July 2025

JULY 2025

NEW ZEALAND

Exploring

synaesthesia

RANZCO NZ

2025

DEANZ

patient day

Page 16

Page 20

Page 50

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY

PO Box 32185, Devonport 0744

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Inside

6

EDITORIAL

NEWS

8 Referrals wanted for world-leading research

10 Snowvision is back, as SnowViz!

12 Support needed for Vision Bus Aotearoa

14 Volunteer for the Special Olympics in Christchurch

40 Boost the workforce, tackle burnout

42 GNZ launches ‘high-impact’ Sightwise

57 Sight is NZ’s most valued sense

58 Style news

12

FEATURES

16 Uncommon sense – exploring synaesthesia

20 RANZCO NZ 2025: unity and innovation

56 Inspiring confidence with frame choice

16

EDUCATION

43 From LA with love – the ASOA annual meeting

48 Pathological myopia

50 Putting patients first: DEANZ 2025 education day

8

RESEARCH

46 New treatments for uveal melanomas and naevi

46

BUSINESS

54 The importance of adequate insurance

60 CHALKEYES PRESENTS:

… And a little child shall lead them

20

62 CLASSIFIEDS

52

58

www.nzoptics.co.nz | PO Box 32185, Devonport 0744 | New Zealand | ISSN 0110-8697 (Print) | ISSN 2703-660X (Online) | facebook.com/NZOptics

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NZ Optics is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times a year, by New Zealand Optics 2015 Ltd. Copyright is held by NZ Optics

2015 Ltd. As well as the magazine and the website, NZ Optics 2015 Ltd publishes the New Zealand Optical Information Guide (OIG), a comprehensive online listing guide that profiles the

products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The views expressed in this publication are not necessarily

those of NZ Optics 2015 Ltd or the editorial team.

A very colourful piece!

IN THE MAGAZINE

industry a ‘colour

piece’ is one that is

based on description,

atmosphere and

emotion, rather than

just reportage. So it

brings me joy this

issue to tell you that

not only do we have

heaps of colour in our

diverse coverage of

RANZCO NZ’s 75th

Annual Scientific

Meeting (p20–40)

Eye-catching, bold colours, huge carved doors and

this illuminated pou acknowledge the region’s Māori

affiliations at the RANZCO NZ conference venue

held in glorious Rotorua, but also in a news item about scientists

tricking the eye into seeing a new colour (p18) and a feature devoted

to the intriguing world of synaesthesia – a ‘crosstalk’ between senses

(p16–18). The latter was particularly interesting to me as I have a form

of synaesthesia where I see numbers and days of the week in different

colours. This, apparently, makes me not only a little weird but also prone

to anxiety!

Also this issue,

our new Eye on

Ophthalmology

series editors

make their debut

(p48) and we hear

about a successful

DEANZ education

day (p50) where

patients shared

valuable insights

to help shape how

Dr Anne-Marie Yardley, Yours Truly and Drs Sarah Welch and

Cheefoong Chong

practitioners care for

people with dry eye

disease. Patient

involvement in

care also got a

good hearing

at RANZCO NZ,

along with facts

about burnout

and cataract

surgery rates in Aotearoa, captivating surgical videos, pearls from highprofile

ophthalmic nurses and much, much more.

Finally, June’s anonymous Chalkeyes’ column about dissatisfaction with

optometry leadership drew some colourful responses, some told to me at

events and others that you should

look out for in upcoming issues.

Along with our Summer and Sun

feature, I see a red-hot issue to

keep us warm for August.

Ma te wa!

Eye on Ophthalmology’s new series editors: Drs Rachel

Niederer, Francesc March de Ribot and Sarah Hull

Farewell to Trish Orr

Susie Hill

Editor, NZ Optics

We were very saddened to hear

that the wonderful Trish Orr of BTP

International Designz has died. Trish

was a stalwart of the optical frames

industry whose warmth, kindness and

vivacity were a joy to be around. NZ

Optics’ publisher Lesley remembers

many occasions where Trish went out

of her way to help her, especially as

she was getting to know the business

of optics. It was a pure pleasure to know her, says Lesley, and we all send

our deepest condolences to her family, friends and colleagues.

CONTRIBUTORS

Shellene Garofalakis

Despite no healthcare

background prior to becoming

Eye Doctors’ practice manager six

years ago, Shellene Garofalakis

says the career choice felt

appropriate after a difficult

family experience. “Our son was

diagnosed with leukaemia at 16

years old and we spent about

four years in and out of hospital.

We met so many amazing, caring

people during that time, so when

a chance came up to work in

healthcare and give back in some

way, it just felt like the right thing to do.”

Shellene has since come to appreciate how incredibly complex the

eye is. “There was definitely a lot to take in, but being surrounded by

surgeons who are passionate and knowledgeable has made the journey

pretty awesome.”

In her spare time, Shellene enjoys the great outdoors. “Like a lot of my

fellow mid-life blues crew, I’ve picked up a pair of tramping boots and

hiking poles and headed for the hills!”

Shellene reports on the ASCRS practice managers’ conference on p43.

Kathryn Millichamp

Auckland’s Greenlane Clinic

nurse practitioner Kathryn

Millichamp says she fell

into ophthalmic nursing

by accident. As a kid she’d

harboured ambitions of

being a dancer, a circus

performer or a gypsy.

However, healthcare had

always been in the back of

her mind as a good career

path, she says.

After training, she went into primary care, but later needed hours

compatible with her son’s schooling. “Having seen a position advertised

to work in the eye clinic, I thought that would be perfect. I thought ‘how

hard can eyes be?’ but it didn’t take me long to realise the answer was

‘very’!”

Away from the clinic, Kathryn loves spending time with her husband,

family and friends. “I look after our granddaughter one day a week and

we also babysit occasionally and enjoy walks in the park, going to the

beach, trips to the zoo or just playing at home. I also love cooking, baking

and entertaining.”

Kathryn brings us her highlights of RANZCO NZ’s nurses meeting on p30.

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20979]. 6. Alcon data on file. US Patent 9968440 B2. 15 May 2018; [REF-03130]. 7. Alcon data on file, 2017. TDOC-0055576; [REF-09755]. 8. Bala C et al. Multi-country clinical outcomes of a new nondiffractive

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NEWS

Referrals wanted for

world-leading research

By Susie Hill

RESEARCHERS IN THE Molecular Vision Research Cluster (MVRC)

at the University of Auckland are calling for eyecare professionals to

refer a specific cohort of patients for a study they hope will result in new

treatments for cataract and presbyopia.

While these conditions are commonly managed with reading glasses

or surgery, the work could lay the foundation for medical therapies to

delay cataract and presbyopia onset, potentially reducing the growing

burden on healthcare systems worldwide, said MVRC head Professor

Paul Donaldson.

Discussing the study as part of his Professor Anthony Molteno

Innovator’s Lecture at RANZCO NZ’s 2025 conference, Prof Donaldson

said that over the past 10 years his team has taken its theories on the

role of water transport dysfunction in the lens, determined in animal

models, and started translating them to human patients. The research

team has now established how the resting water content changes as a

function of age, he explained, and how the water content dynamically

changes during the process of accommodation. The team has also

initiated a study to observe how water content changes during cataract

development, he said.

At the heart of all this work is the lens’ own microcirculation system

which actively regulates water and nutrient movement in the absence

of a blood supply, said Prof Donaldson, who’s also co-director of the

Aotearoa New Zealand National Eye Centre. “The lens has evolved

Prof Paul Donaldson

a very sophisticated

system to regulate its

water content and we’re

investigating how to

exploit this system to

maintain lens function

and delay these agerelated

conditions.”

MRI scans have

proven crucial in this

research, he said. “The

great thing about MRI

is that it can noninvasively

measure water

content in the human

tissue – the free water and

A T2-weighted brain MRI scan showing a slice through

the eyes

water that is bound to proteins. This allows us to do longitudinal studies

on how water content changes in the same individual in response to a

potential therapy.”

The team is now working to identify a biomarker, such as water

content shifts, that could flag when a cataract is about to develop.

“Having a biomarker that is predictive for the onset of cataract not only

provides a way of identifying patients who are ‘pre-cataractic’,” said

Prof Donaldson, “but also provides a metric that can be monitored

to determine the potential efficacy of a therapy to protect against

cataract onset.

“We’re now at the stage where we are seeking volunteers to help us

understand what happens in the lens before cataract forms.” Specifically,

the team is seeking patients who are scheduled to undergo a vitrectomy.

This eye surgery, typically unrelated to cataract, often leads to cataract

formation within two years. By tracking these patients over this time,

the team hopes to pinpoint early water content changes that herald

cataract onset, he said.

The “elephant in the room”, Prof Donaldson told conference

attendees, was that existing surgical treatments are already seen as safe

and effective, leading some to question the need for new therapies.

“The counter to that is that presbyopia and cataract remain a huge

economic and social burden for society and our health system is

struggling to cope. Medical therapies that could delay these conditions

would reduce that burden.”

The research team, supported by the Health Research Council of

New Zealand and the US National Eye Institute, is keen to hear from

all eyecare professionals who can help them recruit patients or are

interested in leveraging the team’s MRI-based methods to study other

eye conditions.

“We hope that by working together we can bring forward new

therapies to help people maintain clear vision for longer,” said

Prof Donaldson.

For more information and to refer patients, please contact the study’s

clinical lead Alyssa Lie: a.lie@auckland.ac.nz or visit auckland.ac.nz/en/

fmhs/research/research-study-recruitment/research-study-recruitment--

u-z-/using-mri-biomarkers.html

See more from the RANZCO NZ conference on p20-40.


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NEWS

Snowvision is back, as SnowViz!

NEW ZEALAND’S COOLEST boutique vision conference, SnowViz

(formerly Snowvision) returns 5–8 August 2026, organised by Ryan

Lester, Francis Hassan, Richard Johnson, Grant Watters and Greg Nel.

While the name might be new (due to the necessity of forming a new

company and similarities with another business name), the format and

the purpose of the conference remain the same, said Lester. “We will

continue to provide the most up-to-date CPD and push boundaries in

our morning and evening sessions mixed up with a mid-day skiing/

outdoor activity break. Content and activities will be fresh and there

will be new things to learn for both early-career optometrists and the

more experienced.”

The conference’s close ties to the State University of New York

(SUNY) also remain. “SUNY will continue to provide speakers and,

as in the past, profits from the conference go towards the annual

scholarship to send a couple of New Zealand optometrists per year to

SUNY,” he said.

The Crowne Plaza Queenstown is to host SnowViz 026

“We have some great sponsors who have stepped up already but if there

is anyone in the industry who would like to be part of the event, we

would love to have a chat!” Lester said. Hosted at the Crowne Plaza

Queenstown, conference lectures will start on 6 August and the event

dinner will be on 8 August.

If you would like to learn more about sponsoring SnowViz, please contact

Lester via ryan@suckling.co.nz or Hassan via francis.hassan@matthews.

co.nz.. More details about SnowViz will follow later this year.

Professional

Education

Programme

Keynote speaker

Dr Aparna Raniga

Deeply dissatisfied Oz optoms

Credit: FreePik

One-day Symposium

Sunday, 13 July 2025,

9am – 4:30pm

Online or The Maritime Room

Viaduct Harbour, Auckland

glaucoma.org.nz/

professional-symposium

Online course

OPEN NOW, 24/7 Online

Choice of 6 Case events & 1 Optic

Disc Assessment event (7 events)

glaucoma.org.nz/professionals

PRELIMINARY RESULTS FROM the Optometry Australia (OA)-

commissioned workforce study reveal significant moral distress

among optometrists at work, with factors such as KPI focus causing

role conflicts.

The results suggest a need to redesign the optometry workplace,

wrote authors led by Professor Nicola Anstice, Flinders University.

“Our findings suggest that optometrists continue to strive to provide

the best possible patient care despite facing challenging situations

and with limited professional autonomy. For many respondents, job

demands far exceed job resources and urgent action needs to be

taken to redesign workplaces,” they said.

A snapshot of the findings showed 77% of survey participants

were dissatisfied with their career options and growth

opportunities; 75% were dissatisfied with their income; and 34% felt

professionally isolated.

OA said the initial findings confirm many anecdotal reports from

members regarding workplace standards and systems. “Optometry

Australia has shared the survey results and updated position

statement with the Australian Health Practitioner Regulation Agency

and several of the nation’s largest optometry employers. We are

calling on these stakeholders to collaborate with us in driving muchneeded

reform.”

The next stage of the research is to conduct focus groups to

more deeply explore how job demands and resources influence

optometrists’ job satisfaction to identify factors that foster positive

working environments, OA said.

The survey included a total of 505 optometrists, with 375 complete

responses. The sample was representative of the broader profession:

aged 22 to 67 years, 62% female, 65% working in full-time roles,

spanning corporate (67%), independent (24%), hospital, academic

and other settings. It was organised in part by Phoropter Free Fridays,

a Facebook forum formed in late 2024 by employee optometrists and

independent owners advocating for workplace reform.


Eye Institute Annual

Optometry Conference 2025

Eye Institute are thrilled to announce our 2025 Annual Optometry Conference.

Celebrate your new points cycle and the end of year with Eye Institute!

A fun filled half-day educational conference at the Aotea centre.

Venue:

Aotea Centre,

50 Mayoral Drive, Auckland

Date: Sunday 9th November 2025

Time:

8.30am – 1.30pm

Join us for an exciting and informative half day of valuable CPD points and engaging

rapid fire presentations from our world class surgeons. Network with your colleagues

and enjoy listening to the latest evidence-based updates relevant to your day-today

practice. This conference includes a stand-up breakfast, morning tea, lunch with

beverages and a barista onsite!

Parking is available at the civic undercover carpark. Your ticket will be validated with the event manager on the day.

WEBSITE

eyeinstitute.co.nz

LINKEDIN

Eye Institute

FACEBOOK

Eye Institute – New Zealand

INSTAGRAM

eyeinstitute

Register: Visit eyeinstitute.co.nz and go to our events page to register

NZOPTICS.CO.NZ | 11

NEWS

Support needed for

Vision Bus Aotearoa!

By Susanne Bradley

THE TEAM BEHIND the Vision Bus

Aotearoa (VBA) is seeking new funding to

support continued mobile eyecare service

delivery to underserved schools, primarily in

the South Auckland region.

Funded entirely by philanthropy, the bus has

been generously supported by Peter and Rae

Fehl, Helen and Barbara Blake, Essilor and the

Buchanan Charitable Foundation since 2022,

said Associate Professor Joanna Black, deputy

head of the School of Optometry and Vision

Science (SOVS), University of Auckland.

“We are incredibly grateful for the continued

support from the Blake family, covering

frames plus a dispensing optician, plus Essilor

for lenses, but we are now looking for funding

to cover the operational costs of the bus: staff,

fuel, maintenance, repair of equipment, that

sort of thing.”

While a recent grant from Rotary is funding

a programme for specialised lenses for myopia

control and higher prescriptions, funding

has been increasingly difficult to come by

recently, said A/Prof Black. “Going forward,

we have now developed a very efficient model

of working which we will look to sustain with

a lot of in-kind support from the university.

The VBA being integrated into clinics, and a

significant proportion of the part V students’

paediatric training, means we’re only really

requiring funding for the direct team on

the ground.”

Visiting about 20 schools, the VBA team

examines 500–550 pre-screened kids (from a

pool of 3,000 primary and intermediate school

students) every year. Most are dispensed

some form of vision correction, indicating

that roughly 20% of children out there fail

screening and need glasses, said A/Prof Black.

“In the different types of schools we visit, we

find this number to be fairly stable.”

They also pick up a range of other issues,

including strabismus (3%), keratoconus or

suspected keratoconus (2%), allergic eye

disease and ocular trauma, particularly

through sport, which are mostly referred to

Counties Manukau.

