Insight - August 2019

gunnamattamedia
  • No tags were found...

AUG

INSIGHT

2019

AUSTRALIA’S LEADING OPHTHALMIC MAGAZINE SINCE 1975

03

COMMITMENT MADE TO

IMPROVE DISPENSING

Australia’s dispensers

focus on rebuilding the

profession at O=MEGA19

25

MAKING DRY EYE

DISEASE A PRIORITY

What does a practice

need to know before treating

dry eye patients?

46

WORLD GLAUCOMA

CONGRESS: PART TWO

Everything from clinical

innovations to managing

personal costs


Neva ® Coatings

NEW

Introducing the new Neva

Coatings range by OSA.

Available in 5 different options,

each coating has its own set

of unique features to suit all

types of lifestyles.

Coating Features

Anti-reflection

Anti-scratch

Anti-smudge

Anti-static

35

UV Protection

Blue Light Filter

To find out more about the Neva Coatings

range contact your OSA sales representative

or visit osalens.com.au

2019 OSA Pty Ltd. All rights reserved. Neva ® is a registered trademark of OSA

and E-SPF 35 is a trademark of Essilor International. May 2019 FR8237b


AUG

INSIGHT

2019

AUSTRALIA’S LEADING OPHTHALMIC MAGAZINE SINCE 1975

AUSTRALIA’S OPTICAL DISPENSERS COMMIT

TO REBUILDING PROFESSION AT O=MEGA19

Australia’s optical dispensers

have met in Melbourne to discuss

the future of the profession, as

well as the exact requirements to

overcome the lethargy that has

held back the sector for years.

The industry-wide meeting,

conducted on 20 July at the

inaugural O=MEGA fair,

sought to initiate the process of

establishing an effective national

representation for the country’s

optical dispensers. A focus was

on providing opportunities for

professional development, as

well as building national

recognition that dispensing is a

complex profession that requires

specialist expertise.

Mr Paul Clarke, inaugural

president of the Australian

Dispensing Opticians Association

(ADOA) and former president of the

International Opticians Association,

moderated the meeting. He

emphasised that the event was an

opportunity to focus on solutions,

rather than a chance to attribute

blame for past problems.

However, he also acknowledged

that “things are not going right” for

optical dispensing in Australia, with

countries such as the UK, Canada

and New Zealand home to strong,

productive dispensing bodies. He

said that since optical dispensing

was deregulated in the 1980s,

and following the establishment of

the ADOA in 1994, the sector had

gradually declined.

To combat this, Clarke proposed

a rejuvenation of the ADOA that

Paul Clarke

would focus on furthering optical

dispensing through lobbying and

improving professional standards.

He also called for members of

Australia’s dispensing community

to volunteer to help work towards

this goal.

Additionally, he also said that the

organisation is unlikely to achieve

this without a paid, full-time

manager. Mr Ron Baroni,

former Australian country manager

for Optometry Giving Sight, was

in attendance and offered his

services for this role, initially on

a volunteer basis.

BROAD SUPPORT

Many of the industry figures in

attendance shared their support for

the initiative.

Mr Darrell Baker, president of

Optometry Australia (OA), said his

organisation fully supported the

project and would be willing to

provide any help that is requested.

He also encouraged those in

attendance to plan for the future,

as well as utilise the findings of

continued page 8

OA HOLDS FIRM ON ‘CONFIDENTIAL’ NUMBERS

Optometry Australia (OA) has

defended its decision to keep

its precise membership number

a secret, following Insight’s

investigation into transparency

and governance practices at the

peak industry body. CEO Ms Lyn

Brodie continues to keep the

organisation’s exact membership

figure off the public record, and

requests for specific membership

figures to OA president and board

chairman Mr Darrell Baker also

remain unfulfilled.

Rather than reveal its

membership number, much like

many of Australia’s other healthrelated

organisations choose to

do, OA asks that members

undertake their own estimation by

visiting the Optometry Board of

Australia’s (OBA) website and

use a percentage to calculate

a figure based on the current

number of registrants.

To clarify this practice, Insight

sought comment from Baker as to

whether the decision to withhold

the official membership number is

a formally endorsed board policy or

the choice of OA staff.

Baker did not clarify the issue and

instead told Insight that Brodie had

supplied sufficient information to

calculate a membership number,

as well as the reasoning behind

the decision.

“As such, the Optometry Australia

board does not see any need to

answer your questions. We fully

support our CEO, Ms Brodie,”

Baker wrote. This is despite

comparing a percentage against

figures published on a separate

party’s website not being the same

as providing the association’s

actual paid membership base.

SECRET MEMBERSHIP

The subject of OA’s membership

number initially arose following

a routine request in February

for a news report in which OA’s

membership tally was relevant.

Ms Kerry I’Anson, general manager

of marketing and communications

at OA, advised that “membership

numbers are confidential”.

When Insight brought the issue to

Brodie and questioned why OA’s

actual membership could not be

provided, she advised: “Member

numbers are not a secret –

but a daily moving feast!”

Brodie claims this is due to

varying membership categories

and renewal periods between OA’s

state bodies, as well as a time lag

in systems and processing.

However, at the time, and

despite denying secrecy, Brodie

still refused to reveal a specific

membership number, even though

the organisation had made the

information a matter of public

record in the past. Instead, she

stated that OA publicly represents

a percentage of Australia’s boardregistered

optometrists, which is

calculated annually. Brodie claims

this figure is currently 82.5%. The

continued page 6


Looking for an

everyday account that’s

more rewarding?

The Everyday Plus Account.

The only everyday account that allows you to earn

points from a choice of two rewards programs.

Earn 1 Qantas Point + or 1 Velocity Frequent Flyer Point^ for every

$10 of daily average balance in your account, calculated at the end

of each month*.

There are no establishment or account keeping fees and you can redeem your

Qantas Points + or Velocity Points^ for flights, merchandise, holidays and more.

It’s an everyday account that could take you places.

Visit us at boqspecialist.com.au/everydayplus to view our exclusive

offers or speak to your local finance specialist on 1300 131 141.

Car loans | Commercial property | Credit cards | Equipment finance | Fit-out finance | Foreign exchange | Home loans | Personal loans | Practice purchase | Practice set-up | Savings accounts | SMSF | Transaction accounts

| Term deposits | Vehicle finance

+

To earn Qantas Points you must be a member of the Qantas Frequent Flyer Program. A joining fee may apply. Membership and Qantas Points are subject to the Terms and Conditions, available at qantas.

com/terms. ^ To earn and redeem Velocity Points you must be a Velocity member. Velocity membership and Points earn and redemption are subject to the Member Terms and Conditions, available at

velocityfrequentflyer.com, as amended from time to time. * To determine the average daily balance for your account, add the closing balance from each day in the month together, and then divide the total by the

number of days in the month. The issuer of these products and services is BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL no. 244616 (“BOQ Specialist”). Terms and conditions,

fees and charges and eligibility criteria apply. BOQ Specialist is not offering financial, tax or legal advice. You should obtain independent financial, tax and legal advice as appropriate. You should obtain and

consider the relevant terms and conditions here before making any decision about whether to acquire the product. We reserve the right to cease offering these products at any time without notice. The financial

services material in this document has been prepared by BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL no. 244616 and not by Velocity Frequent Flyer (VFF) or by Qantas

Frequent Flyer (QFF). VFF and QFF do not hold an Australian financial services licence to provide financial product advice and do not exercise control over the content of the document. VFF and QFF do not take

responsibility for any financial product advice contained in this document.

BOQS001783 V1 06/18


UPFRONT

Just as Insight

went to print, UK

charity FIGHT FOR

SIGHT announced

that it is funding

researchers at

the Centre for Eye

Research Australia (CERA) to investigate

the role of protrudin, a scaffolding

molecule that could be used to restore

vision. CERA director Professor Keith

Martin and chairman of the Cambridge

University Centre for Brain Repair

Professor James Fawcett will work

with colleagues at CERA to investigate

the molecule’s capacity to help heal

n WEIRD

An American ophthalmologist has

voiced his dismay at the injuries he

treated during the Fourth of July

holiday and warnings about eye

protection going unheeded. “I’ve

seen more serious firework injuries in

the last 36 hours than I’ve seen BBgun

injuries in the last 5 or 10 years,”

Dr Curtis Brute Wolf told Tulsa World.

n WONDERFUL

The first ever season of the Victorian

Blind Football League kicked off

in July. AFL Blind is played on an

indoor field using a football equipped

with an electronic beeper. Flashing

lights and high contrast backdrops

help players identify the goals, and

Bluetooth speakers are activated

when players are able to score.

n WACKY

An unlikely partnership has formed

between multinational coffee giant

Starbucks and Australian luxury

sunglasses brand Pared Eyewear.

The collaboration has seen Starbucks

produce an assortment of brightly

coloured cups, mugs and other

merchandise decked out in images

of Pared’s distinctive frames. Pared is

the creation of Samantha Stevenson

and Edward Baker.

and regrow damaged nerve cells. The

molecule has the potential regenerate

sight lost due to glaucoma, or lead to

more successful eye transplants. IN

OTHER NEWS, The Australasian College

of Behavioural Optometry (ACBO) has

appointed Mr Steve Leslie as CEO, after

it was previously announced that Ms

Veronica Kypros would depart the role

after a decade with the organisation.

Leslie is currently president of the ACBO

board, but will resign from the position

to take up the top job. In a statement the

ACBO acknowledged that it might appear

to be an unusual decision, but cited

Leslie’s experience with both the ACBO

STAT

HUNG OUT TO DRY

WHAT’S ON

THIS MONTH

OPHTHALMOLOGY

UPDATES!

AUGUST 24-25, SYDNEY

Back for its fourth year, Ophthalmology

Updates! 2019 features a wide array of

speakers covering a range of topics, all

designed to keep clinicians up to date.

E: registration@

ophthalmologyupdates.com

and Optometry Australia as invaluable,

as well as his vast clinical knowledge.

FINALLY, the Essilor Vision Foundation

has announced the recipient of the

millionth pair of glasses provided by the

charity. Since it commenced operation in

2007, the Essilor Vision Foundation has

donated one million pairs to people in

need across the United States. The lucky

recipient was first-grader Khloe, who will

be provided glasses by the Foundation

until she is 18. To coincide with the

launch, the Foundation is also launching

a ‘One Million Magic Moments’ campaign

in order to highlight the difference a pair

of glasses can make.

Though measures vary, it is estimated that one in five Australians will encounter dry eye

during their lifetime. Thanks to new public awareness, the number of dry eye clinics is increasing.

Full report page 25.

NEXT MONTH

SCC8

Complete 2019 Calendar page 49

SEPT 7-8, MELBOURNE

The annual Specsavers Clinical

Conference will keep the new format

established last year, with two full

days of sessions designed to pack

a full year’s worth of professional

development into one weekend.

E: anz.scc@specsavers.com

insightnews.com.au

Publisher

Coleby Nicholson

Associate Publisher

Angela Han

Clinical & Technical Editor

Lewis Williams PhD

lewis.williams@insightnews.com.au

Assistant Editor

Callum Glennen

callum.glennen@insightnews.com.au

Journalist

Myles Hume

myles.hume@insightnews.com.au

Editorial enquiries

editorial@insightnews.com.au

Insight is published by:

Gunnamatta Media Pty Ltd

Locked Bag 26, South Melbourne,

VIC 3205 AUSTRALIA

Phone: +61 3 9696 7200

gunnamattamedia.com

info@gunnamattamedia.com

Design & Production Manager

Jo De Bono

art@gunnamattamedia.com

Accounts

Paul Blewitt

finance@gunnamattamedia.com

Subscriptions

info@gunnamattamedia.com

Copyright: All material appearing in Insight is

subject to copyright. Reproduction in whole

or in part is strictly forbidden without prior

written consent of the publisher. Disclaimer:

The views and opinions expressed by

authors are not necessarily those of the

publishers. All statements made, although

based on information believed to be

reliable and accurate at the time, cannot be

guaranteed and no fault or liability can be

accepted for error or omission.Gunnamatta

Media Pty Ltd strives to report accurately and

fairly and it is our policy to correct significant

errors of fact and misleading statements

in the next available issue. Any comment

relating to subjective opinions should be

addressed to the editor where the opposing

position may be published to encourage

open debate. The publisher reserves the right

to omit or alter any advertisement and the

advertiser agrees to indemnify the publisher

for all damages or liabilities arising from the

published material.

INSIGHT August 2019 5


NEWS

OA MEMBERSHIP NUMBERS REMAIN VAGUE

continued from page 3

OBA publishes a detailed statistical

breakdown of registered practitioners

every three months.

Confidentiality even surrounds the

membership figure used for OA's 2017-

2018 Annual Report, published last

October, which both Brodie and Baker

also would not divulge. The annual report

includes a comprehensive breakdown of

membership demographics that would

only be possible with an accurate figure

for the organisation’s total membership.

OA’s 2017–2018 Annual Report

also included a page with a detailed

breakdown of the total number of

OBA-registered optometrists. However,

OA’s own membership figure was not

included.

Brodie admitted that OA calculates a

membership number annually for internal

comparison, explaining: “We work

our calculations post-renewal period

October, comparing back to OBA

data in June."

Brodie supplied December 2018 OBA

data to suggest that OA’s membership

was 4,542 (5,506 registrants x 82.5%),

however, in explaining why she would not

provide OA’s actual paid membership

figure, Brodie claimed the exact number

is ultimately "meaningless".

“When I speak to government or other

stakeholders, giving them a number is

meaningless – what they want to know

is the percentage of optometrists we

represent. Even our members would find

a number meaningless,” Brodie said.

Insight sought clarification on whether

Brodie’s comment reflected the position

of the board and Baker advised she has

the board’s full support.

OA’s ‘confidential’ approach can

be compared to a number of other

Australian health and not-for-profit

organisations. When undertaking

research in order to compare OA’s

stance, 15 similar health bodies either

recorded a membership figure on their

website, in their annual reports or freely

provided the information to Insight

upon request in a transparent manner

without debate.

INTERNAL INCONSISTENCIES

OA’s policy of maintaining confidentiality

over its membership numbers is

inconsistent with its state bodies.

The 2018 South Australian President’s

Report, which is freely available on OA’s

recently redesigned website, points to

specific membership numbers as an

area of concern.

“Another year has come and gone

and I’m proud of the strong and

progressive professional association I’m

part of. We have spent the year pursuing

significant projects, which will impact

both current and future optometrists in

South Australia,” SA president Mr Kurt

Larsen wrote.

“We now proudly represent 311

practising and student optometrists

across South Australia.

"Although this number is growing

overall, we recognise that as a

percentage of total optometrists

practising in SA, our representation is

dropping.”

Larsen added that the association

has “better member statistics than

many other professional bodies, but

we hope that with passion, effort, and

good member services we can turn

this number around and grow our

membership still further. Only through

strong member support can we

successfully lobby government and other

stakeholders to advance optometry”.

In 2018, Optometry South Australia and

Optometry Victoria’s membership bodies

voted in favour of amalgamation. At the

time of the vote, maintaining membership

numbers was cited as a reason behind

the merger.

“Both states, individually, are quite

successful in terms of hanging onto their

members, so we think if we can make it

better and cheaper we will be even better

at that,” former Optometry Victoria CEO

Mr Pete Haydon told Insight at the time.

OA’s current stance also differs with its

previous practice of transparency. The

national body last published a specific

membership number in its 2013–2014

annual report, which documented 4,300

members. However; the subsequent

four annual reports omitted an actual

membership number.

BEST PRACTICE

Ms Julie Garland McLellan, a leading

governance consultant and professional

company director, believes membership

numbers play an important role in

associations: “Members have a right

Darrell Baker

"AS SUCH, THE

OPTOMETRY

AUSTRALIA

BOARD DOES NOT

SEE ANY NEED TO

ANSWER YOUR

QUESTIONS"

to understand the financial position

and prospects of their association.

That means they can expect to know if

membership is growing or declining.”

As previously reported, Garland

McLellan points to a range of regulations

and governance standards as set out by

the Australian Securities & Investments

Commission and the Australian Charities

and Not-for-profits Commission. She

also points to the Australian Institute of

Company Directors guidelines for not-forprofit

organisations, particularly principle

7.5 on accountability, as best practice.

“It is tempting [for an association]

to stop reporting an indicator if it

starts to show that performance is not

improving, however good governance

is to give equal weight to news of equal

importance for members in assessing

the performance and prospects of their

organisation.”

Garland McLellan also said it can be

tempting to exaggerate member numbers

to increase an organisation’s status: “It is

typical for large associations to state their

member numbers in submissions and

for smaller associations to mention the

importance of their members to society

rather than state the number of members

they have.”

At the time of publication OA had not

altered its stance on confidentiality, and

of the 15 health-related associations

contacted by Insight, it remains the only

one unwilling to state its membership

number on the record, preferring to

place the responsibility on members

to undertake their own examination

by estimating a figure from a separate

government website, which may or may

not be accurate.

Garland McLellan added: “It is

important for a board to draw a

distinction between what they consider

an appropriate strategy to engage an

outside party and what they consider

an appropriate response to an inquiry

from a member.”

Insight questioned Baker on 5 July

on this issue: “If a current member of

Optometry Australia requests a precise

membership number (the October

2018 number, for example) do you, as

Board Chairman, undertake to ensure

the information will be provided to the

member, without question?”

At the time of publication Baker had

not provided an answer. n

6 INSIGHT August 2019


NEWS

$1 MILLION CONTRIBUTED

TO BIONIC EYE PROJECT

IN BRIEF

n WA OF THE YEAR

The Federal Government has awarded

almost $1 million in funding to support

the development of a business plan for

bionic vision technology.

An investment of $924,100 has been

made towards the Cortical Frontiers:

Commercialising Brain Machine

Interfaces project currently underway

at Monash University, which is headed

by Professor Arthur Lowery of the

Department of Electrical and Computer

Systems Engineering.

The project has received funding under

the government’s new Medical Research

Future Fund: Frontier Health and Medical

Research Program.

It aims to restore vision by sending

images to the brain via a wireless

receiver located at the back of the

head, similar to a cochlear coil. Power

and data is transmitted to a number of

implants that sit on the surface of the

brain. Attached to these implants are

electrodes, which penetrate the cortex

and use electrical stimulation to send

information to the brain.

Speaking to Insight, Lowery said

that because the system bypasses

the majority of the optical system,

such as the eyeball and optic nerve,

the treatment might be suitable for

someone who has lost their eye. Also,

since the implant bypasses the fovea,

the it could have a better resolution than

other systems.

“There are around 500 square

millimetres of the brain dedicated to

foveal vision. And therefore, if we put an

array of electrodes into the brain evenly

spaced at 1 millimetre, we should get

quite a high number where the foveal

vision is. Whereas if you did the same

thing with the eyeball, you’d only get

one, two or three electrodes at that

spacing in the fovea.”

Lowery also said that the image a

patient ‘sees’ might not necessarily be

what the camera sees.

“For example, it could have a meeting

mode where it could represent people’s

faces by emoticons, or it could have a

navigation mode that looks for where

the carpet is, or routes around the city.”

He went on to explain that getting

the maximum amount of useful

information to a person, rather than an

image limited by size or detail,

(From left) Professor Arthur Lowery, Health

Minister Greg Hunt, Professor Margaret Gardner

AO, Vice Chancellor of Monash University and

Professor Jeffrey Rosenfeld AC, Professor of

Surgery. Image supplied by Monash University.

is a relatively new way of thinking.

“Computer scientists are into

segmentation which is if you have an

image, how does the brain separate

images out and say ‘that’s a person

standing in front of a bookshelf in a

room with a window looking outside’?

How do you divide an image up into its

physical parts and then represent those

physical parts?”

Computer scientists working on

driverless cars are currently facing

similar challenges.

The funding will be used for the

development of two business cases

for the brain-stimulating technology,

and is part of the Federal Government’s

$570 million Frontiers initiative designed

to help researchers bring their ideas

to market.

Lowery said one of the two cases

is likely to be for vision, but the other

could be for the treatment of epilepsy

and depression.

”We also have some technology for

recording brain waves and brain signals,

so you could use the recording of the

motor region of the brain to drive a

prosthetic, and then use sensory parts to

provide some feedback.”

The project is currently in its

manufacturing stage, and Lowery added

that first-in-human trials would still be

some time away. However, the grant has

the potential to unlock additional funding

if the business development plan is

successfully approved.

“That would be really exciting because

it would allow us to set up an Australian

manufacturing and industry base for

electronics in the body, with an initial

focus on electronics and the brain." n

“IT COULD HAVE

A MEETING MODE

WHERE IT COULD

REPRESENT

PEOPLE’S FACES

BY EMOTICONS”

ARTHUR LOWERY,

MONASH

Dr Angus Turner, an ophthalmologist

dedicated to improving eyecare services

for people living in regional and remote

communities, has been recognised at

the recent Western Australian of the Year

Awards. The founder of Lions Outback

Vision at the Lions Eye Institute (LEI), he

was among seven people recognised

at the ceremony. Turner received the

Professions Award for his work in

delivering eyecare to people living in

isolated and disadvantaged locations.

He has also announced he will move to

Broome in 2020 to establish an eye health

hub that will deliver eyecare services

closer to home for the 100,000 people

living in the Kimberley and Pilbara.

n DATA BREACH

Specsavers-owned computer equipment

containing private patient details has

been stolen from a storage facility during

refurbishment works at its Stockland

Bundaberg store between 25-26 May. The

server may have contained names, date of

births, addresses, phone numbers, email

addresses, clinical records of optometry

tests and Medicare details, the ABC

reported. “There is no evidence to suggest

customer information has been accessed

at this time, but we are continuing to adopt

a precautionary approach and monitor

the situation carefully,” a Specsavers

spokesperson told Insight. Medicare

is monitoring the records of impacted

customers for suspicious activity and has

advised most people will not need to

make contact.

n CANSTAR BLUE

Independent Australian optometry group

Eyecare Plus has been awarded the top

spot in Canstar Blue’s 2019 review of the

country’s optical stores. For the second

year running it was the only optometry

provider to be awarded five stars in the

category of ‘Overall satisfaction’. The

group outranked major optometry chains

to clinch the prize, including Optical

Superstore, Specsavers, OPSM and

Bailey Nelson. Eyecare Plus was also

awarded five stars in the categories

of customer service, quality of advice,

after sale service and range of available

products. “This is such a strong

vindication of our member’s commitment

to clinical optometry and local

personalised service,” Mr Simon Lewis,

Eyecare Plus general manager, said. n

INSIGHT August 2019 7


NEWS

EDUCATION THE KEY TO IMPROVING STANDARDS

continued from page 3

OA’s Optometry 2040 report in order to

anticipate the direction eyecare is going.

Mr Steve O’Leary, director of products

for Specsavers Australia & New Zealand,

also stated his support both personally

and on behalf of Specsavers. He said

that those in attendance must build

a “big vision”, and that a Certificate

IV should be the minimum standard

expected of an optical dispenser.

Education was a particularly important

subject with Mr James Gibbins, director

of the Australasian College of Optical

Dispensing, and Mr Steve Daras, optical

dispensing course coordinator for TAFE

NSW and current director of the ADOA,

both emphasising the importance of

education in maintaining professional

standards, as well as the foundation of a

strong organisation.

“I didn’t expect anywhere near this

amount of people and there was obvious

passion out there, and it’s exciting,”

Clarke told Insight at the conclusion of

the meeting.

“I think we have the right man on

the job with Ron Baroni, so we’ve got

structure now. We’ve got ideas, we’ve

Attendance was high at the dispensing forum

got passion, and we’ve got agreement

from corporate [optometry businesses].

We didn’t get any of the heckling that I

thought we might get.”

