developments in 

the evolution of this now essential prosthetic. 

The final talk of the day, ‘Evolution of laser 

vision correction’, was also presented by Dr 

Gray, who looked at the improvements offered 

by wavefront guided treatments against the 

more well-known LASIK and SMILE. Wavefront, 

also known as ‘custom LASIK’, uses unique 

precision technology to measure prescriptions 

down to 0.01dioptors and then gathers 

information about the unique architecture of 

the eye to customise the laser’s response. Your 

eye is re-shaped not just according to your 

prescription but in response to its own unique 

landscape, explained Dr Gray. ▀ 

Make it 

readable 

BY NAOMI MELTZER* 

Have you ever tried to read an article, a notice, 

a telephone number or directions on a packet 

and given up in frustration? You are not alone. 

That is why Sight Loss Services Charitable Trust 

launched the Make It Readable (MIR) campaign 

in June 2015. We wanted to draw attention to 

this issue and advocate for readable material by 

persuading those producing print materials to adopt 

readable print guidelines. 

The campaign was funded as part of the Think 

Differently fund, a social change campaign seeking 

to encourage and support a fundamental shift in 

attitudes and behaviours towards disabled people. 

As part of the MIR campaign, a survey was 

conducted with support from Synergia Ltd. This 

survey asked people to provide information on the 

materials that they struggled to read during their 

daily lives and the reasons these materials were 

hard to read. 

The results from the MIR survey provide a useful 

insight into the types of materials that are difficult 

to read and the reasons for this difficulty. The MIR 

survey has shown that there are a large number 

of items that people find hard to read. Some of 

the most frequently identified items included 

newspapers, food products, and phone books, 

though the survey also returned a lot of comments 

about poor website design making it difficult to 

access material by computer as is so often required 

nowadays. These are items that will impact on most 

people, but particularly the quality of life of people 

with vision impairments, reducing their connection 

with community and being less informed about the 

products they can purchase. 

Sight Loss Services continues to distribute the MIR 

guidelines to various organisations particularly those 

who send newsletters or other material out to a 

target audience in the over-50 age group. ▀ 

* Naomi Meltzer is an Auckland-based optometrist specialised 

in low vision and rehabilitation, and a trustee of the charitable 

trust Sight Loss Services. 

If you want it to be read, it must be readable. 

These guidelines have been specially created to enable everyday informaon to be immediately accessed by 

more people and for all types of documents. 

Who benets from Clear Print? 

CLEAR PRINT 

GUIDELINES 

Because Clear Print is designed to be used for all documents, it has far reaching benets. A clearly designed 

and easy to read document will convey your essenal informaon to everyone who reads it, and in the process 

can convey a posive view of the originang individual or organisaon. 

Contrast is how you see things against their background. Aging causes a natural decline in contrast sensivity, 

our ability to detect a difference in contrast. 

Approximately 1 in 7 people over 50 years of age have signicant loss of vision due to condions such as 

Macular Degeneraon or Glaucoma. This rises to at least 1 in 4 over 80 years old. One of the major effects 

of such condions is to reduce contrast sensivity beyond the normal loss, so that the world starts to take 

a “washed out” faded look. This has the most signicant effect on reading print. Maximum contrast is black 

leers on a white non-shiny background or white leers on a black background. 

The modern era of digital print means that newspapers, newsleer, forms and noces are produced on a 

computer screen where prey coloured backgrounds and prinng over graphics such as picture or paerns 

are easily seen on the screen, but the end product on paper is at best difficult to read by those with normal 

vision and impossible to read for those with reduced. The same applies to websites which may look prey 

but unless the principles of contrast as well as size are applied to the layout, the important informaon 

becomes unreadable. Many people just don’t bother to read something that requires too much effort. 

For printed informaon to be accessible to its reader the following guidelines should be followed: 

1) Bold black print is easiest to see. Black print on white background or white print on black background 

is the best contrast. Black print on a yellow background or yellow on black is also good 

contrast. 

2) Items can be highlighted with a coloured border but should not be printed over coloured backgrounds 

or paerns. The closer the background colour is to the colour of the print the harder it is 

to read. 

3) A minimum font size of 10 point should be used for a target market over 65 years of age. Any 

important informaon should be in bold 12 point font with headings and key points in bold 14 point. 

4) Use plain sans serif fonts such as Ariel or Calibri. Fancy prints are decorave but impossible to read 

for people with low vision. 

5) Leave good white space between blocks of print. If print is crowded together it becomes more 

difficult to read. 

6) Do not wrap columns of print around graphics such as photos. People using magnifying aids have 

enough problems keeping their place on a line of print without having to search for it elsewhere 

on the page. 



17

SPECIAL FEATURE: SILMO 2016 (CONT.) 

A spectacle of choice 

Silmo 2016 wowed with the pure breadth of options on display. Read 

on for the second instalment from NZ Optic’s own Lesley Springall 

as she shares more highlights from SILMO 2016 (continued from 

November’s issue). 

Menrad 

Philip Crabtree, general manager of VMD Eyewear, 

was at Silmo to meet a number of suppliers. He met 

with NZ Optics on the Menrad stand, where the 

company’s flagship Jaguar range was in prominent 

display, along with Menrad’s other brands including 

Morgan and JOOP! Menrad’s Davidoff brand, 

however, wasn’t allowed to be shown because 

of France’s strict rules on tobacco advertising – 

Davidoff makes cigarettes as well as eyewear. 

Jaguar is a particularly popular brand in New 

Zealand, said Crabtree, having such a strong brand 

image and having been available for more than 25 

years (distributed by Tony Brooks who retired about 

three years ago). 

Apart from Davidoff, the new collections of all 

Menrad’s brands were available to view at Silmo, 

said managing director Eberhard Müller-Menrad, 

who runs Menrad with his brother and whose greatgrandfather 

founded Menrad. He kindly joined us to 

show us some of the highlights of the new Jaguar, 

Morgan and JOOP! collections, the latter being very 

much on trend with a rounder, strong-coloured look. 

Monoqool 

3D-printed frames pioneer Monoqool, from 

Denmark, had a truly eye-catching stand with its 

far larger-than-life backdrop picture of two models 

sporting frames from its latest collection. A very 

busy co-founder and CEO Allan Petersen showed off 

the company’s wonderful new collection, including 

some very stylish, round, retro-looking styles. 

Five times lighter than acetate, the frames weigh 

just six grams and are very flexible and adaptable. 

They also come with a number of different nosepad 

options for different ethnicities, making it very easy 

for the optician to fit, he said. 

Despite growing competition, Monoqool is still 

very much leading the way in what’s possible in 

the 3D printed frame world, said Petersen, pulling 

a box of “super thin” (and gorgeous) new frames 

out from under the counter. These, he said, will 

be launched in January and are, incredibly, even 

lighter at just four grams, making you feel like you 

are not wearing any frames at all! “We are now 

really pushing the limits of what is possible with 3D 

printing,” he said. 

Sfered 

Hoya was not the only company to unveil a DIY 

3D-printing service for practices to offer patients 

the opportunity to customise their own frames. 

Sfered has partnered with Monoqool in a nonexclusive 

arrangement to offer the same thing (but 

without the Hoya lens being central to the design). 

Patients select the type of frame they want, the 

optician or optometrist then scans the patient’s 

face, customises the frame accordingly for the best 

look and comfort, and then sends this to Monoqool 

(or any other 3D frame manufacturer who signs up) 

which then makes the final frame. Sfered software 

developer Maarten Mathot said following Silmo, the 

new system will be rolled out to opticians in Holland 

first followed by the rest of the world. Monoqool’s 

Allan Petersen said he has always wanted to do 

customised eyewear and now he can. 

Blackfin 

Blackfin’s slot system nominated for a Silmo Gold award 

Innovation, customisation and authenticity were 

all jostling for pride of place on the Blackfin stand. 

The titanium frame manufacturer, based in the 

beautiful Agordino region of the Dolomites, is so 

proud of its Italian heritage and that it’s frames are 

100% handmade in Italy, that it has created its own 

authenticity label “Neo Made in Italy” which, said 

Blackfin’s PR lady Silvia Bocardi, “means they really, 

really are made in Italy!” 

Every frame in the Blackfin range is made from 

titanium – the purest titanium in the world from 

Japan, it claims – and starts as a concept, that 

becomes a sketch and finally a prototype. In total 

the company says it takes 53 “macro-phases” to 

make a Blackfin frame, which it calls the frame’s 

“rites of passage.” As each frame is handmade, 

it can be customised to the wearer, with temple 

adaption, laser personalisation and an everchanging 

raft of colours. 

Oxibis Group 

French frame manufacturer Oxibis Group achieved 

a Silmo Gold award in the technical innovation 

category for its “Exalto” men’s frame which 

features a cleverly-designed hinge that is designed 

to reduce friction with no hinges and a ceramic 

centrepiece. Oxibis’ Caroline Boisson said men are 

very interested in the technical side of the frames. 

“It’s only a small part, but it does a big job.” 

Netlooks 

Winner of the Silmo d’Or (Gold) Award in the 

material/equipment category, French startup 

Netlooks if offering the ultimate in customisation. 

Its Netlooks 3D technology is a new concept which 

allows eye care professionals to scan a customer’s 

face in three dimensions and create an avatar 

for fitting and testing frames, which can then be 

ordered directly from Netlooks. The technology and 

manufacturing process has taken more than three 

years to develop, said Pierre Andrieu, Netlooks’ 

chief executive and founder and a former physicist, 

who until three years ago was also Professor of 

Optical Science at the ESOL Schools of Optics and 

Eyewear, which he also co-founded. Andrieu said 

he’s very proud to have won the award, which is an 

endorsement of the technology, which is now being 

sold in several pilot stores in France. 

3D frame pioneer Allan Petersen from Monoqool 

OGI Eyewear 

Ogi red rose 

A welcome relief to my poor French and the, incomparison, 

exceptional English of most of the 

exhibitors at Silmo was Ogi Eyewear’s creative 

team manager Katy Dajnowski who had flown in 

from Minneapolis to help at Silmo. 

Known for its colour and fashion-forward 

designs, the Ogi stand delivered a luxurious 

smorgasbord of choice: its neoclassic Seraphin 

brand, sporting the latest and still popular “cat 

eye” styles and multidimensional layering of 

colour; its Evolution Collection; its cosmopolitan, 

luxury Bon Vivant brand; the younger-focused Ogi 

brand, whose new range cleverly mixes metal and 

acetate, with detailing showing the metal below 

the acetate; and its Innotec (innovation meets 

technology) range made from unique materials 

including TR-90 surgical plastic and ultem, an 

ultra-lightweight and flexible plastic that’s 

used in the aerospace industry. “This is great 

material because it can withstand really extreme 

conditions and doesn’t lose its shape, while 

remaining comfortable,” said Dajnowski. 

Last but not least was Ogi’s minimalist, metal 

Red Rose collection featuring screwless hinges 

and innovative stamped textures, that is both 

strong and lightweight, and primarily aimed at 

men. 

The company considers itself American, but 

incorporates a lot of European styling. Its Bon 

Vivant styles, some now sporting an attractive 

double bridge, are even made in Italy, said 

Dajnowski. “The Red Rose and Bon Vivant have 

caught people’s eye the most, because these 

are our two newest collections. People are really 

looking for something unique and different, 

but not so unique and different that they aren’t 

willing to wear it. So it has to be very wearable 

and have a lot of style to it, so details like the 

double bridge and pebbly texture have really 

been appealing, as well as the multidimensional 

acetate, where the acetate layers give it more of 

an intriguing look.” 

Komono 

Komono’s “Clovis” 

Komono is a Belgian brand, developed seven years 

ago by some professional snowboarders and surfers, 

and focused on watches and sunglasses. But this 

focus was extended this year with the launch of 

its first optical frame range. Marketing manager 

Annabel Greeve said the range is very affordable and 

consists of 60 products spread over 13 new styles. All 

styles are made of premium Italian acetate and/or 

stainless steel. Greeve said the company had so much 

demand from sunglass customers for optical frames, 

the company decided to launch its own optical range, 

which will only be available through practices. 

Falvin 

Falvin Shade 

Birgitte Falvin, a Danish jewellery designer and 

founder of the still new Falvin eyewear company 

(now available in New Zealand for the first time 

through Beni Vision) says her new luxury range, 

Black Crystal, was inspired by the Black Diamond 

Library in Copenhagen – its not-quite-official name 

reflecting the polished black granite cladding and 

irregular angles of the building. 

The titanium range is all handmade in Japan and 

incorporates 24 carat gold, rosegold, palladium and 

diamonds. 

“To me, eyewear is your most powerful accessory. 

You can tweak and style everything else, but your 

glasses reflect your true personal style. I’ve designed 

a collection of glasses with aesthetic attitude, a 

graphical expression and distinct architectural 

references that give character. My collection is 

VMD’s Philip Crabtree and Glenn Nolan flank Menrad MD Eberhard Muller-Menrad Blackfin CEO Nicola Del Din Katy Dajnowski from OGI Eyewear Netlooks’ founder Pierre Andrieu shows off his coveted Silmo d’Or award 


Birgitte Falvin, Falvin’s designer and founder Jeroen Manders from C-Zone Budri’s “marble drapes” heralding its new marble eyewear range Little Peach’s Jon and David Bearpark with Vanni designer Irene Chinaglia 

focused on aesthetics, elegance and quality, that 

always come first,” explained Falvin. 