“For the younger children, we tend to do

a follow-up after six weeks, but otherwise

the objective is to link them to community

providers, because they’re going to need an

optometrist right throughout their lives and it’s

best if that person is close to home,” she said.

A vehicle for awareness

Speaking to the VBA’s role in raising

awareness, Emily Benefer, professional

teaching fellow and VBA dispensing optician,

said the culture change in the schools it

visits has been

significant.

“When we first

went to the

schools, there was

a general culture

among the kids,

especially the older

ones, that they didn’t want to wear glasses.

But going back to the same schools for two

to three years now, we’re seeing loads of kids

wearing glasses in the playgrounds and in the

classrooms – and they’re the ones that we’ve

given them one year, maybe even two years,

ago. The bus is making those communities

more aware of eye health and the importance

of getting their eyes checked.”

Three-fold purpose

A/Prof Joanna Black

Essentially there are three pillars to the bus,

A/Prof Black said: delivering clinical service

to the community; providing a teaching

platform for the final-year students to apply

their clinical skills under supervision; and the

research aspect, contributing to the knowledge

of eye conditions in Aotearoa and how eyecare

services can be successfully delivered in

the community.

“We’re a university, a training provider, so

the real point of the Vision Bus is to train our

students. It puts them in a new situation and

teaches them some resilience and adaptability,

while offering them an opportunity to work

with young children. That is our purpose, but

we’re also hoping it raises awareness at the

community level within the schools and, by

Ilvero-Devatis swap stings

Germaine Joblin and Sachi Rathod were (figuratively and literally)

the driving forces behind the VBA in 2024. Credit: UoA

leading with research, to the government level

to change policy to increase access to eyecare.”

Looking to the future, A/Prof Black

said while it’s a challenge for university

students to travel outside of Auckland

during their normal clinical rotations, VBA

is considering partnering with some of the

faculty initiatives, such as the Rural Health

Interprofessional Programme, which runs

through Northland and the Bay of Plenty, as

a potential opportunity for students during

their externships.

Currently, the VBA provides eyecare

services to school children (years 0–13)

who have failed the vision screening service

delivered by SOVS and require follow-up care.

It also provides care for the residents of the

Māngere Refugee Centre, visits marae and the

occasional event.

This year, VBA welcomed the return of

optometrist and professional teaching fellow

Veeran Morar to the wheel, while the 2024

crew – Germaine Joblin and Sachi Rathod

– are continuing to serve eye health and the

community through advocacy work and

research, respectively.

For fundraising enquiries, please contact A/Prof

Black on j.black@auckland.ac.nz

PHARMAC HAS SWAPPED funding from nepafenac (Ilvero) to diclofenac sodium (Devatis) eye

drops. Ilevro nepafenac drops were a temporary replacement for Voltaren Ophtha, for which

there were supply gaps between December 2024 and February 2025, said Pharmac. “(Ilevro)

stock is running low and will be delisted 1 July 2025.”

Diclofenac is the same as Voltaren, said Associate Professor James McKelvie. “The main

benefit of nepafenac is the once-daily dosing as opposed to the four times a day required for

diclofenac. It also stings less, which is a small added bonus.”

In October 2024, the funding of Ilevro was welcomed by some of the country’s eyecare

professionals, including Jagrut Lallu, co-owner of Rose Optometry in Hamilton, who

described Ilevro’s funding as a “dream come true” since Voltaren drops “really sting”.

Currently, however, there are no plans to relist nepafenac on the schedule, despite

ophthalmologists telling Pharmac they would like to see it funded permanently, said

Pharmac’s director, pharmaceuticals, Geraldine MacGibbon. “Our team is exploring whether

this would be possible. As nepafenac is a different medicine to diclofenac, we need to assess

whether it would support improved health outcomes for New Zealanders.”

A new step in Pharmac’s approval process involves asking for feedback on potential brand

changes from people who take these medicines, she said. “We want to know what the impact

of a potential brand change would be and what support people would need.”


Childhood visual impairment falls

By Lesley Springall

THE PREVALENCE OF

childhood blindness in

Aotearoa has fallen from

0.05% in 2012 to 0.01% in

2024 and low vision from

0.06% to 0.03%, according

to a new study led by Dr

Cheefoong Chong.

Unveiling initial findings

at the 2025 RANZCO

NZ meeting in Rotorua,

Dr Chong said the study

repeated a 2012 study by

himself, Professor Shuan

Dai and Dr Sam Simkin

using the Blind and Low

Vision Education Network

New Zealand (BLENNZ)

database. The 2012 study was

Dr Cheefoong Chong presenting topline figures from his latest BLENNZ research at RANZCO NZ 2025

(≤6/18 to 6/120) or blind

(<6/120), as per World

Health Organization

criteria. In total, 1,317

children were included in

the 2024 study (compared

with 1,321 in 2012), with

428 classed as low vision

(vs 533 in 2012) and 183

blind (vs 467). However,

324 had no recorded

visual acuity (321 in 2012),

though early data indicated

30.8% had cerebral visual

impairment and 22.3%

had no clear diagnosis, so

further research is required

to understand this group

better, said Dr Chong.

the first national study of its kind, so it was important to see if there

had been any changes, given the adjustments in care for children with

visual impairment, both medical and educational, over the past decade,

he said.

Like the 2012 study, the 2024 study included all children enrolled

with BLENNZ with best-corrected visual acuity of ≤6/18 or binocular

visual field <10°. Severity of visual loss was categorised as low vision

Of those children who were diagnosed, there was an 80% reduction

in the number of children blinded by retinopathy of prematurity

(ROP) from 30 to six children and an 80% reduction in keratoconusrelated

low vision and blindness, most likely due to improved

screening and crosslinking treatment for keratoconus, said Dr

Chong. There was also a 75% reduction in the number of children

blind as a result of optic nerve atrophy.

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©2025 Alcon Laboratories Pty Ltd. AUS: 1800 224 153; Auckland NZ: 0800 101 106. ANZ-VC-2500010

NZOPTICS.CO.NZ | 13

NEWS

Volunteer for the Special Olympics in Christchurch

SPECIAL OLYMPICS LIONS

Club International Opening

Eyes (SOLCIOE) is seeking

passionate optometrists,

dispensing opticians and optical

assistants to volunteer for the

Special Olympics Opening Eyes

Vision Programme, part of the

National Summer Games taking

place in Christchurch, 10–14

December 2025.

“We’re relying on the

generosity and goodwill of our

community to help recruit clinical

volunteers. Whether you can

give a day or the full event, your

time will make a meaningful

difference,” said Mimi Wong,

clinical co-director of SOLCIOE.

Volunteering at the Opening

Eyes programme is an experience

you will never forget, said Yvonne

Shepherd, SOLCIOE co-director. “Providing vision care for athletes with an

intellectual disability makes a real difference in their sport and daily lives.

For many, this is care they wouldn’t otherwise be able to access or afford.

At the same time, you have an opportunity to improve your clinical skills

while being part of a supportive team. It is challenging but rewarding work

– the athletes often show their gratitude with the pure joy on their faces!”

Special Olympics volunteers 2022 under the directorship of Evan Brown (standing, sixth from left) and Grant Dabb (standing, third from right)

All athletes will receive free prescription eyewear or plano sunglasses/

sports goggles of their choosing, courtesy of Essilor and Safilo.

Training is provided. Limited spots available. Register your interest at https://

shorturl.at/l1Gjg. For more see ad on p18.

REGISTER

NOW

Sunday 14 th September

Grafton Campus, The University of Auckland

Our full-day programme will include the following

sessions, delivered in an entertaining 12 minute rapid

fire fashion, along with interactive panel discussions:

Session 1 - Common ocular therapeutics – What is new?

Session 2 - Hot topics in ocular therapeutics

Session 3 - Inflammation & Therapeutics

Session 4 - What difference have therapeutics made to

clinical practice?

More information is available on the

conference website by using the QR code below.

A full day of CPD points has been applied for.

Please scan the QR code to register or contact:

Maree McInerney - m.mcinerney@auckland.ac.nz (09) 923 6991

Eye Institute expands north

EYE INSTITUTE (EI) is partnering with Eye

Specialists in Whangarei, delivering on its longterm

commitment to serve the New Zealand

public in the regions as well as in the centres.

“We have long respected Eye Specialists’ Drs

Brian Kent-Smith and Stefano Guglielmetti’s

work and practice and we felt it would be the

ideal fit for Eye Institute, with the quality of care,

John Fischer

a great team and culture aligned with our values,”

said EI CEO John Fischer. “The name will change to Eye Institute

Whangarei, but it is still the same great team, care and location, just

a different logo.”

Dr Kent-Smith said when EI approached them last year with an

offer to merge, the time felt right. “We’re a medium-sized practice

and the more the practice has grown, the more of our time has

been focused on the business itself, rather than on our patients.

Being part of a larger organisation brings many benefits, including

collegial support and managerial expertise. “Eye Institute has a

depth of resources that we did not. The union will allow us to

expand the range of services we can offer to Northland,” he said.

For example, EI’s Dr Will Cunningham is already running regular

surgical retinal clinics in Whangarei to minimise patient travel for

surgical retinal care. Over the next year, the team will be looking

at what additional services it can offer in Whangarei and further

north, Fischer said.

Fischer isn’t ruling out further growth for EI. “We’d like to

expand further, we think there are still areas that could benefit from

being served by Eye Institute if the opportunity arose.” Eye Institute

now has clinics in Whangarei, Auckland, Hawke’s Bay, Wellington,

Blenheim and Dunedin and a network of 21 ophthalmologists

offering a wide range of subspecialities.


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NZOPTICS.CO.NZ | 15

FEATURE

Uncommon sense

Drew Jones uncovers the intriguing phenomenon of synaesthesia – a ‘crosstalk’ between the five

senses which can produce extraordinary experiences for those with the condition – and how it’s

inspiring technologies to help the visually impaired picture their environment.

“AS A CHILD, I had a neighbour

who was distinctly orange – his

hair, his VW Beetle and even his

name. I remember being amazed

by his uniformity, so I asked my

friend if she thought his name

was orange as well. That’s when

I discovered that I saw things

differently from other people,”

says US artist Cassandra Miller.

Miller has at least two forms

of synaesthesia: a ‘merging’ of

senses where she sees colours

shifting in and out of view when

she hears music (chromesthesia);

and letters and numbers having

distinct tones and personalities

(grapheme-colour synaesthesia).

New Zealand pop star Lorde has

chromesthesia too. She told Far Out magazine

her condition led to a song being initially

discounted for inclusion on her 2013 debut

album Pure Heroine. “When we first started

‘Tennis Court’, we just had (a keyboard

sound) playing the chords and it was the

worst textured tan colour – like, really dated

– and it made me feel sick. Then we figured

out the pre-chorus and I started the lyric

and the song changed to all these incredible

greens overnight!”

One in 23 people experience some form of

synaesthesia, according to Dr Julia Simner, a

professor of neuropsychology specialising in

multisensory processes at the UK’s University

of Sussex. Studies have shown the brains

of synaesthetes are subtly different from

the average person, she says. “People with

synaesthesia have more connections in some

regions of the brain and this seems to be part

of their normal childhood development. It’s

also possible for an adult to suddenly develop

synaesthesia after a disease or injury, but this

type of synaesthesia is extremely rare and very

different from lifelong synaesthesias that start

in childhood.”

However, it is misleading to describe

synaesthesia in terms of pairwise associations

between the five senses, she says. “For

instance, in the ‘vision’ domain some

synaesthetes might experience colour, whereas

others might experience shapes, while

others might experience movement. Thus,

the number of potentially different forms of

synaesthesia is likely to be very big indeed.”

Dr Sean Day, a synaesthete and the

president of the International Association

of Synaesthetes, Artists and Scientists, says

he’s counted at least 80 different variants of

synaesthesia. Research by Prof Simner and

others suggests grapheme-colour synaesthesia

is probably the most common variant and

has therefore been the focus of most research.

“Experiencing days, months, numbers and the

alphabet in a spatial form (eg. in lines, circles,

spirals) is even more common – maybe 20% of

the population, says Prof Simner.

Prof Simner’s lab conducted an experiment

on passers-by at both London’s Science

Museum and the undergraduate population

at the University of Edinburgh. In addition

to questions about perception, they also

used a computer test in which black letters

and numbers were flashed on the screen

and participants had to choose a colour they

associate with them as quickly as possible.

“Most people chose randomly but those

with synaesthesia were very reliable in

their choice of colours,” she says. The

experiment produced an estimate of that

type of synaesthesia occurring in 1–2% of

the population. The Edinburgh study found

coloured days of the week was the most

common type of synaesthesia, but researchers

also observed less-common types, such as

‘tasting’ shapes and ‘coloured’ music.

“In total, we identified 22 synaesthetes

out of the 500 students screened. This

means 4.4% of the population appear

to experience synaesthesia, but that

figure will be higher if other types of

synaesthesia are also considered,” says

Prof Simner.

NZ Optics editor Susie Hill didn’t

realise there was a name for the way

she perceives days of the week, months

and seasons until the team discussed

this article. “I never really thought

much about it and perhaps imagined

everyone saw things this way. I see days

of the week in a line from left to

right: Monday is white, Tuesday

is blue, Wednesday is green,

Thursday is pinkish, Friday is

black and Saturday and Sunday

are pinkish red.” She also sees

numbers as colours and the year

laid out vertically, with most

months having a distinct colour.

Is synaesthesia real?

Professional scepticism of

the condition’s validity began

to be eroded by functional

neuroimaging studies, the first

being Paulescu et al’s 1995 use of

positron emission tomography.

The study demonstrated that some regions of

auditory word-to-colour synaesthetes’ visual

cortex were more active when they listened to

words rather than tones.

Most theories of synaesthesia talk about

rewiring or extra connections in the brain,

explains Prof Simner. “White matter in

the brains of people with synaesthesia is

organised differently and there is more grey

matter in some regions of the brain relating to

perception and attention.” Another brainimaging

study showed that when certain

synaesthetes hear spoken words, the parts of

the brain normally dedicated to colour are

used, she says.

Associate Professor Patrick Shepherd at

the University of Canterbury’s School of

Curriculum, Pedagogy and Assessment is a

musician and composer who has spent many

years researching the condition. Interviewing

people who claimed to have synaesthesia, he

found the ‘genuine’ synaesthetes produced

reproducible responses to tests such as Stanford

University’s Dr David Eagleman’s ‘standardised

test battery for the study of synaesthesia’. “Not

only that, but a synaesthete won’t just tell you,

Kiwi Singer Lorde has chromesthesia


for example, that Tuesday and the letter

C are yellow to them; it will be a very

specific type of yellow, which they can

define clearly,” he says.

If you put two synaesthetes together

they will typically argue over the colour

of letters, says Prof Simner. “However, if

one looks at a larger sample of synaesthetes,

some trends can be discerned. For instance,

‘A’ is often red, ‘B’ is often blue and ‘C’ is often

yellow. This is likely to hold true for other

types of synaesthesia; for instance, certain

musical instruments may tend to produce

particular colours, shapes and movements

even though there will also be a significant

amount of individual variation.”

A superpower or kryptonite?

Most synaesthetes say they could not imagine

life without their experiences and are either

positively disposed towards it – they feel sorry

for people who don’t have it – or neutral, like

being asked whether they enjoy having a left

arm, says Prof Simner.

Synaesthesia has no known effects on IQ,

although three studies have shown adults and

children with synaesthesia have higher rates

of anxiety than otherwise expected, she says.