SURVEY RESULTS

Also presented at the meeting were

the results of the O=MEGA19 Optical

Dispensing Forum Survey, which was

distributed ahead of the event in order to

inform discussion.

More than 210 people completed the

survey, the vast majority of which were

qualified optical dispensers.

The survey revealed broad

dissatisfaction with leadership across

the sector, with 80% claiming they are

not currently members of an optical

dispensing association. Of those who

“I DIDN’T EXPECT

ANYWHERE NEAR

THIS AMOUNT

OF PEOPLE AND

THERE WAS

OBVIOUS PASSION

OUT THERE"

PAUL CLARKE

were a member, more than half were

“neither satisfied or unsatisfied” with the

performance of their association.

For the question “Is dispensing

valued?”, 47% of respondents said the

profession is somewhat undervalued and

24% said it was not valued at all.

However, the results of the survey

also showed willingness for growth.

There was significant interest expressed

in both ongoing education sessions

and a system of formal recognition for

completing these courses.

Additionally, a majority of respondents

indicated they would join a professional

association if they could see value in it,

and 62.5% said they would be willing

to volunteer to help advance an active

association.

Clarke said these results proved that

there is no excuse for the lack of a

great organisation for optical dispensers

in Australia.

“It’s up to all of us to step up and do it.

No-one is going to do it for us at all, the

only people who are going to get optical

dispensing up and running in this country

is us, the optical dispensers.

“That’s going to be the challenge at the

end of this meeting.” n

FRESH CASH INJECTION FOR KEEPSIGHT PROGRAM

The Federal Government has committed

an additional $1.5 million to the KeepSight

diabetes eye screening program.

Health Minister Mr Greg Hunt made the

announcement on 15 July to mark the

beginning of National Diabetes Week.

The funding is in addition to an initial $1

million government grant announced at

the project’s launch last October, as well

as an annual $1 million commitment from

Specsavers for the next five years.

Thousands of eyecare professionals

have registered with KeepSight, which has

been described as a once-in-a-generation

opportunity to significantly reduce the

rate of diabetes-related vision loss and

blindness across Australia.

Following similar overseas models,

eyecare providers and patients are

encouraged to subscribe to the KeepSight

database, which regularly reminds

patients of diabetes eye examinations.

Approximately 1.3 million Australians

have the condition, but it is thought

half are not getting the recommended

number of eye examinations.

Diabetes Australia CEO Professor

Greg Johnson told Insight the ongoing

funding commitment for KeepSight was

part of a broader $2.8 million package

for diabetes complication prevention

initiatives this week.

“KeepSight has the potential to

transform the number of people with

diabetes having regular diabetes eye

checks and reduce the incidence of

vision loss and blindness caused by

diabetes,” he said.

“It’s critical the diabetes and eyecare

sectors work together to address this

major gap in eye disease prevention for

people with diabetes in this country. With

Greg Johnson

many people not having regular diabetes

checks it means eye damage is often

identified too late.”

Specsavers optometry director Mr

Peter Larsen said the combined funding

helps support Diabetes Australia to

communicate the importance of regular,

Medicare-funded eye tests for diabetics.

“From our perspective at Specsavers,

we’re already seeing a dramatic increase

in patients with diabetes signed up to the

KeepSight portal,” he said.

Centre for Eye Research Australia

deputy director Associate Professor Peter

van Wijngaarden also welcomed the

government’s commitment.

“Similar programs have been extremely

effective reducing avoidable blindness

caused by diabetes in the UK and

we hope to emulate those results in

Australia,” he said. n

8 INSIGHT August 2019


THE ULTIMATE EXPERIENCE

OF CONTROL AND CLARITY

1-4

Clareon ® AutonoMe ® . Automated delivery of

unsurpassed clarity. §,1-4

Available

from +6.0D - +30.0D

in 1/2 dioptre steps 1

Clareon ® IOL with AutonoMe ® is the first and only automated, disposable,

preloaded delivery system. With its intuitive, ergonomic design, the AutonoMe ®

delivery system enables easy, single-handed control of IOL advancement and

protects incisions as small as 2.2 mm. 1,5-8 Preloaded with the Clareon ® IOL, the

world’s most advanced optic § ,delivering unsurpassed clarity. §,1-4,9,10

Available with a complete range of dioptres

+6.0D - +30.0D (1/2 Dioptre steps). 1

References: 1. Clareon® AutonoMe® Directions for Use. 2. TDOC-0053487. 3. TDOC-0053516. 4. TDOC-0053488. 5. TDOC-0053511. 6. AutonoMe_CAD drawing_77.122264. 7. UltraSert CAD_77122604_D nozzle. 8. UltraSert

CAD_77122679_C nozzle. 9. TDOC-0053803. 10.TDOC-0053579.

§

Based on aggregate results from in vitro evaluations in February 2017 of haze, SSNGs and glistenings compared to TECNIS §§ ZCB00 (Johnson & Johnson), Vivinex §§ XY-1 (HOYA) and enVista §§ MX60 (B&L; Bausch &

Lomb). §§ Trademarks are the property of their respective owners.

©2019 Alcon Inc. Alcon Laboratories (Australia) Pty Ltd ABN 88 000740830 Phone: 1800 224 153 Alcon Laboratories New Zealand c/- PharmaCo, Auckland, NZ Phone: 0800 101 106

ANZ-CLA-1900001 Date of preparation July 2019


NEWS

FAIR WORK IMMOVABLE ON PAY AWARDS

The Fair Work Ombudsman (FWO)

has held firm in its view regarding pay

Awards coverage for optometry support

staff, in a move that could have financial

and legal repercussions for many

practices.

Following months of confusion and

uncertainty, Optometry Australia (OA)

posted an announcement to its website

on 18 June advising that it had reached

a position on the appropriate Awards

classification for staff in administration,

sales and optical dispensing positions.

“During our meeting with the Fair Work

Ombudsman they were quite firm in their

position that optometry practice support

staff (as well as optometrists) should be

provided coverage under the HP&SS

Award,” the statement said.

“Given that there is currently no

definitive ruling to the contrary, it is

Optometry Australia’s position that the

most risk adverse approach would be

to adopt the Fair Work Ombudsman’s

position on coverage.”

Since February, OA and the FWO

have been working to clarify the correct

Awards classification and remuneration

for optometry support staff.

Confusion arose after FWO published

a four-line press release on its website,

stating the HP&SS Award is applicable

to all optometry practice staff.

At the time, OA labeled the FWO’s

stance as confusing and conflicting with

previous advice; exacerbated by the fact

most employers had been applying the

General Retail Award 2010 to support

staff.

OA and its legal representatives from

Industry Legal Group (ILG) met with the

FWO in March to explain the existing

rationale behind adopting the retail

award, including the nature and structure

of optometry practices.

Following the meeting, OA CEO Ms Lyn

Brodie admitted more work was needed

to ensure “a meeting of the minds”.

However, it now appears the FWO has

not been persuaded in any way that the

General Retail Award is applicable to

optometry.

OA has since undertaken a

benchmarking exercise to compare the

differences between the awards and

the potential impact of change. It found

there were differences between penalty,

loading and overtime rates, and main

pay rates were “slightly higher” under

HP&SS Award.

“Overall the costs to business were

comparable albeit slightly higher under

the HP&SS Award. Following this logic,

employers who pay staff under the

higher HP&SS Award rates would be at

less risk of an underpayment claim,” the

OA statement said.

“Should you continue to pay your

support staff under the Retail Award, just

be mindful that at some future point the

Fair Work Ombudsman or the Fair Work

Commission may deem you to be paying

under the incorrect Award.

“Should that happen the Fair Work

Ombudsman have advised that they will

undertake a ‘no harm’ test, in that they

will simply ensure that the employee has

not been disadvantaged in any way by

virtue of their coverage under the Retail

Award versus the HP&SS Award.”

When Insight queried Brodie about

the number of practices that might be

impacted, and the significance of the

decision, she said: “as with any award,

this award is applicable to all practices”,

without providing further detail.

Asked for OA’s reaction to the FWO’s

response, she added: “Our role is to

provide clarity and to take a considered

risk management approach. It

recognises that optometry staff as being

embedded within the health sector.”

OA and ILG are now expected to

release indicative descriptors for each

award classification under the HP&SS

Award to help employers determine

the most appropriate coverage for their

support staff.

When finalised, these will be distributed

to all members, practice owners and

managers, and will include further

information on how to communicate

with employees about the changes

and ensure practices comply with all

“SHOULD YOU

CONTINUE TO PAY

YOUR SUPPORT

STAFF UNDER

THE RETAIL

AWARD, JUST

BE MINDFUL

THAT AT SOME

FUTURE POINT

THE FAIR WORK

OMBUDSMAN OR

THE FAIR WORK

COMMISSION MAY

DEEM YOU TO BE

PAYING UNDER

THE INCORRECT

AWARD”

OPTOMETRY

AUSTRALIA

provisions under the HP&SS Award.

A FWO spokesperson said the

original press released in on the

authority’s public online library remains

“unchanged”.

“Our approach to any compliance

and enforcement issue is set out in our

Compliance and Enforcement Policy. We

have no further comment.”

INCORRECTLY CLASSIFIED

Assessing the magnitude of this issue,

Workplace Law managing director Ms

Athena Koelmeyer told Insight it could be

significant for the industry.

“It is possible that all optometrist

support staff paid under the retail award

have been incorrectly classified and

potentially underpaid. These difficulties

do crop up fairly regularly, but not on

such a large scale,” she said.

“Unless the practice is prepared to

have the fight in court about the correct

Award application, the least risky path

is to reclassify the employees. In doing

this, it should be noted that there could

be a back pay issue for up to six years if

the employees were paid less than the

new award classification rates over that

period.”

Koelmeyer said she was not surprised

the FWO maintained its stance on the

issue, stating the authority takes its time

to make decisions.

“In the circumstances where the

coverage has been contested, we

would hope that it was unlikely that the

FWO would actively pursue technical

breaches resulting from the application

of the wrong award, although if it did,

penalties may apply.” n

Ms Athena Koelmeyer, Workplace Law

10 INSIGHT August 2019


NEWS

OPTOMETRY MEDICARE FREEZE LIFTED: 1.6%

PATIENT REBATE INCREASE NOW APPLIED

The Federal Government has maintained

its pre-election promise to reinstate

Medicare indexation, ending an almost

seven-year freeze on rebates for

optometry care.

From 1 July, a 1.6% increase will apply

to rebates of optometry-related Medicare

Benefits Schedule (MBS) items – 12

months earlier than the government’s

indicated 2020 timeframe.

While the move has been welcomed

by the sector, advocates warn that

the lengthy suspension has taken a

significant toll, with current optometric

fees no longer representative of the true

cost of providing clinical care.

According to Optometry Australia (OA),

optometry MBS items have not been

indexed since November 2012. Initially

introduced by the Gillard government

as a short-term initiative, the freeze was

extended by subsequent governments

from both sides of the political spectrum.

Then, in 2015, the Coalition government

introduced an unprecedented 5%

reduction to all optometry rebates,

meaning that patient rebates for

optometry are 5% lower today than they

were in 2012. During that year, a fee cap

was also lifted, allowing optometrists to

determine their own fees.

In 2017 the Coalition government

announced that a return to indexation

of MBS items would be phased in over

three years. In their election campaigns

this year, both the Liberal and Labor

parties declared a commitment to a 1

July 2019 reinstatement deadline, with

re-elected Prime Minister Scott Morrison

confirming the decision following his

victory.

OA member services and optometry

advancement general manager Ms Skye

Cappuccio told Insight the organisation

was generally pleased the government

had followed through on its promise, and

delivered sooner than expected.

“However, we don’t believe that

the indexation rate applied by the

Government to MBS rebates … fairly

reflects the true increase in the costs of

"FOR THOSE

PRACTICES

THAT PRIMARILY

BULK-BILL THEIR

PATIENTS, THIS

MEANS THEY ARE

MAKING LESS

AND LESS”

SKYE CAPPUCCIO,

OPTOMETRY

AUSTRALIA

providing quality optometric care,” she

said.

Cappuccio said while the almost sevenyear

freeze had been felt across the

whole sector, it had particularly impacted

bulk-billing practices and those who

serviced lower socio economic areas.

“For those practices that primarily bulkbill

their patients, this means they are

making less and less off the provision of

clinical services,” she said.

“For some practices this can threaten

long-term sustainability. Unfortunately,

this can be particularly the case for

practices with limited sources of income

beyond that associated with clinical care,

including those providing services in

areas of social disadvantage.”

Cappuccio said her organisation

had been a consistent advocate for

fairer patient rebates. In its pre-election

campaign, OA members helped distribute

4,000 pieces of communication to federal

representatives calling for a reassessment

of patient rebates for optometry items.

She added: “We will continue to

advocate for fairer rebates and will look to

politically mobilise our membership on this

issue when it is politically opportune.” n

NEWLY MERGED VISION 2020 TARGETS GOVERNMENT

Vision 2020 Australia has detailed its

lobbying priorities for the 46th Parliament

of Australia following the completion of

its merger with the Australian Blindness

Forum (ABF).

Last April it was announced that ABF

would merge with Vision 2020 Australia

in order to provide a single voice for

the country’s low vision sector. With

the commencement of a new financial

year, the organisation’s boards are now

merged.

Ms Judith Abbott, Vision 2020 Australia

CEO, said this is an important day for

people who are blind or have low vision.

“The coming together of Vision 2020

Australia and the Australian Blindness

Forum will create a strengthen and more

effective advocate to ensure their voices

are clearly heard on a range of important

issues,” Abbott said.

“There is significant experience from

both organisations that will be unified to

achieve the best possible outcomes for

our member organisations across the

blindness and low vision sector and the

people they serve.”

At its 26 June meeting, the Vision 2020

Australia board committed to increasing

the participation of people who are

blind or have low vision, on both its

committees and projects.

Additionally, the organisation has

also welcomed the returning Morrison

government and laid out its priorities.

In particular it has highlighted

implementing the Strong Eyes, Strong

Judith Abbott

Communities plan, progressing the

second National Eye Health Survey in

2020, improving access to assistive

technology for those who are blind or

have low vision and supporting eye health

programs across the Indo-Pacific region.

“There are a number of important eye

health and vision initiatives that can make

a real difference to the lives of many, and

with the benefit of continuity in Canberra,

we are optimistic of making even more

headway in the coming parliamentary

term,” Abbott said.

“We especially want to congratulate The

Hon Ken Wyatt MP on his appointment

as the first Indigenous Australia to hold

the position of Minister for Indigenous

Australians.” n

12 INSIGHT August 2019


SPECSAVERS

CLINICAL

CONFERENCE

8 2019

SPEAKERS ANNOUNCED

SCC8 | MELBOURNE CONVENTION AND EXHIBITION CENTRE

SEPTEMBER 7-8, 2019

SATURDAY SPEAKERS

Dr Caroline Catt

Gordon Eye Surgery

Subject: Paediatric optometry

Associate Professor

Colin Chan

Vision Eye Institute

Subject: Anterior eye disease

Dr Dru Daniels

Dru Consultants

Subject: Glaucoma

Dr Adam Rudkin

Specialist Eye Glenelg /

Victor Harbor

Subject: Vitreoretinal conditions

SUNDAY SPEAKERS

Dr Elaine Chong

Iris Surgery

Subject: Interpretation of OCT in

medical retina conditions

Peter Larsen

Specsavers Australia and

New Zealand

Subject: Transforming Eye Health

Dr Tu Tran

Eyes First

Subject: Glaucoma

co-management

Dr Lindsay McGrath

Oxford Eye Centre

Subject: Ocular oncology

Professor Peter Scanlon

University of Oxford and NHS

Diabetic Eye Screening Program

Subject: Diabetic retinopathy grading

and screening programs

Associate Professor

Lyndell Lim

Centre for Eye Research Australia

Subject: Optometric management

of ocular inflammation

Associate Professor

Peter van Wijngaarden

Centre for Eye Research Australia

Subject: Diabetic retinopathy

management and KeepSight

For full details on the SCC ticket, flight and accommodation prize draw, CPD / CD points and to register your place,

visit spectrum-anz.com/attend-scc


NEWS

LEI APPOINTS NEW

MANAGING DIRECTOR AND

BOARD MEMBER

The Lions Eye Institute (LEI) has made

changes to its management with the

appointment of a new managing director

and board member.

Ophthalmologist and medical

researcher Professor Bill Morgan, who

has been with the organisation for 25

years, has been appointed managing

director. In addition to being a board

member, he has also lead the institute for

the past six months.

Morgan is a glaucoma specialist whose

research interests include studying the

response of the optic nerve to pressure

and the epidemiology of blinding eye

disease.

In June he and young Indonesian

ophthalmologist Dr Virna Oktariana

launched their new, co-invented device

called the Virna Glaucoma Drainage

Device, which is an affordable tube

implanted in the eye to drain fluid and

relieve intraocular pressure.

Morgan said he was excited by the

potential for the LEI to expand as both a

clininc and research institute.

“We are fortunate to have a highcalibre

team of medical researchers

and clinicians who are as keen as I

am to build on our strong legacy of

ground-breaking scientific discovery and

exceptional eye health care,” he said.

“My immediate priorities include

expansion of our research agenda

and capacity, improved service and

processes in our eye clinic, and the

growth of our community footprint.”

Award-winning business executive Dr

Erica Smyth has also been appointed to

LEI’s board of directors.

Smyth is a respected business leader

with 45 years’ experience across a range

of positions in the mineral and petroleum

industries. For the past 15 years she

has served as a professional company

director.

“I am so pleased to be invited onto

the Board of the LEI. Within my close

family we have experienced the fears

and impacts of eyesight deterioration

related to diabetic retinopathy, glaucoma,

macular degeneration and cataracts, so

now being close to where the research

action is will be very relevant and fulfilling

for me,” she said. n

“WE ARE

NO LONGER

RUNNING TWO

OFFICES AND

TWO BOARDS, SO

WE HAVE PASSED

ON SOME OF

THOSE SAVINGS

TO MEMBERS”

PETE HAYDON,

OVSA

OPTOMETRY VICTORIA SOUTH

AUSTRALIA COMPLETES MERGE

The newly amalgamated Optometry

Victoria South Australia (OVSA) has

commenced operations by slashing

fees, promising greater services and

confirming future plans for its marquee

conference events.

Following a landslide vote backing the

partnership last year, Optometry Victoria

(OV) and Optometry South Australia

(OSA) have officially combined into a

single organisation, effective 1 July.

Ms Elise Pocknee-Clem, a former

president of OSA, has been appointed

as OVSA’s inaugural president, while

former OV CEO Mr Pete Haydon has

become CEO of the new entity.

The board, comprising of three South

Australian (SA) and five Victorian

members, also features vice-president

Ms Anne Weymouth, national director Mr

Murray Smith and treasurer Mr Timothy

Lo. Other directors include Ms Allison

McKendrick, Mr Kurt Larsen, Mr Rowan

Prendergast and Ms Cassie Haines,

while Mr Jason Tan has been appointed

as an associate director.

More than 95% of voting members

across both states supported the

historic decision last November after

OSA, the smaller of the associations,

first mooted amalgamation in 2014.

After the idea was first floated, both

staff and board members considered

the best amalgamation model before

putting the decision to a vote.

Haydon told Insight OVSA had begun

by reducing membership fees, and is

planning to increase the availability of

continuing professional development

(CPD) points and events, particularly for

SA members.

“We are no longer running two offices

and two boards, so we have passed

on some of those savings to members

across every membership category in

both SA and Victoria. So they will see

both an expansion of services and a

contraction of fees,” he said.

“Victoria’s successful rural and

regional CPD program and Early Career

Optometrists program is going to be

spread out across both jurisdictions, so

the number of CPD points available for

SA members will increase, the location

of those points will increase and it will

come into line with what we are offering

in Victoria.”

Haydon said membership renewals to

OVSA had already been performing well

across both states, which was indicative

of the support for the amalgamation.

He also confirmed OVSA’s plans for

the future operation of the Melbournebased

O=MEGA show and Adelaide’s

Blue Sky Congress.

Beginning with O=MEGA19,

O=MEGA will be held biennially in ‘odd

years’, and complemented by the Blue

Sky Congress to be held in the alternate

year. The next Blue Sky conference will

take place in November 2020.

“We have been hearing for years

there are too many conferences in the

market place. It’s made it very difficult,

particularly for sponsors and exhibitors,

to get a good return on investment,” he

said.

Additionally, for the corresponding

year a state does not host O=MEGA or

Blue Sky, OVSA will trial smaller, singleday

conferences in that state to ensure

members have continued access to

CPD events.

Haydon said this had been a

successful model applied to other allied

health professions such as dentistry and

physiotherapy.

“We are going to trial that over the next

few years. The number of CPD points

on the calendar in either Victoria and

South Australia will increase each year,

but also the convenience to members or

consumers will increase too.”

OVSA will be headquartered in

Melbourne, and supported by a satellite

office in SA.

Former OSA CEO Ms Libby Boschen

has been appointed as a special advisor

of member services and policy in SA for

at least the next two years. Haydon said

this was an important appointment due

to the subtle political and professional

differences between the states. n

14 INSIGHT August 2019


Miru 1day UpSide with

SmartTouch technology.

Introducing Menicon’s first daily disposable

silicone hydrogel lens created from our innovative

Menisilk Air and NanoGloss Pro technologies.

Designed to deliver all the health benefits of a silicone

hydrogel lens but with the comfort of a hydrogel lens, our

latest innovation offers an unmatched combination of

oxygen, modulus and water content.

Miru 1day UpSide is the only silicone hydrogel lens

with SmartTouch technology; unique packaging

promoting hygienic, hassle free handling.

For more information:

mail@menicon.com.au 1800 639 879

Menicon Australia Pty Ltd. 3 Lloyd Street, St Marys SA 5042.


NEWS

GEORGE & MATILDA REACHES 75-PRACTICE MILESTONE

George & Matilda Eyecare (GME) has

partnered with one of the country’s oldest

independently owned practices to secure

its 75th nationwide store.

A little over three years since its

formation, the nation’s so-called fastest

growing community of independent

optometrists announced Max Astri

Optometrists would become the latest

practice to join its network.

Mr Max Astri has operated the practice

in Dubbo, New South Wales, for the past

42 years, and it is claimed to be one of

the most successful in rural Australia.

Originally established in the 1890s by

a German jeweller and optician, it is

one of the oldest independently owned

practices in the country.

GME CEO Mr Chris Beer said the

latest milestone was indicative of his

company’s reputation of adding value

to existing, high quality independent

optometrists through its strategic

marketing, supply chain and business

support platforms.

“Having someone with the standing of

Max trust us to continue and build upon

the legacy he’s created is a big honour,”

he told Insight.

“We are pleased with where we have

got to. Over the past 12 months we

have seen the development of our

platforms begin to create and drive more

value for our partners. We are seeing

an acceleration in people wanting to

participate with us, which is exciting for

the group.”

GME came to the market with a

unique business model that allowed its

partners to maintain independence while

supporting them with back-office needs,

as well as significant buying power.

Despite launching in April 2016, GME

has already established itself as a major

player in the optometry sector, reaching

50 locations by July last year. The

addition of Max Astri Optometrists marks

its 25th acquisition in the past year alone.

Jenny and Max Astiri

Beer said: “By listening and learning

from our partners and understanding

what has made them successful to date

in their local communities, and then

complementing and supporting this by

adding strategic marketing, supply chain

and business support, we have a winning

formula for success.

“This has meant we have enjoyed

fantastic results at a time when a lot of

retail is hurting.”

Astri said GME’s ability to adapt to the

needs of his practice was a key motivator

behind the decision to join the group.

“I have been practicing in Dubbo for

42 years and it is very important to me to

remain active in the practice and know

my business, team and patients will

continue to be taken care of in the future

as they have in the past,” he said.