Feb 31st 

Just five years old, Feb 31st now distributes its 

customised wooden frames worldwide, including 

New Zealand. Co-owner Stefano Minelli explained 

how practices can help patients “play” and design 

their own wooden frames, with different colours 

inside and out, and even different coloured temples, 

if they want, in different shapes. The frames feel 

smooth and soft, are flexible (a feat that took a 

number of years to master) and are comfortable 

to wear. Once a style and the desired colours have 

been selected they can be made in just two weeks, 

said Minelli, and the unique design makes it easy for 

the eyewear professional to fit the patient’s lenses. 

Vanni 

Vanni Sunshine - first in New Zealand 

Little Peach’s David and Jon Bearpark were on 

the Vanni stand ordering, among other things, 

sunglasses for our summer, allowing New Zealand’s 

optical patients and sunglass consumers to be 

ahead of Europe for a change. 

“Vanni is releasing these styles right now in 

Europe, so they are for Europe’s summer next year, 

so we will have them first,” said David in Paris. 

Vanni sunglasses are aimed at the lady prescription 

wearer who will spend a little more, but won’t 

spend a fortune, he said. “They are colourful, 

innovative and tomorrow’s styles for Europe.” 

Key to Vanni is its Italian authenticity, branding 

all its products, “Made in Italy, for sure” to 

distinguish itself from other brands that are only 

designed in Italy. 

Vanni designer Irene Chinaglia demonstrated 

Vanni’s new acetate Raster collection, sporting 

Vanni’s trademark colour combinations and 

incorporating a textured weave, that draws 

inspiration from a pixelated digital image, creating 

the optical illusion of a cubic geometric pattern. 

Similarly, in metal, Vanni’s Surf-ing range, is made 

from lightweight laminated steel and engraved 

Feb 31st’s Stefano Minelli 

bronze, incorporating delicate horizontal lines in 

different tones and colours with ultra-thin temples. 

Finally, Chinaglia, demonstrated Vanni’s TMT 

(thin milling technology) range, which allows the 

company to create 30% thinner acetate frames than 

other companies – 2 mm versus the normal 3 mm – 

weighing just 16 grams. 

C-Zone 

Jeroen Manders from Dutch stainless steel frame 

company C-Zone, another Little Peach company, 

said the company’s name reflects who it is: “C” 

for seeing, cool and comfort. Though the base 

material is always stainless steel, the company does 

combine it with other materials like acetate, wood 

lamination, silk and even denim. Every design comes 

in four different colour combinations and each 

collection incorporates about 25 new models with a 

broad spread of sizes to cater for women with very 

petite faces to men with very broad faces. 

“The New Zealand market has been doing very 

well, so we’re very happy,” says Manders, adding 

he’s planning a trip to New Zealand to visit 

customers with David next year. 

Face & Cie 

Design your own Face && Cie clip 

A particular highlight at the fair was the ability to 

design your very own clip-on at the very colourful 

Face & Cie stand. Alain Racary said the four-year-old 

company has gone from strength to strength as 

women around the world embraced the ability to 

select different frames and purchase as many clips 

as they like, as different as they like, to give them a 

different look for every occasion. Each clip is priced 

the same whatever their colour or style (and some 

of the lacy styles are quite complex and beautiful) 

making it easy for the optician, said Racary. 

David Bearpark, who launched Face & Cie to the 

New Zealand market at the ADONZ conference 

in Hamilton last year, says it’s one of the hottest 

brands in New Zealand at the moment. “We’ve just 

surpassed three clips for every frame we’ve sold. It is 

seriously gaining momentum.” Though the clips are 

primarily aimed at the middle-aged lady, who is a 

progressive wearer, and likes to accessorise without 

spending a fortune, the brand is also attracting a 

younger audience, said Racary, especially as people 

can now design their own clips and order their own 

customised clip direct from Face & Cie. 

Budri 

Budri’s marble eyewear 

New to the optical market, but with more than 50 

years-experience in marble craftsmanship, Budri’s 

transition into the optical market came about by 

accident when a small piece of decorative marble, 

from its latest installation, fell down and the wife of 

the founder put it to her eye and said, jokingly, “we 

could make glasses out of this,” said Budri’s area 

manager Giulia Voza. After two years of research, 

culminating in the in-house development of a 

specific production technology, Budri has launched 

its first eyewear collection at Silmo. Each frame is 

made from a single slab of stone, which undergoes 

a sophisticated milling-cutting process to produce 

a solid convex piece, from which the shape of the 

glasses frame is cut. Budri’s first eyewear collection 

features five models named, appropriately, after 

famous Italian sculptors. Each weighs between 38 

and 43 grams each. 

Sunshades 

Sunshades’ new Karen Walker “Metals” range was 

attracting a lot of rather unwanted interest from 

picture-taking Chinese manufacturers’ keen to “gain 

inspiration” from the range. Creative director Hamish 

Tame (shooing off one particularly persistent mobile 

phone snapping visitor) highlighted the luxurious 

and innovative new hexagonal and round Karen 

Walker range, which is made from stainless steel in 

gold, silver and blue, and incorporates Zeiss lenses. 

Other highlights on the stand included the new 

Vilebrequin eyewear range, new from popular men’s 

swimming trunks company Vilebrequin, which will 

officially be launched in March, Le Specs’ new flat 

lenses and Adam Selman’s new collection, popular 

with many of today’s high profile celebrities. 

Shamir 

Lens manufacturer Shamir was proudly displaying 

its new tabletop device Spark Mi, which looks like a 

tabletop mirror, but is actually a measurement tool, 

capturing all the patient’s measurements in one click 

when they are looking at themselves in their new 

glasses, even if they are sunglasses. Measurements 

include pupillary distance, fitting height, panoramic 

angle, pantoscopic tilt and vertex distance and are 

passed directly to the patient’s computerised record 

at the practice. ‘The object of this device is to allow 

the optician to have a very simple way to measure 

patients and sell very personalised lenses,” explained 

Laurent Israel, Shamir’s French product manager. 

Lafont 

Lafont had a large, 

particularly colourful stand, 

covering two sides of one 

of the through corridors, 

with easy to view stands for 

passing visitors divided into 

women’s, men’s, children’s 

and sun frames. Lafont’s 

Marina Louis explained 

how, from this year, many 

of Lafont’s frames are now 

labelled “Origin France,” 

meaning they have been 

independently verified 

to ensure that more than 

90% of the product is 

designed and made in 

France. More than 90% 

of Lafont’s frames also 

employ colours exclusively 

belonging to Lafont. “The 

colour combination is very 

important for us,” because 

that’s what Lafont is all 

about, explained Louis, 

showing how colour has 

been brought into the men’s 

frames more subtlety with 

colour detailing on the 

temples. A big drawcard was 

the special limited edition 

version of its Socrate frame, 

designed to celebrate the 

centenary of the French 

Airforce’s Lafayette squadron, 

and two other limited 

edition sunglass frames only 

available to buyers at Silmo. 

Fleye Eyewear 

Fleye 524 from its new contemporay acetate range 

Danish eyewear label Fleye officially launched 

its new marketing campaign at Silmo 2016, 

presenting a mood-driven lookbook to showcase 

their contemporary designs and brand aesthetics. 

The new campaign was shot by Silvia Conde, an 

upcoming photographer from Barcelona, known 

for her work in leading magazines such as Spanish 

Vogue and for creating campaigns for labels like 

Dior and Gucci. Also unveiled at Silmo was Fleye’s 

new range incorporating special, high-density 

compressed acetate for ultra-thin, lightweight 

frames. “This new material allows us to minimize 

acetate width and depth, providing a very slim and 

minimalistic look while retaining its beautiful glow 

and hues,” said Annette Saust Esto, Fleye’s cofounder 

and head of creative developments. ▀ 

Fleye founder Annette Saust Esto 

The 4 days of Optics 

06 - 09 October 2017 

LIVE THE EXPERIENCE 


silmoparis.com 


19

Focus 

on Business 

INTERVIEWING TIPS 

The job interview is your key recruitment 

tool. It will support you in assessing 

candidates to get the right cultural fit 

along with suitability for the role available 

within your company. 

Outlined below are a few tips to help 

identify the best future employees. 

1. Preparing for the job interview 

For an effective and informative interview to 

take place you need to prepare for it. Look at 

your current in-house recruitment tools 

to support this process. Use your position 

description and your list of key competencies 

(qualities, skills and experience) to drive your 

interview. 

Do you have an in-house application 

form that you want them to fill out prior to 

interview? Do you wish them to bring ID? 

Copies of work they have done? References? 

Let them know that this forms part of your 

recruitment process. Will there be any 

assessments to conduct while they are there? 

Let them know so they can come prepared. 

2. Before scheduling an interview review 

each candidate’s CV 

Assess their suitability against the 

competencies you require for the role, look 

at the quality and content of their letter 

and select those suitable for a telephone 

screening interview first. You may have a 

selection of tools to support you with this 

(eg. Seek’s automation process) 

3. Conduct a telephone screening interview 

first 

During this process ask a selection of your 

competency-based questions to assess if 

the candidate’s experience, qualifications, 

qualities, knowledge and attitude fit with 

your company’s needs. You will be able to see 

how passionate they are about your role and 

can find out salary expectations to ensure 

everything is in line with your requirements. 

The telephone interview is a fundamental 

pre-requisite before a face-to-face interview 

and will save you time in the long run. 

4. Interviewers – who should interview? 

Interviews should be conducted by at least 

two interviewers. Ensure each interviewer 

knows what his part should be during this 

assessment of the candidate. Questions are 

prepared and ratings can be compared and 

agreed upon before the interview, which will 

decrease any personal biases. 

5. How do I rate the candidate’s answers? 

Scoring questions 

There are interview questions for each of the 

competencies/skills/knowledge/experience 

identified in the profile. Ask the candidate 

these questions and score their response 

using the rating scale in the box below. 

Sample scoring 

3 Strong evidence that the skill and proven 

expertise IS present 

2 Evidence that skill IS present 

1 Insufficient evidence despite probing 

0 Strong evidence that competency/ 

attribute/knowledge/experience is NOT 

present 

6. How long will the interview typically take? 

Allow up to 1 to 1½ hours for the interview. 

Ensure you allow time to interview effectively 

and then review the competency ratings 

straight after the interview. 

7. Interview Process 

• To relax and make them feel welcome 

outline the interview process and what will 

be involved. 

• Next ask them why they are interested in 

your role and why they are suitable. 

• Ask them to walk you through their 

resume, highlighting the key skills that relate 

to this role. 

• Ask where they have added significant 

value in each position eg. innovation, 

BY THERESE MCNAUGHTEN* 

profitability, customer service. 

• During the interview ask what motivates 

them and to describe their preferred working 

style and how they like to be managed, how 

they deal with stress, how interested they are 

in the role and what their salary expectations 

and availability are. 

What type of interview is recommended? 

Today a structured, competency-based 

interview approach is preferred, also known 

as a behavioural-based interview, with 

questions requiring candidates to provide 

specific behavioural examples of past 

experiences that showcase their skills in each 

specific competency. This type of interview 

will help the candidate tell you how they 

have demonstrated their attributes in the 

past and improve your ability to predict 

future performance in the job. 

A ‘structured interview’ means that: 

questions are planned carefully before the 

interview; all candidates are asked the same 

questions; answers can be scored using 

a rating system; questions focus on the 

attributes needed in the job; and specific 

behavioural type questions are asked about 

each attribute. As well as noting verbal 

responses you will also be observing nonverbal 

reactions throughout the interview 

too. Some candidates need guidance during 

this process, so you may have to give them 

an example first. For each competency 

that needs validation ask them to describe 

the situation or task that needs to be 

accomplished and using the STAR technique 

(see below) they can set the scene and put 

the example in context. 

STAR Technique – when asking for specific 

examples around specific competencies/ 

skills ask them to: S – set the SCENE; T – 

outline the TASKS they owned; A – describe 

the ACTIONS they took; and R – the RESULTS 

8. Sample questions 

• Leadership – In your current role what 

have you done to lead transitional change 

and how did you manage this? 

• Team orientation (managing conflict) – Tell 

me about a time when there was conflict in 

your team and what steps you put in place to 

handle this? 

• Customer service – Describe a specific time 

when you managed a challenging issue for a 

customer and what you did to resolve this? 

• Project management – Describe a time 

when you had uncertainty in a project. How 

did you manage this? Outcomes? 

9. Additional Steps 

Reference checks are critical. Seek a 

candidate’s authorisation prior to speaking 

to referees. Check tertiary qualifications and 

include specific assessments as part of the 

process where necessary. In addition, you 

could add in a second stage. Ask if they were 

to be selected for the role, what would be 

their key focus in the first 100 days? Or ask 

them for solutions to a specific problem. This 

could be done in a presentation or workshop 

style by the candidate. Be creative and 

involved other staff. 

10. Finally… 

Good luck with your recruitment and all the 

best for attracting and securing top talent 

for your business. I wish you all the best for 

the festive season. If you wish to look at 

further tips, please visit my website www. 

wholeornanges.co.nz 

ABOUT THE AUTHOR: 

* Therese McNaughten is 

the founder of Wholeoranges 

Consulting, a boutique 

recruitment firm that 

provides flexible recruitment 

services to businesses 

nationwide, and a business 

coach for those going 

through career transitions. 