“Two small studies published in 2013 also

suggest that synaesthesia is more common in

adults with autistic spectrum disorder. These

results appear broadly reliable and have been

confirmed elsewhere; however, it’s important

to note that most people with autism do not

have synaesthesia and that most people with

synaesthesia do not have autism,” she says.

There is also growing evidence that

synaesthesia may be linked to certain

advantages, including enhanced memory,

superior perception and being able to think

more quickly, says Prof Simner. “One of the

most famous synaesthetes, the late Soviet

journalist Solomon Shereshevsky, actually

made a living out of being a memory expert!

And although synaesthetes’ memory abilities

decrease like the rest of us with age, they

maintain a memory advantage across their

lifespan: research shows older synaesthetes

have an equivalent memory to younger

non-synaesthetes.”

L-R: Dr Sean Day, Prof Julia Simner and A/Prof Patrick Shepherd

Bringing images to the blind

Inspired by synaesthesia, researchers have

developed various systems to help the visually

impaired perceive the visual world via

sound. Dr Peter Meijer, the Dutch founder

and director of Metamodal BV, developed

The Voice, a visual-to-auditory sensory

substitution device (SSD) in 1992 for the

visually impaired. The Voice converts visual

stimuli of the surroundings captured by a

head-mounted camera into corresponding

aural representations delivered to the user

through headphones at a default rate of one

soundscape per second. Each soundscape is a

left-to-right scan, with height represented by

pitch and brightness by loudness.

According to a 2012 paper in PLOS One,

proficient users of The Voice were able to

differentiate the shapes of different objects,

identify the actual objects and locate them

in space.

In the study, one early-onset and eight

congenitally fully blind subjects were

trained for one hour on a Snellen acuity

task and introduced to tumbling Es in all

four directions, said researchers. All the

participants performed better than reported

using tactile SSD (20/860) or the highestresolution

retinal prostheses (20/1,000).

Interestingly, five of the nine participants

(55%) had ‘visual acuity’ exceeding the

threshold for blindness as defined by the

World health Organization, they said.

“Our findings suggest early and congenitally

blind individuals using auditory SSDs can

retrieve detailed visual information at a

much higher resolution than previously

demonstrated with any other sight

rehabilitation approach… It may well be

that further specific high-acuity training

will yield better acuity results. For example,

our participants were able to identify

and mimic the body posture of a person

standing a few metres away and navigate

crowded corridors while avoiding obstacles.

One of the participants was also able to

identify live, three-dimensional emotional

facial expressions.”

Working on similar principles,

LibreAudioView, developed by researchers

at the University of Burgundy, France, uses

a miniature camera integrated into a glasses

frame connected to a minicomputer worn

around the neck. Converting images into

audio sent to the user’s headphones, the

system enables the localisation of moving

objects, the estimation of trajectories and

the detection of approaching objects, say

its developers.

There are also devices which substitute

touch for vision, says Dr Day. “About 20

years ago, I corresponded with members of

the US Air Force and the US Army; both

groups were using devices that translated light

spectrum information (usually infrared, but

also other ranges, including into radio range)

into tactile sensations, usually conveyed

via a device placed on the tongue. A couple

of top fighter pilots used such devices very

effectively. Tongue chips are still used, but

it seems like they might be moving towards

using jacket or arm-patch devices, such as Dr

Eagleman devised.”

Thoughts for the eyecare practitioner

While there is no need to avoid all colours

in the eye clinic, it would be of benefit to a

synaesthete if the focus for tests – such as

charts and the immediate surrounding area –

is as black-and-white as possible, says Dr Day.

“Also, it would help if the clinician is out of

visual range and they talk as little as possible

during testing.

Dr Day has ‘music to colour’ and ‘odour to

colour’ synaesthesia. “While at an optometrist,

Continued on p18

NZOPTICS.CO.NZ | 17

FEATURE

Continued from p17

music playing in the background or a very predominant odour (cologne

worn by the optometrist) has produced synaesthesia, which interfered

with my vision. On more than one occasion, I informed the optometrist

and asked to have the specific test be done again – and, I will add, one

doctor was ‘offended’ and refused to do so.”

It’s often reported that synaesthesia is associated with dyslexia, for

which Irlen syndrome is often misdiagnosed. The syndrome is described

by the Irlen Institute as the brain overreacting to visual stimuli to create

a variety of visual, physical, cognitive, emotional and neurological

symptoms. Irlen patients often use coloured lenses to filter out visual

hindrances, particularly to help with reading.

However, the rate of dyslexia among synaesthetes is only very

minimal and insignificantly higher than the rate among nonsynaesthetes,

says Dr Day. “And I will state up front that I have

my doubts about whether Irlen syndrome is an actual medical

condition. I don’t discount it; but I am not satisfied yet that there is

sufficient evidence.” Dr Day says he has corresponded with at least

three synaesthetes who have used Irlen-style coloured spectacle

lenses to reduce the distractions caused by visual synaesthesia. “One

of them uses rose-tinted glasses, mostly for reading, and green or

yellow for various types of mathematics. Yellow or orange lenses are

sometimes used during migraines. While the coloured glasses do

help some synaesthetes, this has to do with the distractions caused by

the individual’s synaesthesia – not by anything those proposing Irlen

syndrome are suggesting.”

Eyecare professionals should be aware of the existence of

synaesthesia as an actual rare neurological trait, says Dr Day. “Maybe

straightforwardly ask patients if they experience synaesthesia, even if

this means introducing them to the concept.”

RLRL in myopia-control guides

THE WORLD SOCIETY of Paediatric Ophthalmology and Strabismus

(WSPOS) has included repeated low-level red-light (RLRL) therapy

in its Myopia Consensus Statement 2025 as a safe and effective

treatment to slow myopia progression. Interventions described in

the consensus statement are based on studies that have shown

statistical and clinical significance and have at least two years of

follow-up with peer-reviewed publication, reported WSPOS.

RLRL therapy has consistently been shown to slow axial length

elongation, with several papers reporting on a phenomenon of axial

shortening up until 12 months, WSPOS wrote. “More recently, RLRL

has been demonstrated to show a particularly strong effect in high

myopia, unlike other myopia control treatments. Finally, although

all published literature to-date originates from China, (RLRL

device manufacturer) Eyerising International reports numerous

international studies underway in Japan, Australia and Spain,

with interim data provided to the WSPOS committee showing

consistently promising results.”

The review Safety of repeated low-level red-light therapy (RLT) for

myopia found RLT’s most common side effect was afterimages,

which typically resolved within six minutes of treatment. The

incidence of side effects from RLT was 0.088 per 100 patientyears,

comparable to spectacles designed for myopia reduction

(0.22) and significantly lower than for low-dose atropine (7.32)

orthokeratology (20.6) and other anti-myopia contact lenses (19.3).

Authors also suggested RLT does not cause irreversible

visual function loss or ocular structural damage. However, they

recommend conducting fundus photography and OCT before and

during therapy, along with home monitoring of visual acuity and

duration of afterimages, to promptly identify any side effects.

Optical treatments included by WSPOS are spectacle lenses

(peripheral retinal defocus lenses and Diffusion Optics Technology

lenses) and myopic defocus contact lenses (soft contact lenses for

myopia control and orthokeratology), along with atropine eyedrops.

The most common types of synaesthesia

• Auditory-tactile synaesthesia – sound prompting a specific

bodily sensation (such as tingling on the back of the neck)

• Chromesthesia – sounds (like a car honking) can trigger

visualisation of colours

• Grapheme-colour synaesthesia – letters and numbers are

associated with specific colours

• Lexical-gustatory synaesthesia – hearing certain words triggers

distinct tastes

• Mirror-touch synaesthesia – a kind of supercharged empathy,

where a person feels as though they’re being touched if they

witness it happening to someone else

• Number form – a mental map of numbers involuntarily appears

whenever someone thinks of numbers

• Ordinal linguistic personification – ordered sequences (eg. days

of the week) are associated with personalities or genders

• Spatial sequence synaesthesia – seeing numbers or numerical

sequences as points in space.

Olo, olo, olo – a new colour!

RESEARCHERS

AT THE University

of California,

Berkeley, have

discovered a way

to make the human

eye perceive a

completely new

colour, ‘olo’, a vivid

blue-green never

seen in nature. The

technique provides

insight into how we

see and may help

advance treatments

for vision loss,

they reported.

Inspired by

A profoundly saturated peacock green named ‘olo’. Credit:

Marissa Gutierrez/UC Berkeley. Soruce: Trevor McKinnon/

Unsplash

The Wizard of Oz, the system – dubbed Oz – uses tiny laser pulses to

target and activate up to 1,000 individual photoreceptors in the retina.

This allows researchers to project images, moving dots and colours

beyond those typically visible, including olo, said James Fong, a doctoral

student in electrical engineering and computer sciences at UC Berkeley.

“We can now answer fundamental questions about human colour

vision. It gives us a way to study the retina at a new scale.” Humans

perceive colour through three types of cone cells – S (blue), M (green)

and L (red) – but M and L cones have overlapping sensitivities. “There’s

no wavelength that stimulates only the M cones,” said lead researcher

Professor Ren Ng. Wondering if they could activate just the M cones

to produce the greenest of greens, Prof Ng collaborated with Professor

Austin Roorda of UC Berkeley’s School of Optometry, who had already

developed technology to stimulate individual photoreceptors using

microdoses of laser light. With help from the University of Washington,

they built a system that maps the retina and precisely activates cones

using a green laser beam. By primarily stimulating M cones, they were

able to trick the eye into seeing olo, they wrote in Science Advances.

Beyond colour, the technology has potential in eye disease research.

“Many conditions involve lost cone cells,” said doctoral student and colead

author Hannah Doyle. “I’m exploring how cone-by-cone activation

might simulate this loss in healthy subjects.”


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NZOPTICS.CO.NZ | 19

RANZCO NZ 2025

RANZCO NZ 2025

– professional unity and innovation

By Dr Liz Insull

THIS YEAR MARKED a special

milestone for ophthalmology in

Aotearoa New Zealand, with the

75th Annual Scientific Meeting of

the RANZCO NZ Branch held in

the heart of geothermal Rotorua.

Against a dramatic backdrop of

natural hot springs, redwood

forests and Māori cultural heritage,

the event was a vibrant blend of

world-class science, connection

and reflection.

Held from 30 May to 1 June at

the Rotorua Energy Events Centre,

RANZCO NZ 2025 once again

provided a valuable opportunity

to connect with colleagues,

registrars, junior team members

and ophthalmic nurses from across the country. The stunning venue

and warm hospitality was a fitting way to celebrate the Branch’s 75-

year legacy. This year’s theme, ‘Clarity of vision, balanced life: thriving

in ophthalmology’, served as a timely reminder of the importance of

professional growth, personal wellbeing and sustainability in our field.

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Drs Jerome Languido and Theo Sutedja with RANZCO NZ chair Dr Liz Insull (centre)

A true highlight of the

programme was the exceptional

lineup of international keynote

speakers. In what was likely a

first for RANZCO NZ, the featured

panel comprised an all-female

group of global leaders in

ophthalmology. Professor Soon-

Phaik Chee (Singapore), Professor

Laura Balcer (US), Associate

Professor Julie Schallhorn (US),

perioperative nursing expert Lori

Pacheco (US) and pioneer nurse

practitioner Dr Tulay Cakiner-

Egilmez (US) each shared their

wisdom from the podium. Their

presence offered a powerful and

inspiring example of excellence,

leadership and the evolving diversity of our profession.

In addition to their keynote presentations, our international guests

generously shared their expertise during the registrar training day,

offering a rare and invaluable opportunity for in-depth learning. The

interactive format allowed registrars to engage directly with these global

leaders, gaining practical insights and inspiration to carry forward in their

training and careers.

Adding further distinction to the conference programme was the

trio of named lectures, each honouring the legacy of key figures in our

profession. Professor Paul Donaldson delivered the prestigious Anthony

Molteno Innovator’s Lecture, Dr Derek Sherwood presented this year’s

Dorothy Potter Medal Lecture and Prof Chee gave an inspiring John Parr

Medal Lecture.

The scientific

sessions were

enriched by

participation from

our local fellows

and researchers,

with particularly

noteworthy

contributions from

our junior members.

Melinda Lynch, Liz Kupa, Vin Harilal and Justine Millar

Continued on p22

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RANZCO NZ 2025

Continued from p20

Drs Nikki Brandt and Charlotte

Laurent

Drs Dickson Wong and David Kent

Dr Sarah Welch, Esmeralda Lo Tam, Prof

Charles McGhee, Dr Aaron Wong and A/Prof

James McKelvie

Congratulations to Drs Natalie Allen, Jane Shi and Zung Mai for their

award-winning presentations, each a testament to the exceptional

promise of New Zealand’s emerging ophthalmologists. Their calibre,

confidence and professionalism were truly a standout feature of the

meeting. Warm congratulations are also extended to Tara McLennan and

Dena D’Souza for their well-deserved awards in the nursing session.

For the first time, the meeting featured an inaugural video competition,

an engaging and well-received addition to the programme. Trainees,

fellows and industry partners embraced the opportunity to present

complex cases and innovations through a creative and accessible

format, with entries that inspired thoughtful discussion and learning.

Congratulations to our competition winners, Drs Vidit Singh, Sue

Ormonde and Rob Jones.

After sundown, evening events immersed

attendees in the unique spirit of Rotorua.

The speakers’ dinner at Te Puia was a

memorable cultural celebration, set against

the dramatic backdrop of a lightning storm

Penny Wood and

illuminating the steaming geysers, an experience Michaela Deed

as powerful as it was unforgettable. A special

moment was a meeting with a master Māori weaver to explore the

creation of a bespoke NZ Branch korowai – a meaningful project now

under discussion. The gala dinner at Skyline Rotorua, reached by gondola

with panoramic lake views, capped off the conference in style.

This exceptional event would not have been possible without the

dedication of the organising committee, led by Dr Verona Botha, and the

generous support of all our sponsors, particularly

Alcon, our platinum sponsor, whose continued

partnership is deeply appreciated.

As we celebrate 75 years of ophthalmic excellence,

RANZCO NZ 2025 stood as more than just a

scientific meeting – it was a moment of cultural

pride, professional unity and a clear signal that

ophthalmology in Aotearoa continues to thrive

through shared purpose, innovation and connection.

Dr Liz Insull is RANZCO NZ branch chair.

Alcon’s Soojan Hong with Drs Mark Donaldson and

Sophie Hill

Drs Oliver Comyn, Louis Han and Tupac Cordon

Rare report of orbital pyoderma gangrenosum

A RARE AND grisly case of the autoimmune condition pyoderma

gangrenosum (PG) was documented by Nelson Hospital’s Drs Garry

Singh and Sacha Moore, and presented as a poster presentation at

RANZCO NZ 2025.

The doctors’ account said the worldwide incidence of PG is estimated

to be three to 10 cases per million population per year.

Initially assumed to be an abscess, a painful unilateral orbital swelling

had developed rapidly over five days in a 77-year-old man. Following

referral from his GP, it was ascertained at Nelson ophthalmology clinic

that he also had a recent ulcerated left leg infection and left fifth digit

swelling, which was being treated with oral flucloxacillin. Despite

generalised malaise, he had no fever and reported no pain on eye

movement, eye redness, eye pain, light sensitivity or blurring.

Viral and bacterial swabs returned negative results and attempted

drainage of the lesion produced no pus. Bloodwork showed an elevated

white cell count, with neutrophilic predominance and highly elevated

C-reactive protein levels. Although punch biopsies showed acute

inflammation with debris, they were considered non-diagnostic. An

urgent CT scan showed a large solitary mass on the left orbit, not typical

of a drainable abscess or invasive malignancy.