“George & Matilda Eyecare spent the

time getting to know me and my practice,

and so they could understand what

makes us special.” n


1800 637 654


NEWS

MENICON ORTHOK LENS

TO BE AVAILABLE IN

AUSTRALIA NEXT YEAR

The world’s first orthokeratology (OrthoK)

contact lens to secure European

regulatory approval for myopia control will

be available to the Australasian market

early next year.

Japanese contact lens manufacturer

Menicon officially launched its Bloom

Myopia Control Management System on

24 May after European regulators cleared

its Bloom Night OrthoK lens for myopia

control management.

The milestone sees Menicon

become one of the few contact lens

manufacturers to have devices with a

myopia control indication in Europe, with

the company claiming its product is the

first and only among OrthoK lenes.

The reverse geometry OrthoK lens is

manufactured in hyper oxygen-permeable

Menicon Z rigid material, which is said to

ensure optimal corneal oxygenation for

comfortable and safe contact lens wear.

The technology helps form a new

corneal shape that provides a particular

optical path for incoming light that

counters the ocular growth response

associated with myopia. It is through this

mechanism that the lens is indicated for

both the correction of refractive myopia

and myopia control when prescribed

and managed by a qualified eyecare

professional.

“With the accumulation of long-term

and comprehensive scientific evidence

over the years, Menicon Bloom Night

has met the highest standards of safety,

efficacy and quality required to grant the

treatment CE approval for myopia control

management in Europe,” a company

statement said.

Menicon Australia director Mr Mark

Whibley told Insight the product would

now be available to Australian and New

Zealand market early next year.

“Bloom will need [Australian]

Therapeutic Goods Administration

approval but we expect this to be a

fast process with the certificates we

have available,” he said. “Currently it is

being progressively rolled out to various

European countries.”

“Bloom will be presented as a complete

package of both the contact lenses, plus

it will be packaged with Bloom branded

care solutions, making it a total family

of products for patients seeking myopia

control.” n

“TGA APPROVAL

FOR MYLO WAS

ABSOLUTELY

CRITICAL TO

ENSURE EYECARE

PROFESSIONALS

AND THEIR

PATIENTS HAVE

COMPLETE

CONFIDENCE”

CHRIS HAROUS,

MARK’ENNOVY

TGA CLEARS LATEST SOFT CONTACT

LENS FOR MYOPIA CONTROL

Australian eyecare professionals now

have access to MYLO, one of the world’s

few soft multifocal contact lenses

specifically for myopia control, after

regulators approved the product in June.

Manufactured by Spanish contact

lens company mark’ennovy, in

conjunction with the Brien Holden Vision

Institute (BHVI), MYLO was cleared

by the Australian Therapeutic Goods

Administration on 6 June, making it the

latest addition to the expanding suite of

myopia treatments available

to optometrists.

Following European market approval in

March, this latest milestone means the

company can locally market the silicone

hydrogel monthly replacement contact

lens as a medical device specifically for

myopia management.

According the two-year results of a

randomised clinical trial published in

May, MYLO slowed myopia progression

by 32%, as determined by spherical

equivalent refractive error, and axial

length elongation by 25%, when

compared to children wearing single

vision contact lenses.

The study involved 508 myopic Chinese

children aged from 8-13, separated into

five groups.

As well as MYLO, in Australia this

category now consists of CooperVision’s

MiSight 1 Day multifocal soft contact

lens, the pioneering lens of the segment

available in Australia since 2016, and

Ellex Medical Lasers’ 2RT Retinal

Rejuvenation Therapy has been shown

to have an enduring impact in slowing

patients’ progression to late-stage agerelated

macular degeneration (AMD).

The Adelaide-based ophthalmic device

manufacturer has released the results

of the four-year patient follow up of the

landmark Laser Intervention in Early Age-

Related Macular Degeneration (LEAD)

clinical trial, which investigated the use of

the nanosecond laser therapy in patients

with intermediate AMD (iAMD)

“These data once again highlight the

Mark'ennovy's MYLO soft multifocal contact lens

Visioneering Technologies’ NaturalVue

Multifocal 1 Day, available since 2018.

Mark’ennovy is also manufacturing and

marketing the lens for presbyopes under

the name EDOF.

According to Mr Chris Harous

mark’ennovy managing director Asia

Pacific, Brisbane-based Capricornia

Contact Lens would distribute MYLO.

He said eyecare professionals could

now expect to see increased promotion,

conference exhibitions and workshops

featuring the product.

“TGA approval for MYLO was absolutely

critical to ensure eyecare professionals

and their patients have complete

confidence, trust that MYLO is approved

as a myopia management medical

device,” Harous said.

“Its wide range of parameters supports

a more personalised contact lens fit,

allowing MYLO to be carefully calibrated

to your eye at any age or stage of myopia

management.” n

ELLEX’S 2RT THERAPY SLOWS AMD

PROGRESSION IN LONG TERM

significant restorative effects of 2RT on

retinal health in selected patients with

intermediate AMD, resulting in a material

delay in the time it takes for the disease

to progress to late forms of the disease,

where vision is impacted and patient

quality of life declines markedly,” Ellex

CEO Mr Ged Wallace said.

Published in September last year,

the LEAD study was claimed to be the

first time a laser intervention showed a

promising clinical response among a

large group of well-defined iAMD patients

prior to progression to late AMD. n

18 INSIGHT August 2019


YOURSELF

DOING WHAT

YOU

PUSHING

BOUNDARIES

There’s plenty of room to move at OPSM and within the

Luxottica group. We support flexibility, relocation, study

and parental leave. Because we are part of a bigger

global family in Luxottica, there are career opportunities

across other brands across Australia and New Zealand.

OPTOMETRIST – CANBERRA, ACT

Situated just hours away from some of Australia’s

most scenic locations, Canberra is the perfect place for

enjoying the best the region has to offer. As home to the

Australian National Collection, you can explore significant

culture, art and history while enjoying local landmarks,

food and wine. At OPSM you will join an experienced

team and work with state-of-the-art equipment including

OCT, Optos Daytona and retinal camera. We will also

provide you with programs to help develop your skills

to grow both personally and professionally.

Attractive remuneration packages can be tailored

to the right person. If this all sounds appealing,

please contact Elizabeth for a chat and soon we

may be helping you set your comfortable lifestyle

with time to enjoy your new home.

EXPLORE OUR OPPORTUNITIES,

CONTACT: ELIZABETH KODARI

Professional Services Manager, NSW/ACT

Elizabeth.Kodari@au.luxottica.com or on 0418 266 024

OPSM.COM.AU/CAREERS

JOIN OUR COMMUNITY ON LINKEDIN


NEWS

CERA PROJECTS SECURE

$1.5 MILLION IN NEW

PHILANTHROPIC FUNDING

Almost $1.5 million in new philanthropic

funding will advance research into

macular disease progression, Alzheimer’s

disease and keratoconus at the Centre

for Eye Research Australia (CERA).

Fellows Dr Zhichao Wu and Dr Srujana

Sahebjada, as well as CERA deputy

director Associate Professor Peter

van Wijngaarden, have each received

grants totaling almost $360,000 as part

of the coveted Perpetual 2019 IMPACT

Philanthropy Application Program.

For Wu and van Wijngaarden it comes

on top of more than $1.1 million in major

research grants for their respective

projects in recent months.

For his research into Alzheimer’s

disease, van Wijngaarden received

$100,000 from financial services

company Perpetual’s grant program.

In May he also secured more than

$600,000 from the Alzheimer’s Drug

Discovery Foundation and $250,000

from the National Foundation for Medical

Research and Innovation for the project.

The funding will help his team develop

a simple eye test to detect early signs

of Alzheimer’s disease, and enable the

participation in a world-first trial of eye

scans based on imaging technology

similar to that used in NASA satellites.

“Current tests for Alzheimer’s disease

are expensive and invasive. Not only

are they out of the financial reach of

most health care systems, their cost

and limited availability make the testing

of new treatments much more difficult,

slowing down the pace of discovery,” van

Wijngaarden said.

Wu’s project received $134,000 in

funding from Perpetual, which comes in

addition to a $268,000 grant from the USbased

BrightFocus Foundation. Both sets

of funding will help spur the development

of a new technique for determining the

progression of age-related macular

degeneration (AMD).

Based on previous research, Wu’s new

technique will measure how well people

can perceive light at precise locations

inside the eye guided by retinal images.

Meanwhile, $124,000 in funding will help

Sahebjada advance her research into a

new technique to examine the corneas

of people with keratoconus in order to

better understand the genetic cause of

the condition. n

“WE NOW SEEK

TO EXPAND

THE FUND

SUBSTANTIALLY

TO MEET THE

GOALS AND

WISHES OF OUR

MEMBERS”

ANNIE GIBBINS,

GA

NEW GRANTS AVAILABLE FOR

GLAUCOMA RESEARCH

Glaucoma Australia (GA) is now accepting

applications for its newly launched

Glaucoma Research Grants Program.

The organisation is seeking applications

for research projects that support the

organisation’s mission of eliminating

glaucoma blindness.

GA has committed to providing

$200,000 in the initial round, and individual

projects could receive between $50,000

and $100,000 per annum for projects up

to three years in duration.

“Glaucoma Australia research grants

have made significant contributions to

Australian medical and social research

into glaucoma,” Ms Annie Gibbins,

Glaucoma Australia CEO, said.

“We are now very proud to be launching

our new Research Grants Program

which will continue to fund research

that supports our mission to eliminate

glaucoma blindness.”

The funding for the new program will

come from GA’s William A Quinlivan

Research Fund. Originally established

in 2006, the fund is geared towards

both funding glaucoma research and

providing scholarships for specialists

studying glaucoma.

GA states that the fund now has over

$1.8 million in assets, and since the

organisation’s inception it has supplied

Sydney Airport has become the first

airport in Australia to forge an alliance with

US start-up Aira and offer its smartphonebased

navigational service to blind and

low vision travellers.

Aria’s technology works via an app

on any iOS or Android device. The

user beams live footage to an Aira

agent, who then provides immediate

and personalised visual information to

assist the user through a specific task or

location.

While participants normally sign up

to a plan and pay for Aira’s service by

the minute, Sydney Airport – Australia’s

busiest – has agreed to cover the cost to

support visually impaired people when

they visit the airport.

Sydney Airport CEO Mr Geoff

over $930,000 to support projects.

“Over the years the William A Quinlivan

Research Fund has supported over

30 productive research projects and

provided more than a dozen scholarships

for researchers. We now seek to expand

the fund substantially to meet the goals

and wishes of our members and create

a more positive future for persons with

glaucoma,” Gibbins said.

GA research committee chair Dr Simon

Skalicky also welcomed the new program.

“Glaucoma Australia is committed

to funding and supporting high quality

glaucoma research in Australia. The

broad aims of research we support

are to improve the lives of people with

glaucoma through better glaucoma

detection and treatment.

“We are excited to facilitate the

innovative research of academics

who drive progress in glaucoma

management,” Skalicky said.

According to the criteria listed on the GA

website the organisation prefers Australian

teams, applied research and long-term

projects with regular updates, as well as

a desire to work with the organisation’s

partners. Applications close 1 September,

with recipients announced on 10 October

2019. n

SYDNEY AIRPORT EMBRACES NEW

TECH FOR BLIND TRAVELLERS

Culbert said the move was part of his

organisation’s broader commitment to

continually improve accessibility.

“This new service will significantly

improve the airport experience for the

visually impaired community. The trial

we recently completed at T2 Domestic

was a game-changer for the participant

and that’s something we’re really excited

about,” he said. n

20 INSIGHT August 2019


NEWS

FINAL LINEUP ANNOUNCED FOR THE EIGHTH

SPECSAVERS CLINICAL CONFERENCE

The final speaker lineup has been

announced for the eighth Specsavers

Clinical Conference (SCC8), one of the

largest professional development events

on Australasia’s optometric calendar.

This year’s event will be held over 7–8

September at the Melbourne Convention

and Exhibition Centre, and include two

full days of clinical content delivered by

ophthalmology experts.

After welcoming approximately 750

delegates last year, the 2019 edition will

also include shorter, additional ‘Fringe

Talks’ to take place during breaks, with

a view to delivering as close to a full

year’s worth of continuing professional

development points as possible.

UK-based Professor Peter Scanlon

will be the international guest speaker

to feature in the Sunday program,

following opening remarks from

Specsavers Australia and New Zealand

optometry director Mr Peter Larsen.

As program director of the UK National

Health Service’s Diabetic Eye Screening

Program, Scanlon will discuss how he

and his team have moved from limited,

ad hoc delivery of screening services to

systematic, quality-assured processes.

This has been applied to the screening,

assessment and treatment of 3.3 million

people with diabetes in England.

Saturday’s program will comprise four

one-hour sessions from 10am to 4.30pm.

Speakers include; Dr Adam Rudkin,

director of Specialist Eye Glenelg, who will

discuss vitreoretinal conditions; Dr Dru

Daniels, of Dru Consultants, to present

on glaucoma; and Gordon Eye Surgery

ophthalmologist Dr Caroline Catt to

discuss paediatric optometry.

Vision Eye Institute Associate

Professor Colin Chan will complete

the Saturday speaker schedule with a

Peter Scanlon

presentation on anterior eye disease.

Six one-hour sessions are confirmed

for the Sunday agenda from 7:30am to

4:30pm. Following Scanlon’s presentation,

Centre for Eye Research Australia deputy

director Associate Professor Peter

van Wijngaarden will discuss diabetic

retinopathy management and the newly

launched KeepSight program.

Following on, IRIS Surgery

ophthalmologist Dr Elaine Chong’s will

shine a light on interpretation of optical

coherence tomography in medical retina

conditions, and Associate Professor

Lyndell Lim, of Victoria Parade Eye

Consultants, will speak about optometric

management of ocular inflammation.

Finally, Oxford Eye Centre

ophthalmologist Dr Lindsay McGrath will

focus on ocular oncology, while Eyes First

ophthalmic surgeon Dr Tu Tran will discuss

glaucoma co-management. n

“Proud to be a member of the

optometry group with the most

satisfied patients in Australia

two years in a row.”

Jocelyn Udayan, Optometrist

Eyecare Plus Toronto

To join contact Philip Rose 0416 807 546

or philip.rose@eyecareplus.com.au


NEWS

TECNIS EYHANCE IOL NOW AVAILABLE IN AUSTRALIA

Johnson & Johnson Vision (J&JV) has

announced the Australian availability

of the new monofoal TECNIS Eyhance

intraocular lens (IOL). In a first for the

category, the company claims the new

device allows patients to experience high

quality vision at both intermediate and far

distances.

The Therapeutic Goods Administration

approved the lens in March this year. It

has now been listed on the Australian

Government’s Prostheses List and is

widely available.

The TECNIS lens is very similar to J&JV’s

ZCB00 monofocal lens, but includes

a miniscule raised bump on its front

surface. The company claims the design

allows for glasses-free sight at both far

and intermediate distances; a significant

improvement over other IOLs currently

available. Also, the design avoids the

haloing and glare sensitivity at night that

is seen in other multifocal or Extended

Depth of Focus (EDoF) lenses.

Dr Con Moshegov, ophthalmologist and

medical director at the George Street Eye

Centre in Sydney, was the first surgeon in

Australia to implant the IOL and has now

used the device with 10 patients.

Speaking to Insight, he said in his

experience the TECNIS Eyhance IOL

offers more benefits than a standard

monofocal lens with none of the

drawbacks associated multifocal or EDoF

lenses.

“You’re getting something for nothing.

It reduces people’s dependence on

glasses. Not to the point where they

can read without glasses, but they can

manage most things like larger fonts

on an iPad or medium size fonts on a

computer.”

Moshegov believes with the added

benefits of intermediate vision and

little drawback, the device is an easy

recommendation.

“You are getting some intermediate

vision that you wouldn’t get with an

“YOU ARE

GETTING SOME

INTERMEDIATE

VISION THAT

YOU WOULDN’T

GET WITH AN

ORDINARY

MONOFOCAL”

CON MOSHEGOV,

GEORGE STREET

EYE CENTRE

ordinary monofocal, but you’re not paying

the price of unwanted side effects if you

use an alternative diffractive style lens.

“We’ve got to really do enough to

compare it to a standard ZCB00 before we

can say that it is conclusively much better,

but my first impression is that it is.”

Moshegov said the only constant noticed

so far is a small degree of myopia; about

-0.5 diopters.

“A small degree of myopia with these

lenses goes a long way to help [patients]

with intermediate and near vision tasks

without glasses.”

Mr Christoph Vonwiller, regional vicepresident,

surgical, Asia Pacific & Japan,

J&JV, said the devices builds upon the

legacy of the TECNIS family of IOLs.

“We are proud to provide a highly

effective treatment option that can

ensure high-quality vision for patients,

as we continue to work with eye care

professionals to connect cutting-edge

insights, science and technology.” n

Reduce testing time

and increase insight

into glaucoma.

SITA Faster 24-2

SITA Faster 24-2C

UP TO 50% FASTER

Carl Zeiss Pty Ltd, NSW 2113 AUSTRALIA. Carl Zeiss (NZ) Ltd, AUCKLAND 1026 NZ.

1 Donald C. Hood, a,b,*,1 Ali S. Raza, a,c,1 Carlos Gustavo V. de Moraes, d,e,1

Jeffrey M. Liebmann, d,e,1 and Robert Ritch d,f,1 . Glaucomatous damage of the macula.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3529818/

ZEISS HFA3 SITA Faster 24-2C

NEW

24-2C test

pattern now

available!

SITA Fast 24-2

1 2 3 4 5 6 7 8

Typical test time ranges in minutes (mean +/- std. dev.) 1

The Humphrey ® Field Analyzer 3

(HFA3) combines everything you value

in a Humphrey with expanded testing

options and reduced patient test times.

New to the HFA3 is the SITA Faster 24-2C

test, which adds 10 additional central test

points to the 24-2 pattern in order to

examine areas along physiologically

relevant nerve fibre bundles known to

be susceptible to glaucomatous defects. 1

www.zeiss.com.au/HFA3

ZEISS

AU: 1300 365 470

NZ: 0800 334 353

med.au@zeiss.com

SITA Standard 24-2


NEW TS-610 Tabletop Refraction System

• Chart and refractor in a single unit

• Compact footprint and efficient workflow

NEW RT-6100 Intelligent Refractor

• Streamlined Refractor Head

• Comprehensive testing with intuitive interface

NEW LEXCE Trend Edging System

• Unique design all in a compact footprint

• Integrated versatile Drill unit, Digital

Blocker, Tracer and Shape Imager

A Masterpiece of Combination

Auto Refractor – Keratometer - Tonometer - Pachymeter

NFC-700

Non-Mydriatic LEDRetinal Camera

• Fully Automated with 3D Tracking, Auto focus and

Auto Capture

• Compact - integrated Tablet PC with HD touch

screen, Win 10 OS

• Sharp consistent HD Retinal and Anterior Eye imaging

OCT

Elevating eye health care with the touch of a button

• Fully automated operation with a simple touch of a button

• Easy as 1,2,3... enter patient information, position patient & touch to start

• iScan vocally guides the patient through the entire scan process

NEW upgraded model with additional automated features

• Multi-functional compact device for evaluation of dry eye

• Slit lamp mountable or stand alone

• Auto evaluation of Lipid Layer, tear BUT, Tear meniscus &

Eye Blink detection

3D

Meibography

NEW Retinomax ScrEEEn Series

• Hand–held Auto Refractor/Keratometer

• Low-reflection 100 degree tilting screen

• 180 minute battery capacity now twice

that of conventional models

• Automated Axis Compensation feature

and expanded measurement range

People you know.....Products you trust

Telephone: (02) 96437888

Toll Free: 1800804331

Email: sales@bocinstruments.com.au

Website: www.bocinstruments.com.au


COMPANY

ALLERGAN BOUGHT BY ABBVIE IN

MULTI-BILLION DOLLAR DEAL

RODENSTOCK GROUP

COMPLETES MAJOR

REFINANCING PACKAGE

The Rodenstock Group has announced

that it has completed a refinancing of its

senior debt facilities, with a new term loan

of €395 million (AU$647 m) maturing

in seven years. The company has also

secured a new revolving credit facility of

€20 million (AU$32 m).

Mr Anders Hedegaard, CEO of the

Rodenstock Group, said the refinancing

was a milestone for the company. “It

underlines the successful transformation

of the Group and provides a strong

endorsement of the current strategy and

future prospects.

“Following our record performance in

2018 and strong start to the current year,

the outlook for the business remains very

positive.”

According to the company, it is currently

focussed on its core capabilities within

the progressive lens market, which

resulted in sales that reached of €425

million (AU$425 m) during the 2018

financial year. Earnings before interest,

tax, depreciation and amortisation also

reached a record high of €91 million

(AU$149 m), a 10% increase on the

previous year.

Rodenstock Group attributed the rise to

improvements in efficiency of production

and logistics, as well as a continued

increase of lens sales.

Last year the company announced

the results of a successful realignment

across its eyewear division, leading to

the expansion of international production

capacities and the establishment of an

independent eyewear division.

Hedegaard took over as CEO of

Rodenstock on 1 February 2019,

having previously been at GN Hearing,

a manufacturer of hearing aids and

accessories.

He replaced former CEO Mr Oliver

Kastalio, who, on his departure, said it

was time to hand over management after

successfully leading a turnaround and

setting the company on the course for

future expansion. n

“THE

COMBINATION

OF ABBVIE AND

ALLERGAN

INCREASES

OUR ABILITY

TO CONTINUE

TO DELIVER ON

OUR MISSION TO

PATIENTS AND

SHAREHOLDERS”

RICHARD

GONZALEZ,

ABBVIE

US biopharmaceutical company AbbVie

has entered into an agreement to

acquire Allergan for approximately

US$63 billion (AU$90 b). The deal is

one of the largest takeovers in the

pharmaceutical industry this year.

Allergan, the company behind popular

dry eye drug Restasis, will have its entire

product portfolio transferred to AbbVie

in order to contribute to the company’s

future sustainability.

“The combination of AbbVie and

Allergan increases our ability to continue

to deliver on our mission to patients and

shareholders,” Mr Richard Gonzalez,

chairman and CEO of AbbVie, said.

“With our enhanced growth platform

to fuel industry-leading growth,

this strategy allows us to diversify

AbbVie’s business while sustaining our

focus on innovative science and the

advancement of our industry-leading

pipeline well into the future.”

The deal significantly expands AbbVie’s

line of products. The drug maker

produces rheumatoid arthritis treatment

Humira which was, according to Genetic

Engineering & Biotechnology News, the

US’ top selling prescription drug last

year. However, the company is set to lose

Glaukos has completed its acquisition of

DOSE Medical Corporation, a developer

of micro-invasive delivery platforms, in a

deal worth US$2.5 million (AU$3.6 m).

The agreement, which was initially

announced in June, will see DOSE’s

ongoing development of bioerodible

and sustained-release drug delivery

platforms rolled into Glaukos’ portfolio.

DOSE reportedly has multiple projects

currently underway, primarily focussed

on the areas of age-related macular

degeneration (AMD) and diabetic

macular edema.

At the time the deal was announced,

Mr Thomas Burns, president and

CEO of Glaukos, said it would build on

his company’s legacy as an ophthalmic

pioneer.

The transaction means that DOSE

will now once again be a wholly owned

its exclusivity of the drug in 2023, and

is now focussing on securing its future

portfolio and development capacity.

Allergan has faced several challenges

of its own in recent times. Last year

the company laid off more than 1000

employees following failed efforts to

protect patents surrounding Restasis.

“With 2019 annual combined revenue

of approximately US$48 billion (AU$68

b), scale in more than 175 countries, an

industry-leading R&D pipeline and robust

cash flows, our combined company

will have the opportunity to make even

bigger contributions to global health than

either can alone,” Mr Brent Saunders,

chairman and chief executive officer of

Allergan, said.

