AUSTRALIA’S LEADING OPHTHALMIC MAGAZINE SINCE 1975
COMMITMENT MADE TO
focus on rebuilding the
profession at O=MEGA19
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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
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
To combat this, Clarke proposed
a rejuvenation of the ADOA that
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
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.
Many of the industry figures in
attendance shared their support for
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
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
“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.
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
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Just as Insight
went to print, UK
charity FIGHT FOR
that it is funding
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
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.
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.
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
HUNG OUT TO DRY
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.
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.
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.
Clinical & Technical Editor
Lewis Williams PhD
Insight is published by:
Gunnamatta Media Pty Ltd
Locked Bag 26, South Melbourne,
VIC 3205 AUSTRALIA
Phone: +61 3 9696 7200
Design & Production Manager
Jo De Bono
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
INSIGHT August 2019 5
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
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
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
“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
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
“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
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
"AS SUCH, THE
BOARD DOES NOT
SEE ANY NEED TO
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
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
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
$1 MILLION CONTRIBUTED
TO BIONIC EYE PROJECT
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
The project has received funding under
the government’s new Medical Research
Future Fund: Frontier Health and Medical
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
“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
Computer scientists working on
driverless cars are currently facing
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
Lowery said one of the two cases
is likely to be for vision, but the other
could be for the treatment of epilepsy
”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
“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
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
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
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
“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
“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.”
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
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
OF PEOPLE AND
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
Clarke said these results proved that
there is no excuse for the lack of a
great organisation for optical dispensers
“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
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
“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
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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
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
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
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
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
“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
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
CONTINUE TO PAY
THAT AT SOME
THE FAIR WORK
THE FAIR WORK
DEEM YOU TO BE
provisions under the HP&SS Award.
A FWO spokesperson said the
original press released in on the
authority’s public online library remains
“Our approach to any compliance
and enforcement issue is set out in our
Compliance and Enforcement Policy. We
have no further comment.”
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
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
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
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
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
MEANS THEY ARE
providing quality optometric care,” she
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
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
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
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
12 INSIGHT August 2019
SCC8 | MELBOURNE CONVENTION AND EXHIBITION CENTRE
SEPTEMBER 7-8, 2019
Dr Caroline Catt
Gordon Eye Surgery
Subject: Paediatric optometry
Vision Eye Institute
Subject: Anterior eye disease
Dr Dru Daniels
Dr Adam Rudkin
Specialist Eye Glenelg /
Subject: Vitreoretinal conditions
Dr Elaine Chong
Subject: Interpretation of OCT in
medical retina conditions
Specsavers Australia and
Subject: Transforming Eye Health
Dr Tu Tran
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
Centre for Eye Research Australia
Subject: Optometric management
of ocular inflammation
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,
LEI APPOINTS NEW
MANAGING DIRECTOR AND
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
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
“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
TWO BOARDS, SO
WE HAVE PASSED
ON SOME OF
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
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
“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
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
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
Haydon said this had been a
successful model applied to other allied
health professions such as dentistry and
“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
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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
“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
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
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
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
“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
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
“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
FOR MYLO WAS
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
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
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
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
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
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
JOIN OUR COMMUNITY ON LINKEDIN
CERA PROJECTS SECURE
$1.5 MILLION IN NEW
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
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
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 MEET THE
WISHES OF OUR
NEW GRANTS AVAILABLE FOR
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
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
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
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
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
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
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
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
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
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
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
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
“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
Moshegov believes with the added
benefits of intermediate vision and
little drawback, the device is an easy
“You are getting some intermediate
vision that you wouldn’t get with an
GET WITH AN
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
“A small degree of myopia with these
lenses goes a long way to help [patients]
with intermediate and near vision tasks
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
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ALLERGAN BOUGHT BY ABBVIE IN
MULTI-BILLION DOLLAR DEAL
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
“Following our record performance in
2018 and strong start to the current year,
the outlook for the business remains very
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
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
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
OF ABBVIE AND
TO DELIVER ON
OUR MISSION TO
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
“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
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
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
“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
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
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
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,
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
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
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
“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
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
“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
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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
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
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
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
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
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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
Diagnose Dry Eye Disease
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
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
• Upgrade for existing users to Joystick
• Upgrade to NEW longer base for easy
access to lids
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
severe dry eye
EYE-ECO Dry Eye Products
• Nighttime Shelter Masks
Dry Eye Screening
• InflammaDry rapid screening test
• Tea Tree
• Tear Touch Blu
1800 225 307
Available in pharmacies September 2019
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)
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
*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
• 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.
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.
1800 238 742 76 firstname.lastname@example.org
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.
1800 252 224 email@example.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 firstname.lastname@example.org
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
DESIGNS FOR VISION
1800 225 307 or email@example.com
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
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 firstname.lastname@example.org
36 INSIGHT August 2019
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
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
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.
1800 238 742 76
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
GOOD OPTICAL SERVICES
(03) 9645 1066 email@example.com
EXPERIENCE CHROMAPOP TM IN PRESCRIPTION
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
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.
1800 252 224 firstname.lastname@example.org
• 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.
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 email@example.com
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
Evolve ® Hypromellose 0.3%
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.
1800 238 742 76
Evolve ® Carmellose 0.5%
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
1800 586 364 firstname.lastname@example.org
Evolve ® Eyelid Wipes
Australian Distributor: Contact Lens Centre, Australia
Unit 6D 2A Westall Rd, Clayton, VIC 3168 Australia
Ph 1800 125 023
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.
1800 125 023
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.
1800 429 551 device.com.au
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
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
lubricant eye drops
are an artificial tear
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.