VOSO’s dining success 

October’s Dine for a Donation event 

at Meredith’s restaurant in Auckland 

raised a whopping $10,713 for 

Volunteer Ophthalmic Services Overseas 

(VOSO). The month-long event saw patrons 

dining for a donation on Tuesday evenings 

during the whole month of October, with 

all the money paid for food, going direct to 

VOSO. 

“The donated money paid for Erna 

Takazawa to attend the Eye Institute 

conference (see p13)” said Kylie Dreaver 

from VOSO. “Erna is a New Zealand-trained 

optometrist based in Apia. As (restaurant 

owner) Michael Meredith comes from 

Samoa, VOSO wanted to do something 

special for Samoa and helping their only 

optometrist attend a conference back 

in the city where she studied seemed 

appropriate.” 

We caught up with Takazawa at the Eye 

Institute conference, who was delighted to 

be there. “To keep up with my CPD points I have to do 

it all online, so it’s great to come to an event like this, 

BP and Oculo pair up 

Best Practice (BP software), providers of leadng 

ophthalmology clinical management software 

VIP.net, and clinical communications platform 

Oculo have agreed to integrate their systems. 

In a statement, Lorraine Pyefinch, chief relationship 

officer and co-founder of BP software said, “We were 

keen to respond to the clear feedback from our VIP. 

net users that they wanted to be able to receive 

referrals and send correspondence via Oculo. They 

recognise the benefits of being part of the Oculo 

network.” 

CCLS 2016 Scholarship 

Mortimer Hirst optometrist 

Emilie Langley is the 2016 

Cornea and Contact Lens 

Society (CCLS) Scholarship recipient. 

The society awards the annual 

scholarship (up to $2,500 for course 

costs and expenses) to a member of 

the society to upskill in either cornea 

or contact lens speciality fields. 

Langley thanked the CCLS for “this 

amazing opportunity” and says she is 

thrilled to be the 2016 recipient. She 

plans to spend a week undertaking 

some intensive hands-on experience 

with the contact lens specialists at 

Innovative Eyecare in Adelaide. 

“I am really looking forward to using Emilie Langley 

the scholarship to further up-skill 

and develop as an optometrist in the area of specialty 

contact lenses. I hope this further training will fasttrack 

my speciality contact lens practical experience 

and improve my first contact lens fit success rate for 

those complex cases, which do not present every day. 

Reuben Gordon and Erna Takazawa at the Eye Institure conference 

learning and developing with other optometrists. I’m 

really grateful to VOSO for sponsoring my trip here.” ▀ 

“Busy ophthalmology practices are committed to 

business efficiency and clinical excellence,” added 

Dr Kate Taylor, CEO of Oculo. “Integrating Oculo and 

having better communications with optometrists 

and GPs is good for both….We believe that better 

communication will mean better care for patients.” 

Pyefinch added that BP software is committed to 

developing VIP.net as a flexible and functionally-rich 

application and will have the integration with Oculo 

ready for the software’s next planned upgrade in 

2017. ▀ 

This further training will enable me 

to confidently provide contact lens 

treatment options to a greater number 

of clients.” 

CCLS 2017 Conference 

The 2017 CCLS Conference will be 

held at the Rutherford Hotel in sunny 

Nelson from the evening of Thursday 

23 March to 4pm on Saturday 25 

March. Friday and Saturday include 

lectures from Professors Fiona 

Stapleton and Charles McGhee and Drs 

Ken Nischal and Marc Bloomenstein, 

plus many local New Zealand 

presenters. “Nelson offers a relaxed, 

but easy to get to, picturesque and laid 

back style, where top quality education 

can be mingled with great company, food and wine,” 

says CCLS secretary Richard Newson. 

More information about when and how to register for 

the CCLS conference will be shared through NZ Optics 

soon, so keep an eye on your in-box. ▀ 


Paediatric binocular vision 

What about that phoria? Jack’s story 

Jack presents to a paediatric optometric 

practice, on referral following a recent 

educational psychology assessment. Jack, age 

12, thinks his eyes are fine, and this was recently 

confirmed at his ‘free’ optometric eye test two 

weeks ago. 

At school Jack has always struggled with 

handwriting, copying off the board and maths. He 

is OK at reading but has a low processing speed, 

and is not completing tests or assignments on 

time. He is off to grammar school next year and 

Mum is concerned about how well he will keep up 

with the curriculum, “I know he is smarter than his 

test results show”. Jack is fit, happy and well with 

no general health concerns. 

Their family history is positive for maternal 

moderate myopia of late teen onset. Jack’s 

developmental history is uncomplicated and he 

has no history of concussion or significant injury. 

Structurally Jack’s eyes are fine, he is an 

emmetrope with healthy eyes and normal colour 

vision. He has passed his B4 school check, school 

vision screenings, GP eyesight check and the recent 

optometric eye test. 

During an ocular motility examination Jack can 

Fig 1. Howell Near Phoria 

BY EVAN BROWN* 

make smooth eye movements in all positions of 

gaze but he would prefer to track and saccade by 

moving his head, rather than his eyes. He has a 

normal near point of convergence. Cover testing 

reveals a mild exophoria of 4pd using a Howell 

Card (fig 1.) and 6pd behind the refractor head. 

Jack shows a normal accommodative range and 

his relative accommodation findings are normal. 

His MEM for complex word reading is +0.50 DS OU, 

and moves out to +0.82 on easily-known words. He 

finds the green side prominent and dots clearer on 

the Shapiro-Evans Golf Ball (fig 2.). 

A brock string probe shows remote vergence 

posture, and positive fusional vergence ranges 

at near are low. AC/A assessment reveals a low 

minus gradient and moderate plus gradient. The 

Richman-Garzia Developmental Eye Movement 

Test shows vertical processing speed at 30th 

percentile (primarily recognition), horizontal at 

the 2nd percentile (recognition and tracking). The 

Berry-Buktenica Visual-Motor Integration test 

demonstrates normal graphic-motor (drawing) 

ability, but Jack’s knuckles are white with tension 

and effort. 

Discussion 

Fig 2. Shapiro-Evans paddle 

So does Jack have a 

visual problem that 

might impact upon his 

learning aptitude? The 

literature demonstrating 

association between 

vision problems, 

behaviourally at-risk 

pupils and adjudicated 

adolescents would 

suggest this is an 

important question to 

answer 1-6 . 

We can think about 

a phoria as a muscle 

Surviving a brain injury 

When Professor Clark Elliot suffered 

a traumatic brain injury in a car 

accident, he was told to get used to the 

debilitating symptoms that prevented him from 

living the life he loved. But as a single father and 

professor of cognitive science, he wasn’t about 

to let that be the end. Together with a neurooptometrist, 

he fought to restore his visual and 

mental function. NZ Optics caught up with him to 

ask him a bit about his life, his work and his book, 

The Ghost In My Brain, about overcoming brain 

injury. 

What did you do before your injury? 

At the time of the accident in 1999, I was a 

tenured professor of artificial intelligence and 

cognitive science at DePaul University in Chicago. 

My research area was computational models of 

human emotion. I was working on a computable 

model of story generation based on complex 

emotional interactions of the characters. Prior 

to my life as a professor, I was a professional 

classical musician studying at the Eastman School 

of Music. 

How did the injury happen and when did 

you know something was wrong? 

I was rear-ended by an SUV while waiting at a 

red light. I didn’t think much of the crash at the 

time. I seemed to be OK, but from the moment of 

impact very strange things began happening to 

me. For example, I was holding my insurance card 

in my hand, but I couldn’t figure out how to give 

it to the police officer. On my way home, I realised 

I had completely lost my previously infallible 

sense of direction. I couldn’t figure out how to 

walk from the car to my front door and I couldn’t 

work out how to unlock the door. 

Concussion is insidious this way: often the brain 

machinery necessary to realise that something 

has gone missing is exactly the same machinery 

that is gone. I couldn’t initiate action; it might 

take me 10 minutes to rise from a chair. I couldn’t 

make decisions. I was often nauseated from 

balance problems. I didn’t understand time or 

dates any more. I couldn’t understand what 

people were saying to me. I was overwhelmed by 

any kind of loud sound. But I still didn’t realise 

BY JAI BREITNAUER 

anything important was wrong until days later. 

I finally sought help after deciding it wasn’t 

normal for me to take six hours to figure out I had 

put my shoes on the wrong feet. 

Even so, it was probably six months before I 

even began to understand this wasn’t like a case 

of the flu that would soon get better - that I had 

a serious injury. Doctors told me many times that 

I would never recover, but it wasn’t until my third 

year that I finally came to terms with that. 

Why weren’t the professionals you first 

spoke to more helpful? 

The doctors were almost universally wellmeaning 

and had something been immediately 

dangerous they would have saved my life. 

Unfortunately, especially then, the medical 

treatment for brain injury was essentially, “Can 

you go away now? …because I can’t help you 

and if you don’t get better on your own there 

is nothing we can do.” This was frustrating for 

everyone. What I heard over and over was that 

after two years of possibly terraced improvement, 

no one ever gets better so I should learn to live 

with my symptoms. 

What was the turning point for you? 

After eight years I was at the breaking 

point where I would lose my job, my house, 

custodianship of my children and become a ward 

of the state. In a last-ditch effort, after reading 

Norman Doidge’s The Brain That Changes Itself 

we began searches on ‘brain plasticity’ and found 

Dr Donalee Markus (originator of Designs for 

Strong Minds, a programme to improve ‘mental 

flexibility’), who in turn immediately referred 

me to her colleague Dr Deborah Zelinsky, (a 

neuro-optometrist in Illinois). Within a month of 

starting (brain retraining) treatment I was about 

70% recovered. 

That’s incredible, what did they do and 

how important was the vision element? 

Dr Donalee and Dr Zelinsky both work at 

reconfiguring the brain through retinal 

stimulation, taking advantage of the brain’s 

plastic nature. Dr Donalee works at cognitive 

restructuring with visual puzzles and Dr Zelinsky 

or motor imbalance, however another way 

of interpreting the information is that it is an 

indication of the ease and accuracy with which 

that individual is centring the visual process to 

gather and process information. 

Is there a vergence lag or lead in the process? 

How does this person organise associated 

processes such as accommodation, central 

suppression, attention and effort to achieve single 

clear perception? 

Will this phoria cause more problems when the 

visual process for acquiring information becomes 

dynamic, as when making the continuous, 

effortless saccades required to read fluently? 

The optometric results for Jack suggest this is 

probable. Jack can recognise and name a vertical 

array of numbers within the normal variance for 

his age, but place the numbers in a horizontal 

spatial array and his accuracy and speed slow to 

below the fifth percentile! Acquiring information is 

now slow and an effort. 

Jack can draw patterns and shapes to the 

80th percentile for his age on a standardised 

assessment of drawing, but produces the content 

equivalent to a nine-year-old in a simple sentence 

copy test under time constraint. 

So the message here is simple. All children 

attending an optometric evaluation should 

receive in-depth binocular and accommodative 

assessment when presenting with performance 

problems at school. 

How should you measure that phoria? 

The question phoria assessment asks is: “does 

this person organise their visual system closer 

to or further away from the stimulus presented. 

To answer this question it is important to not 

penalise proximal awareness - this is why I like 

using the Howell Card as a primary tool for 

assessing the ‘phoria’ 7 . 

The Howell Card probes the disassociated phoria. 

Disassociation uncouples the disparity component 

used in centring but proximal, tonic, consensual 

and blur driven components remain active. 

When asking the patient to look through two 

small apertures (the refractor head) we penalise 

proximal awareness and will likely obtain a finding 

that does not reflect the person’s true proximal 

works with prescription 

eyeglasses. In my case, 

Dr Zelinsky, using neurooptometric 

testing, found 

healthy tissue in my brain 

which she could work with. 

She redirected the output 

from my retinas to emphasise 

those healthy pathways 

through my brain, balancing 

centre, peripheral and nonimage-forming 

retinal input 

as well. We think of these as 

dirt roads through new brain 

areas. Dr Donalee then had 

me rehearse structured visual 

Professor Clark Elliot 

puzzles over and over to turn 

those dirt roads back into the 

super-highways that let me return to my work as 

a professor. 

The key that makes these treatments effective 

is that the human brain is primarily a visualspatial 

processing device, down to the very core 

of how we represent the symbols that are at the 

root of what makes us human. And our retinas 

are essentially a crucially important part of our 

brains hanging out the front of our heads—the 

perfect window for assessing and treating this 

magnificent device. 

How has your recovery affected your own 

professional life? 

response. 

If the target does not offer a strong 

accommodative stimulus we will likely receive a 

different result. Clinically, the tests we use need 

to be consistent and we need to understand the 

limitations of the information generated. 

The magnocellular dorsal ambient stream 

has been credited as providing us with the 

construct platform from which we perceive space. 

Proprioception, audition and vestibular input 

have a role in the overall interpretation of spatial 

relationships such as ‘which way is up’, ‘me to it’ 

and ‘it to it’. But ophthalmic professionals know 

that changing a person’s visual input with lenses 

or prism will alter their perception of distance, 

velocity, midline projection and balance. 