“Our fast-growing therapeutic areas,

including our world class medical

aesthetics, eye care, [central nervous

system] and gastrointestinal businesses,

will enhance AbbVie’s strong growth

platform and create substantial value for

shareholders of both companies.”

As per the terms of the deal Gonzalez

will serve as CEO. Two members of

Allergan’s board, including Saunders, will

join AbbVie’s board once the transaction

is approved and completed. n

GLAUKOS COMPLETES ACQUISITION

OF DEVELOPER DOSE MEDICAL

subsidiary of the company. In 2010

Glaukos spun DOSE out as a standalone

entity, and in 2015 re-acquired the

iDose line of products back from it for

US$26 million (AU$37 m).

In 2017, Glaukos acquired

DOSE’s intraocular pressure sensor

system for US$5.5 million (AU$7.9

m), with an additional US$9.5 million

(AU$13.6 m) contingent on whether

several development milestones

were reached. n

24 INSIGHT August 2019


DRY EYE REPORT NEWS

Taking the

PLUNGE INTO

dry eye care

Dry eye’s journey from obscurity

to multi-billion dollar industry has led

to an uptake of eyecare professionals

making it their business to treat

this long-ignored patient group.

MYLES HUME finds out what it takes

to establish a dry eye clinic.

For a disease that once struggled for legitimacy, the rapid evolution of dry

eye care in Australia has been remarkable.

Now a well-established subspecialty, only a decade ago a general lack

of clinical and public awareness kept dry eye on the periphery while a significant

patient group suffered in silence.

Today, however, an expanding body of evidence leaves little doubt over dry

eye’s validity as a genuine disease. Measures vary, but it is said to impact at

least 344 million people globally. In Australia, one in five adults encounter dry

eye in their lifetime, and it is no longer perceived as a condition confined to older

patients.

Given the statistics, dry eye is a chronic condition that is reaching epidemic

proportions and, if left untreated, has been proven to significantly erode quality

of life. Its pervasiveness can be linked to several factors including better

diagnostic and treatment capabilities, the environment, technology-dependant

lifestyles, or a combination of the above.

Subsequently, dry eye’s newfound relevance exposed a significant gap in the

eyecare market. As such, Australia is now home to an increasing number of

professionals and clinics that are making it their business.

Insight spoke to Australia’s foremost experts about the dry eye market, and

what should be considered before opening up to this unique patient group.

INSIGHT August 2019 25


PLUNGE INTO

dry eye care

DRY EYE'S ARRIVAL

According to University of Melbourne Department of Optometry and

Vision Sciences senior lecturer Dr Laura Downie, several factors have

converged to spark increased clinician interest in dry eye.

“This likely reflects that dry eye disease is highly prevalent – affecting

about one in five adults – and a chronic eye condition that falls well

within the scope of optometric therapeutic care,” she said.

“Over the past few years, there has also been increased global

awareness about the importance of diagnosing and managing dry

eye disease, particularly through the work of the Tear Film and Ocular

surface Society (TFOS), and the publication of the International Dry Eye

WorkShop II (DEWS II) reports in 2017.”

Many consider DEWS II as one of the most critical contributions to dry

eye’s acceptance as a multifactorial disease. The report involved 150

international clinical and basic research experts, including Downie, who

used an evidence-based approach to also reach a consensus on some

of the main aspects of the disease, and develop recommendations for

diagnosis, management and therapy.

“As with all areas of practice, it is imperative that the diagnosis

and management of dry eye disease is evidence-based. It is thus

essential that eyecare clinicians, particularly those who are considering

establishing a clinic with a particular disease focus, are abreast with the

best-available research evidence,” Downie said.

“The 2017 TFOS DEWS II reports provided a comprehensive synthesis

of state-of-the-art in the dry eye field,” she said, adding that there are

opportunities for upskilling through postgraduate programs such as the

University of Melbourne’s Specialist Certificate in the Management of

Anterior Eye Disease.

As well as a strengthening body of research, dry eye diagnostics

and treatment has become a multibillion-dollar industry, helping fuel

even greater interest and confidence. Increased competition continues

to reduce the price of more sophisticated equipment and therapies,

improving accessibility.

Downie said: “For example, over the past two years, there has been a

400% increase in the development pipeline for dry eye therapeutics.

“As such, we expect to see the availability of a range of new dry eye

therapies over the next several years, particularly those targeted to the

dry eye subtypes such as aqueous-deficient and evaporative dry eye.”

Given the ever-expanding body of research, a suite of new treatments

and an increasing patient cohort, the market conditions may have never

been better for diversification into the dry eye arena.

'THE LEARNING CURVE IS STEEP'

“FOR EXAMPLE, OVER THE

PAST TWO YEARS, THERE HAS

BEEN A 400% INCREASE IN THE

DEVELOPMENT PIPELINE FOR DRY

EYE THERAPEUTICS"

LAURA DOWNIE

For optometrists, particularly independents, offering diagnosis and allinclusive

treatment program for dry eye could be an effective way add

value to a practice. However, dry eye is notoriously time-intensive and

can easily evolve into a costly exercise.

Because of this, according to established dry eye care practitioners,

serious consideration must be given to the extent at which dry eye is

incorporated into a practice, as well as the desired level of care. These

factors, in turn, can help determine the level of financial investment to

ensure dry eye services are viable.

On recommending the best method of entry into dry eye care,

established providers offered varied opinions. Some advised an ‘all or

nothing’ approach, while others believed a gradual introduction is just as

feasible.

Dr Jim Kokkinakis, of The Eye Practice in Sydney, provides a stark

reality for professionals considering the establishment of a dry eye clinic.

“In my opinion it is important that you are either all in or not. This means

providing all options. The reason for this is simple. There is no panacea.

The arsenal you need is extensive,” he said.

Kokkinakis is considered one of Australia’s leaders in dry eye care.

Operating a clinic that primarily specialises in complex contact lenses

and spectacle prescriptions, seven years ago he decided to sharpen his

dry eye expertise.

At his practice, Kokkinakis said a typical dry eye diagnostic

consultation could take up to two hours. Among other things, this

involves the use of the Lipiview imaging tool (meibum and blinking),

meibography, non-invasive tear break up and aqueous volume.

“We have also just started to implement a new technology that is not

available generally yet that is an infrared scan of the mucous layer. This

is something that eye practitioners have ignored as there was no simple

way of assessing this,” he said.

This is then followed by a customised treatment plan, which, in more

severe cases, could result in the use of more sophisticated proceduralbased

treatments such as the LipiFlow thermal pulsation system, intense

pulsed light (IPL) therapy and the MiBoFlo device to treat meibomian

gland dysfunction.

“The learning curve is steep and there is not much change from

$200,000. Leasing this over four years with no residual will be around

$4,500 per month. You will also need extra room and a trained staff

member - about a day a week of wages. Once you factor this in you are

up to about $6,000 per month before you have made one cent.”

Kokkinakis added: “Specialty in anything involves a huge investment in

professional development time and slowly accumulating enough clinical

exposure to ocular surface disease to be able to accurately recognise

the different contributors. Clinical exposure is critical as ‘one patient’s

medicine can be another’s poison’.”

However, Mr Willy Gunawan, of Melbourne’s Collins St Optometrists,

believes significant investments may not be necessary in the immediate

term.

Gunawan, who introduced dry eye care to his practice in 2010, said the

2017 DEWS II report now set out clear treatment protocols, including a

referral pathway. This has meant other optometrists could help ease the

burden that mild to moderate cases currently place on existing dry eye

clinics.

“You actually don’t need fancy machines. I didn’t have them when I

started out. Everyone has access to slit lamps, flourescine and lissamine

green stains. The DEWS II report also mentions you need to measure the

tear osmolarity, which can also be done with inexpensive equipment that

costs $1000-2000,” he said.

“You just start by listening. If the first few steps don’t work in

accordance with DEWS II, you can then tell the patient you are going

to refer them on to someone who has the equipment and tools to treat

them at another level.”

26 INSIGHT August 2019


PBS

Listed

6

months

shelf life after

opening

NOVATEARS ®

for Evaporative Dry Eye & Meibomian Gland Dysfunction

NovaTears ® is a unique preservative-free eye lubricant, which acts as

a lipid layer substitute and evaporative barrier for improved tear film

stability and quality.

Clinically validated with significant improvement in signs and

symptoms with Evaporative Dry Eye Disease and Meibomian Gland

Dysfunction patients 1,2

Innovative water-free

mode of action

Lipid layer deficiency Apply NovaTears ®

Spreads quickly and

easily on the lipid layer

STREAMLINED AUTHORITY CODE 6172

PBS Information: Authority Required (STREAMLINED): Severe dry eye syndrome in patients who are sensitive to preservatives in multi-dose eye drops.

References: 1. Steven, Philipp, et al. “Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease – A Prospective, Multicenter Noninterventional Study.” Journal of Ocular Pharmacology and Therapeutics 31 (8), 498-503 (2015). 2. Steven,

Philipp, et al. “Semifluorinated Alkane Eye Drops for Treatment of Dry Eye Disease Due to Meibomian Gland Disease.” Journal of Ocular Pharmacology and Therapeutics. 33(9), 678-685 (2017). Sponsored by Novaliq GmbH. NovaTears® Eye Drops

(Perfluorohexyloctane 100% v/v, 3mL) are for the lubrication and relief of dry and irritated eyes. Do not use NovaTears® with contact lenses. If using any other eye medication, allow at least 15 minutes between using the other product and applying

NovaTears®. NovaTears® should not be used in children under 18 years. NovaTears® should not be used while pregnant or breastfeeding. AFT Pharmaceuticals Pty Ltd, Sydney. ABN 29105636413.

For more information:

1800 2387 4276

www.aftpharm.com

mydryeyes.com.au


PLUNGE INTO

dry eye care

Gunawan added: “We can’t get all dry eye patients treated through

dry eye clinics. I think everyone needs to be more engaged with these

patients. It’s not just the responsibility of dry eye clinics, it’s every

optometrists’ responsibility.”

Ms Emma Furniss is a clinical optometrist at The Dry Eye Institute.

Established in 2017, it is one of Australia’s few sole dry eye treatment

centres.

She believes eyecare professionals should first invest and familiarise

themselves with the basics in diagnostics treatment. She too identified

osmolarity and lissamine green as a good starting point, as well as a

Schirmer's test and a Meibomian Gland Evaluator.

“I love meibography as a tool for showing patients damage or the rate

at which we should be undertaking treatment. It’s a really good piece of

the puzzle. But this comes at a price,” she said.

“Basic treatments such as punctal plugs are a great idea for treating

mild to moderate dry eye where appropriate. If you decide to invest in

the more advanced diagnostic and treatment options, then yes, you will

need enough space for these machines and extra chair time with the

potential cost of someone to help take these measurements if you were

to get busy enough.

“The technology ranges in price from a few thousand to tens of

thousands but many of the basic diagnostic equipment is relatively

affordable and accessible to the everyday practitioner.”

PROFIT OR PROCESS?

Careful attention needs to be given to the motivation behind establishing

a dry eye clinic. While some consider it a profitable segment of their

business, for others the jury is out.

It can easily become an expensive undertaking; meaning costs are

passed on to patients in most, if not all, cases. This dilemma also

appears to be contributing to a belief that some eyecare providers are

inappropriately marketing or over-servicing therapies instead of adopting

an evidence-based approach to treatment.

Gunawan said his clinic infrequently used its most sophisticated

instruments if he adhered to the DEWS II protocols.

“If you push for treatment, I’m sure you can make a lot of money, but

you won’t be following protocols. I believe I need to be able to defend

everything I do in my management plan, especially since we have now

got an international consensus on how to manage these patients. You

can’t go straight for the machines,” he said.

“I don't believe that seeing dry eye patients will be a particularly

profitable venture, but it certainly will be and has been a very rewarding

aspect of optometry, professionally.”

For Kokkinakis, the introduction of a dry eye service was a clinical

decision, more than a financial one.

“I will definitely not retire because of my dry eye treatments,” he said.

“I have asked myself – if I could turn back the clock, knowing what

I know now, would I bother creating a dry eye practice again, the

answer would be yes. My practice is mainly anterior segment disorders

so having a deep understanding of ocular surface disease has

complemented our specialised niche.”

According to Dr Nicholas Young, of the Dry Eye Centre in Victoria,

despite the ever-increasing emergence of specialty clinics, there are still

only a select few making dry eye their world. Dry eye accounts for the

majority of his business’ revenue and, to set his practice apart, he has

invested heavily in order to treat even the most complex patients.

“Even some of the most internationally renowned dry eye practitioners

can take up to two hours to evaluate a new patient. Medicare doesn't

even come close to remunerating this duration of consultation. The

practitioner needs to place a value on their time and charge accordingly.

We also charge patients for all add-on procedures and treatments,” he

said.

Young believed too many clinics were adopting a ”cookie cutter”

PATIENCE WITH PATIENTS

While investment in diagnostics and treatments can vary, lengthy

consultations and frustrated patients are guarantees at almost

any level of dry eye care.

Practitioners report that consultations can range from 1-2 hours.

Patients are often significantly affected, and many have become

disillusioned after being passed from one provider to the next.

Dr Nicholas Young, of the Dry Eye Centre in Victoria, made dry eye a

major component of his practice in 2013 and quickly discovered he was

dealing with a unique cohort.

“Whilst efficiency in the consultation room is important, these are a

special kind of patient – they need to be heard. A lot of these patients

have been suffering for many years, and suffering during a time period

in which this condition was commonly ignored, so generationally we

haven’t got to a point where many of them have had a good experience

with eyecare practitioners,” he said.

“So I think the absolute minimum level of care is giving patients an

opportunity to discuss their condition in their own time, before quietly

working through a history, examination and management plan. I think

that is fundamental.”

Dr Jim Kokkinakis said attempting to diagnose and treat dry eyes as

part of a normal comprehensive eye exam

was typically only possible in mild cases.

“Having a dry eye clinic means you must

be prepared for the train wrecks that will hit

your doorstep. Your communication skills

and your patience will be stretched to the

limit,” he said.

“Dealing with moderate to severe disease

is well beyond the scope of a standard eye

test. Often 30 to 45 minutes needs to be

devoted to the eye irritation, which presents

a very significant patient flow and billing

problem.”

Dr Nicholas Young

Conversely, due to their ongoing discomfort, dry eye patients are also

among the most compliant and willing. They often sought out other

suffers and conduct their own research into the latest treatments.

Young added: “Due to their malaise, dry eye patients are often very

motivated and tend to be a lot different to manage than those who may

have conditions like glaucoma or macular disease, which generally don’t

have physical pain associated with them.”

30 INSIGHT August 2019


For severe or

chronic dry eye

For mild or

moderate dry eye

The systematic approach to eye lubrication

for

Dry Eyes

Preservative-free and phosphate-free

Can be used for 6 months after opening

Compatible with all types of contact lenses

At least 300 measured drops per pack,

or 150 treatments (both eyes)

Delivered through the unique COMOD ®

multi-dose application system

STREAMLINED AUTHORITY CODE 4105

PBS Information: Authority Required (STREAMLINED): Severe dry eye syndrome in patients who are sensitive to preservatives in multi-dose eye drops.

HYLO®-FRESH, HYLO-FORTE® and COMOD® are registered trademarks of URSAPHARM. AFT Pharmaceuticals Pty Ltd, Sydney. ABN 29105636413.

1800 2387 4276

www.aftpharm.com


PLUNGE INTO

dry eye care

approach to dry eye care. He said it was important for practitioners to

responsibly market their dry eye services around a holistic approach

to patient care, rather than the marketing material that accompanies

popular device purchases.

“The latter not only fails to differentiate practices from each other,

but also conveys a message to the public that dry eye treatment is as

simple as pushing a button or flicking a switch, and unfortunately, in my

experience, this notion couldn't be further from the truth,” he said.

“Clinics operate at different levels. I don't think we could claim to be a

leading dry eye clinic without having such a unique approach and broad

range of diagnostic and treatment options. That's mainly because many

of our patients are referred to us from other health care providers, and

might have already tried various other treatments.

“Having said that, optometrists can obtain a lot of valuable information

using a basic slit lamp and should be encouraged to embrace dry eye

as part of a standard consultation.”

He added: “For us, it’s about sitting down with these patients, giving

them a level of commitment they may not have had before, and trying

to understand their condition at a new level, which often involves areas

of the body removed from the eyes, including physiological issues,

allergies and gastrointestinal issues.”

MARKET MOVEMENTS IN THE DRY EYE CATEGORY

All signs point to a prosperous future for the dry eye market.

Pharmaceutical companies are generating billions from sales, and

Australia’s eye lubricant market recorded $93.5 million in sales in

the year to June, a 5.3% increase on the year previous.

An extensive range of experimental treatments are also in development

and are expected to result in many new therapies, particularly targeted

to subtypes such as aqueous-deficient and evaporative dry eye.

Allergan’s flagship dry eye drug Restasis (cyclosporine 0.05%) remains

the largest earner in the global market, with sales of US$1.26 billion

(AU$1.8 b) in 2018. Though despite its dominance, Restasis’ annual net

revenue is decreasing. It also comes at a time when competing generic

drugs are expected to enter the market.

Despite Restasis not being approved in Australia, local eyecare

professionals have had cyclosporine produced in various concentrations

(even up to 0.5%) via compounding chemists, but have offered mixed

reviews on its performance.

An Allergan spokesperson told Insight the company had no

plans to register or commercialise Restasis in Australia, however

it would continue to provide access under the Therapeutic Goods

Administration’s Special Access Scheme.

Xiidra (lifitegrast), which is said to be the first and only prescription

treatment approved to treat both the signs and symptoms of dry eye by

inhibiting inflammation, is also expected in Australia soon.

Novartis now owns the Xiidra – which has dry eye indications in the US,

Canada and Australia – after purchasing it from Takeda Pharmaceuticals

in a deal worth up to US$5.3 billion (AU$7.5 b). Xiidra generated US$400

million (AU$568 m) in revenue in 2018, with Novartis claiming it is “well

positioned for blockbuster potential”.

It was listed on the Australian Register of Therapeutics Goods in

January. A Novartis spokesperson said the company would be working

with suppliers and regulators to provide access in Australia soon.

Locally, AFT Pharmaceuticals reported its Hylo-Forte eye drops have

leapfrogged three positions to become Australia’s top selling eye

lubricant by value.

According to the latest Australian pharmacy sales data to June,

published by market research company IRi, Hylo-Forte generated more

than $8.9 million in sales, $3.3 million more than the previous year.

This follows AFT’s 2018 launch of the non-aqueous, preservative-free

eye lubricant NovaTears, which has itself moved into the top 40 selling

eye lubricant products, generating $556,000. Within the latest quarter

alone, NovaTears sales have exceeded 1700% compared with the same

period in 2018.

“We are seeing the relative sales position for NovaTears being

even further ahead than Hylo-Forte was at the same time of its life

cycle. This bodes well for the future potential of this unique patented

product – which is specifically designed for evaporative dry eye,” AFT

Pharmaceuticals CEO Dr Hartley Atkinson said.

According to the same figures, Alcon Laboratories’ Systane Ultra

Lubricating Eye Drop 10ml – last year’s category leader – and Systane

Lubricating Eye Drop 15ml were the second and third highest earners

respectively. They produced $8.8 million and $6.2 million in sales.

Overall, Atkinson said the European dry eye market had seen a 4%

increase in units sold, and 8% rise in revenue.

“People do seem to be moving to higher value products, which you

can see between the unit growth and the dollar growth. There seems

to be a general trend towards preservative-free products; patients and

customers are prepared to pay a little bit extra, which demonstrates they

are mindful of the fact they are using these products long term.”

Lumenis has also released its sixth generation M22 Optima IPL, which

is a drug and drop-free solution combining IPL and the company’s

unique Optimal Pulse Technology. It is cleared for 20 different skin

indications including inflammatory conditions such as Rosacea.

“US sales of the M22 grew by nearly 150% from 2017 to 2018 with the

majority of systems purchased by optometry practices. This increase is

expected to reach Australia with clinicians expanding treatment offering

and profit centres,” a Lumenis spokesperson told Insight.

Good Optical Services last month released NuLids by NuSight

Medical, which is said to offer fast doctor directed, at-home dry eye

relief. The device consists of an oscillating Soft Tip design, which works

by gently stimulating and rejuvenating the patient’s meibomian glands.

“The system has been in use in America for almost two years where

patients are very pleased with the clinical relief of symptoms, easy

one-minute per day treatment time, and the low cost of NuLids,” Good

Optical Services general manager Mr Rick Good said.

DRY EYE MARKET LEADERS:

The escalating incidence of Dry Eye Disease has led to an expanding portfolio of diagnostic equipment and devices, as well as new treatment

options for optometrists and patients. Starting on page 36 we provide an at-a-glance guide to the leading products in the market.

32 INSIGHT August 2019


DFV - THE Dry Eye company

ANALYSIS

Diagnose Dry Eye Disease

I-PEN

Hand-held Electronic Osmolarity Testing Device

• Results in 4 seconds taking the average of 250 readings

• No calibration necessary

• No setup procedure required

Diagnostic Dry Eye Assessment

Meibo-scan

Imaging

TF-Scan

TF-Scan, R-scan

Oculus

Keratograph 5M

The Gold Standard in dry eye

diagnosis & documentation

• Update to NEW JENVIS PRO Dry Eye

Report, easily identify your patients DED

origins, and tailor your treatment to their

needs.

• Upgrade for existing users to Joystick

Capture

• Upgrade to NEW longer base for easy

access to lids

TREATMENT

I-LID ’N LASH

PRE-MOISTENED LID WIPES

• Choose standard hydrating lid wipes, or anti-bacterial

I-LID ’N LASH PLUS wipes with 5% tea-tree oil

• Removes make-up and soothes inflamed skin around the eyes

• Does not sting, burn or irritate sensitive eyes

• Resealable tub of 60

• Hydrating properties - no need to wip off

NEW

OPTIMEL

Antibacterial

Manuka Honey

Eye Drops

& Gel

For chronic,

moderate to

severe dry eye

disease

EYE-ECO Dry Eye Products

OASIS

Punctum Plugs

• TranquilEyes

• Nighttime Shelter Masks

for lagophthalmos

Mastrota Paddles

& Forceps

Dry Eye Screening

• InflammaDry rapid screening test

• D.E.R.M.

mask

• Tea Tree

Cleanser

• Tear Touch Blu

Schirmer Strips

DV958-0718

1800 225 307

dfv.com.au


Available in pharmacies September 2019

3x

BENEFITS 1

Hydrates

Protects

Restores 1

OPTIVE FUSION ® is a dry eye formulation that

contains a unique combination of ingredients 1

delivering FAST 1 relief for dry eyes.


OPTIVE FUSION ® has shown rapid and

sustained improvements in dry eye patients 1

How does it work? 1-6,8,9

Optive Fusion® is an artificial tear combining

Hyaluronic Acid (HA) + Carmellose Sodium (CMC)

with Osmoprotectants.

The individual components of Optive Fusion® coat

the ocular surface with a hydrating and lubricating

protective shield 2,5,6,

• HA is a lubricant naturally found in the eye.