1800 252 224 email@example.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
P: +61 3 9645 1066 / F:+61 3 9681 7976
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 firstname.lastname@example.org
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.
1800 224 153, CH2: 1300 283 122
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
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
DESIGNS FOR VISION
1800 225 307 or email@example.com
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.
1800 238 742 76 firstname.lastname@example.org
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 email@example.com
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 firstname.lastname@example.org
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
MINIMISE IMPACT OF
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
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
SHOWS THAT THE
IMPLANT IS SAFE
AND MAY ONLY
CLINIC VISIT AND
REFILL EVERY SIX
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
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
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
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
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
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
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
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
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
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
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
“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
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,”
“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
A report describing the autofocal
glasses was published in the journal
Science Advances. n
JUST SIT ON A
SHELF IN THE
OFFICE AND BE
USED AND PUT
PEOPLE IN A
ADAM WAX, DUKE
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
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
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
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.
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
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
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.
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
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
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
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
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
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
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
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
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.
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
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
Indian ophthalmologist and glaucoma specialist
Dr HARSHA RAO NARAYANA from the Nethralaya
Eye Care Hospital presented 10 points about
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
• 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.
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
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
• Can detect the progressive decrease in the population of capillaries,
• Might or might not be able to detect disease progression earlier than
• 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
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
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.
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
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.
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
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
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.
IT WAS SO MOVING
FOR US TO BE
INVOLVED IN NOT
THE SIGHT OF
SO MUCH OF HIS
LIFE AHEAD OF
HIM, BUT TO ALSO
HELP HIM GET HIS
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,
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
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.
IN THIS AREA
SKILLS ARE NOT
Customer service skills are easy to
master but they are impeded and
compromised in many instances
by inadequate, superficial and narrowlyfocused
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
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
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
The importance of customer service
may be appreciated, but it too remains
unrealised to the dismay of front-line
THE PERSONAL TOUCH
Customer and client satisfaction is
determined by, and measured against,
expectations, as well as first impressions
that occur long before personal
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
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
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
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
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 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.
EVEN IF THE
KID SAYS ‘THEY
TEND TO SAY
USED TO THEM.
IF THEY DON’T
THEY WILL NOT
WEAR THEM AT
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
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
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
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
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
To place a classified advertisement
Mechanic with 30+
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
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
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 email@example.com
• Optometrist qualifications and/
or AHPRA Registration
• Minimum 2 years post
qualification / practice
• Practice management systems
experience – Optomate
• Superior communication skills
• Genuine care and empathy for
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
QLD/NT: Brendan Philp
VIC/TAS: Melissa Downing
SA: Sophie Pym
WA: Mario Basso
NZ: Jonathan Payne
SPECSAVERS – YOUR CAREER, NO LIMITS
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
firstname.lastname@example.org or 0401 353 587
For NSW/ACT, SA & WA enquiries:
Marie Stewart – Recruitment Consultant
email@example.com or 0408 084 134
For QLD/NT & VIC/TAS enquiries:
Madeleine Curran – Recruitment Consultant
firstname.lastname@example.org or 0437 840 749
Locum employment enquiries:
Cindy Marshall – Locum Team Leader
email@example.com or 0450 609 872
New Zealand employment enquiries:
Chris Rickard – Recruitment Consultant
firstname.lastname@example.org or 0275 795 499
Graduate employment enquiries:
Careers at EyecarePlus
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
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.email@example.com.
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 firstname.lastname@example.org.
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
To Apply: Please email your application to email@example.com
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 firstname.lastname@example.org
CURRENT POSITIONS VACANT for more: www.eyecareplus.com.au/careers/
OPTICAL DISPENSER / SALES ASSISTANT: Neutral Bay - Sydney, Lake Munmorah - NSW
OPTOMETRIST: Muswellbrook & Scone - NSW
list an event in our calendar
RANZCO QLD BRANCH
ANNUAL SCIENTIFIC MEETING
Main Beach, Australia
1 – 4 August
VICTORIA JULY SCIENTIFIC
A FOCUS ON ORTHOPTICS IN
EYEBANKING - A PRIMER
FOR ALLIED HEALTH
23 – 25 August
24 – 25 August
SOCIETY OF AUSTRALIA
5 – 8 September
THYROID EYE DISEASE
AND OTHER AUTOIMMUNE
7 – 8 September
16 –17 September
OPTOMETRY AND GLAUCOMA
16 – 17 September
VISION EXPO WEST
Sands Expo, Las Vegas
18 – 21 September
19 – 20 September
EUROPEAN SOCIETY OF
20 – 23 September
27 – 30 September
OF CATARACT AND
3 – 5 October
CONFERENCE ON CLINICAL
11 – 12 October
NEW ZEALAND ASSOCIATION
OF OPTOMETRISTS 89TH
Napier, New Zealand
18 – 19 October
LA TROBE UNIVERSITY
8 – 12 November
76TH ORTHOPTICS AUSTRALIA
9 – 11 November
14 – 15 November
WORLD EYE AND VISION
Abu Dhabi, UAE
5 – 6 December
76th ORTHOPTICS AUSTRALIA
9 - 11 NOVEMBER 2019
INTERNATIONAL CONVENTION CENTRE SYDNEY
REACHING OUT GLOBALLY, LEARNING LOCALLY
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
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
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
A constant in my dealings with
Reg were the familiar people
who answered the phones at
All his employees were all long
serving; a testament to the way
Reg looked after those who looked
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
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
Workplace: Eyes & Optics Wonthaggi
Special interests: Co management
Years in profession: 35
REG LOOKS BACK
ON HIS CAREER
HAD A SIMPLE
STORIES TO MAKE
58 INSIGHT August 2019
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