We can help Jack to manage his remote visual 

centring responses by prescribing appropriate 

lenses, prisms and or optometric vision therapy, so 

that he can enjoy and achieve academically with 

an efficient and sustainable visual process. ▀ 

References: 

1. Zaba J. Social, emotional, and educational consequences 

of undetected children’s vision problems. J Behav Optom 

2001;12:66-70. 

2. Johnson R, Nottingham D, Stratton R, et al. The vision 

screening of academically and behaviorally at-risk pupils. 

J Behav Optom 1996;7:39-42. 

3. Johnson R, Zaba J. Vision screening of at risk college 

students. J Behav Optom 1995;6:63-65. 

4. Johnson R, Zaba J. The visual screening of adjudicated 

adolescents. J Behav Optom 1996;10;13-17. 

5. Maples W, A comparison of visual abilities, race and 

socio-economic factors as predictors of academic 

achievement. J Behav Optom 2001;12:60-65. 

6. Johnson R, Zaba J. The link: vision and illiteracy. J Behav 

Optom 1994;5:41-43. 

7. Howell E. The differential diagnosis of accommodation/ 

convergence disorders. J Behav Optom 1991;1:20-26 

* 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. 

Because of my own experiences, I am filled with 

compassion for the six million people living 

with the long-term effects of brain injury in the 

US alone. I wrote The Ghost In My Brain with 

the idea that we might make some dent in 

this epidemic. Coinciding with publication I’ve 

seen an international groundswell of interest in 

understanding brain injury, and because of this 

I’ve spoken to more than ten million people via 

radio and TV interviews. Along the way I’ve run 

into scores of highly dedicated people working 

at the leading edge of these new plasticitybased 

approaches to treatment. Through them 

I’ve learned a great deal about neuroscience 

approaches to understanding the brain. 

I’m still an A1 scientist at heart. But I’ve 

come to realise how crucial it is to develop 

much more sophisticated models of the visualspatial 

nature of human 

symbol processing - the 

symbols that give us our 

internal human voice and 

awareness. 

What role do you think 

optometry has in the 

rehabilitation of brain 

injury patients? 

Neuro-developmental 

optometry is the wave of 

the future. It will be at 

the core of understanding 

how the brain works and 

of diagnosing problems 

and fixing them when 

something goes wrong 

with cognition. Consider, for example, that even 

in listening to the world around us, including 

speech, once our brain has detected the audio 

input signal all the rest of the massive processing 

that goes on to interpret the meaning of those 

sounds is visual-spatial in nature: I tap a wine 

glass behind your ear, you see the glass in your 

mind’s eye, you understand what it is, where 

it is, and that it is not you. You see the color of 

red wine. You know you can drink it. You recall 

two friends you shared wine with last week at a 

restaurant. So hearing is primarily visual-spatial 

in nature, so is proprioception, so is planning and 

decision making, and significant elements of 

both our complex human emotion system and 

our spiritual lives. Retinal processing is also part 

of our balance systems and helps control our 

emotional body states. 

You are having hearing problems? You might 

need glasses that treat all three of the retinal 

pathways. You have balance problems? You 

might need glasses. You can’t think? You might 

need glasses. You are anxious or have attention 

problems? You might need glasses. 

A major pathway into understanding cognition 

is through the retinas and neuro-developmental 

optometry will be one of the foundations of 

neuroscience in the years to come. ▀ 

For more information about Professor Elliot 

or his book, The Ghost In My Brain, visit www. 

ClarkElliott.com 



21

Frizzell, Fred Hollows and Specsavers 

Iconic New Zealand artist, Dick Frizzell 

has joined forces with Specsavers to raise 

money for The Fred Hollows Foundation 

NZ through a limited edition Frizzell frame. 

The funky frames feature Frizzell’s famous 

‘woodgrain’ print that first featured on Crown 

Lynn ceramics 27 years ago, before becoming 

an iconic fabric print. 

Frizzell, Specsavers and the Fred Hollows 

Foundation have been working on the project 

for two years and Frizzell says the print has 

never been used on anything as complex 

as glasses. “I hadn’t worked with the Fred 

Hollows Foundation before but I was totally 

flattered and excited to be asked. The bloke 

himself (Fred Hollows) is so inspiring, his 

no-nonsense, humble approach to his work 

appealed to me.” 

Frizzell’s new frame range 

Kiwi musician and Frizzell’s friend Tiki 

Tane was part of a documentary crew that 

followed the Fred Hollows Foundation to 

Papua New Guinea, so Frizzell discussed the 

project with him. “We had a chat about it 

and Tiki’s enthusiasm reinforced my initial 

instincts. This is a powerful cause to put your 

name to.” 

Frizzell has worn glasses since the late 

‘70s and they’ve now become “a bit of a 

trademark” for him, he says. “Some years 

ago I decided to design my own glasses, so I 

could get exactly what I wanted. When I sent 

the drawings to the manufacturer in London, 

they refused to proceed because they were 

concerned the designs wouldn’t work. I ended 

up making a working model of them, out of 

wire and papier-mâché.” 

Frizzell painted them tortoise 

shell, put them in a glasses box 

and posted them to London. 

“The model was exactly how 

I imagined they would look, 

exactly how I wanted them,” 

laughs Frizzell, who received an 

identical, working pair of glasses 

back a few weeks later. He 

admits, however, he did not have 

as much hands on involvement 

with this project, but is equally 

pleased with the result. 

Brendan Thompson, Specsavers 

NZ retail director, says Frizzell’s 

status as a Kiwi icon meant the 

decision to approach him was 

elementary. “We did something 

similar with an aboriginal artist in Australia. 

When it came to New Zealand, who better to 

approach than Dick Frizzell?” 

Specsavers have released 500 pairs of the 

limited edition, unisex frames and will donate 

$25 from each frame sold to the Foundation. 

Gabi Hollows, the Foundation’s founding 

director and patron, says the money will go 

towards cataract kits that include the vital 

components needed for cataract surgery. ▀ 

Hollow’s mobile magic 

One thing visiting ophthalmologists 

noticed when they went to help in Fiji was 

that during the week they were there, 

more people turned up on a Friday than 

on a Monday, said Andrew Bell, executive 

director of the Fred Hollows Foundation 

NZ, at the Dick Frizzell launch. “It’s because 

the patients have to travel long distances. 

They’re old, they’re blind and they live 

in remote areas. Even 10km can be too 

much.” 

The Fred Hollow’s team realised this 

meant many Fijian’s were not receiving 

treatment during the Foundation’s visits. 

The solution was a mobile surgery unit, 

which came into operation in November 

2014. One half of the unit is designed for 

cataract surgery and the other for diabetic 

eye problems. Since its launch, this mobile 

unit has treated 11,000 people, all in 

remote areas of Fiji who would otherwise 

be blind, said Bell. 

Dick Frizzell and Brendan Thompson 

Highlights from AAO 2016 

News from the American Academy of 

Ophthalmology’s 120th annual meeting in 

Chicago poured out over the wires at the 

end of October as researchers released the results 

of studies, and presenters questioned current 

practices. 

More than 25,000 eye surgeons and other eye 

care professionals attended the annual meeting, 

which is considered to be the world’s largest 

showcase for vision research and innovation. 

It featured more than 350 instruction courses, 

56 surgical skills labs, 51 symposia and 585 

exhibitors, collectively addressing all aspects of 

ophthalmology. Highlights included: 

Progress in the precision of cataract and 

LASIK surgery – Professor Douglas Koch, from 

the Baylor College of Medicine, discussed how 

new technology has great potential to improve 

the precision of cataract and LASIK surgery 

in the Jackson Memorial Lecture, including 

innovations such as the latest class of intraocular 

lenses whose optical power can be modified 

postoperatively 

Surgical alternatives to reading glasses – Dr 

Julian Stevens from Moorfields Eye Hospital 

discussed corneal inlays, while Dr Dimitri Azar, 

Dean of the College of Medicine at University of 

Illinois, reviewed recent advancements including 

the Google/Verily smart accommodating 

intraocular lenses. (See side story) 

Mediterranean diet may cut AMD risk – new 

data from the ongoing Portuguese Coimbra Eye 

Study, presented during a poster discussion, 

showed the risk for age-related macular 

degeneration (AMD) can be cut by more than 

one-third by eating a Mediterranean-style 

diet heavy in fruit, vegetables, legumes, whole 

grains, fish and lean meats. Also caffeine, not 

traditionally included in the Mediterranean diet 

but consumed in beverages popular in the region 

and high in anti-oxidants, might be especially 

protective against AMD, said co-author Dr Joao 

Figueira, from the Department of Ophthalmology 

at the University of Coimbra in Portugal. 

The next step in this study is to rescreen 

patients to see if those who did not have 

macular degeneration developed it and to look 

at the diet those patients were 

eating, he added. 

The IRIS Registry: Measuring 

value and improving quality – a 

detailed discussion about how the 

IRIS Registry (Intelligent Research 

in Sight), the world’s largest 

real-time database of ophthalmic 

patient outcomes, is helping 

ophthalmologists track, report 

and improve quality performance, 

evaluate patient outcomes and 

perform simple analytics. 

International award winners 

Each year, the Academy presents 

a series of awards, the most 

prestigious of which is the Laureate 

Recognition Award, which recognises 

ophthalmologists who have made 

exceptional scientific contributions 

to preventing blindness and 

restoring sight worldwide. The 2016 

recipient was Dr Matthew Davis, 

from the University of Wisconsin- 

Madison School of Medicine and 

Public Health Department of 

Ophthalmology and Visual Sciences, 

for his ground-breaking work in 

the study of retinal diseases, especially diabetic 

retinopathy. 

Other notable international award winners from 

this year’s meeting included Dr Paul Bernstein, 

from the John A. Moran Eye Centre at Utah 

University, and Dr Benjamin Roberts, a missionary 

ophthalmologist affiliated with the University of 

Alabama Hospital, who were both awarded the 

Outstanding Humanitarian Service Award. 

AAO 2016’s exhibition floor in Chicago 

Cutting-edge treatments for presbyopia 

Studies presented at AAO 2016 showed that a 

new method using lasers to reshape a small part 

of the cornea, and a separate technique using 

painless electrostimulation, may be effective in 

treating presbyopia. 

The first treatment uses a femtosecond laser 

to extract a disc of corneal tissue, which is 

then sculpted. This treatment may offer safety 

advantages over synthetic corneal inlays for 

presbyopia as it uses the person’s own more 

biologically-compatible corneal tissue, said Dr 

Soosan Jacob, lead author and creator of the 

new PEARL, or PrEsbyopic Allogenic Refractive 

Lenticule, technique. “Because it’s made of human 

corneal tissue, the inlay remains stable. Our 

preliminary findings have been very promising,” 

Dr Bernstein spent eight years training 

ophthalmologists in developing nations, and 

expanding the availability of retinal care from 

Ghana to Nepal, while Dr Roberts has dedicated his 

career to preventing blindness in the developing 

world, focusing on the people of East Africa. 

Dr Van Charles Lansingh, a medical officer in 

Latin America for HelpMeSee was awarded the 

International Blindness Prevention Award for 

making major contributions to reduce blindness 

said Dr Jacob, who is also director and chief of Dr. 

Agarwal’s Group of Eye Hospitals in India. 

The other treatment is for people who have 

mild presbyopia. It uses electrostimulation to 

activate and exercise the eye’s ciliary muscle, 

located behind the lens of the eye, which controls 

near vision. As this muscle contracts, it causes the 

flexible lens to change shape to enable seeing 

up close. The technique requires no surgery, 

providing a potential advantage over invasive 

presbyopia treatments, said Dr Luca Gualdi, lead 

author and a refractive and anterior segment 

surgeon at Dignostica Oculistica e Microchirurgia 

Ambulatoriale in Italy. “This is like going to the 

gym. I tell patients electrostimulation helps them 

train their eye muscles to delay development 

and restore eyesight in Latin America, North 

America, South East Asia and the Pacific. ▀ 

For more information and news from AAO 2016 

visit: www.aao.org/newsroom/news-releases/ 

detail/innovation-surgical-eye-care-center-stageaao2016 

AAO 2017 will be held in New Orleans from 

11-14 November 

of presbyopia. The key is early treatment. 

Electrostimulation is much more effective when 

it’s performed in people who are early in the 

process of developing presbyopia before their eyes 

become dependent on reading glasses and the 

ciliary muscle is less reactive to treatment.” 

The contact lens-shaped device that is 

connected to a micro-current generator via tiny 

cables, developed by the Italian research team, 

has already received European approval but has 

not yet been submitted for FDA approval. The 

researchers noted studies with longer follow-up 

should be done to verify their findings. 

Other studies involving electrostimulation 

for other eye conditions, such as glaucoma and 

macular degeneration, are also underway. 


ODOB consultation on 

Optometrist Scopes of Practice 

The Optometrists and Dispensing Opticians 

Board (ODOB) is seeking views on a proposal 

to reduce its four current scopes of practice 

for the optometry profession to one general scope. 

The ODOB has wanted to rationalise the 

scopes for some time to make sure that all new 

optometrists added to the register meet the same 

standard, wherever they have been educated, 

they said. They also felt four scopes of practice in a 

small profession can be confusing to the public. 

The proposal is to create one general scope, with 

the addition of a separate time-limited scope to 

allow overseas optometrists who don’t have the 

qualifications to prescribe therapeutic medicines, 

to upskill to the current New Zealand and 

Australian standard. It closes a loophole whereby 

overseas applicants are able to register with a 

lower-level qualification than that required of New 

Zealand and Australian graduates. 