HA has lubricating, water retention and wound

healing properties 1

• CMC is a mucoadhesive agent which lubricates

and protects the eye surface 2,3,4

• Osmoprotectants help restore osmotic balance in the

eye and hydrate the cells on the eye surface 8,9

Mean change in OSDI score from baseline

0

-2

-4

-6

-8

-10

-12

-14

-16

7

*

*p ≤ 0.001 vs baseline

Study visit day

Adapted from Simmons 2015 1

30 60 90

*

OPTIVE FUSION ® n = 101

*

*

OPTIVE FUSION® promotes an optimal

environment for ocular surface

regeneration 1,2,3,6,7,11

• HA stimulates corneal epithelial migration which is

one of the first steps in wound healing processes 7

• CMC binds to human corneal epithelial cells and is

a modulator of corneal epithelial wound healing 2

• In a clinical trial it was found that Optive Fusion®

produced significant improvements in corneal and

conjunctival staining (p < 0.003) compared to

baseline in dry eye patients over a 3 month period 1

A 15-point reduction in OSDI

score could potentially reduce

Dry Eye Disease symptoms from

severe to mild, or from moderate

to normal 1,10 , demonstrating that

the magnitude of symptom

improvement provided by

OPTIVE FUSION ® is very relevant

to Dry Eye Disease patients.

1. Simmons PA, et al. Clin Ophthalmol 2015;9:665–75. 2. Garrett Q, et al. Invest Ophthalmol Vis Sci 2007;48:1559–67. 3. Johnson, P & Lloyd-Jones, J.G, Drug Delivery Systems -

Fundamentals and Techniques, Chichester, Ellis Horwood Ltd, 1987, Chapter 11, Mucoadhesive polymers in drug delivery systems, 180-189 4. Kaercher T, et al. Clin Ophthalmol

2009: 3:33-39 5. Goa KL and Benfield P. Drugs 1994;47(3):536–66. 6. Aragona P, et al. Br J Ophthalmol 2002;86:181–4. 7. Nishida T, et al. Exp Eye Res 1991;53:753–8. 8.

Baudouin C et al. Eur J Ophthalmol 2012; 22:751-61 9. Baudouin C et al. Ocul Surf 2013;11:246-58. 10. Schiffman RM, et al, Arch Ophthalmol 2000;118(5):615-621. 11. Grene RB, et

al, Cornea 1992;11:294-301

© 2019 Allergan. All rights reserved. TM ® Trademark and registered trademark of Allergan, Inc. Allergan Australia Pty Ltd. 810 Pacific Highway Gordon NSW 2072. ABN 85 000 612 831.

Always read the label. Follow the directions for use. If symptoms persist, talk to your health professional.

AN-OPT-1900015 V1


PRODUCT GUIDE

VITA-POS

VitA-POS (retinol palmitate 138 µg/g, 5g) is a smooth, preservative and

phosphate-free eye ointment containing Vitamin A for night-time relief of dry

eye. It stabilises the tear film and protects the ocular surface by preventing

evaporation during sleep, and spreads easily over the ocular surface.

AFT PHARMACEUTICALS

1800 238 742 76 customer.service@aftpharm.com

REFRESH EYE DROP RANGE

Allergan’s Refresh eye drops range includes Refresh Tears Plus, which offer temporary

relief of eye dryness, discomfort and may protect against further irritation. Refresh Contacts

lubricate and rewet soft and rigid gas permeable contact lenses as well as cushion lenses

prior to application, while Refresh Liquigel is for persistent dry eye. For preservative-free

options, Refresh Plus (ocular lubricant) and Refresh Eye Drops both treat dry, irritated eyes.

Refresh Night Time ointment gives longer-lasting, overnight protection.

ALLERGAN

1800 252 224 australiaenquiries@allergan.com

SYSTANE GEL DROPS

LUBRICANT EYE GEL

Systane Gel Drops Lubricant Eye Gel is for night time

protection and offers the thickest gel formulation to

coat the eye with a strong layer of dry eye symptom

protection. It provides patients with long-lasting

protection while they sleep. Available in 10mL bottles

and can be used in conjunction with Systane Ultra

Lubricating Eye Drops or Systane Balance Lubricant Eye

Drops for extra relief.

ALCON 1800 224 153,

CH2: 1300 283 122 or pharmacy@ch2.net.au

MANUKA DROPS AND GEL

Optimel Manuka+ Drops are a front-line treatment

for mild to moderate dry eye. The concentration of

the high activity Manuka honey is 16% in a saline

solution with benzoic acid as the preservative.

This drop is great for dry eye but also sore, red

and irritated eyes. On the other hand, the Optimel

Forte antibacterial gel formulation contains 98%

Manuka honey and is ideal for chronic, moderate

to severe dry eye disease, particularly meibomian

gland disease and ocular Rosacea sufferers. It

is best described as ‘a drop for every practice to

have, but not for every patient to use’ due to the

significant sting on instillation. Close practitioner

guidance is essential which is why it is not sold

through pharmacies.

DESIGNS FOR VISION

1800 225 307 or enquiries@dfv.com.au

THERATEARS

LUBRICATING EYE DROPS

TheraTears Lubricant Eye Drops ‘osmocorrect’

the tear microenvironment, reducing the

concentration of salt that can lead to ocular

surface irritation and inflammation. The

eye drops are hypotonic, so they lower the

elevated tear osmolarity - not just wetting and

lubricating, but actually rehydrating dry eyes.

TheraTears is the only lubricant drop that

not only corrects osmolarity, but also

uniquely mimics the electrolyte balance

of the human tear.

CONTACT LENS CENTRE AUSTRALIA

1800 125 023

contactlenscentreaustralia.com.au

OCUSOFT LID SCRUB

When it comes to dry, scratchy, irritated eyes, often the problem may not be the eyes,

but rather the eyelids. OCuSOFT Lid Scrub effectively removes excess oil and debris

from the eyelids that may lead to eye irritation, including dry eyes. It’s recommended for

routine daily eyelid hygiene, while OCuSOFT Lid Scrub PLUS is an extra-strength, leaveon

formula recommended for moderate to severe conditions with bacterial involvement.

Patients can choose from convenient pre-moistened pads (30 Ct.), an instant foam pump

(50 mL) or an economical Compliance Kit (includes a 50 mL bottle of OCuSOFT Lid

Scrub Original Foaming Eyelid Cleanser and 100 dry, lint-free pads).

GOOD OPTICAL SERVICES (03) 9645 1066 or goodopt@ozemail.com.au

36 INSIGHT August 2019


LIPIVIEW II

OCULAR SURFACE

INTERFEROMETER

The LipiView II Ocular Surface

Interferometer with Dynamic

Meibomian Imaging (DMI)

measures lipid layer thickness

(LLT) with nanometer accuracy,

captures blink dynamics, and images meibomian gland structure. It features

patented technology that provides a sophisticated assessment of factors that

contribute to dry eye. Compelling visuals and video captures provide a unique

opportunity to educate patients about their personal ocular health.

JOHNSON & JOHNSON VISION

1800 266 111 or tearscience.com

HYLO FRESH AND FORTE

Preservative-free HYLO-FRESH (sodium

hyaluronate 0.1% w/v, 10mL), delivers lubrication

for dry eyes of moderate or medium severity, while

the more viscous HYLO-FORTE (0.2% sodium

hyaluronate w/v, 10mL) is ideal for the treatment

of severe or chronic dry eye. HYLO drops provide

a systematic approach to dry eye treatment

through the unique COMOD (COntinuous MOno

Dose) application system, delivering at least 300

sterile drops per bottle. Both can be used with all

contact lenses, are suitable for post-surgery use,

and are phosphate-free.

AFT PHARMACEUTICALS 1800 238 742 76

customer.service@aftpharm.com

C

M

Y

CM

MY

Finally…a fast and effective at

home treatment for Dry Eye disease

• NuLids offers a simple at-home

dry eye therapy for your patients

• NuLids treatments take

only 1 minute a day

• NuLids’ oscillating Soft Tip

design works by gently

stimulating and rejuvenating the

patient’s Meibomian Glands

• NuLids has been shown to remove

scurf, improve Meibomian Gland

effectiveness, and increase

Meibomian output by 2x1

Studies have demonstrated a 65% improvement in

tear film breakup time [TBUT] and an 81% increase

in Meibomian Gland Yielding Liquid Secretions

in less than 30 days 1

INTRODUCING

CY

CMY

OPTI-SOOTHE MOIST

HEAT MASK

K

The new Opti-Soothe Moist Heat Mask is a

reusable mask that provides soothing symptom

relief of dry eye, blepharitis, meibomian gland

dysfunction, chalazion and styes. It utilises

HydroBead technology, which absorbs moisture

from the air and once heated activated, releases

10 minutes of natural consistent moist heat. The

mask is easy to use, washable, and can also be

used for cold therapy.

AFT PHARMACEUTICALS

1800 238 742 76

customer.service@aftpharm.com

NULIDS

NuLids offers fast and effective doctor directed, at-home dry eye relief.

NuLids requires only one minute a day, providing a natural, more

effective alternative dry eye treatment. Its oscillating Soft Tip design

works by gently stimulating and rejuvenating meibomian glands (MBs),

and has been shown to remove scurf, improve meibomian gland

effectiveness, and increase meibomian output by 2x1. Studies have

demonstrated a 65% improvement in tear film breakup time and an

81% increase in MB yielding liquid secretions in fewer than 30 days.

NuLids is safe, comfortable and easy to use. All patients surveyed said

its oscillating Soft Tip was more convenient than manual treatments.

Sterileyes® is an antibacterial shield which kills

99.9% of bacteria. The patented solution is bound

to the fibres of the fabric on the Eye Doctor range

to protect the eyes from potentially harmful bacteria.

HOT & COLD

EYE COMPRESS

GOOD OPTICAL SERVICES

(03) 9645 1066 goodopt@ozemail.com.au


PRODUCT GUIDE

EXPERIENCE CHROMAPOP TM IN PRESCRIPTION

LIPIFLOW THERMAL

PULSATION SYSTEM

The LipiFlow Thermal Pulsation System is

a cleared medical device for Meibomian

Gland Dysfunction (MGD), shown to

improve gland function. It consists

of a Console and a single-use sterile

device, known as the Activator, and has

a drug-free mechanism of action. A

phased pressure profile with adaptive

force equalization and proximal-to-distal

peristaltic motion evacuates gland

contents as the inner lid is gently heated.

JOHNSON & JOHNSON VISION

1800 266 111

tearscience.com

OPTIVE EYE DROPS

SMITH RX PROGRAM BENEFITS

• 50+ years of optics experience;

• Proprietary ChromaPop technology;

• Enhanced colour, clarity and comfort;

Allergan’s Optive eye drops range, available in five varieties, includes Optive Advanced

Preservative Free and Optive Advanced drops, which offer temporary relief of burning,

irritation and discomfort due to dry eyes, and may protect against further irritation. Optive

Eye Drops and Optive Sensitive (preservative-free) provide temporary relief of eye dryness

and discomfort, and may protect against further irritation. Optive Gel Drops offer instant

and long-lasting relief of persistent dry eye symptoms night or day.

ALLERGAN

1800 252 224 australiaenquiries@allergan.com

• Broad range of sport & lifestyle frames;

• 100% UV protection;

• Polarised lenses available;

• Lenses available in single vision or progressive;

• Anti-reflection, water and oil resistant coatings.

I-PEN

For any questions, contact your Safilo Sales Representative

or our customer service team.

Telephone: 1800-252-016 | M-F 9:00am - 5:00pm AEST

The I-Pen osmolarity sensor is the world’s first, hand-held, point-of-care,

solid state electronic diagnostic device to detect and indirectly measure

the elevated tear film osmolarity levels associated with mild, moderate

and severe dry eye. The device features quantitative measurement, which

is to easy record and follow over time, and produces rapid results in

fewer than five seconds. I-Pen results can be incorporated into the Jenvis

Reports. It requires single-use-sensors, sold separately.

DESIGNS FOR VISION

1800 225 307 or enquiries@dfv.com.au


IDRA

SBM Sistemi’s IDRA device incorporates all

the benefits of the its Ocular Surface Analyser

model, with more automation and additional

features, including auto interferometry analysis,

auto non-invasive tear break-up mapping,

fluorescein exciter filter, eye blink rate detection

and 3D meibography imaging. IDRA is

extremely compact, slit lamp-mountable and

can be used stand-alone with an optional base

and head rest.

BOC OPHTHALMIC INSTRUMENTS

Ph. 1800 804331

Email: sales@bocinstruments.com.au

Evolve ® Hypromellose 0.3%

NOVATEARS

NovaTears (Perfluorohexyloctane 100%, 3mL)

is a unique preservative-free eye lubricant

and tear film stabiliser in a multi-dose

bottle, specifically designed for the relief of

Evaporative Dry Eye and Meibomian gland

dysfunction. NovaTears spreads quickly and

easily on the eye with a long lasting effect;

and has a pleasant warm silky feeling with no

blurring or stinging. It contains no preservatives,

phosphates, surfactants, or water and can be

used for six months after opening.

AFT PHARMACEUTICALS

1800 238 742 76

customer.service@aftpharm.com

For Mild

Dry Eye

Evolve ® Carmellose 0.5%

For Moderate

Dry Eye

M22

M22 is a drug-free, drop-free solution that

combines Intense Pulsed Light (IPL) and

Lumenis’ unique Optimal Pulse Technology

(OPT). It is cleared for 20 different skin

indications, including rosacea treatment and

other skin inflammatory conditions and is

supported by more than a dozen studies.

With more than 80% of rosacea patients

suffering from inflammatory ocular

conditions, such as meibomian gland

dysfunction (MGD), the M22 invites

eyecare professionals to think outside

the eye and offer patients a solution to dry

eye disease.

LUMENIS

1800 586 364 vision.au@lumenis.com

Evolve ® Eyelid Wipes

For Daily

Eyelid

Hygiene

Australian Distributor: Contact Lens Centre, Australia

Unit 6D 2A Westall Rd, Clayton, VIC 3168 Australia

Ph 1800 125 023


PRODUCT GUIDE

STERILID EYECARE

SOLUTIONS

SteriLid is a science-based solution

for daily lid hygiene which is important

for those with blepharitis and dry eye,

as well as those preparing for eye

surgery. SteriLid is a convenient and

effective way to cleanse the eyelids

and eyelashes and is the first eyelid

cleanser shown to kill both gram

positive and gram negative bacteria.

CONTACT LENS

CENTRE AUSTRALIA

1800 125 023

contactlenscentreaustralia.com.au

LIPISCAN DYNAMIC

MEIBOMIAN IMAGER

With a small footprint and user-friendly design, the

LipiScan with Dynamic Meibomian Imaging (DMI) was

designed to make high-definition meibography

accessible for any ophthalmic practice.

It’s the first dedicated HD meibomian

gland imager designed for efficiency

and versatility. The durable yet

lightweight device was designed

for workflow maximization

and easy integration into busy

practices. Both lower eyelids

can be imaged in about a minute.

JOHNSON & JOHNSON VISION

1800 266 111 tearscience.com

LACRYDIAG AND LACRYSTIM

LacryDiag enables the practitioner to automatically diagnose various forms of dry

eye in less than five minutes. It allows eyecare professionals to analyse, through

non-contact exams, the ocular surface to evaluate precisely the three different

layers of the tear film – aqueous, lipid and mucinic. Adopting intense pulsed light

technology, LacryStim IPL system treats dry eye diseases such as meibomian gland

dysfunction. The device features a unique wavelengths spectrum and train of pulses

to stimulate the lachrymal and meibomian glands, helping reduce inflammation. These

mechanisms help improve the tear film quality and reduce symptoms associated with

mild to moderate dry eye.

DEVICE TECHNOLOGIES

1800 429 551 device.com.au

1

This placebo controlled clinical trial ((No. BEC-LSMU(R)-402) was performed in LHSU KUC Hospital. There were 60 patients observed at initial visit, after 3 days and then after 7 days of treatment.

Eye friendly! Safe! Unique! Natural!

Effective and practical!

Preservative free! No antibiotics! No aggressive active ingredients!

PROPOLIS ALOE VERA CHAMOMILE

TREAT LONG TERM IRRITATIONS AND DRY EYE NATURALLY

Australian Distributor: Contact Lens Centre, Australia. Unit 6D 2A Westall Road, Clayton, Victoria 3168 Australia. Ph 1800 125 023

New Zealand Distributor: Corneal Lens Corporation NZ Ltd. 2 Ballarat Way, Wigram, Christchurch 8042 New Zealand. Ph 03 3666247


Your One Stop Shop

for Dry Eye Products

SYSTANE ULTRA

LUBRICATING EYE DROPS

Systane Ultra Lubricating Eye Drops are clinically

proven to deliver extended protection and highperformance

dry eye symptom relief that lasts.

It’s available in both 10mL bottles and a ‘Home

and Away’ pack consisting of two 10mL bottles.

Systane Ultra Lubricating Eye Drops are also

available in a preservative-free formulation for

patients with sensitive eyes.

ALCON 1800 224 153,

CH2: 1300 283 122

or pharmacy@ch2.net.au

OPTIVE

FUSION

Optive Fusion

lubricant eye drops

are an artificial tear

combining hyaluronic

acid (HA) and carmellose sodium (CMC) with osmoprotectants to deliver fast relief

for dry eyes. Individual components of Optive Fusion coat the ocular surface with a

hydrating and lubricating protective shield. HA is a lubricant naturally found in the eye

that also has water retention and wound healing properties. CMC is a mucoadhesive

agent, which lubricates and protects the eye surface, while osmoprotectants help

restore osmotic balance and hydrate the cells on the eye surface. Optive Fusion also

promotes an optimal environment for ocular surface regeneration.

A Systematic Approach

to Dry Eye Management.

ALLERGAN

1800 252 224 australiaenquiries@allergan.com

LUMECARE SINGLES CARMELLOSE

Lubricant eye drops for lasting and soothing relief, and protection against burning, irritation

and discomfort due to ocular dryness or exposure to environmental factors. For moderate

to severe dry eye. They are preservative free and can be used with contact lenses.

Exclusively distributed by

Good Optical Services,

to the Optical Industry.

CONTACT LENS CENTRE AUSTRALIA

1800 125 023 contactlenscentreaustralia.com.au

Good Optical Services

FOR MORE GOOD PRODUCTS

Suite 2a, 4 Rocklea Drive,

Port Melbourne, VIC 3207

goodopt@ozemail.com.au

P: +61 3 9645 1066 / F:+61 3 9681 7976

www.goodoptical.com.au


PRODUCT GUIDE

THE EYE DOCTOR HOT/COLD EYE COMPRESS

The Eye Doctor has introduced the new ‘Sterileyes’ antimicrobiol protection for its Hot/Cold Eye

Compress. Sterileyes is an antibacterial shield proven to kill 99.9% of bacteria. The patented

solution is bound to the fibres of the mask to protect the eyes from potentially harmful bacteria.

It also provides stain protection and eliminates germs that create odour. The Eye Doctor

Hot/Cold Compress is designed to treat meibomian gland dysfunction. It can be used in the

microwave, oven or freezer and has a removable washable cover. Used hot, it alleviates the

symptoms of dry eye disease, blepharitis, chalazion, grittiness, irritation and sore eyes. Used

cold, it soothes the symptoms of hay fever/allergies, inflammation, tired/itchy/puffy/sore eyes,

sinus headaches and migraines.

GOOD OPTICAL SERVICES

(03) 9645 1066 goodopt@ozemail.com.au

SYSTANE BALANCE

LUBRICANT EYE DROPS

Systane Balance Lubricant Eye Drops

help support and restore your patient’s

delicate lipid layer by replenishing essential

moisture to eyes. This clinical strength

intensive therapy provides lasting relief

from moderate to severe symptoms of

dry eye. Available in 10mL bottles for

home or on the go.

ALCON

1800 224 153, CH2: 1300 283 122

or pharmacy@ch2.net.au

EVOLVE

CARMELLOSE &

HYPROMELLOSE

EYE DROPS

Both drops provide soothing relief for patients with mild, moderate or severe dry eye. It’s a

unique system designed to combine the benefits of unit dose preservative-free eye drops

with the convenience of a standard eye drop bottle. Once opened the bottle can be used

for up to three months.

CONTACT LENS CENTRE AUSTRALIA

1800 125 023

contactlenscentreaustralia.com.au

OCULUS K5M

The OCULUS K5M is an advanced corneal

topographer with a colour camera optimised

for external imaging. It can help to accurately

diagnose DED origins and document the

findings in the Jenvis Dry Eye Report, which

removes guesswork because the results point

to the treatment regime to undertake for each

patient. Once treatment is complete the K5M can

compare results to evaluate the success of the

treatment.The summarised results in the Jenvis

report can be printed and given to, or emailed

to, patients and other medical professionals.

The K5M can image meibography, NIKBUT

(noninvasive tear break time), tear meniscus

height, lipid layer, OSDI or McMonnies Dry Eye

Questionnaire and automatically quantify bulbar

redness.

DESIGNS FOR VISION

1800 225 307 or enquiries@dfv.com.au

OPTI-SOOTHE PRESERVATIVE-

FREE EYELID WIPES

The new Opti-Soothe Preservative-Free Eyelid Wipes are

ideal for daily gentle cleansing to assist in the removal of

debris from the eyelid. The 20 individual, preservative-free

textured wipes contain a unique formulation of tea tree oil,

hyaluronic acid, camomile and aloe vera.

AFT PHARMACEUTICALS

1800 238 742 76 customer.service@aftpharm.com

I-LID ‘N LASH

The I-Lid ’n Lash range works to wipe clean and

remove ocular debris, and hydrate sensitive skin. In

addition to I-Lid ‘n Lash regular, the I-Lid ‘n Lash Plus

edition is a formulation combining sodium hyaluronate

and 5% Tea Tree Oil, offering a powerful antiseptic

with cleansing and hydrating properties. The stronger

Pro formulation is for professional use, and works

to disinfect eyelids and lashes requiring advanced

cleansing. It helps manage symptoms associated

with meibomian gland dysfunction, rosacea, dry eye,

demodex, chalazia and other lid margin diseases.

DESIGNS FOR VISION

1800 225 307 or enquiries@dfv.com.au

ICP OCULAR SURFACE ANALYSER

The multifunctional ICP OSA analyses the functionality and

stability of tear film layers, and features advanced infrared

meibography with automated detection and quantification of

meibomian glands (MGs). It delivers comprehensive qualitative

tests and quantification reports, including lipid layer thickness,

tear meniscus height, non-invasive tear break up time, MG

imaging, classification of MG dysfunction, vivid anterior eye imaging, pre and

post treatment trend reports, and more. It's compact, slit lamp mountable and

can be used stand-alone with an optional base and head rest.

BOC INSTRUMENTS 1800 804331 sales@bocinstruments.com.au


Treat

86%

MGD has been shown

to affect 86% of

patients with dry eye 1

INDICATIONS FOR USE: The LipiFlow System is intended for the application of localized heat and pressure therapy in adult patients with chronic cystic conditions of the

eyelids, including Meibomian Gland Dysfunction (MGD), also known as Evaporative Dry Eye or Lipid Deficiency Dry Eye. CONTRAINDICATIONS: Do not use the

LipiFlow System in patients with the following conditions. Use of the device in patients with these conditions may cause injury. Safety and effectiveness of the device have

not been studied in patients with these conditions.•Ocular surgery within prior 3 months, including intraocular, oculo-plastic, corneal or refractive surgery

procedure•Ocular injury within prior 3 months Ocular herpes of eye or eyelid within prior 3 months•Active ocular infection (e.g., viral, bacterial, mycobacterial,

protozoan, or fungal infection of the cornea, conjunctiva, lacrimal gland, lacrimal sac, or eyelids including a hordeolum or stye)•Active ocular inflammation or history of

chronic, recurrent ocular inflammation within prior 3 months (e.g., retinitis, macular inflammation, choroiditis, uveitis, iritis, scleritis, episcleritis, keratitis)•Eyelid

abnormalities that affect lid function (e.g., entropion, ectropion, tumor, edema, blepharospasm, lagophthalmos, severe trichiasis, severe ptosis)•Ocular surface

abnormality that may compromise corneal integrity (e.g., prior chemical burn, recurrent corneal erosion, corneal epithelial defect, Grade 3 corneal fluorescein

staining, or map dot fingerprint dystrophy) PRECAUTIONS: The Activator or Activator II (Disposable) may not fit all eyes, such as eyes with small palpebral fornices.