Following referral to dermatologists, a diagnosis of PG was made,

with probable superimposed bacterial

infection. After four weeks of tapering

prednisone (40mg daily for seven days

and subsequent 10mg reduction per

week), continued oral antibiotics, daily

10-minute vinegar soaks, plus topical

paraffin 50/50 and triamcinolone

treatment, complete resolution of the

lesion was achieved.

The doctors concluded that clinicians

should consider PG as a differential

diagnosis if patients present with

rapidly progressive lesions with atypical

features. There is no definite diagnostic

test for PG, so work-up should include

a blood panel, cultures of affected

sites, biopsies for histology and orbital

imaging. Recurrence is not uncommon,

and corticosteroids are the mainstay

of treatment alongside supportive

measures, they said.

Left orbital lesion in presentation

to ophthalmology clinic

Left periorbital lesion resolved at

four-week follow-up


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NZOPTICS.CO.NZ | 23

RANZCO NZ 2025

Shaping the future of eyecare

By Dr Jahnvee Solanki

BRIGHT, WARM DAYS in Rotorua

reflected the collegial nature of

this year’s RANZCO NZ Branch

Annual Scientific Meeting. The

event brought together brilliant

minds from around the country

and overseas, sharing new

insights in ophthalmology.

The first day was registrar

training day, where Auckland’s

Professor Charles McGhee joined

three international keynote

speakers, Professors Soon-Phaik

Chee (Singapore) and Laura Balcer

(US) and Associate Professor

Julie Schallhorn (US), to impart

knowledge of their respective

sub-specialties to aspiring

trainees and non-trainees.

The next two days were spectacularly organised with the

main symposium running alongside a full nursing stream;

the former, a combination of talks from keynote speakers

and doctors from around the country.

Prof Balcer discussed the importance of clinical

judgment in diagnosing optic neuritis. She outlined key

research that has led to the inclusion of optic neuritis in

the diagnostic criteria for multiple sclerosis (see separate

story p30) and noted that disease-modifying therapies,

such as natalizumab, may now be considered in cases

involving a first demyelinating lesion of the optic nerve.

She also presented several interesting patient cases.

One particularly memorable case involved a 27-year-old

presenting with symptoms suggestive of raised intracranial

pressure. The patient also reported sciatica symptoms, prompting a

spinal MRI that revealed a spinal ependymoma. This case served as a

reminder of the value of taking a thorough history, as optometrists and

ophthalmologists may be the first to detect conditions extending well

beyond the eye, she said.

A/Prof Schallhorn provided an analysis of the current literature on

presbyopia-correcting intraocular lenses. Her talk highlighted the

challenges of choosing the most appropriate lens due to the variability in

study methodologies. New standardised patient questionnaires are being

developed that may improve comparability of future studies, she said.

She also presented cases where anterior segment OCT has demonstrated

clinical utility in assessing abnormal growths, including ocular surface

squamous neoplasia and squamous cell cancer, and for planning anterior

stromal treatments and repeat refractive surgery.

Prof Chee wowed us all with her graphic videos demonstrating helpful

Drs Emma-Jane Paton, Amy Chen, Jahnvee Solanki and Jacob Mitchell

microsurgical techniques for

managing tricky cataract surgery.

She also shared her approach

to operating on advanced black

and white cataracts and her

impressive suture snare technique,

which uses scleral suturing with

7-10 gauge Gore-Tex to stabilise

dislocated intraocular lenses.

Artificial intelligence and

technology

A few talks from our junior

doctors highlighted the potential

for technology to assist patient

assessment. Medical student

Andrew Holmes presented his

work on identifying individuals

at risk of primary open-angle

glaucoma using machine-learning

algorithms. His analysis found

that the strongest predictors were

ophthalmic factors and systemic

comorbidities such as elevated

cholesterol, high HbA1c and low

blood pressure. Interestingly,

no lifestyle factors appeared

among the top 15 risk variables.

With further research, this model

has the potential to support the

development of a prognostic risk

calculator for glaucoma.

Dr James Lewis trained a

convolutional neural network, using >27,000 ocular images, to detect

and accurately measure ptosis in patients. This tool had an accuracy

of 92.3% on test data and may offer a more objective method for

assessing ptosis, particularly in cases involving young children or difficult

clinical examinations.

Dr James Corbett then shared his data showing the feasibility and

repeatability of home visual field testing using personal computers. This

could be a valuable adjunct in glaucoma monitoring and would require

less follow-up in person making glaucoma care more accessible.

International keynotes Prof Laura Balcer, Prof Soon-Phaik Chee

and A/Prof Julie Schallhorn

New techniques explained

Auckland’s Dr Kyla Fung shared her work on prescribing colchicine for

preventing fibrosis in patients after a trabeculectomy. In her patient

cohort, 500µg of colchicine per day reduced ischaemia and led to

favourable bleb outcomes.

Continued on p26

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RANZCO NZ 2025

Continued from p24

Dr Sophie Hill, a medical retina

consultant in Auckland, shared her

case series of patients who were

switched to the new intravitreal

medication faricimab (Vabysmo),

after failing Avastin and Eylea

treatment. She found benefit in

most patients with neovascular

age-related macular degeneration,

but no benefit in patients with

vein occlusions.

Whangarei-based oculoplastic

specialist Dr Anna March de Ribot

then discussed patient outcomes

with her new treatment, the MARCH technique, for removing lower

eyelid lesions. This novel approach eliminates the need for a flap or graft

and demonstrated great cosmetic outcomes.

Burnout a hot topic

Throughout the meeting, in and out of the presentations, talk of burnout

was on people’s lips: from personal stories shared over drinks and at the

Skyline dinner’s Q&A session between Drs Kevin Taylor and Lucy Lu to

Otago registrar’s Dr Theo Sutedja’s ‘Work satisfaction, stress and burnout

among ophthalmologists in New Zealand’ and motivational speaker

Dani Fennessy’s ‘From burnout to breakthrough: a story of healing and

hope’ presentations.

Dr Sutedja’s survey of New Zealand ophthalmology

registrars found burnout is common and recurring,

with only 15% of those experiencing burnout

taking time off because of it. Three out of five

participants had had burnout at least once,

four in 10 greater than or equal to twice and

Continued from p24 one in 10 greater than or equal to five times.

“Addressing burnout is vital to protect the

workforce and patients who count on it,” said

Dr Sutedja (see full story p40).

Drs Ahmed Sadiq and

Muhammad Khalid

Drs Himanshu Wadhwa and Natalie Allen

Dian Zhuang and Kyla Fung with Drs Brandon Nunns, Josh Read, Daniel

Zhang, Jane Shi and Chuen Yen Hong

Cataracts a key workforce lever

Rotorua Eye Clinic’s Dr Derrell Meyer shared his

practice’s public-private partnership experience

for clearing the cataract backlog in

the Rotorua area. There is clearly

enough work for everyone in

public and private when it comes

to cataracts, he said, and “cataracts

were a key lever to improve

workforce retention in public.”

Modelling showed there may be

483,000 people in New Zealand

with cataracts right now. In 2018,

public and private capacity was

roughly equal with a 25-year backlog, said Dr Meyer, while from 2024

the combined capacity would have a 10-year backlog. He proposed a

three-tiered approach to help solve the problem: private outsourcing for

short-term capacity relief; public insourcing to build sustainable public

capacity; and dedicated content cataract centres to unlock lock longterm

efficiency.

Medals and awards

This year’s Dorothy Potter Medal Lecture was delivered by Nelson

ophthalmologist and Te Whatu Ora clinical lead, planned care, Dr Derek

Sherwood, who spoke in depth about the challenges of driving change

within healthcare systems and the critical role that doctors play in

leading and supporting this process. The John Parr Medal Lecture was

delivered by Prof Chee, who shared more amazing videos demonstrating

her multiple techniques to rescue eyes where cataract surgery does not

go the way it was planned!

The Professor Anthony Molteno Innovator’s Lecture was delivered by

Professor Paul Donaldson, from the Department of Physiology, University

of Auckland. He shared his fascinating work looking into the role of

free and bound water, as well as ion flow through a lens, in presbyopia

and cataract formation. These insights may be able to help guide the

development of treatments that target lens water content for prevention

and delay of cataract formation in the future (see story p8).

This year, the best paper award went to ophthalmology registrar

Dr Natalie Allen for her PhD research paper ‘Attitudes to eye donation

in Aotearoa’. Her qualitative study highlighted a widespread lack of

awareness about eye donation in New Zealand and explored the factors

that may both encourage and discourage individuals from choosing to

donate. The two runners-up were Dr Zung Mai for his work ‘Refractive

changes and optimal follow up time for children with retinopathy of

prematurity’ and Dr Jane Shi’s paper ‘A decade of glaucoma prescribing

in Aotearoa’.

In conclusion

Dr Derek Sherwood presenting the 2025 Dorothy Potter

Medal Lecture

This year’s conference offered a rich exchange of clinical insights, research

advancements and practical innovations that promise to shape the

future of eyecare in New Zealand. It also rewarded effort and explored

some of the challenges facing ophthalmology,

especially with respect to the workforce. It will

be interesting to see how these play out and

I am looking forward to hearing more at the

next RANZCO NZ conference!

With additional reporting from Susie Hill

Dr Jahnvee Solanki is a non-vocational

ophthalmology registrar at Greenlane Clinical Centre.

She completed her bachelor of medicine and bachelor

of surgery at Auckland University in 2020 and a

postgraduate diploma in ophthalmic basic sciences

with the University of Sydney in 2024.

Drs Emma-Jane Paton, Dineo Mpe and Jane Shi

J&J’s surgical sales team Matthew Northage, Phillip Lu, Chris

Hughes, Sri Chandrasekaran and Ian Stansfield


Affordable true-colour UWF

TAKING PRIDE OF place on Ophthalmic Instrument Company’s

(OIC’s) stand at RANZCO NZ was the new Reticam 3100 Plus, an

ultra-widefield (UWF) retinal camera from SysEye.

Launched this year and unveiled for the first time in Australasia,

the Reticam 3100 Plus provides a 176° single-shot field-of-view

with traditional white-light, true-colour imaging, said OIC’s Tim

Way. “It’s true-colour, ultra-widefield imaging at a very affordable

entry-level price.”

As well as the UWF true-colour imaging, SysEye’s new Reticam

offers one-button operation for binocular capture; non-mydriatic

operation, eliminating the need for pupil dilation; soft exposure

technology, minimising pupil constriction after exposure;

automatic focus adjustment to reduce the risk of user error; an

AI-powered system enabling highly precise positioning and

quick fundus image

acquisition and analysis;

high-definition imaging

for exceptional image

quality; and advanced

image processing,

including easy lesion

area and cup-to-disc

ratio measurements, said SysEye.

Bronwyn Snodgrass, A/Prof James McKelvie, OIC’s Tim

Way and Heidelberg Engineering’s Jacki Simmins

Aimed at both ophthalmology and optometry, it allows eyecare

professionals to easily, and now affordably, expand their retinal

images from 45° to 176°, said Way, “providing unprecedented views

of the retina and enabling faster and more accurate diagnosis and

treatment of a wide range of eye conditions”.

Heidelberg’s

Orbis

support

HEIDELBERG ENGINEERING

HAS extended its partnership

with international sight-saving

charity Orbis to help improve eye

health services in underserved

areas by funding crucial training

for eyecare professionals

(ECPs) and supporting Orbis’

telemedicine and e-learning

platform, Cybersight.

In 2024, the partnership

enabled four live webinars

focusing on how OCT can

enhance the diagnosis,

management and treatment

of a range of ophthalmic

conditions. The sessions were

viewed more than 2,050 times

by ECPs from low- and middleincome

countries, including

conflict-affected areas such

as Afghanistan, Somalia and

Ukraine. Further webinars

will be released this year, with

details published on Cybersight’s

website, said the organisations in

a joint statement.

Heidelberg’s support also

allowed Orbis to complete

its research project into

retinoblastoma, which affects

9,000 children annually.

Published in JCO Global

Oncology, the study found

telemedicine significantly

improved care and survival

rates for children with

retinoblastoma, while virtual

mentorship enhanced diagnosis,

disease classification and

treatment outcomes.

09 443 0072 info@oic.co.nz www.oic.co.nz

NZOPTICS.CO.NZ | 27

RANZCO NZ 2025

Ophthalmic-trained AI scribe’s ANZ push

By Lesley Springall

ISCRIBE, AN ARTIFICIAL

intelligence (AI) note-taking

tool that converts patient

conversations into clinical notes,

referrer and patient letters, has

gained 15-20% of the Australian

ophthalmology market since

its launch at the beginning

of 2024, reported its parent

company Akuru.

The digital scribe technology is

one of several similar technologies

targeting the health market,

particularly GPs, since rapid

advancements in AI, automatic

speech recognition and natural

language processing made the

technology possible over the past

five years. But iScribe is probably

the only one designed by an

ophthalmologist, said co-founder,

Akuru’s chief technology officer

and Australian ophthalmologist

Dr Chandra Perera.

iScribe’s Laura Wilson (centre) with ophthalmic nurses Amy Hurrell and Dena

D’Souza at RANZCO NZ 2025. Inset: Ophthalmologist Dr Chandra Perera, cofounder

of iScribe

Dr Perera said he started trying to design his own digital notetaking

tool a few years ago, frustrated by the time he was spending

on administration and looking at his computer instead of talking to

patients. He further developed his coding skills during his ophthalmic

fellowship training at Stanford University in California, but back then

AI technology was simply not advanced enough to create the tool

he wanted, he said. Two years ago, however, he joined forces with

some similarly tech-savvy medical specialists from ophthalmology

and other medical fields to take advantage of the new AI advances to

finalise iScribe.

In just over a year since iScribe’s launch, as well as capturing 15–20%

of the Australian ophthalmology market, it has gained 10–15% of

Australian ENT specialists, landed a significant national contract with

a 100-plus cardiologist group, launched the product in New Zealand

and started talking to optometrists, said Dr Perera. “We probably have

at least 1,000 paid users now and about 3,000 people using it across

Australia and New Zealand; so it’s growing quickly.”

Key to the technology’s success is that it’s been developed for

medical specialists by medical specialists, he said. “I’m a high-volume

ophthalmologist; I want to click one button, talk, click another button

and everything to be done at

once. So the design is built

around a specialist’s workflow.

We’re not some coders trying

to work out how doctors work.

It’s been built to solve our

own problems.”

iScribe transcribes

the patient meeting in a

customisable note form that

culls all unnecessary chat,

only noting down information

pertinent to the patient’s

diagnosis and

treatment,

both in a more

detailed medical

format for the

specialist and

the referrer

and in a more

patient-friendly letter for the patient.

All notes should be reviewed by the

specialist, said Dr Perera, but, with 92% accuracy for patient letters,

this doesn’t take long, so the letter can be given to the patient at the end

of the consult as a reminder of what was said and recommended. “It’s

about offering more patient-centred care,” said Akuru’s chief operating

officer, ophthalmologist Dr Jamie Chew.

In a 2023–2024 study using AI scribe technology across 17 Kaiser

Permanente medical centres in the US, patients reportedly felt

“comfortable” with the technology and noticed their doctors “were more

focused on them instead of their screens”. Akuru’s own research of 250

patients last year found most felt comfortable with the tool, though

transparency about its use was essential. The post-consult letter had an

open rate of 96.73% and an “overwhelmingly positive impact on the

patient experience”, reported Akuru, with 97% of patients giving a score

of four out of five or greater for how the letter helped them understand

their own diagnosis and treatment plan. For specialists, the Kaiser study

found a 20% reduction in health record interactions, a 30% reduction

in after-hours documentation and a two-minute increase in face-toface

time with patients. In Akuru’s survey of 76 specialists, 21% said

it saved them two hours or more, 30% one hour and 36% 30 mins a

day on administration, as well as improving their clinical workflows,

consistency and note quality.