If the proposal is approved, all currently 

registered optometrists would transfer to the 

new General Scope of Optometry and conditions 

would be applied to the scope of practice of 

some practitioners in order that they can be 

deemed safe to practise. Optometrists without 

qualifications to prescribe therapeutic medicines, 

for example, would have a condition applied to 

their scope of practice indicating to the public 

Bon Vivant goes semi-rimless 

frame designer Ogi Eyewear has added 

US two new semi-rimless models to its 

Bob Vivant collection of architecturally-inspired 

eyewear. According to the company, “The Adele 

and Marius demonstrate a fashion-forward 

interpretation of a timeless aesthetic and 

display tremendously rich and sophisticated 

coloration. 

“Adele is a feminine, semi-rimless combination 

pair that has been handcrafted in Italy from 

stainless steel and the finest Mazzucchelli 

acetate…. Marius is a classic semi-rimless optical 

frame that adds a dash of sophistication to the 

contemporary professional’s attire.” 

Bon Vivant is distributed by BTP International 

in New Zealand. ▀ 

Objective Acuity heads out 

Objective Acuity, a new company born from 

research by Auckland University research 

fellow Dr Jason Turuwhenua and Associate 

Professor Ben Thompson into measuring visual 

acuity in young patients and those with special 

needs (see NZ Optics September 2016) was listed 

as a company on 12 October. 

ASX-listed tech investor Powerhouse Ventures 

has invested an unspecified amount into 

Objective Acuity and Adam Podmore, formerly 

commercialisation manager at Auckland 

Uniservices, has joined as CEO as the young 

company gears up to take its first products to 

market. 

The investment by Powerhouse is the first 

ever by the Christchurch-based company into a 

University of Auckland spinout. 

Powerhouse Ventures 

specialises in developing 

and shaping research from 

New Zealand and Australian 

universities into businesses. 

Its portfolio currently 

comprises 22 early stage 

that they may not prescribe medicines. Those 

originally registered in an educator scope of 

practice would similarly have a condition applied 

indicating to the public that they are restricted to 

working in an educational setting. 

The principle aim of scopes of practice under 

the Health Practitioners Competence Assurance 

(HPCA) Act 2003 is to provide a transparent 

framework so that health professionals and 

consumers of health and disability services can 

easily know the parameters a health professional 

is competent to work within. It is intended 

that the General Scope of Optometry would 

encompass the full breadth of optometry, so the 

purpose of any conditions imposed would be to 

identify to health professionals and the public 

areas of practice where a practitioner was not 

authorised by the Board as competent to practise, 

the ODOB said. 

In developing this proposal, the ODOB said they 

considered feedback from earlier consultations, 

changes in the health care environment in New 

Zealand, a change to registration standards in 

Australia as well as the legal framework and 

guiding principles of the HPCA Act. 

The consultation document can be downloaded 

from the ‘Latest News’ page of the ODOB’s website. 

Submissions close on 23 December 2016. ▀ 

Stars and their 

eyes: Bono 

The charismatically cool lead singer of uber-band 

U2, Bono, opened up about his glaucoma diagnosis 

in 2014. The 57-year-old said he had been dealing 

with the condition for 20 years and his trademark dark 

or coloured-lens glasses help alleviate symptoms of the 

condition. In an interview with British chat show host 

Graham Norton, Bono was asked if he ever removed 

his shades. “This is a good place to explain to people 

that I’ve had glaucoma for the last 20 years. I have good 

treatments and I am going to be fine.” Commentators 

said he is the perfect example of someone who despite 

his glaucoma leads a full and active life with the right 

support and treatment. ▀ 

to mature businesses founded on university and 

research institutes’ intellectual property. 

Dr Turuwhenua and A/Prof Thompson’s 

technology uses optokinetic nystagmus (OKN) and 

involuntary ocular reflex, and requires no input 

from the subject. A child can sit on their parent’s lap 

in front of a screen watching a moving stimulus. If 

they can see the movement, it induces OKN, which 

is measured by a head and eye tracking device. 

Novel imaging processing algorithms extract 

the OKN image from the video footage of the 

subject’s eyes. Unlike an eye chart it requires no 

communication or understanding from the patient. 

The technology means that serious visual issues 

can be picked up in very young children, allowing 

earlier treatment. The system also has the potential 

to be used for non-verbal older 

children and adults. 

As well as Powerhouse 

Ventures, Objective Acuity also 

has backing from UniServices, 

through the University of 

Auckland Inventors Fund, and 

Callaghan Innovation. ▀ 

Style-Eyes 

With Christmas approaching, it’s time to 

think about gifts for the eyewear fans in 

our and our customer’s lives. Ideally we’d like to 

sell them more specs, but there are some great 

eyewear-related accessories sure to please 

when unwrapped on Christmas day. 

How do we keep hold of our 

sunglasses this summer? 

American company La LOOP make eyewear 

necklaces with a small ‘loop’ to thread through 

one temple of a folded pair of glasses. La 

LOOP make everything from affordable sporty 

eyewear necklaces, necklaces out of stretch silk, 

acetate chains and leather through to US$500+ 

necklaces made of metals and semi-precious 

stones. A great gift for the person always 

rummaging in their bag for their sunnies. 

Another brand that is turning the process of 

holding eyewear into jewellery is Kimba – check 

them out on Instagram at @shopkimba. 

Glasses chains and cords (AKA retainers. 

Apparently they are also nicknamed ‘croakies’!) 

to hang open eyewear around the neck have 

been making a slow comeback over the past 

several years. Balenciaga seem to be the main 

force making this comeback happen. Giselle 

Bundchen was pictured in their Spring 2011 

campaign wearing a subtle cord attached to 

her sunglasses. In Spring 2015, Balenciaga 

sent models down the runway with sunglasses 

strapped to their head by pads of thick 

luxurious fabrics. Earlier this year, they took 

it a step further and their Fall show featured 

oversized flocked eyewear chains attached to 

the model’s sunglasses. 

This trend is filtering to the mainstream. I’ve 

seen fashion chains and cords in various stores 

around Melbourne and they featured strongly 

at ODMA’s O-Show earlier this year. 

Australian-based Loops (www.weareloops. 

com) are making eyewear cords and they are 

launching very soon. Expect to see colourful 

woven cords and metallic-dipped leather. 

As someone who is ALWAYS telling customers 

that wearing their sunglasses on their head is 

going to bend the temples out, I welcome this 

trend! 

Store it 

Carry cases are a tricky thing. Often, the cases 

that the brand provides are not very durable 

or practical. I’m always keeping an eye out for 

great cases and often with not much luck. There 

are a lot of independent leather workers on Etsy 

BY JO EATON* 

Balenciaga 

selling very individual handmade cases. 

For storage at home, Bushakan make wooden 

stands for those of us with multiple pairs to 

display their frames www.bushakan.com/ 

collections/bushakan. Oyo Box have smart 

storage solutions for eyewear collections www. 

oyobox.com/shop.html. 

What else? 

For the die-hard eyewear fans, some excellent 

books have come out in the past few years. 

Cult Eyewear by Neil Handley and published 

by Merrell came out in 2011 and I managed to 

find a copy. It’s a beautiful coffee table style 

book featuring photographs and histories of 

brands such as Oliver Goldsmith, Kirk Brothers/ 

Originals, Cutler and Gross and many more. 

I’m also hoping to get my hands on the 

book Forgotten Eyewear, Art of the Frame by 

Mark Jensen which was published this year. It 

contains over 140 photographs of frame details 

from the 1950s to present day. You can order it 

through @forgotteneyewear on Instagram. 

Taschen’s Eyewear: A Visual History, by Moss 

Lipow is another must-have book. It documents 

Lipow’s eyewear obsession and has spectacle 

history dating back 500 years. 

If you’re trying to find something for someone 

who has everything, perhaps 

Kerin Rose Gold’s A-morir 

eyewear is the place to start. 

Kerin embellishes eyewear 

with chains, tassels, and 

various shiny objects. You 

might have seen her work on 

the likes of Rihanna, Beyonce 

and Lady Gaga. Check it out at 

www.a-morir.com. 

Have a great summer. As for 

me, I’m looking forward to 

reading new eyewear books in 

the sun, under the protection 

of new sunglasses! ▀ 

* Jo Eaton is a native Wellingtonian, 

now studying optical dispensing in 

Melbourne. She runs eyewear fashion 

blog, Eye Heart Glasses’. 

Bushakan 



23

with 

Prof Charles McGhee 

& A/Prof Dipika Patel 

Series Editors 

OCT-A in macular and optic 

nerve disease 

BY DR ANMAR ABDUL-RAHMAN* 

Optical coherence tomography angiography 

(OCT-A) is a nascent non-invasive imaging 

OCT modality applicable to retinal and optic 

nerve assessment of the microvascular network 1 . 

Its main indication is in the diagnosis and follow 

up of exudative and ischemic maculopathies in 

addition to establishing a diagnosis of some forms 

of optic neuropathy where there is associated 

atrophy or vasculopathy. 

Due to the similarity of OCT-A and the more 

familiar fluorescein/indocyanine green angiography 

(FFA/ICG) images it is prudent to note when 

interpreting OCT-A images there is a poor 

concordance in regards to hyper-fluorescence (FFA/ 

ICG) and hyper-reflectivity (OCT-A), the two methods 

are complementary and not comparative 2 . Table 1. 

compares the attributes of the two techniques. 

All images in this article are obtained using the 

DRI Triton Swept Source OCT (SS-OCT), which 

utilises central wavelength 1,050 nm, allowing 

some level of imaging through optical opacities. 

Scan speed 100,000 A-scan/sec. 

Interpretation of normal OCT-A images 

In spite of the use of the recently available 

OCT-A, there is limited information on normative 

databases 3 . The macular scan of the DRI Triton 

SS-OCT printout generates the following seven 

images (fig 1). 

1. The superficial vascular plexus: Located in 

the ganglion cell and the nerve fiber layer. 

Course retinal vessels appear in this layer that 

demonstrate dichotomous branching pattern 

converging on the foveal avascular zone (FAZ). The 

finer branches of this network form a continuous 

circumferential vascular plexus around the FAZ. 

2. The deep vascular plexus: Located in the inner 

nuclear and the external plexiform layer. These 

vessels originate from vertical anastomoses with 

the superficial vascular plexus the terminal ends 

forming a network of a fine interconnected network 

of vessels with a concentric pattern around the 

FAZ. 2, 4 . The FAZ area is variable, reported normal 

population mean values are 0.266 ± 0.097 mm2 in 

the superficial plexus and 0.495 ± 0.227 mm2 in the 

deep plexus. Therefore FAZ area is larger in the deep 

plexus compared to the superficial plexus 5 . 

3. The outer retina (photoreceptor layer): A fine 

granular layer, normally devoid of vascularity. 

4. The choriocapillaris: A homogenous granular 

layer. 

5. OCT B-scan provides a cross section through 

the examined choroidal retinal interfaces, which 

provides an overview of the distribution of the 

pathologic process. 

6. Composite angiogram of all retinal layers 

7. A color fundus photograph centered on the macula 

demonstrating the scanned area and centration. 

(Fig 1.) Right eye in a 40-year-old male. Internal 

limiting membrane to choriocapillaris, 4.5 x 4.5mm. 

The optic nerve is supplied by two main sources of 

FFA/ICG 

OCT-A 

Mydriasis Required Required 

Contrast dye Required Not required 

blood flow: the superficial layers (nerve fiber layer) 

by the central retinal artery; and the deeper layers 

(the prelaminar, lamina cribrosa, and retrolaminar 

regions) by the posterior ciliary artery. 6 The structural 

differences of these fine capillary networks are not 

discernable by OCT-A. The optic nerve scan of the 

DRI Triton SS-OCT use the following reference levels 

in addition to the OCT B-scan and color fundus 

photograph: 

1. The superficial optic nerve head scan. 

2. The deep scan at the level of the vitreo-retinal 

interface. 

3. The radial capillary network, which lie within the 

retinal nerve fiber layer (RNFL). 

4. The optic nerve at the level of the choroid. 

5. OCT projection, which is a composite of surface 

points generated from all scans of the optic nerve 

and peri-papillary retina. 

Selected ocular diseases 

Choroidal neovascularisation (CNV) in AMD 

CNV is classified by location in the deep retinal 

layers below (type I) or above (type II) the retinal 

pigment epithelium, or within the neurosensory 

retina (type III) 7 . Treatment naïve membranes have 

a characteristic pathophysiologic stage dependent 

appearance in the form of a fan-like arborescent 

mesh, unlike normal retinal and choroidal vessels, 

the irregular flow gives the membrane a faint 

signature. Associated anastomoses and feeder 

vessels are common (fig 2.) 2 . 

Treatment causes fragmentation of the lesion 

in addition to reducing the number of secondary 

branches. This appearance precedes regression of 

the associated exudative changes. Intralesional fine 

vessels are seen in the presence of longstanding 

fibrosis 2 . Caution should be exercised when 

attempting to establish a diagnosis of CNV on 

the basis of OCT-A only as exudative and fibrotic 

changes can mask the characteristic appearances. 