Use of the LipiFlow System in patients with the following conditions may result in reduced treatment effectiveness because these conditions may cause ocular

symptoms unrelated to cystic meibomian glands and require other medical management. Safety and effectiveness of the device have not been studied in patients with

these conditions.•Moderate to severe (Grade 2-4) allergic, vernal or giant papillary conjunctivitis•Severe (Grade 3 or 4) eyelid inflammation(e.g., blepharochalasis,

staphylococcal blepharitis or seborrheic blepharitis). Patients with severe eyelid inflammation should be treated medically prior to device use•Systemic disease

conditions that cause dry eye(e.g., Stevens-Johnson syndrome, vitamin A deficiency, rheumatoid arthritis, Wegener’s granulomatosis, sarcoidosis, leukemia, Riley-Day

syndrome, systemic lupus erythematosus, Sjögren’s syndrome)•Taking medications known to cause dryness (e.g., isotretinoin (Accutane ® ) and systemic

antihistamines)•Esthetic eyelid and eyelash procedures (e.g., blepharoplasty, lash extensions, eyelid tattooing). In addition, the treatment procedure may loosen

previously inserted punctal plugs, which may worsen the patient’s dry eye symptoms. Reference: 1. Lemp, M. A., Crews, L. A., Bron, A. J., Foulks, G. N., &

Sullivan, B. D. (2012). Distribution of Aqueous-Deficient and Evaporative Dry Eye in a Clinic-Based Patient Cohort. Cornea, 31(5), 472-478. doi:10.1097/

ico.0b013e318225415a. Australia: AMO Australia Pty Ltd, 1-5 Khartoum Road, North Ryde, NSW 2113, Australia. Phone: 1800 266 111. New Zealand: AMO

Australia Pty. Ltd. 507 Mount Wellington Hwy, Mount Wellington, Auckland 1060, New Zealand. Phone: 0800 266 700.| PP2018TS4191


RESEARCH

COMMUNICATION CAN

MINIMISE IMPACT OF

AMD DIAGNOSIS

Improved communication between

eyecare professionals and patients

can play a major role in minimising the

psychological impact of an atrophic

age-related macular degeneration (AMD)

diagnosis, a new study has found.

Though the disease is incurable, more

effective communication might prevent

patients from overestimating condition's

impact on their daily life.

Based on interviews with 27 participants

at various stages of AMD progression,

a research team from City, University of

London assembled a framework to cover

the key themes and issues encountered

by patients.

A particular focus of the unstructured

interviews was how people react to being

told they have an incurable condition, and

the impact this has. One patient reported

their experience as being very abrupt:

“At the end of the day he just said

you’ve got dry macular degeneration, end

of story and that’s how he put it; end of

story. So I said to him, what do you mean

end of story? He said well that’s it, there’s

nothing we can do, there’s no cure for it

so there’s nothing we can recommend

you do, which is quite a big shock.”

The authors of the study emphasise

that the way the diagnosis is explained to

patients can have an impact on patient

fears, and have proposed that new steps

be put in place in order to minimise worry.

Recommendations include standardising

rehabilitation pathways across the

eyecare sector, and referring patients to

relevant support services.

“What I learned from the research is

that there are many people diagnosed

with dry AMD who perceive the impact

of the condition on their daily life as

considerable, whilst their measurable

visual function remains reasonable,”

Professor David Crabb, Professor of

Statistics and Vision Research at City,

University of London, said.

“Many fear going blind, and suffer a

great deal of anxiety, particularly with

the current lack of a treatment for the

condition. Much of this distress might

be allayed through more supportive

conversations with their eye health

professionals, and receiving timely

information about the disease and

outcomes, and referral to any further

necessary support.” n

“THIS STUDY

SHOWS THAT THE

IMPLANT IS SAFE

AND EFFECTIVE,

AND MAY ONLY

REQUIRE A

CLINIC VISIT AND

REFILL EVERY SIX

MONTHS”

PETER

CAMPOCHIARO,

JOHNS HOPKINS

MEDICINE

MEDICATION IMPLANT FOR AMD

SHOWN TO BE EFFECTIVE AND SAFE

Recently published results have shown

the safety and effectiveness of a slow

release medication implant designed to

treat neovascular age-related macular

degeneration.

The implant technology, developed by

Genetech and Roche, is designed to

continuously deliver medication into the

eyes, subsequently avoiding the need

for ongoing anti-VEGF injections.

A reservoir is implanted into patients’

eyes, which slowly releases drugs and

can be replenished without additional

major surgeries.

In a clinical trial of 220 people,

researchers from Johns Hopkins

Medicine have found the implant is both

effective at maintaining vision and safe

for patients. As part of the trial each

patient received the implant in one eye,

and was split into groups receiving

various levels of dosage. Patients were

monitored over a two-year period from

2015 to 2017.

Though patients who received low

dosages recorded some vision loss,

those who received high dosages

experienced a vision improvement at a

level higher than a control group who

received traditional injections. Patients

also needed fewer treatments when

compared to traditional injections, with

patients receiving a high dosage not

requiring a refill for 15 months

on average.

Type 2 diabetics are more likely to

experience dry eye disease (DED) and,

subsequently, reduced quality of life

compared with their Type 1 counterparts,

a UK study has revealed.

Researchers at the Glasgow

Caledonian University School of Health

and Life Sciences and the University

Hospital Ayr surveyed 110 diabetics and

42 non-diabetics.

Following the completion of Ocular

Surface Disease Index and Dry

Eye-related Quality of Life Score

questionnaires, it was discovered that

44% of all diabetic participants suffered

dry eye symptoms, compared with 29%

The port delivery system with ranibizumab

implant

The technology also proved to be

safe for patients. Of the first 22 patients

to receive the implant, 11 experienced

some bleeding into the eye. However,

a change in the implant procedure saw

only seven of the next 157 patients

experience bleeding.

Dr Peter Campochiaro, the George

S. and Dolores D. Eccles Professor

in Ophthalmology at the Wilmer Eye

Institute at Johns Hopkins, said the

implant could help patients avoid

irreversible vision damage by making

complying with treatment easier. “This

study shows that the implant is safe and

effective, and may only require a clinic

visit and refill every six months,” he said.

Future studies are planned for a bigger

group of patients all receiving the larger

dosage. According to Campochiaro the

cost of the treatment is not yet known.

The findings were published in the

journal Ophthalmology n

STUDY REVEALS DRY EYE DISEASE

MORE LIKELY IN DIABETIC PATIENTS

in the control group.

DED was found to be more prevalent

in Type 2 diabetics, with 55% of those

patients reporting symptoms compared

with 27% of Type 1 patients.

“Dry eye symptoms are associated

with reduced quality of life and are more

common in people with Type 2 than Type

1, irrespective of diabetic retinopathy

status,” the researchers concluded.

“Routine clinical screening for severe

DED could potentially allow for a timely

and more effective treatment and could

contribute to mitigating the dry eyeassociated

reduction in quality of life in

those with Type 2 diabetics.” n

44 INSIGHT August 2019


TECHNOLOGY

LOW-COST OCT SYSTEM COULD

IMPROVE ACCESS TO SCANS

A low-cost, highly portable optical

coherence tomography (OCT) scanner

has been unveiled, with its developers

claiming it has the potential to bring

the powerful technology to remote or

underserved regions.

The team at Duke University behind the

project have engineered the device to be

15x lighter and smaller than conventional

OCT systems, and anticipate it could be

sold for only one tenth of the cost of what

is currently available on the market.

The device has also performed well in

initial clinical trials. According to a study

published in Translational Vision Science

& Technology, 120 images captured by

the device were 95% as sharp as images

taken by commercial systems, allowing for

accurate diagnosis.

The innovation that allows for the

smaller and cheaper device is a new

type of spectrometer. While conventional

spectrometers have a high degree

of accuracy, their complex array of

lenses and mirrors is susceptible to

misalignments due to bumps and

changes in temperature. Wax’s device

takes the light in a circular pattern in

Engineers at Stanford University have built

a pair of so-called ‘autofocal’ glasses

that have been designed to adjust their

focus depending on what the wearer is

looking at.

The prototype glasses use eye-tracking

technology to automatically control a

pair of autofocus lenses. By triangulating

using each eye’s line of sight, the glasses

are able to determine exactly how far

away the wearer is looking, and then

automatically adjust the lenses to the

required level of focus.

While the technology is still early and

bulky, the team behind the device hope

it could one day offer an alternative to

progressive lenses.

“More than a billion people have

presbyopia and we’ve created a pair

of autofocal lenses that might one day

correct their vision far more effectively

than traditional glasses,” Assistant

order to prevent misalignments from

affecting results.

The end result is a device that is about

the size of a lunchbox and could cost as

little as US$15,000 (AU$21,400).

“Right now OCT devices sit in their own

room and require a PhD scientist to tweak

them to get everything working just right,”

Wax said.

“Ours can just sit on a shelf in the office

and be taken down, used and put back

without problems. We’ve scanned people

in a Starbucks with it.”

A study conducted by Dr J. Niklas Ulrich,

retina surgeon and associate professor of

ophthalmology at the University of North

Carolina School of Medicine, confirmed

the device’s effectiveness.

“It obviously lacks some bells and

whistles of our $100k+ OCT scanners, but

allows for accurate diagnosis of structural

retinal disease as well as monitoring of

treatment success,” Ulrich said.

Wax is currently in the process of

commercialising the device through his

startup Lumedica, which is now selling

devices for research purposes. n

‘AUTOFOCAL’ GLASSES ADJUST BASED

ON WHERE A USER IS LOOKING

Autofocals adjust based on the eye's direction

Professor Gordon Wetzstein, one of the

device’s developers, said.

The prototype device was tested on 56

people with presbyopia, with subjects

reporting that the autofocus lenses

performed better and faster than their

progressive lenses.

A report describing the autofocal

glasses was published in the journal

Science Advances. n

“OURS CAN

JUST SIT ON A

SHELF IN THE

OFFICE AND BE

TAKEN DOWN,

USED AND PUT

BACK WITHOUT

PROBLEMS.

WE’VE SCANNED

PEOPLE IN A

STARBUCKS WITH

IT”

ADAM WAX, DUKE

UNIVERSITY

ANCIENT GLASS BLOWING

METHOD USED TO

PRODUCE OCT LENSES

An ancient method of glass blowing

has been applied to the fabrication of

axicons, the miniature cone-shaped

lenses used to shape the light from

lasers. The technology could lead to

the development of cheaper and more

accurate OCT devices.

The technique, developed by the

FEMTO-ST Institute in France, was

recently described in The Optical

Society journal Optics Letters. It is

based on the process used to make

large numbers of photonic and

electronic circuits, and allows the

researchers to make glass axicons with

diameters of 0.9 and 1.8 millimetres.

The team behind the innovation have

developed a method that combines gas

expansion from multiple reservoirs to

produce the axicon, shaping its surface

from underneath and leaving a highquality

optical surface.

Silicone cavities are deposited in

concentric rings that are sealed in

glass. Placing this in a furnace causes

in the gas trapped in the cavities to

expand, creating ring-shaped bubbles

that push the glass surface into the

desired cone shape.

The technique allows for multiple

lenses to be made at once, rather than

just one at a time, at a far lower cost

than the methods currently employed.

“Our technique has the potential of

producing robust miniature axicons

in glass at a low cost, which could be

used in miniaturised imaging systems

for biomedical imaging applications,

such as optical coherence tomography,”

Mr Nicolas Passilly, a member of the

research team, said.

“Wafer-level microfabrication allows

the axicons to be integrated into more

complex microsystems created also at

a wafer-level, leading to a system made

of a wafer stack. This type of integration

comes with better optical alignments,

high performance vacuum packaging

and much lower-costs for the final

systems because a large number can be

processed simultaneously.”

According to The Optical Society, the

research team plans to incorporate the

axicons in OCT devices that are also

currently under development. n

INSIGHT August 2019 45


REPORT

GLAUCOMA EXPERTS SHARE

RESEARCH IN MELBOURNE

The 2019 World Glaucoma Congress was held in Melbourne from 27-30 March

at the Melbourne Convention and Exhibition Centre. In part two of his report,

LEWIS WILLIAMS details more of the event’s highlights.

Melbournian Professor ROBIN BATTERHAM AO was

Australia’s chief scientist from 1999 to 2006. He comes

from a background in chemical engineering and, in

addition to his science background, is also a published

organist. For a time he was also the Kernot Professor of

Engineering at the University of Melbourne.

DISPELLING 'ANTI-SCIENCE'

His opening remarks revealed that 46% of US

citizens support creationism over evolution,

and there is no reason to believe that

Australians would think significantly differently.

He concluded that figures like 46% believing

in what amounts to anti-science puts pressure

on the scientific method.

Unfortunately, scientists taking extreme

positions on their own and other's work,

often to counter anti-science extremism, can

significantly damage science’s credibility and reputation.

He described science as utilitarian as opposed to a ‘belief system’,

and thinks that science education should be compulsory in schools until

Year 12.

During his time as chief scientist, he oversaw a doubling of R&D funding

to the tune of $2.9 billion. He also believes that Australia is not especially

good at balancing basic versus translational funding.

Compounding, if not confounding, that issue is Australia’s poor record

of interdisciplinary research. This usually leads to separate funding for

entities that could be, or should be, co-operating.

In his opinion, science funding is a balancing act. One driver is the

likelihood of commercial returns, which he noted could distort priorities.

What is required is a balance between direct commercial benefits versus

community benefits at large.

WHO SAYS GLAUCOMA IS AN

INCURABLE DISEASE?

Professor KEITH MARTIN, managing director of

the Centre for Eye Research Australia (CERA) and

president of the World Glaucoma Association, shed

light on this vexed question.

To cure glaucoma he proffered that the prevention of damage to, or

the repair of, retinal ganglion cells (RGCs) all the way to the brain was

a major issue. This is followed by the restoration of all that was ‘lost’

because of the disease.

He noted that insulin could support dendritic tree recovery or

regeneration. In mice, it has been shown that high concentrations of

Vitamin B3 can significantly decrease the loss of axons. Gene therapy

using AAV vectoring of brain-derived neurotrophic factor (BDNF) into

RGCs is already showing promise in alleviating RGC loss after optic

nerve damage, as well as neuroprotection for up to 6 months.

However, Martin stated: “regeneration of N II was a long way off”.

Zymosan (a fungi-derived glucan) either alone or in combination with

an appropriate enzyme, has been shown

to enhance axonal regeneration. However,

the vision restoration proved to be poor.

Even with regeneration, it is usually only

the low-level functions that are restored,

and certainly not the full complement of

capabilities. In Martin’s opinion, ‘protection

and regeneration’ are the future, and much

of his research is aimed at exactly that.

46 INSIGHT August 2019


Professor JONATHAN CROWSTON, professor of

ophthalmology at Duke-NUS Medical School Singapore

and former CERA director, tackled the subject of

Primary open-angle glaucoma disease progression, an

art with notoriously poor accuracy.

GLAUCOMA PROGRESSION

Overall, 75% of cases progress and the remaining 25% do not progress.

Furthermore, it takes a long time to study progress validly, meaning

few undertake the task due to it being impractical. He also noted that

neuroprotective trials were prohibitively expensive and were unlikely to be

undertaken either lightly or without significant support.

Stressed RGCs can lead to cell death and annexin V (also known

as annexin A5, a cellular protein) assays permit quantification of the

number of dying cells. However, that in turn only allows a rough estimate

of the number of residual RGCs. Cells that have already undergone

phagocytosis fluoresce.

It is estimated that about 65 RGCs die each day as part of the normal

ageing process. Also of interest are RGCs undergoing dendritic pruning

involving axonal cytoplasmic and mitochondrial micro-changes.

Recovery of RGC function remains largely unknown and its exact nature

is still debated.

RGC recovery in rodents has been confirmed in the lab over a period of

at least 7 days. Importantly, real-time assessment of RGC health in a lab

setting is now possible.

THE BIG PICTURE

Ophthalmologist, Assistant Professor LUCY SHEN,

a glaucoma specialist at Massachusetts Eye and

Ear Hospital, gave a brief presentation on imaging,

particularly wide-field imaging.

Swept-source optical coherence tomography (OCT)

already offers 12 x 9 mm image areas, allowing for a

useful analysis of the retinal nerve fibre layer (RNFL).

Adaptive optics imaging offers a view of individual

cells and nerve fibres, but the process is slow and

intense.

Other ocular parameters of interest include Bruch’s

membrane opening, minimum rim width, and lamina cribrosa depth,

including its deeper layers between 40 and 80 microns further out.

A recurring difficulty involves marrying old and new data due to different

instruments and techniques creating incompatibilities. Parameters of

interest include changes in RNFL thickness and macula ganglion cell

populations, among others.

Another clinical pursuit is reconciling structure and function. OCT-A, for

example, uses high-speed OCT to detect retinal features that change

over time, especially moving blood. In NAION (Non-arteritic, Anterior

Ischaemic Optic Neuropathy), the density of the superficial retinal blood

vessels is reduced. Shen predicted that future OCT devices would be

better at characterising the glaucoma patient and their eyes. However,

she also noted that artefacts, including optical artefacts, remain an

imaging issue.

WHAT’S BEYOND MIGS?

Well-known Canadian eye surgeon and

ophthalmology academic Professor IKE AHMED

spoke about minimally invasive glaucoma surgery

(MIGS) and other anterior chamber drainage

approaches to glaucoma therapy.

Significant factors to be considered when selecting a treatment

regimen include quality-of-life, cost, and the approach’s ability to

prevent blindness. According to Ahmed, the invasiveness of the ab

interno MIGS approach “does not matter”, noting that only part of the

trabecular meshwork is involved in filtering at any one time.

Despite the number already available, he believes that more

devices are still required and that there are some novel examples

in the pipeline. He also holds the view that the interest in MIGS is

considerable, based on the recent number of publications that focus

on the devices. Promoting further interest is the fact that there is a

plateau across the purely surgical approaches to glaucoma.

One new approach is the Swiss eyeWatch; an adjustable-flow

device featuring a magnetically-coupled, external, adjustable valve.

The eyePlate drainage shunt is inserted sub-conjunctivally and is

connected to the eyeWatch via a short elastomeric tube. A rigid

extension of the eyeWatch component is plumbed into the anterior

chamber. Sutured scleral tissue is used to protect the ‘system’ once

implanted.

When placed directly over the implant, the eyeWatch Pen surgeon’s

tool indicates the current valve setting. It also contains a magnet that

is used to adjust the eccentric-cam clamp that impinges upon the

eyeWatch’s internal tubing, altering outflow control.

Other devices take a suprachoroidal approach, but he cautioned

that any such device needed to be anti-fibrotic to avoid problems in

the longer-term. Another device is the Camras Shunt from Camras

Vision, now marketed as the Sollevio from Alievio Inc. The shunt

targets lower levels of intraocular pressure (IOP), less than 14 mm,

and incorporates a micropore antibacterial filter to prevent ingression

of micro-organisms into the anterior chamber. Its outlet is located

externally, under the upper eyelid.

The iDose (Glaukos) is an intraocular implant that delivers travoprost

after a ‘micro-invasive’ surgical procedure. More than half the

participants in an early trial showed about a 30% IOP reduction at 12

months compared to baseline results. A much larger clinical trial is

underway.

The XEN Gel Stent (Allergan) is a permanent, porcine-gelatine/crosslinked

with glutaraldehyde, anterior chamber implant that shunts the

anterior chamber to the sub-conjunctival space. A needle ‘introducer’

is used to enter the anterior chamber. It is already available.

In a later presentation, Professor Andrew White from Westmead

Hospital (Sydney) reported on his department’s experience with the

XEN shunt combined with MMC (mitomycin C used in a large volume/

low concentration dose). They found a rapid rehabilitation, with

visual acuity back to baselines within seven days. Insertion required

minimum manipulation, but care was required to avoid excessive

pushing at the time of insertion. As with all tubes, there is a risk of

erosion at the insertion site. His study used topical steroids for 4-6

weeks post-insertion to prevent local fibrosis.

Ahmed wrapped up his presentation with a prediction that in the

future, microstenting of filtering blebs would be used as a possible

glaucoma therapy, or as an adjunct to existing therapy.

INSIGHT August 2019 47


REPORT

THE 14TH GILLIES LECTURE

Queensland ophthalmologist and academic

Professor RAVI THOMAS gave this year’s Gillies

Lecture. A born entertainer, he titled his lecture ‘Of

Glaucoma, Prevention of Blindness & the Reverend:

A personal Khichdi’ (a khichdi is an Indian one-pot

lentil and rice dish).

Thomas is the director of glaucoma services at the Queensland Eye

Institute and holds academic positions at University of Queensland and

Beijing University.

In one study of 118 PACG suspects, 82 progressed to develop the

condition after five years. Overtly, there are no differences between

those that progressed and those that did not. He noted that PACG

progression data cannot be replicated, but it has been shown that the

iris volume decreases less in PACG suspects. He posed the question:

“Should we screen for it?”

Population attributable risk (PAR%) helps decide if a disease is a

public health problem. In his 2012 paper on glaucoma in developing

countries, he concluded that PACG is not one, and other more basic

issues were much more pressing. He concluded that ultimately, we

remain reliant on a clinical examination of each case, not screening

programmes.

In POAG cases only, MRI reveals changes in the visual cortex with

and without concurrent visual stimulation. On the topic of the effect

of combined phaco and intraocular lens implantation on IOP, Thomas

summarised most studies as showing small decreases in IOP (1 to 3

mm Hg) with only a 3-4% chance of decreases >5 mm Hg. In cases of

PACG resulting in a peripheral iridectomy, he advised against locating

them so that they were partially or completely covered by the upper

eyelid in normal gaze.

Thomas was also critical of too many blindness prevention

studies reporting the number of patients operated on as their main

performance indicator without any reference to, or a minimal airing of,

the actual outcomes achieved.

NZ ophthalmologist and academic Professor

HELEN DANESH-MEYER from the New Zealand

National Eye Centre in Auckland shared some of her

cutting edge research.

CONNEXIN43 IN RGC INJURY

She dated the discovery of gap junctions to 1969 and described such

junctions as electrical synapses that operate bi-directionally and rapidly.

Gap junction protein Connexin43 (GJA1) is just one of a family of

connexions including 32, 26 and 46, as well as her topic, 43, the most

ubiquitously expressed isoform.

In humans, Connexin43 (CX43) is located in the optic nerve head

and retina, as well as in astrocytes and the vascular endothelium in the

central nervous system, RPE, Müller cells, and microglia. CX43 mutations

increase the risk of POAG some 16-18x.

Normally, CX43 hemichannels are unlikely to be open but when injured

or in disease, CX43 upregulation and hemichannel opening have been

implicated in all aspects of secondary damage. This includes glial cell

activation, oedema, and loss of vascular integrity leading to neuronal

death. Leaky hemichannels are implicated in several diseases.

In an experimental retinal ischaemic reperfusion model, upregulation of

CX43 was confirmed and injury was apparent after 4 hours of ischaemia.

Peak damage was observed at

about 24 hours.

In human glaucoma, CX43

upregulation has been confirmed

in the lamina cribrosa. A concept

now being pursued is blocking

CX43 or closing hemichannels

to stall or prevent the opening

up of an inflammatory pathway.

Danesh-Meyer believes that CX43

blocking has significant potential,

and some of her research is

investigating that possibility.

2019

WORLD GLAUCOMA CONGRESS

48 INSIGHT August 2019


DRIVING WITH GLAUCOMA

Optometrist and Queensland University of

Technology academic Professor JOANNE WOOD

turned her expertise to studying drivers who

suffer from glaucoma in real-world situations.