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RANZCO NZ 2025

Remain calm and thrive

in ophthalmology

By Kathryn Millichamp

ATTENDEES OF THE RANZCO NZ conference this year were welcomed

to Rotorua by a beautiful mihi whakatau from the Ngāti Whakaue Te

Arawa people. Dr Liz Insull, NZ Branch chair, then gave special thanks

to Dr Verona Botha, this year’s conference organiser, and scientific

chair, Professor Charles McGhee for curating the diverse, interesting

and enjoyable scientific programme. This is a snapshot of some of my

personal highlights from the two-day event.

The first of the plenary speakers was international keynote, Professor

Soon-Phaik Chee from Singapore, who discussed the challenges of

managing various complex types of cataract and the importance of

documenting the type in your clinical findings, providing important

tips for increasing the surgeon’s confidence, such as the use of anterior

segment OCT for dense cataracts and various surgical techniques

minimising anterior capsule rip and zonular weakness. Her surgical

videos were outstanding!

Professor Laura Balcer from New York advised that optic nerve

inflammation (optic neuritis, ON) is now part of the formal diagnostic

criteria for MS; however, she argued that ON remains a clinical

diagnosis. This was illustrated by a clinical

presentation of eye pain in a patient

known to have MS but with no other

ON symptoms. Clinical exam was

unremarkable; however, a very subtle

area of optic disc swelling was noted on

OCT. OCT imaging has revolutionised

Left: Professor Helen

Danesh-Meyer and

Helena Danesh-Clough

Elainee Calimag, Qingfeng Ren, Melinda Lynch, Liz Kupa,

Ruby Ripley and Priya Gounder

eyecare, she said,

noting that more

patients with ON

will have optic

disc swelling

than previously

thought. Another

tip that I will

remember is that

patients with ON

often mention pain

when applying

eye makeup.

Prof Balcer also

recommended

requesting orbital

MRI for MS/ON

patients to gain a

AFT’s Xavier Glass, MSO’s Gethin Sladen, Roche’s Shainal Awadh and Dr Sid Ogra

Kath Millichamp, Titchui Chan, Shweta Chandra and Jess Clark

full picture of diagnostic findings.

San Franciscan keynote Associate Professor Julie Schallhorn told us

about recent research on the rapidly evolving world of intraocular lens

(IOL) technology for the correction of presbyopia. She stressed the

importance of counselling patients regarding potential outcomes; eg.

they may experience reduced glare with a particular IOL. However, their

overall vision may not be improved, so what is important to the patient is

of utmost importance in the IOL selection, she said.

The plenary ended with a from-the-heart account by motivational

speaker Dani Fennessy about her personal experience of idiopathic

intracranial hypertension, including the rare complication of vision loss.

She reminded us of our important role in not only protecting vision but

also for protecting people’s futures. I was inspired by her quote “make

time for your health before you have to make time for sickness”.

Great mix of nursing talks

Over 80 nurses attended in person and more than 15 virtually. Renee

Stapleton from Waikato Hospital Eye Clinic had put together a fantastic

programme with lots of nurses presenting and a good mix of topics

from clinics and theatre, case studies, nursing research and expanding

ophthalmic nursing roles. I began the session with an overview of herpes

zoster ophthalmicus, including an update from ZEDS (the Zoster Eye

Disease Study), whose recommendation was that prophylactic use of oral

valacyclovir 1,000mg per day reduces recurrences of ocular inflammation

and post-herpetic neuralgia.

With World No Tobacco Day on 31 May, Lyn Scott from Waikato Eye

Clinic gave us a poignant reminder about the effects of both smoking

and vaping on the eye. I was surprised to hear it takes more than 10 years

after stopping smoking to reduce these risk factors. Hopefully, armed

with this knowledge, we can all help our patients to understand the risks

and encourage them to stop earlier rather than later, or preferably not to

start at all.

For the first time at this conference, we were fortunate to have prizes

for the best nurses’ presentations, which was very exciting! Auckland’s

Dena D’Souza was runner-up (winning $500) with a talk on her

involvement with a new ocular prosthesis service at Greenland Clinical

Centre – a great new initiative reducing the number of visits patients

need to have their ocular prosthesis made and also leaving with the

prosthesis the same day! I was as surprised as many others to learn that

ocular prosthetics were first

made by Romans in the 5th

century BC, albeit from clay and

worn over the socket!

The first prize ($1,000) went

to Tara McLennan, Waikato

Hospital Eye Clinic, for her postgraduate

research reviewing

patient diabetes and tips

on how to improve patient

engagement and education.

Patients in her clinic wanted

more resources to better

understand their conditions

Penny Wilson, Dr Verona Botha and Arina Khramenko


and to know what resources were available to them. She also shared a

survey result about nurses’ knowledge of diabetes management that

encouraged us to improve our understanding and introduce meaningful

changes to patient care.

Strong representation from theatre

There was strong representation from our ophthalmic theatre colleagues

this year. Featured speaker for the nursing programme, Lori Pacheco from

Boston was clearly passionate about health and safety and, in particular,

sterilisation of instruments and maintaining a safe environment. The

first of her talks was a comprehensive overview of the how, what,

when and why of handling hazardous drugs, which discussed the

difference between guidelines and standards. In a nutshell, guidelines

are recommendations and are not enforceable, while standards are

requirements from the Ministry of Health. She offered tips for handling

hazards, ie. to have a designated person, standards of practice and plans

in place for spill management, storage and disposal, PPE requirements

and to be aware of what happens to the different types of waste bins.

Are they managed locally or sent overseas? Are they buried or burnt?

This will help us to be sure of what type of waste goes into each bin (see

story p36).

Pacheco’s next talk was on instrument sterilisation, reviewing industry

guidelines, stressing the importance of following manufacturers’

instructions for use, cleaning and sterilising instruments. She said if an

instrument came from the manufacturer in separate pieces then it should

be cleaned and sterilised in separate pieces as well, and remember to

check if tap water is safe to rinse instruments in. Everything in the process

has to be compatible from containers to sterilisers; I certainly made

myself a list of things to check when I get back to clinic! Top tip: a pencil

eraser can remove rust from instruments before cleaning and sterilising.

Pacheco also gave a wonderful update about teaching, research and

community outreach

in her presentation

on Orbis, an

international

nonprofit

organisation that

provides ophthalmic

care and training and

runs a flying hospital

to reach more

remote areas.

Continuing with

the surgical theme,

Penny Wilson and

Arina Khramenko, Eye

Surgeons NZ, gave an

account of their role

as oculoplastics nurses

in the management of

surgical patients in a busy

private practice, including

triaging referrals, pre-op

assessments, assisting

and supporting in the

perioperative phase and

comprehensive post-op

assessment and support,

Drs Dean Corbett, James Corbett, Sam Preston and Garry Singh

Drs Robert Barrett, Oren Cohen and Alexander

Chorny

including removal of sutures and chasing histology. They summarised

that they are masters of sterilising, procurement, marketing and

caffeination of their surgeons.

Continued on p34

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Reference: 1. Vabysmo (faricimab) Data Sheet available at www.medsafe.govt.nz.

Vabysmo (faricimab) 120 mg/mL solution for injection for intravitreal use is a Prescription Medicine indicated for the treatment of neovascular (wet) age-related macular degeneration (nAMD), diabetic macular oedema (DMO) and macular oedema secondary to

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NZOPTICS.CO.NZ | 31

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RANZCO NZ 2025

Continued from p31

Dr Colin Parsloe with Optos’ Anton Tesoriero

Ali Fellowes, Jillian Blakley and Liz Lubbers

Roche’s Jenny Patchell with Walieke Barran and Tamsyn Clark

Jillian Blakely, Eye Surgery Associates, spoke of the important attributes

for ophthalmic theatre nurses in supporting the surgeon and being

able to act effectively if complications occur. She shared a rare case of

choroidal haemorrhage when a patient coughed during routine cataract

surgery. Fortunately, the team acted quickly to wrap up the surgery

to minimise the impact on the patient’s eye. A good tip for all clinical

practice was to “know the norm so you can recognise when something

goes wrong”. She inspired us all with her mottos: “be prepared” and my

favourite, “Better to be looking at it than looking for it!”.

Back in the plenary session, Pacheco presented on TASS (toxic anterior

segment syndrome), which is rare but devastating. She told of a case

where a single scrub nurse, who was found not to be following the

same process with surgical instruments as others, caused a number of

TASS cases. The key message was the importance of a high standard of

instrument cleaning and sterilisation and appropriate identification and

management of any source of infection.

IVIs to the fore

Of course, an ophthalmology conference wouldn’t be complete without

discussing intravitreal injections (IVIs)! Dr Sophie Hill, Eye Institute,

updated us on an exciting new drug, faricimab, that is showing promise

in her small cohort of 10 patients, with less frequent injections generally

indicated. While it has been found to be good for neovascular age-related

macular degeneration (nAMD), it may not be as effective for retinal

vein occlusion. She

concluded that if

faricimab is funded,

it could be a good

second-line treatment

for nAMD.

Dr Tulay Cakiner-

Egilmez Zoomed

in from Boston to

clarify glaucoma and

associated risk factors;

it is estimated 50% of

Medix21’s Julian Knaggs with Tara Mudgway, Debbie

McMahon and Freya White

Drs Morgan Arnold, Derek Sherwood and Garry Singh

people with glaucoma

are unaware they

have it. She outlined a

theory that increasing

risk with increasing

age may be due

to thinning of the

trabecular meshwork,

iris and lens. She

said low blood

pressure may be the

mechanism in normal

tension glaucoma due

to reduced blood flow

to the optic nerve and

shared some tips on

assessing anterior

chamber angle

depth, eg. the Van

Herick assessment,

penlight and

smartphone flash.

And in brief…

Waikato Hospital’s

Lyn Scott talked

about a change

in her IVI practice,

reviewing waste

and the impact on

the environment,

recycling as much

as possible from

the packaging and

Toomac’s Ian MacFarlane,

Graham Brown and

Mark Taylor with Dr

David Dalziel (third

from left)

discussed the cost of instruments,

sterilisation and consumables.

Dr Cakiner-Egilmez showed an

at-home device for patients to check

IOP, which raised a question for me: will

we rely on more self-assessment by patients

in the future to manage the increasing health

burden?

Sarah Berman, Macular Degeneration

Drs Stephen Best and

Annika Quinn

New Zealand (MDNZ) general manager, said the latest AMD awareness

research found that major barriers for patients engaging in seeing an

eyecare professional were costs associated with the check and glasses,

accessibility, and anxiety about what would happen and what the

outcome would be.

PhD candidate Esmeralda Lo Tam, who runs a Mana Vision Pasifika

Facebook page, shared her vision to promote organ donation and her

personal corneal graft surgery experience, stressing the importance of

communicating with the patient regardless of their age.

And the last words go to Prof Chee, who gave the John Parr Medal

Lecture covering very complex cataract surgery. We were all entertained

when she was asked about her techniques for stress management,

but clearly she didn’t seem to have stress because her advice was “just

remain calm”!

Remaining calm was temporarily hindered for me by a precarious

gondola trip to the Skyline Rotorua gala dinner, but was restored with

the stunning view once up there and, of course, by the social side of

things where we had the chance to take a breath and catch up with our

wonderful colleagues.

Remaining calm seems like good advice for us all!

Kathryn Millichamp is a nurse practitioner with more than 24 years of experience

in ophthalmology nursing. She is currently practising in the out-patient clinics at

Te Whatu Ora Te Toka Tumai Auckland and is a member of the Eye Health National

Clinical Network.


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NZOPTICS.CO.NZ | 35

RANZCO NZ 2025

Safe handling and disposal of

ophthalmological waste

By Fiona Suter

FOLLOWING THE RECENT

ophthalmic nurses RANZCO

NZ meeting in Rotorua, there

has been ongoing discussion

of how best to handle and

dispose of substances

used in ophthalmology,

particularly intravitreal

anti-vascular endothelial

growth factor (anti-VEGF)

therapies and botulinum

toxin (Botox or Dysport). As

awareness increases about

occupational safety and

environmental sustainability,

clinical protocols must reflect

current evidence and drug

classification guidelines.

This article outlines

a practical, evidence-based overview

of best practices for handling anti-

VEGF agents, botulinum toxin and true

cytotoxic medications. It highlights the

differences between these agents and

provides recommendations that ensure

staff safety, regulatory compliance and

environmental responsibility.

Agent descriptions

Anti-VEGF agents – including bevacizumab,

ranibizumab, aflibercept and faricimab –

are recombinant humanised monoclonal

antibodies, or fusion proteins. They are

not considered hazardous in terms of

occupational exposure in ophthalmology and

there is no systemic toxicity reported during

intravitreal use 1 .

Botulinum toxin is a purified protein

derived from bacteria. It works by attaching to

nerve endings where they meet muscles and

blocking acetylcholine, which helps muscles

to contract. In blocking acetylcholine, the

muscle becomes temporarily paralysed.

Neither of these agents is classified as

cytotoxic or hazardous under guidelines

from the United States National Institute for

Occupational Safety and Health, the American

Society of Health-System Pharmacists, or

other international regulatory bodies. They

are administered using sterile techniques and

pose minimal risk to staff. For both anti-VEGF

agents and botulinum toxin, handling requires

no special personal protective equipment

(PPE) beyond standard aseptic precautions –

such as gloves and masks – and eye protection

is not required, as neither poses a splash

or aerosol hazard during preparation or

administration. Routine disposal via yellowlidded

sharps containers is sufficient, unless

contamination with cytotoxic substances

occurs 2–6 .

In contrast, true cytotoxic agents, such as

mitomycin C and 5-fluorouracil (5-FU), which

damage or kill rapidly dividing cells, pose wellestablished

occupational hazards, particularly

to pregnant staff. Their handling requires

specific essential precautions, detailed below.

Staff involved in their use should be trained in

hazardous drug protocols 7 .

• Double-gloving with chemo-rated nitrile

gloves to minimise dermal exposure

• Use of long-sleeved gowns, eye/face

protection and other barrier

methods

• Disposal of

materials in

designated

cytotoxic waste

bins, following

institutional

protocols

• Comprehensive

staff training in

safe handling, spill

management and waste

procedures.

These steps are critical

to safeguarding staff

while maintaining high

standards of patient care 3,8-11 .

Dr John

Beaumont

and Blake

Durney

Matching risk with precaution

For anti-VEGF and botulinum toxin

administration, standard PPE –

gloves, masks and aseptic technique

– is sufficient. There is no evidence

to support the need for cytotoxiclevel

precautions in the routine

ophthalmic use of

these agents 3,4 .

A key challenge in

clinical environments

is fear-driven PPE use.

Anecdotal concerns

or historical practices

have sometimes led

to unnecessary or

excessive protection.

While well-intentioned,

this overuse can

increase healthcare

costs, waste and staff

anxiety. Education

and clarity on the

actual risks can help

promote confidence

and ensure appropriate

PPE is used without overburdening staff or

the environment.

Although anti-VEGF agents and botulinum

toxin are not classified as hazardous, caution

is recommended for pregnant or vulnerable

staff, due to limited long-term safety data.

While the risk is considered minimal, avoiding

preparation or administration during

pregnancy is a prudent precaution 5,6,12 .

Environmental considerations

Correct classification and segregation

of waste play a crucial role in reducing

environmental impact:

• Anti-VEGF and botulinum toxin waste can

be safely discarded in standard sharps

containers, unless mixed with cytotoxic

substances

• Avoiding unnecessary use of

cytotoxic-labelled bins and excessive

PPE reduces clinical waste

• These practices align with national

and international sustainability goals

in healthcare 13-16 .