Although a high specificity (91%) has been reported 

in the diagnosis of CNV, Talisa et al in the same 

study of 48 eyes, reported a sensitivity of 50% 8 . 

(Fig 2.) A 78-year-old Caucasian female with wet 

AMD partially treated with Bevacizumab. Visual 

acuity 6/30 OS. A 4.5 x 4.5mm OCT-A showing a 

mesh of abnormal vessels surrounded by a patchy 

loss of choriocapillaris homogeneity. The abnormal 

vessels exist both below and above Bruch’s 

membrane and extending to the deep capillary 

plexus. Vascular texture of the deep capillary 

plexus is disrupted by intra-neurosensory oedema 

as demonstrated on the OCT B-scan image. 

Diabetic retinopathy 

Optical opacity Image degradation + Image degradation ++ 

Image target 

Image acquisition speed 

Anterior segment, retinal 

Periphery, posterior pole 

Slow acquisition 

Late phase requires 

FFA 10-15 minutes 

ICG 20-30 minutes 

OCT-A demonstrates structural changes due 

to microangiopathy in both the superficial and 

deep capillary layers (fig 3.). Capillary loops, 

anastomoses, microaneurysms, widening of 

the FAZ and remodeling of the fine perifoveal 

capillaries have been described 9, 10 . Retinal nonperfusion 

is of particular prognostic importance. 

Agemy et al have shown a significant decrease in 

retinal capillary perfusion 

Posterior pole (macula and optic 

nerve) 

Rapid acquisition: 5-10 seconds. 

Image dimensions 2 dimensional imaging 3 dimensional imaging 

Imaging phases (Early-Late), 

leakage pooling, staining 

Distinction of the anatomical 

layers of the retina and choroid 

Imaging the microvascular 

network of the macula and optic 

disc and separating the layers 

Available 

No lesion depth resolution 

Not applicable 

Not Applicable 

Produces en-face images 

including the internal limiting 

membrane (ILM) to the choroid 

Primary indication 

Imaging artifacts Less prone More prone 

Shadow artifact from large 

retinal vessels, fluid and blood. 

Signal decorrelation artefacts 

with movement. 

Blink artifact. 

Table 1. Comparison of OCT-A with Fluorescein (FFA) and Indocyanine Green Angiography (ICG) 

density with increase in 

severity of DR using OCT-A 11 . 

Some of these changes can 

be observed in the absence 

of clinical retinopathy. 

Impaired vascular perfusion 

is seen as flow void resulting 

in disruption of the regular 

texture. 

Neovascularisation could 

be detected at early stages 

of the proliferative process. 

(Fig 3.) A 57-year-old Asian 

male showing disruption 

of the superficial capillary 

network and deep capillary 

network in addition to 

posterior shadowing of the 

deep capillary and outer 

retinal layers indicated by 

a loss of granularity in the 

image texture. A punctate 

loss of choriocapillaris 

homogeneity can be noted 

secondary to patchy loss 

or flow reduction in the 

choriocapillaris. Intraretinal 

and subretinal fluid in addition 

to high signal areas can be seen 

on the OCT B-Scan. Vessels of 

the superficial retinal layers are 

artefactually projecting in the 

images of the deep capillary 

plexus and choriocapillaris. 

Normal tension glaucoma 

Impairment of the optic nerve 

circulation is an important 

pathophysiologic factor in 

the etiology of glaucoma 

OCT-A of the optic nerve may 

add structural information 

that complements existing 

investigative methodology 

(fig 4). Retinal capillary 

non-perfusion is associated 

with areas of RNFL thinning, 

ganglion cell complex loss and 

visual field defects. 

(Fig 4.) A 39-year-old 

Caucasian female presented 

with an incidental left superior 

nasal step on automated 

visual field assessment. A 

retinal nerve fiber layer bundle 

defect can be seen from the 

superficial through to the 

radial capillary layer, in addition 

to the color fundus photograph 

(arrow). A notch is seen in the 

lower pole of the optic nerve in 

the OCT project image (circle). 

Research/future directions 

1. Ultra-high speed swept 

source OCT-A with scan speeds 

of 400-kHz A-scan rate, 5-10x 

faster than commercially 

available devices, allows 

a wider field of view (12 x 

12mm), faster acquisition of 

images and higher image 12, 13 . 

2. OCT-A using variable 

interscan time analysis (VISTA) 

which allows visualisation of 

relative flow speed, especially 

valuable when assessing 

diseases in which progression 

is linked to flow impairment, 

rather than vasculature loss, 

thereby offering possible 

quantitative data 12 . 

Fig 1. Normal OCT-A of the macula 

3. Jones matrix optical coherence tomography in 

this technique, tissue pigment contrast is used to 

enhance the interpretation of vascular images 14 . ▀ 

References 

1. Methods and algorithms for optical coherence tomographybased 

angiography: a review and comparison. Zhang 

A., Zhang Q., Chen C. L. and Wang R. K.J Biomed Opt 

20(10):100901 (2015). 

2. Clinical Guide to Angio-OCT: Non Invasive, Dyeless OCT 

Angiography. Lumbroso B., Huang D., Jia Y., Fujimoto J.G., 

Rispoli M.(2015). 

Optical coherence tomography angiography in retinal 

diseases. Chalam K. V. and Sambhav K.Journal of ophthalmic 

& vision research 11(1):84 (2016). 

In vivo characterization of retinal vascularization morphology 

using optical coherence tomography angiography. Savastano 

M. C., Lumbroso B. and Rispoli M.Retina 35(11):2196-203 (2015). 

Correlation of foveal avascular zone size with foveal 

morphology in normal eyes using optical coherence 

tomography angiography. Samara W. A., Say E. A., Khoo C. T., 

Higgins T. P., Magrath G., Ferenczy S. and Shields C. L.Retina 

35(11):2188-95 (2015). 

3. Blood supply of the optic nerve head and its role in optic 

atrophy, glaucoma, and oedema of the optic discHayreh S. 

S.Br J Ophthalmol 53(11):721-48 (1969). 

4. The incidence of neovascular subtypes in newly diagnosed 

neovascular age-related macular degenerationJung J. J., Chen 

C. Y., Mrejen S., Gallego-Pinazo R., Xu L., Marsiglia M., Boddu 

S. and Freund K. B.Am J Ophthalmol 158(4):769-779.e2 (2014). 

5. Spectral-domain optical coherence tomography angiography 

of choroidal neovascularizationTalisa E., Bonini Filho M. 

A., Chin A. T., Adhi M., Ferrara D., Baumal C. R., Witkin A. 

J., Reichel E., Duker J. S. and Waheed N. K.Ophthalmology 

122(6):1228-38 (2015). 

Optical Coherence Tomography Angiography of Diabetic 

RetinopathyBandello F., Corbelli E., Carnevali A., Pierro L. and 

Querques G.Dev Ophthalmol 56:107-12 (2016). 

Fig 2. OCT-A of Choroidal Neovascularization (CNV) in AMD 

Fig 3. OCT-A in diabetic maculopathy 

Fig 4. 

Detection of microvascular changes in eyes of patients with 

diabetes but not clinical diabetic retinopathy using optical 

coherence tomography angiography. Talisa E., Chin A. T., Bonini 

Filho M. A., Adhi M., Branchini L., Salz D. A., Baumal C. R., 

Crawford C., Reichel E. and Witkin A. J.Retina 35(11):2364-70 

(2015). 

6. Retinal vascular perfusion density mapping using optical 

coherence tomography angiography in normals and diabetic 

retinopathy patients. Agemy S. A., Scripsema N. K., Shah C. 

M., Chui T., Garcia P. M., Lee J. G., Gentile R. C., Hsiao Y. S., 

Zhou Q., Ko T. and Rosen R. B.Retina 35(11):2353-63 (2015). 

Ultrahigh-Speed, Swept-Source Optical Coherence 

Tomography Angiography in Nonexudative Age-Related 

Macular Degeneration with Geographic Atrophy. Choi W., 

Moult E. M., Waheed N. K., Adhi M., Lee B., Lu C. D., de Carlo 

T. E., Jayaraman V., Rosenfeld P. J., Duker J. S. and Fujimoto J. 

G.Ophthalmology 122(12):2532-44 (2015). 

7. Ultrahigh-speed swept-source OCT angiography in exudative 

AMD. Moult E., Choi W., Waheed N. K., Adhi M., Lee B., Lu 

C. D., Jayaraman V., Potsaid B., Rosenfeld P. J., Duker J. S. 

and Fujimoto J. G.Ophthalmic Surg Lasers Imaging Retina 

45(6):496-505 (2014). 

Birefringence imaging of posterior eye by multi-functional 

Jones matrix optical coherence tomography. Sugiyama S., Hong 

Y. J., Kasaragod D., Makita S., Uematsu S., Ikuno Y., Miura M. 

and Yasuno Y.Biomed Opt Express 6(12):4951-74 (2015). 

About the author 

* Anmar is a medical retina 

and glaucoma sub-specialist 

at CMDHB. He was the first 

eye surgeon to graduate from 

the University of Otago with 

a Master of Ophthalmology 

degree in 2008. 


Hoya’s builds presence in ANZ 

Lens company Hoya announced it is to 

invest millions of dollars in beefing up 

production, introducing new technologies 

and building a new state-of-the-art 

Australasian headquarters in Sydney after the 

city council purchased the company’s current 

site earlier this year. 

“It’s an interesting time for us,” said Craig 

Chick, Hoya Lens Australia’s managing director. 

“We’ve been in our current location since 1994, 

and it was designed and built according to our 

business structure, which was very different 

22 years ago. We manufactured everything in 

Sydney then.” 

Hoya have a lab in Bangkok, where around 

65% of their lenses are now made. 

“This has been a real opportunity to look at 

our business and make some key decisions,” 

said Chick. “Currently we make more entry-level 

products in Sydney, with the high-end products 

coming via Bangkok. We are aiming to flip that 

around and have Australia focus on the highervalue 

products, with Thailand concentrating on 

the entry level lines.” 

This will improve delivery times by around 24 

hours and allow Hoya to focus more on service 

and quality, particularly for the company’s 

multifocal products. 

“We are taking delivery this week of a new 

free-form generator and we will also be 

purchasing a new robotic edger,” said Chick. 

“We want the new equipment in place and 

functioning before we move buildings to ensure 

a smooth transition.” 

In the short-term this will mean a small 

reduction in staff, but staff numbers will then 

be increased when the company moves to its 

new site and into its new building, something 

Chick said he hopes would happen before 

December 2018. 

Chick was keen to stress that on the ground 

in both Australia and New Zealand, customers 

will see little change, except for the intended 

improvement in delivery times and service 

standards. He noted that Hoya products already 

arrive in New Zealand direct from Bangkok with 

no middle-man involved, and that New Zealand 

fitting will continue to take place at the current 

Auckland site. 

“This move is about refining the production 

process. Our end goal is for the customer to 

order as usual, and for us to decide where it 

will be produced. The practitioner will receive 

the job back with the same quality and delivery 

time regardless of where the manufacturing 

takes place.” 

The investment being made by Hoya 

Corporation in its Australasian business is 

unspecified, but is rumoured to be several 

million Australian dollars. The company, 

Craig Chick 

currently celebrating 75 years in business, 

announced the changes at their anniversary 

events in September and October, and will 

continue to keep customers updated on the 

changes. ▀ 

Global eye 

care index 

According to the 2016 World Eye Care Index, 

an overview of the current status quo of 

international eye health, New Zealand is 

ninth in the world for access to eye care, with 

just 0.44% of the New Zealand population who 

need eye care unable to access it. 

The research, from British online optician 

Mister Spex, also showed New Zealand ranked 

48th out of 65 countries for the percentage of 

the population using glasses, at 48%; was about 

average for contact lens (CL) wear, at 6%; and 

was relatively low among developed nations for 

those who’d had laser surgery, at just 0.55% - this 

compares to 8% of the UK population, which had 

the highest proportion. 

At 0%, Norway and Italy were top of the list 

for access to eye care, while Eritrea was bottom 

with 29.4%. China and Japan, at 65.5% and 63.2% 

respectively, topped the glasses wearing table, 

while the Philippines was lowest with 33%. The 

Czech Republic and France have the highest 

proportion of CL wearers with 14.5% and 14.22%, 

and Romania the lowest at 1%. 

For the full table, visit www.misterspex.co.uk/ 

world-eye-care-coverage-index#2016 ▀ 

Change at The Terrace Eye Centre 

The Terrace Eye Centre and 

Ophthalmology from the University of 

Wellington Public Hospital have 

Otago. She undertook a further two 

a new ophthalmologist on the 

years of fellowship training in paediatrics 

team, Dr Anne-Marie Yardley. 

Dr Anne-Marie Yardley is a general 

ophthalmologist and cataract surgeon 

who specialises in all aspects of 

paediatric ophthalmology and adult 

strabismus. She says she’s particularly 

passionate about children’s eye health 

and delivering the best possible care 

to our paediatric population. “I am 

delighted to be home in New Zealand 

and working at The Terrace Eye Centre 

with such a great team. It is wonderful 

to be working with supportive 

colleagues who have mentored me and 

played an integral role in my training. 

Our new facilities are a pleasure to work 

in and the purpose-built environment 

helps us to provide our patients with 

the highest standard of care.” 