The visual field losses and decreases in contrast sensitivity are the

known sequelae of glaucoma. Vision problems are, theoretically

at least, netted by regular vision checks that are part of the licence

renewal process. Wood posed the question: “Drivers are assessed

regularly for vision standards, but is there more?”

Vision loss due to glaucoma is already known to result in an increased

crash rate, and up to 25% of those involved in accidents are found to

have severe visual field loss. However, when some form of integrated

visual field loss estimate and crash rates are compared, they do not

correlate.

Data suggests that the crash risk in glaucoma is 6x with moderate to

severe field loss, 2x with severe binocular vision impairment, and 1.65x

with severe field loss when driving in unfamiliar circumstances.

Factors noted during an assessment include lane keeping, scanning

ability, anticipatory skills, and the number of driving instructor

interventions needed. There is evidence that some glaucoma cases

can partially compensate for their condition.

No visual field measures were associated significantly with driver

performance or safety ratings. However, motion sensitivity tested

using random dot displays was found to better correlate with driving

performance than any other test.

Overall, ‘observation’ was the glaucoma patient’s greatest challenge,

especially in situations involving ‘Give Way’ signs and traffic lights.

Experts in the field generally agree that fitness-to-drive should be

based on performance, rather than age or diseases. It also needs

to be fair. It is known that training can improve results, but there are

limits to what can be achieved. Wood finished her presentation with

an observation that current drivers licence standards are not actually

evidence-based.

Indian ophthalmologist and glaucoma specialist

Dr HARSHA RAO NARAYANA from the Nethralaya

Eye Care Hospital presented 10 points about

OCT-A.

OCTA-A: EVOLUTION OR REVOLUTION?

He noted that OCT-A is scanned in ‘slabs’: the optic nerve slab, the radial

peripapillary capillary slab, the choroidal slab, and the foveal superficial

layer. In glaucoma, OCT-A:

• Shows a decreased density of superficial vessels,

• Shows microvascular dropouts in the choroidal layer along with a

global decrease in RNFL thickness, increased axial length, and disc

(Drance) haemorrhages,

• Shows changes before visual fields changes are detectable. A sectoral

Wilmer Eye Institute ophthalmologist and

glaucoma researcher Dr DAVID FRIEDMAN gave a

presentation that showed the effects of glaucoma

on activity levels.

FALLS, FRACTURES,

AND PHYSICAL ACTIVITY

He described a 5 dB decrement in central visual fields as “meaningful”,

and listed a number of relevant studies of glaucoma patients of which

he was a co-author. In his view, mobility is not just about getting about.

Rather, it is about getting about ‘safely’. He also has an interest in the

related issues of confidence and fear-of-falling.

In the developed world, independence and the ability to drive are

almost one and the same. Driving cessation can be related to glaucoma

severity and, perhaps more importantly, subsequent depression.

Glaucoma cases are up to 4x less likely to drive according to Friedman,

and each 5 dB visual field decrement doubles the likelihood of not

driving.

Any inactivity attributable to glaucoma increases the likelihood of the

patient dying due to inactivity. In bilateral glaucoma, the walking pace

can be reduced by as much as 2.4 m per minute. Accelerometers can

monitor a patient’s physical activity levels, and data shows that bilateral

glaucoma cases are 70% less likely to be active or leave their home.

Severe disease halves the likelihood that patients will undertake

excursions. Because of the induced drowsiness resulting from alphaagonist

glaucoma therapy, such cases experience a further reduction

to 4.42x less likely. Turning to peripheral visual field losses, Friedman

showed that they increased the likelihood of falls more than central

field issues. Shockingly, he gave the annualised probability of falls in

glaucoma as 44%. Returning to his “meaningful” comment in relation to

each 5 dB decrement in visual fields, he gave the falls rate, especially

those involving steps, as a 41% increase.

Visual field losses also increase the hip fracture rate in female

glaucoma patients, where advanced age is likely to be a contributing

factor. Regrettably, there are few papers on the ‘rehabilitation’ of

glaucoma patients, especially in view of the fact that ‘disability’ occurs

before, or well before, glaucoma ‘blindness’.

analysis of blood vessel densities reveal local retinal changes,

• Might be a better tool for assessing blood vessel density and

differentiating glaucoma from non-glaucoma cases,

• Is not superior in cases of primary angle-closure glaucoma (PACG),

• Detects choroidal microvascular dropouts that are associated with faster

disease progression. Drance haemorrhages and microvascular dropouts

are associated, independently with progressive RNFL thinning,

• Shows that lower baseline vessel density is associated with faster RNFL

thinning,

• Can detect the progressive decrease in the population of capillaries,

• Might or might not be able to detect disease progression earlier than

conventional OCT,

• Has increased test/retest variability than conventional OCT, which might

also apply to reference scans.

Rao does not believe that OCT-A is superior to OCT in the diagnosis

of glaucoma and his parting summary was that currently OCT-A is

evolutionary but has the potential to be revolutionary.

INSIGHT August 2019 49


REPORT

ANTERIOR SEGMENT IMAGING

Brazilian glaucoma specialist Dr LISANDRO

SAKATA gave a wide-ranging lecture on

anterior segment imaging.

Professor KEITH MARTIN returned to the

lectern and posed the question:

Are RGCs either healthy or dead?

In angle-closure glaucoma, the aim of therapy is to ameliorate or

prevent the adverse outcomes of angle closure, true cases of which are,

fortunately, relatively rare.

Despite the advances made in imaging over the last 25 years, Sakata

believes that gonioscopy remains the gold standard. Standards using

the technique need to be improved as well as maintained. Despite the

availability of anterior segment OCT (AS-OCT), gonioscopy still plays an

important role.

Regardless, the evaluation and documentation that AS-OCT provides

is valuable. While anterior angle imaging has been possible for more

than a decade, the angle’s true anatomy may not be shown realistically.

Although gonioscopy gives a broad quadrant view of the anterior angle,

SS-OCT can provide a 360° view.

However, the current resolution of OCT does not resolve the trabecular

meshwork, only the scleral spur. According to Sakata the older timedomain

OCT (TD-OCT) is potentially better at detailing the anterior angle,

but in up to 20% of cases an image of the scleral spur is captured poorly.

As instrument resolution improves, new anatomical landmarks are

disclosed. For example, the Schwalbe’s line to scleral spur transition

zone has trabecular meshwork tissue between the two, but the actual

anatomy varies by quadrant and between individuals. The relationship

between the anterior angle and angle closure as seen in AS-OCT has

been studied poorly, but AS-OCT now detects anterior angle closure in

more instances than gonioscopy.

Furthermore, if the anterior angle is ‘open’ on AS-OCT, it is now

believed that the patient probably has a low risk of angle closure. AS-

OCT also confirms what has been known for a long time; phaco opens

up the anterior angle, but the actual contribution the crystalline lens

makes towards angle closure is not fully understood.

The retinal detachment rate from phaco in younger ages is interesting,

as it is higher than in other groups. High myopia, one reason for clear

lens extractions, only makes the situation worse.

Sakata suggested doing gonioscopy in dark conditions to observe

the bunched-up iris in vivo. To view the trabecular meshwork, scleral

indentation might be required.

RESUSCITATING RGCS

There is evidence that in humans and other animals, RGCs can exist in

an in-between stage where their function is reduced, but they are not

dead. Therefore, the possibility exists that they can be rehabilitated.

While it is known that cell injury at the optic nerve head is largely

responsible for the functional damage that manifests as POAG, the

question that needs to be asked is: Do some cells survive?

While cells that undergo the natural process of apoptosis can be

labelled and identified, the detection of ‘sick’ cells was not as easy

or straightforward. While the inhibition of apoptosis is a necessity if

progress is to be made in tissue preservation, the restoration of function

is not necessarily the primary aim. Early damage to RGC axons occurs

at the lamina cribrosa, and in very early stages of the disease changes

can only be detected there. Early obstruction to transport processes,

such as movement of mitochondria along axons, can now be imaged.

Optic nerve transport can be ‘improved’ after 7-10 days of induced

ocular hypertension, by which time some debility can be demonstrated

all the way back to the brain. Interestingly, exercise has been shown

to improve function recovery. However, there is only some supporting

evidence, including electrophysiology, for vision recovery in human

glaucoma. Predictably, older animals do not recover as well.

Visual field-assessing devices assume a one-tail testing stance, i.e.

visual fields only get worse, an aspect that needs to be factored in

when analysing results.

US-based glaucoma specialist Assistant

Professor ALEX HUANG from the Doheny and

Stein Eye Institute, School of Medicine, UCLA,

revealed his findings on where and how the

aqueous outflows from the eye.

CHARACTERISTICS OF AQUEOUS OUTFLOW

He reports that the outflow is segmented. For example it differs in various

parts of the outflow architecture. However, this might vary in different

disease states. He also suggested that a successful study of aqueous

outflow in individuals would be a good guide to where MIGS devices

should be implanted/inserted. For example, if it is possible to visualise

where the aqueous flows, or where flow is greatest, that is where a MIGS

device should be located for optimum efficacy. He described that pursuit

as aqueous angiography, and used the Heidelberg Engineering Spectralis

OCT/multimodal imaging platform to demonstrate outflow segmentation.

He was also able to show that the outflow is sometimes pulsatile,

suggesting the whole system is quite dynamic.

IndoCyanine Green dye injected during cataract surgery showed that

the operated eye’s direction of gaze could also affect outflow, further

confirming its dynamic nature.

Regardless of a MIGS device’s position Huang believes that there is

always some improvement, but ideal positioning gives an optimum result.

He also demonstrated that the flow within the trabecular meshwork is also

segmented, but more complex than the flow to the collector channels

studied earlier.

50 INSIGHT August 2019


Lisa Kaey Angelica Ly Fiona Stapleton

UNSW RECOGNISES HIGH STANDARDS

At the School of Optometry and Vision Science’s annual prize giving ceremony, the school’s top graduates

were recognised for their excellence. Lewis Williams details the event’s proceedings.

The School of Optometry and Vision Science (SOVS), UNSW, held its

annual prize giving ceremony as a lunch at Doltone House, Sydney,

on 14 May.

The event acknowledges those about to graduate and students who

reached noteworthy levels of academic, clinical, or research excellence

during their time at UNSW, with a focus on the 2018 academic year.

Some of the awards were presented to current undergraduates in

acknowledgement of their achievements at various stages of the course.

The master of ceremonies for the event was head of school Professor

Lisa Keay, assisted by outgoing head of school Professor Fiona Stapleton

on whose watch most of the attendees were students.

The guest speaker was Dr Angelica Ly, the Centre for Eye Health’s

integrated care coordinator and lead clinician. She is also a Director on the

board of OA NSW/ACT.

She concluded her address by congratulating the graduands and wished

them all every success for their futures.

THE STARS

Yet again, a SOVS student, Ms Patricia Tsong, has been awarded the

prestigious University Medal (UNSW) as well as other awards (Luxottica

and Specsavers Prizes), confirming that the high entry standard into the

double-degree course has been maintained.

The Neville Fulthorpe Prize went to Ms Courtney Priestly and the Dr

Andrew Whatham Prize went to Ms Amanda Sobbizadeh.

Mr Kevin La, outgoing OptomSoc President, delivered the valediction

speech on behalf of the graduating class. n

FUTURE PROSPECTS

Ly suggested that the graduating class should get ‘comfortable’ in their

new roles, but warned that optometric practice was not all ‘fun and games’

as there were still many challenges ahead.

She estimated that of the approximately 5,500 optometrists in Australia,

some 2,000 are in NSW. To some extent, they are their competitors. She

recommended that the new graduates maintain their links to one another

in order to retain the ability to learn as a group.

Ly advised the cohort to consider how much they should give back to

the profession and to colour their thinking with whatever expertise they

develop over their career. She suggested a five to 10 year period for

progress to be made towards developing, and then sharing, that expertise.

Although she divided practice pathways along the retail and medical

models, she also acknowledged other practice possibilities such as

educational institutions, hospitals, volunteering, and public health.

She suggested that the audience lives up to their own standards and

recommended lifelong learning to those present.

She then spoke briefly about her employer, the Centre for Eye Health

(CFEH), which has optometrists and ophthalmologist on staff in order to

offer a more cohesive and comprehensive service.

Despite the equipment, resources, and staff available at the CFEH, she

admitted that it did not always have all the answers.

Patricia Tsong and Angelica Ly

Amanda Sobbizadeh and Val Whatham

Courtney Priestly and Judy Rainsford

Kevin La

INSIGHT August 2019 51


GIVING BACK IN PAPUA NEW GUINEA

THE LEVEL OF HEALTHCARE AVAILABLE TO PEOPLE VARIES GREATLY ACROSS THE WORLD. FAREN WILLETT AND

SHANDELL WISHART RECENTLY EXPERIENCED HOW DIFFERENT EYECARE IN PAPUA NEW GUINEA CAN BE.

SHANDELL

WISHART &

FAREN WILLETT

IT WAS SO MOVING

FOR US TO BE

INVOLVED IN NOT

JUST RESTORING

THE SIGHT OF

SOMEONE WITH

SO MUCH OF HIS

LIFE AHEAD OF

HIM, BUT TO ALSO

HELP HIM GET HIS

INDEPENDENCE

AND DIGNITY

BACK

We recognised each other at

the airport in Lae, Papua New

Guinea (PNG), though we only

knew each other by name, profession,

and our role as council members of

Orthoptics Australia. However, we soon

realised that we were very similar in not

just a job title, but in shared a passion

to volunteer in a developing country.

Our meeting was at the beginning of a

two-week outreach program organised

by Youth With A Mission (YWAM).

Among its many projects, YWAM works

collaboratively with PNG’s National

Department of Heath, provinces and

districts, as well as village leaders and

health workers on the ground, to provide

basic services to remote communities

in the country.

Our first day was at Braun hospital

where the optometry team saw 120

patients, some walking two hours to

attend the clinic. It was here we realised

that the service we were providing

would be life-changing. This was in

stark contrast to Australia, where the

procedures would be considered basic

eye health care.

Having to adjust to island life was

relatively easy, and setting up a clinic

in a church, school or even under a

coconut tree became a pleasant norm.

We were fortunate enough to have an

opportunity to work both in the villages

as part of the optometry team, and on

the ship with ophthalmology.

This collaboration between the village

and our ship worked well, with over 100

surgeries performed and many pairs of

glasses, donated by Lions Recycle For

Sight and Essilor Vision Foundation,

distributed.

Although we did not have the

opportunity to work directly alongside

each other, we did share a number of

patient experiences. There was one in

particular who stuck with us both.

On the first day five patients were to be

referred to the ship for cataract surgery.

Willie had been on the waiting list since

the last time the YWAM ship had visited,

which was 12 months earlier, and could

see only hand motions in both eyes.

Eye tests being performed in Papua New Guinea

At the age of 42, it was a condition

you just wouldn’t see in Australia. On

the spot, he was referred for surgical

consultation. A concern with such dense

cataracts at such a young age was that

there might be other pathology at play.

Willie needed two guides to help

him up the stairs of the ship, and we

operated on his first eye that afternoon.

The next morning upon removing the

patch a great smile broke out, and he

read the 6/12 line.

For the rest of the time he spent on the

ship he was shaking our hands, and we

heard it was the first time he had been

able to take himself to the bathroom in

five years. We operated on his second

eye a few days later and by the time we

left both of his eyes had near 6/6 vision.

It was so moving for us to be involved

in not just restoring the sight of

someone with so much of his life ahead

of him, but to also help him get his

independence and dignity back.

Our work as orthoptists equipped

us with the necessary skills to volunteer

in PNG; training general volunteers on

the ship how to assess visual acuity,

refracting patients, measuring patient’s

eyes for cataract surgery, slit lamp

examinations, managing work flow

and critical thinking when language

was a barrier.

However there is also a list of skills

we didn’t anticipate on accumulating;

speaking basic Pidgin, basket weaving

From left: Shandell Wishart and Faren Willett

with PNG volunteer and fellow roommate

Nama and engaging with the culture

of the PNG community, who graciously

shared food and gifts in appreciation of

our time in their villages.

Shimay, one of the volunteer nurses,

set us a task of reflecting on three

things that made us thankful each day.

It was during this exercise, while sitting

on the aft deck with our other friend

and volunteer paramedic Lucy, that we

realised that neither of us anticipated

the personal impact a trip like this would

have on us.

The patients we met, the people we

worked alongside, the many eyeopening

experiences and the friends we

made will make us smile for years

to come. n

ABOUT THE AUTHORS: Shandell Wishart is a

senior orthoptist at Eyemedics in Wayville, South

Australia. She has been working at the clinic since

2007, after graduating with honours from La Trobe

University in Melbourne.

Faren Willett is an orthoptist who graduated from

La Trobe University’s graduate entry masters

program, and is currently working in paediatrics at

the Queensland Children’s Hospital in Brisbane.

ORTHOPTICS AUSTRALIA strives for excellence

in eye health care by promoting and advancing

the discipline of orthoptics and by improving

eye health care for patients in public hospitals,

ophthalmology practices, and the wider

community. Visit: orthoptics.org.au

52 INSIGHT August 2019


MARKETING

UNSHACKLED CUSTOMER SERVICE

IT’S NOT ENOUGH FOR A BUSINESS TO OFFER CUSTOMER SERVICE – IT SHOULD BE CUSTOMER-CENTRIC FROM TOP

DOWN. BARRY URQUHART EXPLORES HOW CORPORATE CULTURE MUST EVOLVE TO PUT SERVICE SKILLS FIRST.

BARRY

URQUHART

UNDER-UTILISED

CUSTOMER

SKILLS OFTEN

REMAIN

UNRECOGNISED;

COMPANIES LACK

A DELEGATED

AUTHORITY

IN THIS AREA

BECAUSE THESE

SKILLS ARE NOT

VALUED

Customer service skills are easy to

master but they are impeded and

compromised in many instances

by inadequate, superficial and narrowlyfocused

corporate cultures.

Well-scripted mission statements and

brand philosophies are insufficient and

often misleading. This is because they

seldom articulate the underlying driving

force that makes things happen in a

business.

As a consequence, considerable

resources and funds are channelled

into processes that reduce costs and

seek to enhance internal efficiency – at

the expense of customer and client

satisfaction.

Under-utilised customer skills often

remain unrecognised; companies lack a

delegated authority in this area because

these skills are not valued, so employees

go unsupported and improvements are

not implemented.

The importance of customer service

may be appreciated, but it too remains

unrealised to the dismay of front-line

service providers.

THE PERSONAL TOUCH

Customer and client satisfaction is

determined by, and measured against,

expectations, as well as first impressions

that occur long before personal

interactions.

Automated telephone systems remain a

source of frustration and dissatisfaction,

mostly because there’s no way to bypass

pre-recorded messages and get access

to actual service professionals.

By the time a customer reaches a

person, it can be difficult for staff to

recover from the anxiety and frustration

that customer feels.

The ability of staff to neutralise such

emotions is important, but this falls a

long way short of creating customer

satisfaction. A case in point is the recent

declaration by Centrelink that telephone

wait-times have been significantly reduced

to ‘just’ 17 minutes!

Against the benchmark of service

excellence – when incoming calls are

answered within three rings – it is little

wonder that customers are reluctant

to call.

SERVICE BEGETS PERFORMANCE

Even if staff have excellent service skills,

any inadequate corporate culture will

compromise customer service standards.

Department stores throughout Australia

are reporting losses in sales, profits

and market share. The response from

senior management has been to declare

a commitment to customer-focused

endeavours, including increased training.

Such utterances again fall well short,

as do the number of available and

accessible service providers.

The consumer perception of the

Australian department-store sector is

that it is difficult to find staff when visiting

stores. Having highly-trained, qualified

team members who possess great

product knowledge counts for little if they

are insufficient in numbers and can’t

readily be found. There is a universal

need for all senior leaders to champion

customer service delivery. Financial

spreadsheets do not necessarily measure

relevant performance standards.

ONE TOUCH ONLY

A need for staff to refer matters to another

person or department mars the customer

experience and diminishes the chances of

them becoming a long-term advocate of

the business.

Delegated authority improves morale,

contributes to staff loyalty, stabilises team

compositions and reassures customers

that they are dealing with people who are

willing and have the capacity to resolve

issues to their satisfaction; however, at

the same time, context and ambience are

important elements in achieving customer

satisfaction and peace-of-mind.

The manner and speed in which

product returns take place, and in which

quality issues and service deficiencies

are addressed, are key indicators of

the degree to which a service-oriented

corporate culture prevails.

For some, following up with customers

who have just outlaid considerable

funds to do business is expensive, time-

Customer service is easily undervalued

consuming and does not necessarily

generate additional referrals and revenue.

Moreover, businesses are frequently

reluctant to expose themselves to

expressions of dissatisfaction from

customers – but some things are better

to know first-hand. Third-party complaints

are difficult to manage and impossible to

contain.

It remains true that open, two-way

communication is a key characteristic for

sustaining positive relationships, client

satisfaction and achieving loyalty.

DON’T COMPROMISE COMMITMENT

With service excellence there is no

place to hide. Training undertaken by

team members should involve senior

management, and active participation is

essential.

At the very least, participants will feel

rewarded and be reassured that they have

been heard when they are able to present

considered action at the conclusion of the

program. This is the very least one would

expect of a customer-centric entity.

In the new retail environment, customerservice

initiatives are particularly relevant

at this time and businesses should ensure

all endeavours are universally embraced

and applied. n

BARRY URQUHART is managing director of

Marketing Focus and an international keynote

speaker. Visit: marketinginfocus.net.au

INSIGHT August 2019 53


DISPENSING

DISPENSING TO KIDS AT THEIR LEVEL – PART TWO

DISPENSING GLASSES TO CHILDREN IS A VERY DIFFERENT EXPERIENCE COMPARED TO ADULTS. IN PART TWO OF A

SERIES, CHEDY KALACH LOOKS AT WHAT MAKES A GOOD CHILDREN’S FRAME AND HOW TO FIT THE COMPLETED GLASSES.

CHEDY KALACH

EVEN IF THE

KID SAYS ‘THEY

FEEL FUNNY’,

GUARDIANS

TEND TO SAY

THEY’LL GET

USED TO THEM.

IF THEY DON’T

THEY WILL NOT

WEAR THEM AT

ALL

In part one we looked at the

importance of children receiving early

eye tests, and how to build a rapport

with both the patient and their guardian.

Most kid’s frames are now specifically

designed for children. A good one has

a lower crest, larger frontal angle, larger

splay, flatter pantoscopic angle, the

ability to shorten the temples, and spring

hinges or a flexible frame.

The first few characteristics are to fit the

child’s development, whilst the last few

are to ensure it is durable.

As mentioned in part one, many

companies are now specifically

designing frames with these

characteristics. Hence, you shouldn’t just

carry smaller adults frames.

While on frame characteristics, it is also

important to recommend a suitable lens.

Ideally, the lens should be lightweight,

comfortable, durable and, I believe

most importantly, impact resistant.

I’d suggest you recommend a Trivex

or polycarbonate material for these

reasons.

Thickness is generally not a major

concern, as the eyesize tends to be fairly

small. Just ensure you order a grind lens

if it’s a plus power. On the other hand,

you may need to re-consider this advice

if you have an atypical prescription.

Furthermore, as dispensers we can

also be ‘money conscious’ on behalf

of the client, and therefore possibly

not recommend multiple pairs or an

additional cheap backup pair.

CONVENIENCE AND PROTECTION

It is estimated by the World Health

Organization, Fact Sheet No. 261, July

2001, that 80% of a person’s lifetime

exposure to UV occurs before the age

of 18. Therefore, it is also important to

recommend lenses with UV protection.

Photochromic treatments may

be a good suggestion, particularly

considering how much they have

improved over the years.