Eye Health National Clinical Network co-leads Drs Justin Mora, Sarah

Welch and Alistair Papali’i-Curtin


Summary

A clear understanding of the pharmacology and occupational risks

of ophthalmic agents allows for safe and sustainable clinical practice.

Anti-VEGF and botulinum toxin therapies, while potent and effective,

are not classified as hazardous or cytotoxic in ophthalmology. However,

caution is advised for pregnant or vulnerable individuals who may be

present during the preparation or administration of these medications.

Aligning PPE and waste disposal protocols with actual risk promotes

safety, reduces clinical waste and supports environmentally responsible

healthcare delivery. By following evidence-based guidelines and

fostering ongoing education, ophthalmology teams can confidently

maintain high standards of care while ensuring staff wellbeing and

regulatory compliance.

Ziemer of Switzerland Z8

femto laser lands in NZ

References

1. Velez-Montoya R, et al. Lack of systemic toxicity of anti-VEGF intravitreal injections. Ophthalmology.

2020;127(4):495–503.

2. European Society of Retina Specialists (EURETINA). Expert Consensus Statement on Intravitreal

Injections. 2020.

3. American Society of Health-System Pharmacists (ASHP). ASHP Guidelines on Handling Hazardous Drugs.

Am J Health Syst Pharm. 2018;75(7):e34–e71.

4. Centers for Disease Control and Prevention (CDC). Guidelines for Safe Handling of Biologics. 2016.

5. Allergan, an AbbVie Company. Botox Product Monograph. 2022.

6. National Institute for Occupational Safety and Health (NIOSH). List of Antineoplastic and Other

Hazardous Drugs in Healthcare Settings. 2020.

7. New Zealand Nurses Organisation (NZNO). Guideline: Safe Handling of Hazardous Drugs. Wellington,

New Zealand: NZNO; 2020.

8. Connor TH, MacKenzie BA, DeBord DG, et al. NIOSH Workplace Solutions: Personal protective equipment

used when handling hazardous drugs. 2014.

9. International Society of Oncology Pharmacy Practitioners (ISOPP). Standards of Practice. 2016.

10. Oncology Nursing Society. Safe Handling of Hazardous Drugs. 2018.

11. World Health Organization (WHO). Health-care Waste Management. 2018.

12. Saeed MU, Tameem A, Probert C, et al. Safety considerations for intravitreal anti-VEGF therapy in

pregnant or breastfeeding patients. Eye. 2014;28(6):695–700.

13. Moynihan R, Sanders S, Michaleff ZA, et al. Impact of COVID-19 on clinical practice: Environmental

consequences of protective protocols. BMJ. 2020;370:m2736.

14. Peaky M, Johnson R, Lee D. Environmental footprint of healthcare waste and sustainability in ophthalmic

procedures. J Environ Health. 2022;85(3):24–31.

15. Slawomirski L, Auraaen A, Klazinga N. Waste not, want not: Promoting value and sustainability in

healthcare. OECD Health Working Papers. 2020; No. 104.

16. Te Whatu Ora – Health New Zealand. Healthcare Waste Management – National Policy. 2021.

Fiona Suter is a nurse practitioner with more than 30 years’

experience in ophthalmology in the UK and New Zealand. She

practices privately at Nelson Eye Surgeons and is contracted to

work at Te Whatu Ora Nelson Marlborough and Westport.

Dr Andrew Riley with Device Technologies’ Jared Prinsloo and Louie Tan and Dr

Marc Gimblett

DEVICE TECHNOLOGIES HAS unveiled the Ziemer femto

LDV Z8 laser in New Zealand, describing it as a true “Swiss Army

knife” for eye surgery.

The Swiss-made laser’s capabilities not only span refractive

and cataract but its inbuilt OCT also allows for therapeutic

treatments, including keratoplasty and keratoconus treatments,

said Device Technologies refractive specialist Louie Tan. Using

low-energy pulses in the nanojoule range, the Z8 delivers precise

cuts with minimal tissue disruption, he said. “Lower energy levels

mean faster recovery times for patients. The Ziemer Z8 can be

used to create LASIK flaps and is also capable of performing

CLEAR (corneal lenticule extraction for advanced refractive

correction) as a one-step, all-femto refractive procedure directly

correcting refractive errors”.

What also sets this laser apart from others, is that it is compact

and portable, unlike traditional systems, said Tan. Another notable

feature is the system’s ability to perform the corneal allogenic

intrastromal ring segments (CAIRS) procedure for patients with

keratoconus, he said. The Z8 creates a tunnel in the patient’s

cornea to insert donor tissue, which is a big improvement over

synthetic materials, offering 100% biocompatibility and reducing

the risk of extrusion, said Tan. “And it can cut donor tissue to exact

specifications, something that would otherwise be done manually

and take much longer.” While CAIRS is still gaining traction in

New Zealand, the Ziemer Z8 is currently the only system in the

country equipped for this revolutionary treatment, he said.

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12/6/2025 9:23 am

NZOPTICS.CO.NZ | 37

RANZCO NZ 2025

Understanding registrars’

wants post-training

By Lesley Springall

WITH A SHORTAGE of ophthalmologists in

the regions, RANZCO’s education committee

surveyed 23 New Zealand-based ophthalmology

trainees and a few recently made fellows to

understand what mattered to them after

they completed their training. Presenting the

results at the RANZCO NZ 2025 conference,

Dr Cheefoong Chong, director of training for

RANZCO NZ, said the survey provided some

interesting insights.

One of the most important factors

influencing where they’d like to live after

they qualify was access to natural resources,

including beaches, hikes, biking, etc. “It’s why

many of us are here,” said Dr Chong.

Raising an appreciative laugh from the

audience was the least important factor:

proximity to nightlife, culture and events. Also

important for most was proximity to family and

the ability to practise their desired subspecialty,

while city amenities and on-call rosters were of

little consequence. Real-estate affordability was

pretty evenly split between those who thought

it important and those who didn’t.

By far and away the most important factor for

selecting which practice or hospital to work in,

however, was theatre access,

said Dr Chong. “So if you want

to retain or attract trainees to

come and work in your hospital, theatre access is

really important.”

Currently about 80% of ophthalmologists

work in urban areas in New Zealand, but 43%

of the trainee cohort surveyed said they found

working in a regional centre most appealing. This

suggests RANZCO NZ’s current selection criteria,

intended to attract more ophthalmologists to

the regions, is working, said Dr Chong, but it’s

what happens during and towards the end of

their training that can upset this balance.

Firstly, trainees’ annual income expectations

for their first five years are greater than

$200,000, which is the maximum a medical

officer in the public sector earns in their first

five years. “This implies that everyone wants

to do some form of private practice from their

first year,” said Dr Chong. Additionally, 74% of

trainee ophthalmologists want to practise as

a primary sub-specialist after they graduate,

which is not compatible with being a generalist

ophthalmologist in the regions, he said. “As

fellows of the College, it is really important for

Drs Kent Chow, Sid Ogra and Cheefoong Chong

us to highlight the importance of being a wellrounded

generalist rather than a sub-specialist.

Yes, we do need super sub-specialists but we

need more generalists.”

Most also want a mix of public and private

practice, with just over 50% wanting to spend

more than 50% of their time in private practice

in their first five years, while working in a group

practice was seen as far more attractive than

working solo. “Interestingly, none of our trainees

wanted to work for a corporate,” said Dr Chong.

“They either want to be a part-owner or an

employer or they want to go solo.” Finally, all

envisaged training or supervising others as

part of their future careers, while more than

80% also hoped to be involved in research, he

said. “This is just a snippet of what our registrar

cohort thinks about what they want to do in

the future… but I hope it brings some insight

to us as fellows as to where we can improve in

delivering quality education.”

See related story, p40.

FDA approval for ZEISS’ next-gen AI OCT

THE ZEISS CIRRUS 6000

OCT device, integrating highspeed

imaging and an artificial

intelligence (AI)-guided OCT

image assessment support tool,

received FDA approval just over a

month ago, said Lahiru Gunasena,

Zeiss product specialist.

Operating at 100,000 A-scans

per second, the Cirrus 6000

delivers rapid, high-definition

OCT and OCT angiography

(OCTA) scans, which facilitate a Drs Sarah Hull and Paul Rosser with Zeiss’ Lahiru Gunasena (centre)

wider field of view – up to 12mm

in a single scan – and reduces motion artefacts, enabling clinicians to capture detailed

images swiftly, the company said. The device provides non-invasive visualisation of retinal

microvasculature, aiding in the detection and management of conditions such as diabetic

retinopathy, age-related macular degeneration and glaucoma.

Its integration into clinical practice supports informed decision-making, efficient

workflows and improved patient outcomes, said Gunasena. “The goal is integration and

digital interconnectivity into the Zeiss ecosystem. That includes the Zeiss Forum where all

devices ‘talk’ to each other, all with one window open. A surgeon can access this information

from anywhere and plan their surgeries from abroad.”

The latest Cirrus 6000 software is supported by the largest OCT reference database in the

US, comprising 870 healthy eyes with diverse age ranges and optic disc sizes, Zeiss said.

Clinics can run the Cirrus PathFinder 500, 5000 and 6000 via software licence activation,

Gunasena said.

RION remains

difficult to treat

A REVIEW OF radiation-induced optic

neuropathy (RION) by Auckland University’s

Professor Helen Danesh-Meyer and Dr

Dineo Mpe has highlighted it as a cause of

vision loss with a lack of good prophylaxis

or treatment.

RION, a late complication of radiotherapy

cancer treatment, is a rare but devastating

condition typically presenting with

painless vision-loss in one or both eyes,

peaking one to two years after radiation

exposure. Although its pathogenesis is not

yet fully understood, it is thought RION

occurs through delayed radiation-induced

ischaemic necrosis from free radical damage,

said the authors.

Hyperbaric oxygen therapy is suggested

as one, controversial, RION treatment, with

overall results “disappointing”. “However,

systemic or intravitreal anti-VEGF may have

a role in improving or stabilising vision,”

they said. Since using radiation levels

within strict parameters can limit RION

incidence to around 1–2%, meticulous

planning with today’s more precise

radiotherapy technologies is essential, the

authors concluded.


VR testing headset hot off

the press!

By Susie Hill

JUST TWO DAYS after the Retinalogik AIbased

virtual reality (VR) system reached New

Zealand shores it was on display on Medix21’s

stand at the RANZCO NZ 2025 conference,

ready to wow eyecare professionals.

The Canadian-designed and manufactured

shiny new VR field testing headset gave

attendees the chance to ‘leave’ the exhibition

hall and enter a stylish lounge with a

magnificent mountain view, not unlike those

in Queenstown. Retinalogik’s virtual AI agent

‘Robyn’, who can speak in 20 languages, was

there to give tutorials and voice prompts.

By integrating AI and VR, the headset

tests visual fields, visual acuity, colour vision

and contrast sensitivity “all in one go”, said

Medix21’s surgical sales manager Camille

Furnandiz. “Retinalogik provides print outs

that are identical to Humphrey – the gold

standard for visual field testing. Its visualfield

capabilities allow for progression

analysis and detection and monitoring

of glaucoma, macular degeneration and

diabetic retinopathy.”

The beauty of the headset is the patient can

sit comfortably in the clinic waiting room and

have all their tests done there in just a few

minutes without the need to move around or

having a technician keeping them on task, she

said. “They don’t have to sit in the dark or have

one eye patched.”

Furnandiz said Retinalogik will also be

integrated with CatTrax to push the tests via

DICOM, making the transfer of patient data

into digital records seamless.

The VR units are available as an outright

purchase or on a subscription basis, which

includes support and software updates pushed

out every three months with new tests, which

Furnandiz said makes it cheaper than buying

a piece of capital equipment. The device is also

easy to use, she said. “Our team has had it for

two days and we only learnt to use it last night!”

IOL for cataract and AMD

Also on show on Medix21’s stand was the new

EyeMax Mono Sharp View intraocular lens

(IOL), designed for patients with cataract and

Medix21’s Camille Furnandiz wearing

headset with colleague Julian Knaggs

dry age-related macular degeneration (AMD)

who have been stable for six months.

The EyeMax looks like a cataract IOL and

is implanted during cataract surgery but,

unlike monofocal lenses, distributes light

across a wider area, allowing patients to use

healthier parts of their retina, said Furnandiz.

“It magnifies a 6mm diameter around the

fovea, shifting the image to use any healthy

macula within that zone. As long as there is

any healthy macula within that 6mm diameter,

it will keep shifting the image… improving

functional vision and prolonging useful vision

for AMD patients.” The IOL is limited to

patients who still have some healthy macula

and require cataract surgery, she said.

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NZOPTICS.CO.NZ | 39

RANZCO NZ 2025

Boost the workforce; tackle burnout

By Lesley Springall

ACCORDING TO RESEARCH from Massey University, the risk of

burnout is twice as high for medical doctors compared with other

workforce groups in Aotearoa.

Though the Medscape Physician Burnout & Depression Report 2024

found ophthalmology had one of the lowest burnout rates across

medical specialties in the US (39% compared with 63% for emergency

medicine) the problem is compounded in New Zealand due to our

low number of ophthalmologists (27.8 per million people, compared

with 40.1 in Australia, 46.4 in the UK, 54.7 in the US and more than

100 in Switzerland and Japan), said Dr Theo Sutedja, a non-training

ophthalmology registrar based in Dunedin.

Presenting the results of his own research into burnout among

ophthalmologists in Aotearoa at the 2025 RANZCO NZ conference,

Dr Sutedja found one-in-five was burnt out. Of these, 29% worked in

public-only, 15% in private-only and 19% in public and private, while

66.7% were female and 62% male. “The data shows it’s a daily reality for

many of us,” he said.

For his research, Dr Sutedja surveyed 84 Kiwi ophthalmologists using

the ‘Mini Z’ tool, a 10-question survey developed by Dr Mark Linzer,

professor of medicine at the University of Minnesota Medical School,

to measure physician burnout. The survey assesses three outcomes

(burnout, stress and satisfaction) and seven drivers of burnout (work

control, work chaos, teamwork, values alignment with leadership,

documentation time pressure, EMR use at home and EMR proficiency).

Burnout is also common and recurring, said Dr Sutedja, with four out

of 10 of those he found to be burnt out having been burnt out at least

once before and one in 10 having had it more than five times. “Yet only

50% ever sought help and only 15% took any time off,” he reported.

The Massey University research also found that burnt-out medical

doctors were 4.7 times more likely to seriously consider quitting the

medical profession compared with their non-burnt-out peers. While the

Association of Salaried Medical Specialists in New Zealand found more

than 15% of senior doctors were considering cutting their public hours.

“So, it’s not just a wellness issue, it’s a workforce risk,” said Dr Sutedja,

who closed his talk by suggesting three strategies for tackling the issue:

• Reduce systemic stressors – reduce low-value tasks (audits, meetings)

that don’t improve patient care

• Expand training capacity – of the current 6–7 new trainees accepted

to the RANZCO training programme each year in New Zealand, only

two-thirds of them remain in New Zealand post-training. The number

of trainees needs to increase to eight a year simply to maintain the

status quo, or 11 per year to reach similar numbers of ophthalmologists

per population to Australia by 2050

• Public-private models – improve the shared working relationship

between public and private and narrow the pay gap to improve

retention in public.

See related story, page 38.

What a cat-astrophe!

By Susie Hill

CATS COME UNDER fire

for numerous disease

transmissions and Te

Whatu Ora Southern’s

Drs Theo Sutedja and

Jerome Languido’s poster

reminded us of yet

another disadvantage

of owning a moggie:

cat-scratch disease (CSD),

caused by the bacterium

Right neuroretinitis at first presentation

Bartonella henselae.

CSD neuroretinitis is a rare ocular manifestation of the disease,

occurring in 1 to 2 % of CSD cases and is characterised by optic disc

swelling and macular star, the doctors wrote in a RANZCO NZ 2025

poster.