Dr Yardley completed her medical 

degree at the University of Auckland 

in 2003 and went on to complete her 

Dr Anne-Marie Yardley joins Wellington’s Terrace Eye Centre 

and strabismus, working at the Lions Eye 

Institute and Princess Margaret Hospital 

for Children in Western Australia and 

then the Hospital for Sick Children in 

Toronto, Canada. 

Dr Yardley will be taking over Dr Keith 

Maslin’s paediatric ophthalmology and 

strabismus work, while he continues to 

practice at The Terrace Eye Centre and 

Masterton in general ophthalmology, 

including cataract surgery, and his 

subspecialty, medical retina especially 

diabetic retinopathy. 

In other news earlier this year, The 

Terrace Eye Centre moved to its new 

purpose-built premises in Wakefield 

House, 90 The Terrace, above the Rise 

café, and long-serving Wellington 

ophthalmologist Dr Peter Wellings 

retired to pursue interests outside 

ophthalmology. The Terrace Eye Centre’s 

other doctors Keith Maslin, Keith Small 

postgraduate professional training in Dunedin, Christchurch 

and Wellington, during which time she obtained a Master of 

and Kolin Foo, wished Dr Wellings all the very best for his 

retirement. ▀ 

Insight provided 

by Auckland Eye 

BY AUCKLAND EYE 

Auckland Eye was pleased to bring together many of their 

much valued optometrist referrers on 18 October for another 

enjoyable evening of good food and education at their second 

insight seminar for 2016. There was a wonderful line up of Auckland 

Eye specialists presenting on a wide variety of topics. Dr Stephen Best 

discussed the intricacies of a number of neuro-ophthalmology case 

studies, highlighting the importance to look beyond the obvious and 

also be aware that more than one condition can exist at one time. 

Dr Justin Mora ran an interactive session on ophthalmic congenital 

anomalies, which tested attendees’ general knowledge of common 

and less common paediatric eye conditions. Lastly, Dr Sue Ormonde 

discussed a systematic approach to the use of steroids, which gave 

tremendous insight into the benefits and potential side effects of 

treating eye conditions in this way. 

Feedback was that 

the evening provided 

another excellent learning 

opportunity (with the bonus 

of yummy food and drink) 

and attendees said they were 

looking forward to the 2017 

insight series. ▀ 

NZOSS exec: thanks 

and farewell 

BY NIKKU SINGH, NZOSS 2016 PRESIDENT 

Since its establishment in 2013, the New 

Zealand Optometry Student Society (NZOSS) 

has served as a platform for all optometry 

students, providing us invaluable exposure to the 

professional community. With 2016 coming to 

a close, not only does this mark the 4th year of 

operation for our little student society, but also 

our class’ final year of undergraduate study, so 

forgive me for being a little nostalgic! 

It all started in 2013, where our class embarked 

on its very first year of optometry. Sheepish as all 

new students are, we sensibly sat in our very first 

lecture and were greeted by an enthusiastic part 

V student, convincing us to join the illustrious 

NZOSS. Little did we know, this was it’s very first 

year of being. Despite this, we headed off to the 

first BBQ of the year, which has now become a 

tradition of sorts. This was followed by what has 

now become the usual suspects; the pub crawl, 

pub quiz and the Eyeball. The first committee did 

a fantastic job setting up NZOSS and really helped 

welcome us warmly into the degree. 

As we progressed through optometry school, 

NZOSS developed rapidly. We begun to appreciate 

the society as its own entity. It offered exposure 

to optometry outside the university and now 

plays a vital role in bridging the gap between 

students and the professional community. It also 

successfully brings together students from all 

years, fostering long-lasting relationships within 

a network that includes recent graduates as well. 

Although we didn’t get to tick everything off our 

to do list, I am incredibly proud of the work the 

2016 executive committee has put in. This year 

we kept up with our usual social traditions and 

further explored the educational front. For 2017, 

we have expanded the committee by an extra 

two members, which will help distribute the work 

load more efficiently and allow NZOSS to grow. 

Of course, the relationship which has been 

achieved between NZOSS and the optometry 

profession would not be possible without the 

help of many organisations within the industry. 

On behalf of all the students, I would like to thank 

these industry organisation for their ongoing 

generosity and willingness to collaborate with us. 

On behalf of the part V class of 2016, I would 

like to thank the teaching staff at the University 

of Auckland. From part II through to part V, you 

have all played a vital role in our development, 

Goodbye from the 2016 NZOSS Executive: Jada Meni, Kendall Johnston, Sophie Woodburn, Nikku Singh (lying down), Aaron Chin, Gunnika Gill, Alicia 

Han, Jonathan Albert and Oli Munro 

and for that we cannot thank you enough. To 

all the supervisors in clinic, I don’t know how 

appreciative we come across during a reasonably 

stressful year, but we are forever grateful for the 

dedication, patience and wisdom you have shared 

with us. Without your guidance, we would not be 

the practitioners we are today. 

Finally, good luck to Alicia Han (2017 NZOSS 

President) and her team! I’m sure you will do a 

fantastic job and I can’t wait to see what you guys 

bring to the table next year! ▀ 



25

MACULAR MILESTONES 

“ 

What’s hot in the world of 

macular disease research 

Improving wet AMD 

therapy 

Every solution breeds new problems,” 

was coined by Arthur Bloch (of Murphy’s 

Law fame). Anti-VEGF agents have 

revolutionised wet AMD therapy but have 

created problems: many patients exhibit a suboptimal 

response; treatment burden and cost 

have become major healthcare issues; and there 

is an emerging concern that long-term therapy 

may lead to geographic atrophy. 

Improved anti-VEGF therapy 

There are a large number of research initiatives 

aiming to improve anti-VEGF activity, either 

lengthening activity of current agents or using 

new longer-acting anti-VEGFs. An implanted 

delivery system with a refillable subconjunctival 

port providing long-term Lucentis therapy 

is currently in a phase II trial; a hydrogelbased 

sustained release formulation of Eylea 

providing six months’ therapy with a good 

safety profile is in preclinical development; an 

implantable semi-permeable capsule containing 

a genetically modified cell line secreting 

Lucentis (NT-503 ECT) is also in a Phase II trial; 

and abicipar pegol (a DARPin), a potent new 

anti-VEGF agent with double the half-life of 

current anti-VEGFs, is about to commence phase 

III trials. 

Gene therapy is another approach making 

significant headway. The eye is well-suited to 

gene therapy; it is small and easily accessible, 

allowing precise, localised delivery of a small 

dose. The small dose reduces the risk of systemic 

side-effects. As the eye is immune-privileged, 

there is a reduced chance of an immune 

response. Two potential approaches for treating 

wet AMD would be to upregulate naturally 

occurring bioactive molecules or manufacture 

new ones. 

One promising approach now in phase II 

trials, involves upregulating an existing anti- 

VEGF molecule by encoding a viral vector with 

an anti-VEGF complementary DNA construct 

and injecting it adjacent to the choroidal 

neovascularization (CNV) from where it 

transfects nearby photoreceptors and RPE cells. 

Specifically, the agent is an adenoviral vector 

harbouring a gene encoding soluble fms-like 

tyrosine kinase-1 (sFLT-1) protein, also known as 

VEGF receptor 1 (VEGFR-1). It is the only known 

endogenous VEGF inhibitor in the body and, 

interestingly, Eylea binds to the same receptor 

complex. 

The treatment is given as a single subretinal 

injection, having first given a dose of Lucentis 

to establish initial and short-term VEGF 

suppression. Lucentis is then used as required to 

manage any breakthrough CNV activity. A phase 

I study treated six advanced wet AMD eyes and 

the treatment was found to be safe. Although 

Phase I studies are not designed to assess 

efficacy, only two of the six vector-treated eyes 

required a single repeat Lucentis injection over 

12 months, and five of the six eyes showed 

improvement in vision despite previously 

responding poorly to a mean of 10 anti-VEGF 

injections. These findings suggest the treatment 

exerted a biological effect over a sustained 

period of time. A phase II study of 32 subjects 

for three years is in process. 

Additional targets in the CNV complex 

Many factors other than VEGF are involved 

in the pathogenesis of CNV and may serve 

as therapeutic targets. Anti-VEGF agents kill 

only endothelial cells that aren’t covered with 

protective pericytes. This prevents the complex 

enlarging by killing the tip cells, but existing 

vessels protected by pericytes mature rather 

than regress. Platelet derived growth factor 

(PDGF) is essential for pericyte survival. So an 

BY DR DAVID WORSLEY* 

anti-PDGF agent will strip pericytes from the 

CNV, expose the endothelial cells and allow an 

anti-VEGF agent to kill them. 

Therefore, a combination treatment of an anti- 

PDGF agent with an anti-VEGF is a promising 

approach. The phase IIb trial of an anti-PDGF 

called Fovista in combination with Lucentis 

showed a 62% improvement in visual acuity 

compared to Lucentis alone, with the visual 

acuity improvement with Fovista continuing to 

outpace and diverge from Lucentis monotherapy 

over the course of six months. Further, there 

were fewer patients with visual loss compared to 

Lucentis alone. In those eyes with robust vision 

gain, Fovista combined with Lucentis shrank the 

CNV, while with Lucentis alone, the CNV only 

stabilized. Among patients who experienced 

vision loss, those on Lucentis alone had disciform 

scar formation while in the combination therapy 

arm, there was little, if any, scarring. 

In short, the dual inhibition of VEGF and PDGF 

has demonstrated the potential of not just 

reducing exudation from choroidal neovascular 

lesions, but actually arresting and destroying 

the neovascular complexes. 

The phase III Fovista programme is evaluating 

the combination with Eylea and Avastin as well 

as Lucentis. 

Squalamine, a small potent anti-angiogenic 

molecule, works intracellularly to give broadspectrum 

inhibition of VEGF, platelet derived 

growth factor (PDGF), and other factors. Phase 

II trials of squalamine eyedrops, in combination 

with intravitreal Lucentis, were promising with 

improvements in vision and a reduction in 

intraretinal fluid compared to Lucentis alone. A 

Phase III trial is underway. 

OPT-302 is a soluble VEGF-3 receptor that 

‘traps’ VEGF-C and VEGF-D. ‘VEGF’ is actually 

a contraction of VEGF-A; VEGF-C and D are 

distinct and potent angiogenic factors. A 

phase I trial combining this with Lucentis 

recently reported an excellent safety profile 

and evidence to suggest an improved clinical 

outcome. A phase II trial is in process. 

Gene therapy can also be used to deliver 

other agents. A lentiviral vector, Retinostat, 

expressing two endogenous anti-neovascular 

proteins, endostatin and angiostatin, has 

recently undergone a phase I study. Retinostat 

demonstrated safety and also evidence of 

biological activity over a sustained period of time. 

Conclusion 

We face serious problems in the treatment of 

wet AMD. We have three excellent anti-VEGF 

agents, but there are issues with suboptimal 

outcomes and the burden of frequent 

injections is unsustainable. One potential 

solution is improved and longer-acting anti- 

VEGF therapy. Another potential solution is 

new anti-angiogenesis agents, alone or in 

combination with current anti-VEGF agents. 

Undoubtedly, the next few years will bring 

improved therapies that will change the 

way we manage wet AMD, provide superior 

outcomes and reduce treatment burden. 

About the author 

* Dr David Worsley is a medical 

and surgical retinal specialist at 

Hamilton Eye Clinic and Waikato 

Hospital, with a particular interest 

in the rapidly evolving treatments 

for AMD. He is a trustee for 

Macular Degeneration New 

Zealand and is a medical advisor 

for several biomedical companies. 

Disclosure: David is a clinical 

advisor for, and has a financial 

interest in, OPT-302. 

Working on the Taveuni 

Eye Project 

BY DR DAVID PENDERGRAST* 

The hospital on Taveuni Island is on a hillside 

above the main town overlooking the 

straights between Taveuni and Vanua Levu. 

It’s an area famous for diving, especially for soft 

corals on the Rainbow Reef. In past trips, however, 

we’ve never had enough time to go diving. So each 

day, during breaks from surgery, I would stand in 

the front entrance of the hospital and gaze out 

at the beautiful changing colours of the sea as 

the tide flowed over the reef. But this time, the 

surgical load was less frantic, so when someone 

organised a snorkelling trip, Lois and I went out 

as well. Beautiful colours, tropical fish and clear 

water; a great change from our normal recreation 

break – walking home from the hospital along the 

coast road: something that seems like a good idea 

at the time, but after about an hour we usually 

put our thumbs out to hitch a ride the rest of the 

way. The road goes through the main town on the 

island, where we usually buy a drinking coconut 

or vegetables – eggplant, pumpkin, greens, snake 

beans, chillies or pineapple. Last year there were 

mangoes, but this year Cyclone Winston, which tore 

through here in February, ruined the Island’s mango 

crop. 

The patients for the Taveuni Eye Project eye clinic 

come from all over Fiji. Rotary organises transport 

from their villages, which usually means a bus and 

boat trip, which can be a 12-hour or overnighttrip 

for some from the more distant parts of the 

country, then the Rotary van from the wharf to the 

patient accommodation in the hospital, church or 

school. On post-op day, patients with eye patches 

sit in rows on chairs, watched by others who 

have either just had their surgery or are awaiting 

surgery the next day. The local hospital team 

provides food for the patients: hundreds of kilos 

of taro; sacks of rice; and lots and lots of sugar for 

tea. Most patients would be unable to afford to 

come for surgery if transport, accommodation and 

food was not provided. 