At the age of 13 I misplaced my

specific prescription sunglasses within a

week, even though I had been wearing

specs fulltime for a few years. For the

Kids are best served by specially-designed frames, rather than smaller adult frames

convenience, photochromic treatments

might have been a better option.

After the frames and lenses are

chosen, it is critical to take the

appropriate measurements accurately

and precisely. Use a pupillometer or a

digital measuring system to measure

corneal reflex interpupillary distances,

and measure heights according to the

centre of rotation rule for single vision

lenses.

For bifocal lenses check with the

prescriber, but I’d suggest to raise the

bifocal segments as high as the pupil

centre. This way it ensures the wearer

looks through the bifocal segment.

For any degressive, occupational or

progressive lens design, I’d recommend

to fit these lenses in accordance to the

manufacturer’s instructions.

As mentioned in part one, children can

be fairly adaptable so it is important to

get accurate measurements. You want

children to get used to wearing the best

appliance you can supply them.

It is also important to final check the

glasses when the specs come back from

edging and fitting.

THE FINAL FIT

If it’s your practice’s policy not to final

check jobs that come back from the lab

I’d suggest to make dealing with children

and exception, particularly as kids are

not as vocal if they don’t feel right. Even

if the kid says ‘they feel funny’, guardians

tend to say they’ll get used to them. If

they don’t they will not wear them at all.

Either way, it’s not a great outcome

for their vision. Therefore, to avoid any

potential harm, its best to measure them

accurately and check they are correct

prior to handing them over.

On a final note, take charge at the

handover and final fit and ensure you let

the guardian know they should regularly

pop back in to get them readjusted.

Just like adults, if children like the

frames and can see perfectly through

them, they will wear them. If they are

uncomfortable, they won’t.

If you want to dispense to children, I

would advise setting up a kid’s corner,

similar to speciality kids hairdresser.

Parents will recommend your practice

to their friends if they have a great

experience. Word of mouth marketing is

great for local businesses.

Dispensing to kids can be challenging,

but can give your practice loyal and

regular customers. Most importantly,

make it fun and enjoy the process of

dispensing. n

CHEDY KALACH is a director of the Australasian

College of Optical Dispensing. Since 2009 he has

lectured throughout Australia and New Zealand

across a variety of topics such as ophthalmic

optics and business management.

54 INSIGHT August 2019


MARKETPLACE

To place a classified advertisement

email: info@insightnews.com.au

DISPENSING/

MECHANIC

LOCUM SERVICE

Optical Dispenser/

Mechanic with 30+

years experience

available for locum work

anywhere in Australia.

Reasonable daily and

half-day rate only. (no

travel or accommodation

charges). Happy to

consider any blocks from

1 week to 3 months.

Contact 0408 008 862 or

hylax1956@gmail.com

for further information.

George & Matilda is determined to hire the best people and give them the freedom

and flexibility to look after their patients with support of a National organisation.

n OPTOMETRIST- HOBART

PERMANENT ROLE

This is a fantastic opportunity for

an experienced and motivated

Optometrist to join our Eyelines

practice in Hobart.

George & Matilda Eyecare (G&M

Eyecare) unites some of the best

optometrists from across Australia.

Proudly independent, we’re your

local optometry experts with the

latest in eyecare technology and

eyewear brands. Eyelines, by G&M

(Hobart) has 6 practices located in

the greater Hobart area. These are

existing practices established for

over 20 years. The friendly team

are proud to offer a quality service

and stylish eyewear.

As an Optometrist, you will be

at the heart of the practice,

where you will work alongside

a highly skilled team to provide

our patients with superior optical

care. You will be a team player

and encourage and support the

practice in all areas, proactively

working together to role model

George & Matilda characteristics &

optometry best practice.

The successful person will possess:

Generous remuneration package on offer for the right candidates.

If any of these roles are for you, please email your resume

and cover letter to opportunities@georgeandmatilda.com.au

• Optometrist qualifications and/

or AHPRA Registration

• Minimum 2 years post

qualification / practice

experience

• Practice management systems

experience – Optomate

(preferable)

• Superior communication skills

• Genuine care and empathy for

your patients

MANAGING OPTOMETRIST – MORLEY, WA

Join our team of Managing Optometrists and partner with

one of our most experienced Store Managers as well as the

Professional Services Manager. We are looking for an individual

with a proven track record in customer experience execution and

demonstrated clinical excellence. Your role will encompass primary

care Optometry as well as coaching and development, managing

performance and team engagement. If you see the bigger picture

and dream of inspiring other with your contagious passion

through role modelling, coaching and support, apply now!

OPTOMETRIST – MORWELL, VIC

Joint an experienced and motivated team and practice full scope

optometry. Morwell is located in the Latrobe Valley in South-Eastern

Victoria and an easy 150km drive down the Monash freeway

from Melbourne. Be part of something bigger and contribute to

the community of Morwell with a loyal and appreciative customer

base in this two-room practice.

OPTOMETRIST – WHYALLA, SA

Looking for a change of lifestyle? Join our well-established

practice and be a part of the local community. Whether it’s

the vivid landscapes, aquatic serenity or overall great adventures,

Whyalla is a superb place to be. You will work alongside

another Optometrist in this 2-room store. Friendly team,

flexible hours and an amazing lifestyle could all be yours!

OPTOMETRIST – HASTINGS, NZ

Want to play a pivotal role in providing an excellent customer

experience and growing the OPSM business? Join our

Hastings practice and be part of a passionate and vibrant

team. Hastings is a chilled-out town that truly has it all – from

beaches to vineyards, Hastings is the place for taking it easy.

With a great community vibe, Hastings is fantastic opportunity

for an optometrist looking for the ultimate life-balance.

OPTOMETRIST – TAREE, NSW

Join our Taree practice and be well equipped with an OCT

and an experienced retail team who are well networked into

the local community. Taree is at the heart of the beautiful

Manning Valley on the North Coast of NSW. On your days

off enjoy some of the best scenic drives in NSW and explore

the national park wilderness, wineries and farmers markets!

OPTOMETRIST – TWEED CITY, QLD

Looking for a chance to further your career? OPSM is looking

for a recent graduate or experienced Optometrist to join a

vibrant, supportive and experienced team in our brand-new

Tweed City store on the Gold Coast. As one of Australia’s

premier tourist destinations, the city offers a lively mix of

shopping, theme parks, restaurants, entertainment and

events, along with an abundance of natural attractions.

JOIN OUR TEAM

In these roles you will work closely with vibrant and

supportive store teams and have many opportunities to

make a difference through our OneSight outreach program.

We offer world class technology including leading edge

technology Optos UWDRS. We provide opportunities for

continuing professional development through financially

supported industry training, peer learning communities and

product training, and reward with a competitive salary and

bonus scheme to recognise your contribution. We have fulltime,

part-time, casual and fixed-term opportunities available.

Attractive relocation packages are available for the right candidate.

Contact the relevant Professional Services Manager

for the region to discuss these opportunities and more:

NSW/ACT: Elizabeth Kodari

elizabeth.kodari@au.luxottica.com

QLD/NT: Brendan Philp

brendan.philp@luxottica.com.au

VIC/TAS: Melissa Downing

melissa.downing@luxottica.com.au

SA: Sophie Pym

sophie.pym@luxottica.com.au

WA: Mario Basso

mario.basso@luxottica.com.au

NZ: Jonathan Payne

jonathan.payne@opsm.co.nz

OPSM.COM.AU/CAREERS


SPECSAVERS – YOUR CAREER, NO LIMITS

VISIT

SPECTRUM-ANZ.COM

Optometry Partner – Echuca, VIC

We have an exciting opportunity for an optometrist to join the brand-new Specsavers Echuca store as a Joint Venture Partner.

Located within an irrigated pastoral and agricultural district on the Murray River in Victoria, the Echuca store was opened last year

and has been fitted with state-of-the-art equipment including OCT. The store boasts four optical testing rooms, one audiology room,

nine dispense desks and a stand-up contact lens desk.

Full-time Optometrist – Tamworth, NSW

Specsavers Tamworth are seeking an experienced optometrist to join them in a full-time role.. If you are successful in joining

Specsavers, you will be rewarded with an attractive salary package, including quarterly and annual bonuses, performance-based

incentives and your AHPRA registration, OAA membership and insurance will be covered every year.

Locum Optometrists – WA and Far North QLD - $150,000 package!

Do you love the idea of a locum lifestyle but prefer the security of regular work? If you answered “yes”, a fly in, fly out or drive

in, drive out role could be perfect for you. If you are successful, you will join the Specsavers Mobile Optometry Team and be

guaranteed a $150,000 package, five weeks’ annual leave (plus sick/carers leave), CPD allowance, all registrations paid, networking

opportunities and a robust induction at Specsavers Support Office. With stores in WA and Far North Queensland to fill your

roster, what’s not to love about this position? If you have a minimum of two years’ experience, a desire to travel and want to work

with the latest technology, get in touch today.

Graduate Optometrist – Mt Gambier, SA

Specsavers Mt Gambier is looking for a passionate graduate optometrist to join their vibrant team. This store, which boasts four

test rooms, will provide you with the opportunity to work with the latest ophthalmic equipment and give you exposure to a broad

demographic of patients, primarily children and over 60s. Mt Gambier lies halfway between Adelaide and Melbourne and strikes the

ideal balance between the vibrant lifestyle of a big city and comforts of a small town.

Full-time Optometrist – Blenheim, NZ

Specsavers Blenheim has a fantastic opportunity for an optometrist to join the team on a permanent basis with a wonderful

incentive – you work four days a week and get paid for a full-time position. The store has two consulting rooms equipped with fully

automated equipment including a new OCT, as well as an experienced and well-trained dispensing team.

Full-time, Part-time and Locum Optometrists, NZ

Have you been considering a move to NZ? Specsavers has a number of permanent and locum opportunities based across the

country. Whatever your interests, whether you enjoy the hustle and bustle of city life or if you prefer a more relaxed, outdoorsy

lifestyle there will be an opportunity for you. Contact us today to discuss our full-time, part-time and locum vacancies.

SO LET’S TALK!

In a few short years, Specsavers has achieved

market leadership in Australia and New Zealand with

more people choosing to have their eyes tested and

buy their prescription eyewear from Specsavers than

any other optometrist. To learn more about these roles,

or to put your hand up for other roles as they emerge,

please contact us today:

Joint Venture Partnership (JVP) enquiries:

Maria Savva – Partner Recruitment Manager

maria.savva@specsavers.com or 0401 353 587

For NSW/ACT, SA & WA enquiries:

Marie Stewart – Recruitment Consultant

marie.stewart@specsavers.com or 0408 084 134

For QLD/NT & VIC/TAS enquiries:

Madeleine Curran – Recruitment Consultant

madeleine.curran@specsavers.com or 0437 840 749

Locum employment enquiries:

Cindy Marshall – Locum Team Leader

cindy.marshall@specsavers.com or 0450 609 872

New Zealand employment enquiries:

Chris Rickard – Recruitment Consultant

chris.rickard@specsavers.com or 0275 795 499

Graduate employment enquiries:

apac.graduateteam@specsavers.com

*

Careers at EyecarePlus

®

Optometrists

EYECARE PLUS OPTOMETRISTS

Eyecare Plus provides business support and marketing services to over 155 clinically

focused independent full scope optometry practices throughout Australia.

Our practices are owned and operated independently by our member Optometrist and

Dispenser owners. All of our practices have complete clinical independence and are

equipped with the latest diagnostic equipment, including an OCT in the majority of our

practices.

Eyecare Plus offers three membership options; branded, co-branded and unbranded.

Further benefits include marketing support, business tools and advice, exclusive territories,

conferences, workshops and staff training.

We also actively assist Optometrists and Dispensers who are looking to establish their

own practice. If you are looking to buy, or sell, an optometry practice, please contact us.

For more information call Philip Rose: 0416 807 546

or email: Philip.rose@eyecareplus.com.au.

OPTOMETRIST – MUSWELLBROOK & SCONE, NSW

The two full-time positions would suit recent graduates or experienced optometrists. We

are looking for passionate and dedicated optometrists to join our modern practices

and friendly teams. We are a member of Eyecare Plus which is a group of independent

optometrists with 170 practices, multiple winner of the Canstar 5 star award for patient

satisfaction. The group holds regular face to face training and has an annual conference

or boot camp where optometrists are encouraged to attend. Our own group of 15

practices with 14 optometrists has an annual Rolfe Group optometry conference over a

weekend. So we have a great environment for inter colleague connection and support.

We promote our practices as leaders in Optometry and being regionally based this

allows up to practice full scope optometry from high incidence of eye disease detection,

glaucoma co management, macular degeneration co management and treatment of dry

eye disease. We are fully equipped with modern equipment including a retinal camera at

every location, automated visual field analysers, automated corneal topographers, 4 in 1

(autorefractor, tonometer, pachymeter, keratometer), and OCT.

To Apply: Please contact Don Granger, 0407 485 028 or d.granger@eyecareplus.com.

au to discuss this great opportunity to work in independent optometry.

OPTICAL DISPENSER – NEUTRAL BAY, SYDNEY

Eyecare Plus Neutral Bay is an independent Optometry Practice. We are a small

dedicated team, with a primary focus on eye health. We pride ourselves on putting our

patients first and exceeding patient expectations.

We are currently seeking an experienced, energetic, enthusiastic and highly motivated

Optical Dispenser to join our busy team. The applicant should have good organisational

skills and excellent communication skills. A passion for delivering outstanding customer

service in a health focused practice and a willingness to learn and broaden your skills is

essential.

To Apply: Please email your application to r.klinger@eyecareplus.com.au

OPTICAL DISPENSER – LAKE MUNMORAH, NSW

Eyecare Plus Lake Munmorah is an award-winning independent optometry practice built

on a solid local reputation for delivery of quality customer service and eyecare.

We are seeking a vibrant and enthusiastic team member with prior knowledge and

experience in optical dispensing. Although Certificate IV in Optical Dispensing is not

essential, a minimum 2 years experience in the optical retail environment is required.

The position is for a flexible 2-3 days a week part-time, with rare Saturdays and no

Sundays or Public Holidays. Our flexible team allows for a great work-life balance.

To Apply: Please apply with your CV and cover letter to lchenoptometrist@gmail.com

CURRENT POSITIONS VACANT for more: www.eyecareplus.com.au/careers/

OPTICAL DISPENSER / SALES ASSISTANT: Neutral Bay - Sydney, Lake Munmorah - NSW

OPTOMETRIST: Muswellbrook & Scone - NSW


2019 CALENDAR

To

list an event in our calendar

email: info@insightnews.com.au

AUGUST

RANZCO QLD BRANCH

ANNUAL SCIENTIFIC MEETING

Main Beach, Australia

1 – 4 August

tdf@conferencelink.com.au

ORTHOPTICS AUSTRALIA

VICTORIA JULY SCIENTIFIC

MEETING 2019

Melbourne, Australia

3 August

orthoptics.org.au/education-cpd/

event-calendar/

A FOCUS ON ORTHOPTICS IN

NEUROLOGY SYMPOSIUM

Sydney, Australia

10 August

orthoptics.org.au/

eventdetails/3872/oa-and-utspresent-a-focus-on-orthoptics-inneurology-symposium

EYEBANKING - A PRIMER

FOR ALLIED HEALTH

PROFESSIONALS

Melbourne, Australia

22 August

orthoptics.org.au/

eventdetails/3748/oa-vicbranchrveehrchltu-orthopticcontinuing-education-seminar-4

LIFESTYLE CONGRESS

Hobart, Australia

23 – 25 August

optometry.org.au/TAS

OPHTHALMOLOGY UPDATES!

CONFERENCE 2018

Sydney, Australia

24 – 25 August

ophthalmologyupdates.com

SEPTEMBER

NEURO-OPHTHTHALMIC

SOCIETY OF AUSTRALIA

Brisbane, Australia

5 – 8 September

nosa.com.au

THYROID EYE DISEASE

AND OTHER AUTOIMMUNE

DISEASES

Melbourne, Australia

7 September

orthoptics.org.au/

eventdetails/3749/oa-viccontinuing-education-day

SPECSAVERS CLINICAL

CONFERENCE

Melbourne, Australia

7 – 8 September

spectrum-anz.com

OPHTHALMOLOGY AND

OPTOMETRY

Singapore

16 –17 September

opthalmologycongress.

insightconferences.com/

GLOBAL OPHTHALMOLOGY,

OPTOMETRY AND GLAUCOMA

CONFERENCE

Dubai, UAE

16 – 17 September

glaucoma.conferenceseries.com

INTERNATIONAL

VISION EXPO WEST

Sands Expo, Las Vegas

18 – 21 September

west.visionexpo.com

OPHTHALMOLOGY AND

OPHTHALMIC SURGERY

Osaka, Japan

19 – 20 September

worldophthalmology.

conferenceseries.com/

EUROPEAN SOCIETY OF

RETINA SPECIALISTS

Vienna, Austria

20 – 23 September

euretina.org/vienna2018

SILMO 2019

Paris, France

27 – 30 September

silmoparis.com

OCTOBER

ASIA-PACIFIC ASSOCIATION

OF CATARACT AND

REFRACTIVE SURGEONS

Kyoto, Japan

3 – 5 October

apacrs2019.org/apacrs

30TH INTERNATIONAL

CONFERENCE ON CLINICAL

AND EXPERIMENTAL

OPHTHALMOLOGY

Dublin, Ireland

11 – 12 October

europe.ophthalmologyconferences.

com

NEW ZEALAND ASSOCIATION

OF OPTOMETRISTS 89TH

ANNUAL CONFERENCE

Napier, New Zealand

18 – 19 October

nzao.co.nz/2019-conference

LA TROBE UNIVERSITY

RESEARCH SHOWCASE

Melbourne, Australia

23 October

orthoptics.org.au/

eventdetails/2370/oa-vicbranchrveehrchltu-orthopticcontinuing-education-seminar-5

NOVEMBER

RANZCO CONGRESS

Sydney, Australia

8 – 12 November

ranzco.edu/home/event-details/

ranzco-congress

76TH ORTHOPTICS AUSTRALIA

ANNUAL CONFERENCE

Sydney, Australia

9 – 11 November

orthoptics.org.au/education-cpd/

annual-conference-2019/

33RD EUROPEAN

OPHTHALMOLOGY CONGRESS

Madrid, Spain

14 – 15 November

ophthalmologycongress.

ophthalmologyconferences.com

DECEMBER

WORLD EYE AND VISION

CONGRESS

Abu Dhabi, UAE

5 – 6 December

76th ORTHOPTICS AUSTRALIA

ANNUAL CONFERENCE

9 - 11 NOVEMBER 2019

INTERNATIONAL CONVENTION CENTRE SYDNEY

REACHING OUT GLOBALLY, LEARNING LOCALLY


SOAPBOX

MARKING THE END OF AN ERA IN OPTICAL REPAIR

Across the ophthalmic sector

there are many people who

contribute an extraordinary

amount to the profession, but avoid

the spotlight. Though they do not

often receive it, these people deserve

recognition for their role in making

optometry as exceptional as it is.

Reg Quaife is one such person.

For nearly 60 years he provided

engineering solutions to the optical

profession, but has now taken down

his shingle and retired.

I first met Reg in 1984 when my

ophthalmoscope needed a service.

Reg came to my rescue and returned

the instrument back to its original,

pristine condition by ultrasonically

cleaning each individual lens, followed

by painstakingly positioning them back

into their individual carriers. I admired

his precision, patience and attention to

detail, and we have been career-long

friends ever since.

Reg has a remarkable history, dating

back to 1960 when UK Optical Bausch

& Lomb employed him as a toolmaker.

His job was to both develop and make

the tooling for the manufacture of

spectacle frames. Later on he became

involved in the instrument department

servicing most optical equipment.

Of the company’s 60 staff, Reg

was one of six in this department. In

contrast to today, almost all frames

were handmade in Australia. It

would take three months to design

and construct the tools needed to

manufacture a single frame. It’s hard

to believe now, where CNC design and

3D printing can produce spectacle

frames within days or even hours.

After 12 years Reg joined Kennedy

Optical, a wholesale lens laboratory

that also sold spectacle frames

and lens edging equipment. Reg

looked after the lens edgers within

the laboratory, which led to him

establishing a service department

that was later opened to the general

optometric and optical public.

As this flourished, the company

acquired an agency for ophthalmic

equipment.

This was where Reg honed his

current skills. It would often take four

months or more to source parts from

overseas, however Reg could often

make a replacement quicker and

better than the original.

In 1980 Reg took on the instrument

side of the business. This marked the

birth of his company, Servicing Optics,

which was established in the garage

of his modest home. At first Servicing

Optics was the only independent

company which both serviced and

repaired almost every ophthalmic

instrument on the market, irrespective

of brand, type, make or model. Reg

recalls the generosity of several

optometrists who supported him

throughout those fledgling years.

Reg quickly became the ‘go to’

man for everything optics, and then

more. His portfolio was diverse, from

helping people both sell and buy

their businesses to being an inventor

with the unique ability to make ideas

become reality.

Some of his more notable projects

include a driver reaction device

developed in collaboration with the

RACV, and a role in the creation of

Medmont’s benchmark visual field

analyser. He also helped to design

one of the early remote controlled

illuminated letter charts, which are

now ubiquitous throughout the optical

industry.

A constant in my dealings with

Reg were the familiar people

who answered the phones at

Servicing Optics.

All his employees were all long

serving; a testament to the way

Reg looked after those who looked

after him.

Reg looks back on his career with

great fondness. He had a simple

mantra in business: be truthful,

be honest, no stories to make a

sale. If Reg did not believe in the

product, there was no way he would

recommend it.

I asked him on what he was looking

forward to in retirement. He replied:

“Things I never had time to do when I

was working; travelling with my wife,

Joy, and the occasional Wednesday

afternoon game of golf.”

Reg has always been one to avoid

the limelight and let his actions do the

talking, but people like him deserve a

lot of credit for what they bring to the

profession. He has been the righthand

man for so many of us as he has

been so reliable, so consistent and so

knowledgeable. He has always been

true to his roots and is still the same

man I first met 35 years ago. n

Name: Malcolm Gin

Qualifications: BScOptom

Workplace: Eyes & Optics Wonthaggi

Victoria

Position: Optometrist

Special interests: Co management

ocular disease

Location: Wonthaggi

Years in profession: 35

REG LOOKS BACK

ON HIS CAREER

WITH GREAT

FONDNESS. HE

HAD A SIMPLE

MANTRA IN

BUSINESS: BE

TRUTHFUL, BE

HONEST, NO

STORIES TO MAKE

A SALE.

58 INSIGHT August 2019


See more, know more

with new Insight

Subscribe FREE and

receive the latest news

Find jobs and advance

your career with

Insight’s Classifieds

Insight is now

mobile and

tablet friendly

Find new products and meet

new suppliers with Insight’s

Showrooms

Insight’s new website keeps you updated on the latest industry

news and information. With a world-class responsive design,

Insight is now accessible seamlessly on any device, 24/7.

Sign-up FREE to our eNewsletters and industry reports

delivered weekly straight to your inbox.

www.insightnews.com.au


A new era begins.

Become its pioneer.

ZEISS VISUFIT 1000

ZEISS VISUFIT 1000

The new digital platform that will shape your business

and create a memorable patient experience.

• Highly accurate one-shot 3D centration, with 9 mutually

calibrated cameras and no need for a clip frame.

• Best ease-of-use with an iPad or PC managed device, featuring a

body posture correction assistant to grant a natural position.

• Right / left back vertex distance determination to enhance the

accuracy of the individualized lenses.

• 180° view for the comparison of an unlimited number of

frames and for lens demonstration as worn.

www.zeiss.com.au/instruments+technology

More magazines by this user
Similar magazines