They described the case of a 19-year-old woman who presented

with a one-day history of painless vision-loss in one eye but was

otherwise well. She reported having newborn kittens in her home.

Both eyes showed best-corrected visual acuity (BCVA) at 6/120.

OCT revealed serous retinal detachment, with hyperaemic and

oedematous optic disc, with macula elevation and a spoke-wheel

pattern of hard exudates.

Serological testing confirmed elevated Bartonella henselae IgG

levels. After six weeks of combined oral rifampicin 300 mg and

doxycycline 100 mg, both twice daily, plus three days of intravenous

methylprednisolone (10 mg/kg/day) followed by several weeks

of oral prednisone at 1 mg/kg/day, the serous retinal detachment

resolved and, at two months, BCVA improved to 6/12.


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NZOPTICS.CO.NZ | 41

NEWS

GNZ launches ‘high-impact’ Sightwise

By Susanne Bradley

GLAUCOMA NEW ZEALAND

(GNZ) is launching

Sightwise, a programme

to educate and support

glaucoma patients,

reduce the burden on eye

departments, improve

patient treatment outcomes

and reduce avoidable

blindness from glaucoma.

Glaucoma Australia

launched Sightwise in 2018

and, working closely with

them to align services, GNZ

general manager Pippa

Martin said the programme’s

impact is significant. A

2023 Australian patient

survey showed that 91% of Sightwise patients attended their glaucoma

appointments, 84% adhered to their treatment regimen and 84% had

told their relatives to get tested.

Conducting a six-month trial in New Zealand last year, Martin

said the response from eyecare professionals and patients alike was

overwhelmingly positive. “We have developed strong links with eye

health professionals in New Zealand who can see the benefit of the

programme being developed here.”

Sightwise is developed for newly referred patients and delivered by

GNZ at no cost to the patient or the health system, Martin explained.

The objectives are to empower people with glaucoma to understand

their disease; for patients to make informed decisions to maintain

quality of life and preserve vision; provide one-on-one practical support

via GNZ clinical educators to help manage the anxiety of receiving a

diagnosis; play a facilitation role within each patient’s circle of care

to maximise rates of appointment and treatment adherence, slow

disease progression and reduce vision loss; and support eye health

professionals by extending care beyond the practice to maximise longterm

treatment outcomes. Newly appointed to manage GNZ’s Sightwise

Pragmatic professional education

programme is optometrist

Shubhneet Nanda (see p55).

“I’m confident the

programme is going to

improve patient outcomes.

We encourage eye specialists

to refer their glaucoma patients

to the Sightwise programme,”

Martin said.

To support Sightwise, either

financially or by volunteering,

GNZ welcomes any contribution

to assist with calls, develop

new resources or to help fund

ongoing programme costs

Contact Pippa Martin on

p.martin@auckland.ac.nz.

GNZ’s annual Professional Education Symposium is on Sunday 13 July at

the Maritime Room, Viaduct Harbour, Auckland, or online via Zoom.

Convened by world-leading ophthalmologist and GNZ chair Professor

Helen Danesh-Meyer, the conference is themed ‘The role of optometrists

and real-world glaucoma’. It will deliver professional education that is

“pragmatic, empowering and unapologetically focused on excellence in

front-line decision-making”, GNZ said.

Featuring keynote Dr Aparna Raniga, a Sydney-based comprehensive

ophthalmologist with sub-specialty training

in glaucoma, cataract and uveitis, the event is

open to all health professionals and students

(optometrists, nurses, orthoptists and

technicians). Optometry CPD is approved (6.9

GE points).

For more, see https://glaucoma.org.nz/

get-involved/professionals/professionalsymposium.

Dr Aparna Raniga

Expanding OCT to the periphery

LAUNCHED AT THE same time as its

latest advanced spectral-domain OCT

system, the Revo HR (high-resolution),

Optopol Technology’s new ultrawidefield

(UWF) module is a real game

changer, said Optimed’s Craig Norman.

The Revo HR offers a super-fast

130,000 scans per second as well as

one of the highest OCT resolutions

out there at 3µm, so it’s a powerful tool

for optimising precision, accuracy and

improving the detection of the smallest

lesions, he said. “But the UWF module

takes this to a whole new level. Typically,

OCT scans to 12mm or 18mm, but with

the new UWF module, which attaches

to the front of the Revo, eyecare practitioners can take OCT scans

out to a 105° field of view… and it does OCT angiography scan, too.”

Optimed’s Craig Norman with the new Revo HR and UWF module

attachment

The new module allows eyecare

professionals to image the macular

area along with the far periphery

to capture early stages of disease

in the posterior part of the eye

in a single scan, said Optopol. “It

allows 3D imaging for full analysis

and angio-OCT with the ability to

visualise perfusion problems in the

periphery.”

As well as the new Revo HR, the

module can also be fitted to Revo’s

simpler OCT models, the FC 130

and FC, and it’s very affordable at

around NZ$10,000, said Norman.

“So you don’t have to buy a whole

new OCT to diagnose peripheral pathology, you can just buy the

module. You can see why we’re excited about it.”


EDUCATION

From LA with love – the ASOA

annual meeting

By Shellene Garofalakis

WITH A MIX of nervousness

and anticipation, I stepped

into the vast atrium of the Los

Angeles Convention Centre

for the 2025 annual meeting,

hosted by the American Society

of Ophthalmic Administrators

(ASOA). Running alongside the

American Society of Cataract

and Refractive Surgery (ASCRS)

scientific programme from 25–28

April, this four-day event was a

deep dive into the business of

ophthalmology and an invaluable

opportunity for learning, reflection

and connection.

As the strategic partner of

ASCRS, ASOA is a guiding force

for ophthalmic administrators,

managers, clinical directors and

practice leaders, with a mission to

empower us through education,

innovation, support and

collaboration. It delivered just that.

With an overwhelming variety

of breakout sessions and speakers,

the biggest challenge was

narrowing down which ones to

attend, especially when trying

to identify those most relevant

to the New Zealand market. It

was quite an experience to be surrounded by

leaders from across the US, many managing

large, multi-site, high-volume practices. Though

the scale was impressive, the principles were

familiar: patient-focused care, operational

excellence and adapting to change.

The accompanying trade show added even

more value, offering hands-on interaction

with vendors showcasing the latest in

ophthalmic technology, software and service

solutions. From AI-assisted diagnostics

to patient-engagement platforms, the

meeting was a front-row seat to the future of

ophthalmic practice.

Of the 14 sessions I attended, three

stood out for their practical insights and

immediate applicability.

Patient engagement across the

generations

This session was a fascinating look at

how different generations engage with

healthcare. From Baby Boomers to Gen Z, each

cohort brings unique expectations around

communication, sustainability, technology and

service. The key message? One size does not fit

all. While technology enhances relationships,

The conference was held at the Los Angeles

Convention Centre

it doesn’t replace them.

We were reminded to

tailor our approach, not

just in messaging but

in tone, language and

even delivery channels.

Building loyalty means

knowing your audience

and adjusting accordingly.

…But did you

document it?

This compelling

presentation focused on

the importance of robust

documentation across

all areas of practice. It

emphasised handling

incidents involving upset

patients. Clear, factual, professional records

not only protect the practice but help identify

recurring issues and training needs. Takeaway

tips included using objective language,

avoiding opinion or emotion, recording

accurate dates and times and ensuring

information is stored securely. The take-home:

“If you didn’t document it, it didn’t happen.”

Dr Penny McAllum (left) and Shellene

Garofalakis outside Langer’s Deli

Mitigating risk: strategies for

handling upset patients

Building on the previous session,

this presentation introduced

the ‘risk reducer framework’ for

managing conflict:

• Recover: listen actively,

acknowledge feelings, apologise

and offer a solution

• Respond: stay calm, respectful,

empathetic and clear

• Resolve: identify root causes

(eg. wait times), communicate

effectively and document

thoroughly.

This framework provided a

practical toolkit for turning

potentially negative experiences

into opportunities to learn and

preserve trust with patients.

Outside of the ‘classroom’, the

schedule offered the chance to

explore the vibrant culture of

Los Angeles. Dr Penny McAllum

(attending the ASCRS

sessions) and I made time

to sample some iconic local

eats, including a pilgrimage

to the legendary Langer’s

Deli, famous for its pastrami

sandwiches and rye bread.

With a queue snaking down

the street, it was clear this LA

institution, now celebrating 77

years in business, still delivers

on its reputation. An additional

highlight was dining in the

Polo Lounge at the iconic

Beverly Hills Hotel, devouring

its world-famous soufflé.

Attending the 2025 ASOA

annual meeting was a privilege

and an eye-opener. The

professionalism, generosity

and openness of the speakers

and delegates made for an

inspiring few days. There is

so much value in stepping

outside your day-to-day environment and

learning from peers around the world. I

returned home with fresh ideas, practical tools

and a renewed appreciation for the global

community we’re part of.

Shellene Garofalakis has been Eye Doctors’ practice

manager since 2021.

NZOPTICS.CO.NZ | 43

NEWS

Auckland Optotypes go global with Essilor

By Susanne Bradley

THE UNIVERSITY OF Auckland’s

School of Optometry and Vision Science

(SOVS) has signed a licensing agreement

with Essilor Europe supporting the

inclusion of The Auckland Optotypes in

Essilor’s refraction devices.

Seeking a simple and accurate test,

Essilor reviewed the different sets

available and concluded The Auckland Prof Steven Dakin. Credit: UoA

Optotypes had the best science base to

support it, said SOVS’ Professor Steven Dakin, the researcher who,

together with Dr Lisa Hamm, is behind The Auckland Optotypes.

Distributed under a Creative Commons licence, the goal has always

been for The Auckland Optotypes to be as widely used as possible, said

Prof Dakin. “This partnership with Essilor is very exciting as it helps

secure long-term sustainability and continued public access for The

Auckland Optotypes.”

The licensing agreement itself is also innovative as the entire fee goes

towards supporting a PhD student at SOVS, dedicated to working on

improving The Auckland Optotypes, he said, adding Essilor is also

thrilled by this model. Unlike most collaborative agreements with

industry, SOVS in this case will hold the intellectual property for

anything generated by the PhD student and, importantly, will remain

completely unencumbered, Prof Dakin said.

The agreement is for three years in the first instance, but Prof Dakin

said he hopes it will become an ongoing arrangement.

Save Sight Society

Save Sight Society

Conference

2023

Conference

2025

Friday 8 th September

Hagley Friday Oval Pavilion, 1 st August

Christchurch

Register at: savesightsociety.org.nz

Park Hyatt Hotel, Auckland

Register at: Savesightsociety.org.nz

“With Essilor on board,

we are hoping that The

Auckland Optotypes will

become more widely

accepted and move towards

becoming a standard for

vision testing in children.

They are the best symbols

available; they are better

than the alternatives by quite

some margin.”

Initially supported by

Cure Kids and SOVS,

The Auckland Optotypes

were developed to deal

with several shortcomings

SOVS’ Auckland Optotypes

in common eye charts,

including issues with some symbols being easier to identify than others.

Dr Hamm designed 10 easily recognisable, similar but distinctive

symbols and tested them in low-decile schools in New Zealand and

Tonga. Compared to the commonly used Sloan Letters, The Auckland

Optotypes consistently achieved a higher intraclass correlation value,

demonstrating more consistent acuity estimates between optotypes.

The Auckland Optotypes are available for download here: github.com/

dakinlab/OpenOptotypes.

Ocular Therapeutics

Conference is back!

THE ONLY NEW Zealand meeting focused entirely on ocular therapeutics,

the Ocular Therapeutics Conference (OTC), returns on 14 September for a

day of translational research and practical learning.

Responding to feedback from delegates, the OTC returned to its oneday

format in 2023 after a series of education evenings trialled during the

Covid pandemic, said organiser Professor Ilva Rupenthal, director of the

Buchanan Ocular Therapeutics Unit. “We feel the one-day format enables

more educational value and offers better networking opportunities. We

have also recently decided to make the OTC a biennial rather than an

annual event due to the large number of educational meetings scheduled.”

Ophthalmologists, optometrists, pharmacists and support staff,

especially those with an interest in the latest developments in ocular

therapeutics, are invited to attend, she said. “The event will feature rapid,

12-minute, presentations focused on enhancing practical understanding

of key aspects of ocular therapeutics. Each of the four sessions will focus on

a specific topic with subsequent panel discussion.”

“Our speakers are selected by the programme committee for their

clinical experience, subject knowledge and ability to entertain from

the podium, ensuring a high-calibre line up, Prof Rupenthal said. This

year’s keynotes, Professor Gerard Sutton, honorary professor in clinical

ophthalmology and eye health at the University of Sydney’s Save Sight

Institute, and Auckland ophthalmologist Dr Jo Sims, will deliver sessions

titled ‘Restoring the cornea’ and ‘Inflammatory eye disorders – more than

steroids’, respectively.

The conference will be hosted at the Grafton Campus, University of

Auckland. Recordings will be available online for remote learning following

the conference. The ocular therapeutics online modules are available and

accredited for two years. CPD points under application.

For more, see ad on p8.


DRY EYE

WHAT’S NEW?

NZ Optics’ September 2025 issue will feature our

internationally lauded annual DRY EYE special

feature. Curated by Professor Jennifer Craig, chair

of the lifestyle TFOS workshop and vice chair of

TFOS DEWS II, our 2025 feature will share the latest

thinking and research on dry eye disease from

New Zealand and overseas.

As well as appearing in print, this special feature is shared far and wide as a

dedicated online pdf e-magazine.

For all advertising enquiries, please contact lesley@nzoptics.co.nz by 23 July 2025.

NZOPTICS.CO.NZ | 45

FOCUS ON EYE RESEARCH

NEWS

Dr Mo Ziaei,

series editor

New treatments for uveal melanomas

and naevi

By Dr Peter Hadden

Targeting ocular malignancies

using a novel light-activated viruslike

drug conjugate

Maa S, Huis In’t Veld RV, de los Pinos

E, Ossendorp FA, Jager MJ (2025)

Advances in Ophthalmology Practice

and Research 5:49–57

Review: This article explains

how a virus-like particle (VLP)-

photosensitiser drug conjugate,

belzupacap sarotalocan (Bel-sar,

previous name AU-011), can be used

to treat choroidal melanoma.

Bel-sar is derived from the human

papilloma virus and is injected

into the suprachoroidal space. It

specifically binds to uveal melanoma

cells by way of heparan sulfate

proteoglycan molecules on the cell

surface. The VLP is loaded with a large number

of phthalocyanine molecules and, once bound,

discharges these into the tumour cells. If bright

689nm light is then shone on the tumour

using a laser in the presence of oxygen, these

phthalocyanine molecules release singlet

oxygen, which is toxic to biological structures.

Sufficient damage will kill the tumour cells

outright. However, even if they survive this,

they will release damage-associated molecular

patterns, which the immune system uses to

target the tumour cells.

Uveal melanoma

Comment: This novel approach to treating

choroidal melanoma offers the advantage of

being a highly targeted therapy which, unlike

radiation, is less likely to damage surrounding

structures. This is particularly important for

a tumour close to the macula, which would

also get a dose of radiation if the tumour is

irradiated by a plaque. And we already have a

mechanism to inject it into the suprachoroidal

space, as well as a laser that can activate it.

Animal and, more recently, initial clinical

trials in the US have proved promising. Now

there is a worldwide trial in which both Dr Riyaz

Bhikoo and I are involved. Potentially, it offers

patients with melanomas close to the fovea a

treatment that can kill their tumour without

affecting their central vision. Not only that, but

there is the possibility that immunogenic cell

death (those cells killed by the immune system

after being damaged) could trigger a systemic

immune response against other tumour cells

elsewhere in the body. Thus, this treatment has

the potential to kill unrecognised metastatic

disease at an early stage.