The medical team is a great mix of locals and 

New Zealanders. The Taveuni Eye Project has been 

going for 11 years now and some of the team have 

come each year. Ineke Van Laar from Tauranga is 

the very efficient organiser from the nursing and 

theatre side. Generally, there are seven to nine 

assistants in theatre, pre- and post-op, including 

some registered nurses and theatre technicians, 

plus there are usually two or three local nurses. 

The transport, logistics and food is all organised 

by Michael Prasad, a tireless and enthusiastic local 

businessman. He sits at the hub of the clinic area 

and makes sure we all have enough to do. We have 

Patients sleep in the hospital just before and following surgery 

MORE CLASSIFIEDS ON PAGE 28 

OPTOMETRIST WANTED 

FOR SUNNY, TROPICAL 

FIJI! 

Brand new, fully equipped practice opened in 

Suva CBD. Perfect opportunity to travel and 

earn at the same time! 

Looking for an experienced optometrist to 

cover a short term/ long term period. 

Attractive rate plus relocation salary offered. 

Please email 

optique-fiji@gmail.com or text/call 

+6799990866 

Dr David Pendergrast examining a patient 

learned never to believe Michael when he says, 

“only another four more cases and we are finished 

for the day” – somehow he always manages to fill 

the day up to the brim. 

There are difficult cases and the frustration 

of having patients who could be treated if they 

were in New Zealand, but there are no, or limited, 

options for them here. There are no vitreoretinal 

services in Taveuni and so patients with posterior 

segment disease generally have no options, for 

example. In addition, access to ongoing medication 

is difficult and expensive, so even simple things 

like intraocular inflammation or glaucoma may not 

get adequate or, indeed, any treatment once the 

team leaves. But anyone who has participated in 

a trip like this, be it through Rotary or VOSO, will 

understand the satisfaction of helping people who 

are often severely visually impaired and would 

not otherwise have access to any treatment. The 

faces of the patients on post-op day, their thanks, 

the beautiful singing that always seems to follow, 

especially on the final day, makes all the hard 

work and many of the frustrations more than 

worthwhile. 

The leader of our surgical team is Dr Jeff Rutgard, 

an American surgeon from San Diego who has 

been operating in Taveuni since the project 

started. The type of cataract surgery we carry out 

is manual small incision cataract extraction. This 

avoids the need for phaco equipment, and has 

been shown to have similar outcomes to phaco in 

several studies. 

Pterygium surgery is challenging, as these are 

generally large and vascular, and often recurrent. 

One case last year had four pterygiums on the same 

eye, overlapping each other. I generally carry out a 

free conjunctival graft, as I would do here in New 

Zealand, but sutured rather than using Artiss glue. 

Many instrument and surgical supply companies 

also assist with the project. This year we had the 

benefit of two beautiful operating microscopes 

supplied by Zeiss, one at minimal cost and one 

donated. They were much appreciated. 

Dr Jeff was impressed that in New Zealand there 

is a tradition of voluntary surgery, with significant 

numbers of surgeons regularly participating 

in VOSO or similar trips, as well as those who 

work with the Pacific Eye Institute or other 

organisations, as only a handful of US surgeons 

are interested in voluntary surgery, he said. ▀ 

* *Dr David Pendergrast is an ophthalmologist at Auckland Eye, 

with sub-specialty expertise in cataract surgery, refractive 

and laser surgery, corneal transplantation, anterior segment 

surgery, conjunctival surgery and external eye diseases. He is 

clinical director of the NZ National Eye Bank, clinical senior 

lecturer at Auckland University and a member of the NZ 

Society of Contact Lens Practitioners. He is married to Lois, an 

ophthalmic nurse, who also volunteers her time and expertise 

to the Taveuni Eye Project. 

OPTOMETRIST WANTED 

ROLLESTON EYE 

We see a wide range of ages and 

nationalities. An interest in extension 

learning in behavioural optometry and 

binocular vision is essential. 

Rolleston Eye is located with access to the 

outdoors of Canterbury and the South 

Island. There is vibrant city life in the suburban 

surrounds of Christchurch. 

This position would suit an optometrist who 

likes to work independently but have advice 

a phone call away. See our website and 

contact leesastuart@gmail.com 


Eye on optics 

by 

Chalkeyes 

There’s a saying, maybe Taoist, that ‘if you 

carry on the way you are going you will get 

to where you are going to’ and this may be 

true for the provision of eye care services in New 

Zealand. 

New Zealand has a unique 

mix of public and private 

sector funding. Like the 

UK, it has a universally free 

public sector, but the private 

sector provides a much 

larger slice of the total care 

given than in the UK. In 

Australia the margins are 

blurred by Medicare, which 

funds most of the total 

care given, although this is 

supplemented by private 

contributions. In the UK it 

is common for user-pays 

private care to be given 

in public hospitals, but in 

New Zealand that is taboo, 

apart from a handful of private providers who 

contract some clinical services. But it is becoming 

more and more common for our, dare I say, failing 

public sector to contract out both clinical and 

surgical services to meet a quota specified by the 

Ministry of Health, to avoid retaliatory funding 

cuts. In my opinion, nearly all public sector eye 

care services are failing in New Zealand, especially 

in the provision of follow up appointments in 

routine eye care – an opinion supported by the 

recent furore about the significant delays in 

treatment at our southern hospitals last month 

(see story p3). 

With a few exceptions, the public sector eye 

clinics are ‘paper bound’. This makes the rapid 

review of records and test results very difficult. 

It makes clinical audit almost impossible, except 

for laboriously kept records on applications, 

which seldom interoperate, or with even more 

laboriously reworked paper records. In practice, 

the plethora of paper forms and electronic 

transactions in separate silos hinders rather 

than helps the doctors and has recently been 

identified as a cause of physician burnout. Yet 

specialists and hospitals refuse to change to 

the more efficient paperless systems that are 

now readily available, partly, I believe, because 

they shortcut established financial and power 

In practice, the plethora 

of paper forms and 

electronic transactions 

in separate silos hinders 

rather than helps the 

doctors and has recently 

been identified as a cause 

of physician burnout. 

hierarchies, which therefore act as ‘destructive 

technology’ for the status quo. 

Issues of power, control and lack of foresight 

abound. Traditionally the relationship between 

ophthalmologist and 

optometrist has been 

adversarial. This drama is 

still playing out but the 

optometrists have ‘won’ 

on a number of issues, 

which is a good thing if we 

are to tackle the problems 

in our healthcare system. 

For example, optometrists 

are now ranked equal 

with ophthalmologists by 

government in planning for 

eye care’s future and some 

have prescribing rights on 

some medications, including 

glaucoma medications, 

though they have to have 

attended additional courses. 

The ideal review interval after changing 

treatment for glaucoma is six weeks. This is 

unachievable in the public sector, where there 

are great wait-lists-in-the-sky of unallocated 

follow-up appointments. So you would 

think there would be a good opportunity for 

therapeutically-qualified optometrists to pick up 

this work but, unlike Australia where Medicare 

funds optometrist visits, Kiwis must fund their 

own optometry visits, and most New Zealand 

pensioners do not have the funds for regular 

optometrist visits, or indeed at all in many cases, 

sadly! 

There are other unexplored options for the 

future of eye care services, however. The clinical 

service could be outsourced to external providers 

through the internet. Tests such as visual field 

interpretation, reporting on photographs and 

scans could all be outsourced. The ground 

work for this has already been done for other 

specialties such as radiology and cardiology, 

so it shouldn’t be that hard for optometry 

methinks. Again, funding would be a problem, 

but a price war in such services would bring 

down prices. Maybe, horror of horrors, we could 

even encourage ‘virtual medical tourism’, with 

basic facilities like field and OCT machines being 

publicly-funded, but reporting done by the 

cheapest bidder, perhaps in a remote location – 

Fiji seems nice! This would involve de-regulation 

of eye care and might bring local optometrists 

and ophthalmologists closer together finally, 

after more than a century of unnecessary turf 

wrangling! 

There has been an argument that high-tech 

services should be centralised and people outside 

our few larger centres bussed or flown in for 

treatment. But as soon as the argument swings 

in that direction, it seems to Chalkeyes that it just 

becomes a big resource grab by the larger centres. 

An unholy alliance has developed between some 

ophthalmologists and DHB managements, in 

some cases to protect the extant order which 

‘works’ best for them, and not necessarily 

the patient. While the formally adversarial 

relationship between 

ophthalmologists 

and DHBs persists, 

a ‘way through’ for 

public services is rarely 

discussed. Indeed, there 

is an assumption on 

the ‘market’ model that 

services are worth much 

more than the public 

sector funding allocation. 

Sometimes there is even 

feuding between private 

institutions (for example, 

St George’s and Southern 

Eye in Christchurch) which 

leads to, in my opinion, an 

unnecessary duplication 

of facilities. And our 

Southern providers are 

not alone, other private 

eye clinics have also found 

it necessary to build 

their own new, concrete 

Paperwork, as much a cause of burnout as too many patients 

palaces – the cost of which will all be factored into 

the bill for the consumer. 

Arguably the New Zealand public sector has 

never met the demand and is not designed to. 

Demand has hugely increased and expectations 

have changed as a greater proportion of the public 

learn there is a lot more that can be done to help 

them. But if we carry on the way we are going, 

then access to contemporary standards of eye care 

will simply be unobtainable for the majority of 

the population, with all the unattended morbidity 

this will bring. Somehow we must bring all the 

people involved, and their skills, together to 

deliver a standard of care, which keeps up with 

the pathology in our populations. 

Keep an eye on this column to learn more 

about Chalkeyes’ master plan. ▀ 

Welcome to Eye on optics by Chalkeyes, a new column brought to you by the team at NZ Optics. 

Inspired by the once legendary (and anonymous) Chalkie who used to grace the back page of that 

once wonderful, independent battler for all things business in New Zealand, The Independent 

Business Weekly, the views expressed by Chalkeyes are his, or hers, alone and not necessarily the 

views of NZ Optics. Anyone wishing to comment on Chalkeyes’ views should email a brief letter to 

the editor at info@nzoptics.co.nz. 

❄ 

Merry Christmas from NZ Optics 

If you have any news, case studies or stories you wish to share, or if you have a job vacancy 

you need to fill or equipment you need to sell, please just drop us a line at info@nzoptics.co.nz. 

We always love to hear from you. 

We hope you have a wonderful Christmas and New Year and a good break. 

We’ll be back at the end of January with our February issue. 

All the best and Merry Christmas, from Lesley, Jai, Nick, Susanne and Tracey. 

❄ 

❄ 

For all the news, views, social occasions and latest research from our part of the world, let NZ Optics help keep you informed 

NZ Optics: your publication – supporting New Zealand’s ophthalmic industry 



27

DISPENSING OPTICIAN OR 

EXPERIENCED OPTICAL 

ASSISTANT 

Our modern progressive independent practice requires a dispensing optician to join our experienced 

dispensing team. A dispensing qualification is not necessarily required, but experience is a must. 

The main role will be dispensing but also includes auxiliary testing as the practice has a strong clinical 

focus. Our large onsite Laboratory allows for fast and efficient glazing and adjustment services. 

Pukekohe is a fast growing area, 30 minutes south 

of Auckland central (travelling against the traffic). 

John Kelsey and his team are proud of the high 

standard of our services and would like to welcome 

an enthusiastic and motivated new staff member 

to join our well established team. 

This position is full-time with some Saturday 

morning work. In the first instance please contact 

Laurraine at admin@optik.co.nz 

Low Vision Consultations available at 

REMUERA, TAKAPUNA, MANUKAU and 

PUKEKOHE 

An Optometrist dedicated to Low Vision 

support. 

FULL-TIME ORTHOPTIST 

WANTED 

Auckland Eye is New Zealand's Centre of 

Excellence for eye care and we are looking for 

an experienced full-time orthoptist to join 

our team. 

Auckland Eye is a dedicated private 

ophthalmic care provider, with 13 specialists. 

We have a state of the art clinic and day stay facility in central Remuera and 

Takapuna. We also provide a number of suburban clinics throughout Auckland. 

We are looking for an orthoptist to join our team to provide assistance to the 

ophthalmologists covering all ophthalmic sub-specialties including three 

paediatric ophthmologists plus adult and neuro-ophthalmology. 

For more information, please contact janet@aucklandeye.co.nz 

AUCKLAND PRACTICE FOR SALE 

Finally, a bustling, central Auckland practice for sale! 

The current owner is looking to retire and would like to find someone to take 

over this profitable, independent practice and their loyal customers. There’s 

tremendous scope for growth for the right owner who has the skills and the 

energy, drive and marketing know-how to make this practice stand out. 

This practice is ideally suited to an optometrist who yearns to be truly 

independent and is ready to run their own business, make their own decisions 

and reap the rewards from the hard work they put in. Or perhaps you’re 

overseas and looking to move or return to New Zealand? 

Situated in a very sought after suburb with good schools and amenities close by, 

with many high-value customers and a great team, this practice has it all, and you’ll 

receive the full support of the current owner in a comprehensive handover process. 

If this sounds like you, please email, in strictest confidence, 

info@nzoptics.co.nz, quoting code PFSB20 

MORE CLASSIFIEDS ON PAGE 26

Dec 2016

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