Feb 2016

Low vision adventures in Israel
BY NAOMI MELTZER*
Going from New Zealand to Hadassah
Hospital in Jerusalem in September 2015, I
imagined there would be armed guards at
every entrance searching bags and checking IDs.
Security was not the problem. Finding my way to
the Michaelson Institute in the main building of
Hadassah’s sprawling campus outside Jerusalem,
was the problem.
The Michaelson Institute is a multi-disciplinary,
low-vision clinic staffed by ophthalmologists,
optometrists, a social worker, a genetic counsellor
and a very experienced rehabilitation instructor.
Hadassah is a teaching hospital where all medical
students, particularly ophthalmology registrars,
attend a lecture on low vision as part of their
course. The lecture is given in a mix of Hebrew,
Arabic and English. Fortunately, instead of letter
charts they use number charts, and I was able to
learn my numbers in Hebrew very quickly this way.
Israel, though not a wealthy country, has a social
welfare scheme for people with low vision and
blindness, based on visual and financial need.
Those with very severe loss (less than 6/120)
receive a benefit similar to New Zealand’s disability
benefit. However, those with low vision between
6/12 and 6/120 or less than 20 degrees visual
fields, including homonymous hemianopia, receive
a means-tested subsidy from the government,
which pays for between 50% and 90% of consulting
fees and cost of low vision devices, depending on
their income.
The Israeli technology I was keen to learn about
was the OrCam device for those with really
significant loss of vision. This head-mounted device
is worn with a transmitter, strapped to a belt or
carried in a bag, and a small attachment worn on
a finger. The device recognises objects through a
smart camera, mounted on your glasses, and speaks
through an earpiece. Patients can activate OrCam
by pointing the device at text or a product, or by
pushing a button while looking in the direction of
text, a face or product. These options allow for even
a blind person to operate it, according to the sales
team, although they add that it is not suitable for
everyone and requires training. The sales team also
concede that the better the vision, the easier it is to
learn to use it, which correlates with the advice of
colleagues at Hadassah, who pointed out that if you
have sufficient vision to use it, you would usually use
other cheaper and more readily available technology.
I visited other Low Vision clinics in Israel. I was
introduced to new lens technology designed
Hadassah Hospital, Jerusalem
specifically for people with macular degeneration,
but suitable for other low vision situations as well,
which I hope will be available here shortly.
For reading and other near tasks there is a special
type of magnifying spectacle which incorporates
three LED lights beautifully aligned with the point
of focus. These come in a range of magnifications
and are supplied with a USB cable-charger. For
distance, there are spectacle lenses which give a
small amount of magnification and a tinted filter
to enhance contrast. Another advance is a spectacle
prescription lens which shifts the image to a better
seeing point on the retina.
I was hoping to find a centre for rehabilitation
of stroke and traumatic brain injury victims at
Hadassah. Unfortunately, despite my research
on the internet indicating such a centre exists, in
reality this turned out to be a small research team
in the neuro-ophthalmology department.
I did, however, finally manage to meet up briefly
with the one person who seemed to know the
most about visual rehabilitation, Haya Shames.
This optometrist takes some clients privately for
rehabilitation, while also doing a PhD in Posterior
Cortical Atrophy. PCA is a very interesting type of
Alzheimer’s disease which strikes at an earlier age
(about 50 to 60 years old) and affects a person’s
ability to read because the part of the brain which is
responsible for reading—not just seeing—is affected
first. People in the early stages often do the rounds
of optometrists and ophthalmologists complaining
they can’t read and are told there is nothing wrong
with the health of their eyes or with their vision,
which indeed is quite normal when tested on a
(high-contrast) distance single letter chart. In my
limited experience (n=2) of this condition, maximal
enhancement of contrast can be of great assistance
New appointments
at Essilor Australia
in the early stages when the patient still has the
cognitive ability to read but is struggling.
Overall, the experience of living and working in
such a different environment was wonderful and
confirmed for me that there is always something
new or different to be absorbed particularly in
low vision where so much relies on observation of
and communication with the client, whatever
Abbott rebrands
Revitalens
Abbott Medical Optics has rebranded
its premium Revitalens multipurpose
disinfecting solution brand to bring all
its contact lens solutions under its well-known
Complete brand.
Now called Complete Revitalens MPDS, the
rebranded product has been available since the
beginning of this year. According to a company
announcement the “solution provides proven
peroxide quality disinfection with advanced
Ocutec Duel Cleansing action, for 16hr long
Complete Dry Eye
Solutions: diagnosis and
therapeutic treatment options
• Oculus Keratograph 5M
Diagnostic Dry Eye Assessment
Meibo-scan
• Infra Red LED
Imaging
• Blue & White LED
TF-Scan
• White LED
OrCam is a tiny camera that can help visually impaired
people recognise and interpret the world around them
TF-Scan, R-scan
• White or IR Placido-ring
* Naomi Meltzer is a rehabilitation
optometrist with Sight Loss
Services. She was the recipient
of the Valda Knight Memorial
Scholarship, awarded by the NZ
branch of Hadassah International
to assist a New Zealand medical
professional to study their
particular area of interest at
Hadassah Hospital in Jerusalem.
lasting comfort….The formulation removes lipid
and proteins to condition the contact lens.”
Recent studies by the company show,
Complete Revitalens has a significantly lower
(up to four times lower) incident of adverse
events and lower rate of solution-induced
corneal staining and, perhaps most importantly,
is still effective with even the most noncompliant
patients.
More details about the findings of these
studies can be found on Abbott’s website. ▀
their age. ▀
Freecall: 0800 338 800
Eric Breda has been appointed general
manager for Independents & Affiliated
Optometry, Essilor Australia. Another key
appointment is that of Laurent Soudier who has
joined the company as operations director.
Breda joined the Essilor Australia team in August
taking direct responsibility for driving Essilor’s
organic growth objectives across the independent
optometry market through effective strategic
partnering and relationship management. Well
known in the industry, Breda more recently
held the position of business director ANZ with
Transitions Optical for more than ten years. During
this time, the company not only saw tremendous
sales growth, but also the establishment of
the Transitions Lenses brand in the psyche of
Australian and New Zealand consumers. Prior to
Eric Breda
Laurent Soudier
joining Transitions Optical in 1999, he held various
marketing related roles and holds a Bachelor of
Business degree, majoring in marketing.
Soudier joins the team from Essilor Greater
China where he has held the role of senior
director, Operations and I.T. He returns for what
is his third working period in Australia, after
several years working overseas and has been with
Essilor for an impressive 28 years. According to
a company announcement he brings with him
an extensive amount of insight, knowledge and
expertise to the Australia market. Soudier holds
a master degree in engineering (CNAM Poitoux
Charentes).
In his new role Soudier will take charge
of, and be responsible for, all manufacturing
processes and activities across Australia and
New Zealand, including
the branch laboratory
network, supply chain
and logistics, quality
assurance, maintenance
and the cluster’s offshoring
strategy. He will
be directly responsible
for defining and
implementing the core
operational strategies to
ensure reliable quality
and great service to all
our customers,
said Essilor. ▀
• Blephasteam
Therapeutic heat and moisture treatment for the relief
of Meibomian Gland Disfunction and associated diseases
• Optimel
Antibacterial Honey Eye Drops
for improved ocular surface health
and reduced inflammation
www.designsforvision.co.nz
A division of Paragon Care Group of Companies
Feb 2016
NEW ZEALAND OPTICS
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