Slow enlargement of choroidal naevi: a

long-term follow-up study

Mashayekhi, A, Siu S, Shields CL, Shields JA

(2011)

Ophthalmology 118:382–388

Review: This paper is a retrospective

observation case series of 278 patients with 284

choroidal naevi who were followed up for at

least seven years photographically, without any

clinical signs of transformation into melanoma.

The median age at presentation was 57 years

and the median largest basal diameter of the

naevi was 5mm, with a median thickness of

1.5mm. Some had suspicious features, with 6%

having lipofuscin and 5% with subretinal fluid

extending outside the naevus.

Over a mean follow up of 15 years, 31%

enlarged, with the diameter increasing by a

median of 1mm (mean, 0.9mm; range, 0.2–

3.0mm). The median rate of enlargement was

0.06mm/year (mean, 0.06mm/year; range, 0.01–

0.36mm/year). None of the lesions that enlarged

developed new risk factors generally associated

with malignant transformation. Naevi enlarged

more frequently in patients under 40 years (54%)

than in those older than 60 years (19%).

Comment: This is not a new study, but it

segues into a topic that is prompting research

at the moment, mainly due to the advent of

widespread fundus photography allowing more

patients who have new or growing choroidal

naevi to be seen.

It has stimulated unpublished research on

the topic of when is a new or growing naevus

actually a melanoma. When I attended an

International Society of Ocular Oncology

meeting in Goa earlier this year, a

Danish study (as yet unpublished)

was presented showing naevi enlarge

and increase in number in the first

40 years of life; in fact, almost no one

under 10 years of age had a choroidal

naevus. Naevi in that study were

present in 2.7% of the population,

with 96.6% being common or low risk

(0 or 1 on the MOLES scoring system,

a gauge of how suspicious naevi are).

Clearly, the vast majority of new

and even slowly growing naevi are

not melanomas, especially in people

younger than 40 years, and this

paper gave us some handle on how

common that is (very common), as

well as a rate of change. This is going

to become increasingly important to

know given that many people have

now had their eyes photographed and will have

their eyes photographed.

Globe salvage and vision preservation by

neoadjuvant darovasertib and crizotinib in

uveal melanoma

Hiong A, Roderick O’Day R, Lotte S. Fog LS, Daniel

McKay D, McKenzie J, Ameratunga M, Joshua AM,

Shackleton M (2024)

Ophthalmology Retina 8: 325-330

Review: This paper, a single case study

from Australia, reported the effective use of

neoadjuvant darovasertib and crizotinib in a

patient with a large uveal melanoma in his only

functional eye.

A patient with a blind left eye (secondary

to retinal artery occlusion) presented with

rapidly declining right eye vision due to a

primary uveal melanoma measuring 18mm

in maximal diameter and 16.5mm in maximal

thickness. This size of tumour is usually treated

with enucleation, but such an operation

would completely blind him. To salvage vision,

neoadjuvant treatment was initiated using

darovasertib and crizotinib. After six months

of treatment, which included cataract surgery

for tumour-associated cataract, the melanoma

regressed to 14.1mm in maximal diameter

and 2.6mm in maximal thickness, enabling

treatment with plaque brachytherapy.

The authors concluded this combination of

darovasertib and crizotinib for uveal melanoma

is an effective neoadjuvant strategy warranting

further investigation as an approach to improve

visual outcomes in the treatment of primary

uveal melanoma.


NEWS

Comment: The treatment of metastatic uveal

melanoma remains unsatisfactory, but in

recent years we have started to learn about

the mutations these tumours carry and

sought drugs which might target cells with

those mutations.

Emerging treatments for uveal melanoma

include those targeting mutations in GNAQ

and GNA11, which encode members of the

G-protein alpha subunit, Gq and G11 and are

present in >90% of these tumours. GNAQ/11

mutations lead to activation of protein

kinase C (PKC), resulting in activation of the

Raf-MEK-ERK pathway and promotion of cell

proliferation. Inhibition of PKC has been shown

to suppress the growth of GNAQ/11-mutant

melanoma cells and has activity in patients

with uveal melanoma.

However, targeting PKC alone doesn’t

seem to be enough. A potential mediator of

resistance to Raf-MEK-ERK inhibition in uveal

melanomas is hepatocyte growth factor,

which binds to c-MET (mesenchymal-epithelial

transition factor), a receptor tyrosine kinase,

leading to increased cell proliferation. In uveal

melanoma cells, hepatocyte growth factor

blunts the effect of MEK inhibition on cell

growth, but this resistance can be overcome

in vitro using c-MET inhibition, giving rise to

the rationale of combining darovasertib, a

selective PKC inhibitor, with crizotinib, a c-MET

inhibitor. This combination has been evaluated

in metastatic uveal melanoma, with early

clinical data demonstrating disease control

and response rates of approximately 90% and

45%, respectively.

The authors took this potentially promising

treatment and, in an apparent act of

desperation, tried to shrink a tumour which,

given its size, would have ordinarily required

enucleating his only eye… and it worked!

However, there are a few potential problems.

One is that these drugs are pretty toxic and

have a lot of potential side effects. Another

is that, having been effective in this patient,

it was tried in others, for whom it didn’t work

so well. Finally, does it kill all the cells? The

aim is to sufficiently shrink a tumour to allow

treatment with a plaque instead of having to

remove the eye. So, in the end the plaque is

a smaller diameter than the original tumour.

However, could there be viable cells outside the

area that you plaque that you can’t see? And

could these cells start growing again and the

tumour come back?

Dr Peter Hadden is an

ophthalmologist based at Eye

Institute Remuera and New Lynn,

as well as Greenlane Clinical Centre.

He specialises in cataract and

vitreoretinal surgery, as well as

ocular oncology.

Enhanced digital health

records delayed

THE END OF the first

phase of the Shared Digital

Health Record (SDHR),

intended to enhance and

increase coverage of existing

regional shared electronic

health records (SEHRs),

is now scheduled for

December 2025.

The delay from its

intended June roll-out is

due to “various internal

and external factors”, said a

Health New Zealand update.

The existing SEHRs

include HealthOne in

the South Island and TestSafe, Your Health

Summary and the SEHR in the North Island.

Health New Zealand says that the SDHR

is a data service designed to securely share

patient data across healthcare settings.

With patient consent, providers nationwide

will have secure access to critical health

information such as allergies, adverse

reactions, conditions, encounters and

observations, and will be able to access and

update a patient's core health information

through this new service, it said. The

SDHR roll-out doesn’t, however, include

implementation for general practice.

In this first phase, Health New Zealand is

collaborating with primary care providers

who opt in to collect and share read-only

versions of the data held in their practice

management systems (PMS). SDHR provides

an opt-out process for patients who prefer not

to share their information and any current

confidentiality notifications about patient data

in PMSs will be observed. Patients will also be

able to request the details of who is accessing

their records.

The SDHR will be a fast healthcare

interoperability resources (FHIR)-based data

service, with APIs (application programming

interfaces) being made available on the Digital

Services Hub later in 2025.

“Patients’ ophthalmology and optometry

records will not be included in the first phase

of the Shared Digital Health Record data

service project,” said Jean Flemming, acting

director Strategy and Investment Digital

Services, Health New Zealand. “It is planned

that additional types and sources of health

information from various care settings will be

included (within usual privacy and consent

requirements).”

Subject to funding, future development

will expand access to other parts of the health

system, including first responders, hospitals

and specialist services, she said.

Metastatic risk

in conjunctival

melanoma

AN INTERNATIONAL STUDY found

metastasis occurred in 10% of conjunctival

melanoma patients, with the liver and

lungs the most commonly reported sites

(45% each).

A total of 288 patients with conjunctival

melanoma were recruited from nine

countries. Of these, 29 developed

metastases, with five of them having

metastasis at presentation and

exhibiting tumour-surface ulceration.

Those presenting with metastasis had

shorter survival times, said authors led

by Dr Puneet Jain, Eye Cancer Center,

New York, writing in the British Journal

of Ophthalmology.

Authors reported 71% of those

developing metastatic conjunctival

melanoma had died by the end of the

study. Tumour-specific characteristics

including American Joint Committee on

Cancer cT3-category, conjunctival location

and surface ulceration were associated

with highest metastatic risk.

Conjunctival melanoma

NZOPTICS.CO.NZ | 47

NEWS

EYE ON OPHTHALMOLOGY

Pathological myopia

By Dr Leo Sheck

PATHOLOGICAL MYOPIA IS the presence of structural

changes in high myopia, driven by axial elongation

and posterior staphyloma 1 . High myopia is defined as a

highly negative refractive error (> -6 to -8 dioptres), along

with axial elongation (>26–26.5mm), while posterior

staphyloma is defined in Spaide et al’s Pathologic Myopia

(2021) as “an outpouching of the wall of the eye that has

a radius of curvature that is less than the surrounding

curvature of the wall of the eye”. This is the most common

finding of pathological myopia, although occasionally

posterior staphyloma can be present in eyes with normal

axial lengths.

In pathological myopia, myopic maculopathy is an

important cause of vison loss accounting for 12.2%

of vision loss in Japan and is the fourth leading cause

of vision loss in Spain (after age-related macular

degeneration, glaucoma and diabetic retinopathy) 1 . Here,

I present eight key points to aid your clinical practice in

pathological myopia.

Recognise the key findings of a myopic fundus

The diagnosis of pathological myopia can be missed in patients with

previous laser refractive surgery or cataract surgery and previous high

myopia, as their refraction may be close to emmetropia. Clinicians must

recognise the classic signs of a myopic fundus on examination, Optos

ultra-widefield imaging and optical coherence tomography (OCT)

imaging to make the correct diagnosis. These are:

• Optic nerve is often tilted, small with parapapillary atrophy. OCT

imaging can show incorrect segmentation

• Peripheral retina can appear thin and tessellated. This is best

appreciated on Optos ultra-widefield imaging

• Macula can show posterior bowing on OCT, along with thinning of the

choroid and sometimes tractional changes.

If these signs are present, one should find out if there is a history of high

myopia and consider obtaining axial length measurements to confirm

the diagnosis.

Grading of myopic maculopathy

Myopic maculopathy is graded as per Table 1, using the ATN (atrophy,

traction and neovascularisation) system 1 .

MRIs of two patients. Patient A (left) has pathological myopia and an elongated axial eye length that is

obvious when compared to age and sex-matched patient B (right), who has normal globes. Credit: EyeRounds.

org, The University of Iowa

In clinical practice, this grading system is useful for clinicians to

anticipate how the disease can progress and help guide the assessment

so important signs are not missed. For example, clinicians need to be

vigilant to the presence of active neovascularisation if there are lacquer

cracks and new onset of distortion, or be mindful of the development of

a full-thickness macular hole when there is foveal detachment.

How is myopic neovascularisation presenting?

Myopic neovascularisation can present without subretinal or intraretinal

fluid (Fig 1). These type II (subretinal) lesions present as an area of

thickening in the outer retina with or without minimal subretinal fluid.

With high-resolution OCT imaging, active lesions will have an area of

‘fuzziness’ around the border and the external limiting membrane can be

interrupted. However, these subtle signs can be difficult to detect with

lower resolution OCT systems. As a result, myopic neovascularisation can

be difficult to diagnose. However, there are two tips to help:

• Myopic patients are very sensitive to distortion caused by

neovascularisation, so the clinician should have a high degree of

suspicion if the patient is symptomatic

• Comparison of current OCT imaging with previous scans often helps

illustrate subtle neovascular changes.

Table 1. Grading of myopic maculopathy

Recognise signs of dome-shaped maculopathy

Dome-shaped maculopathy can cause subretinal fluid in pathological

myopia without neovascularisation. It is caused by a bulge in the

macular retina, choroid and retinal pigment epithelium (RPE) within the

posterior staphyloma 1 . This is often associated with a localised shallow

retinal detachment with subretinal fluid. The subretinal fluid responds

poorly to anti-VEGF therapy and photodynamic therapy 2 , but the fluid

is indolent and visual acuity can remain stable for a long period of time.

The diagnosis can be relatively easy to make if there is a clear dome

detectable on OCT. However, the dome can be more ridge-like in some

cases and, if that ridge is parallel to the OCT B-scan, the diagnosis can be

missed unless both horizontal and vertical scans are performed.


Drs Sarah Hull,

Professors

Francesc March de

Charles McGhee

Ribot and

& Dipika Patel,

Rachael Niederer,

series editors

series editors

How to treat myopic neovascularisation

Patients with myopic neovascularisation respond

quickly to anti-VEGF injections, and often only

one or two injections are required to achieve

quiescence. In the Myrror study 3 , patients with myopic

neovascularisation were randomised to aflibercept or

sham treatment with a pro re nata approach. Those

patients with myopic maculopathy did very well

with aflibercept, requiring a median number of two

injections within the first eight weeks and no further

injections in the rest of the first year. As a result,

ongoing maintenance injections are not routinely

required for patients with myopic maculopathy, unless

the patient is elderly with co-existing age-related

macular degeneration.

Fig 1. An example of a myopic neovascular membrane on OCT. Notice that there is no associated subretinal or

intraretinal fluid

Watch for punctate inner choroidopathy or multifocal

choroiditis mimics

In a paper published in 2022 4 , 11% of patients with patchy

atrophy had unrecognised previous punctate inner choroidopathy

(PIC) or multifocal choroiditis (MFC). PIC/MFC lesions are more

common in those with macular neovascularisation (81.8% vs

33.9%). Signs signifying PIC/MFC included an elevation of the RPE

by homogenous and medium hyperreflectivity material, often

associated with disruption of the photoreceptor ellipsoid zone

and interdigitation zone and/or choroidal hypertransmission

below the lesions, along with mid-peripheral curvilinear scars

and hyper-autofluorescence changes. It is important to recognise

PIC/MFC early, as treatment with prednisone and systemic

immunosuppression can slow or stop the disease process and

prevent further vision loss (Fig 2).

Pathological myopia associated with significant

peripheral vascular changes

As Optos imaging becomes more widely available, these mostly benign

peripheral retinal findings in patients with pathological myopia are being

detected more frequently. In a paper published in 2014 5 , peripheral

capillary telangiectasia was a common finding in both emmetropic and

myopic eyes (around 80%). However, peripheral retinal non-perfusion

was present in 82.6% of myopic eyes vs only 4.8% of emmetropic eyes.

Furthermore, the perfused area was limited to just beyond the staphyloma

border and none of these eyes developed neovascularisation (Fig 3).

Be aware of optic nerve pathology in myopic patients

High myopia is a risk factor for glaucoma, and it is associated with longer

axial length, larger optic disc size and/or larger parapapillary delta

zone. Furthermore, a non-glaucomatous optic neuropathy can develop

from parapapillary gamma-zone lengthening of the retinal nerve fibre

affecting the papillomacular region.

However, assessment of optic neuropathy in pathological myopia is

challenging. Structural assessment of the parapapillary retinal nerve

fibre layer with OCT is unreliable due to segmentation error. Some

authors advocate assessment of the retinal nerve fibre layer and

ganglion cell layer thickness on the macular OCT scan in these cases 6 ,

but if there is a staphyloma or coexisting myopic maculopathy the

disturbance in the anatomy renders this assessment method unreliable.

Pattern-reversal visual evoked potential (p-VEP) is traditionally used

for the measurement of optic nerve function but, as this response is

driven by macular function, the reliability of this measurement is, again,

limited if there is myopic maculopathy. The photopic negative response

on the full-field electroretinogram has been used to assess optic nerve

function, but this is a small amplitude response and intervisit variability

can limit its usefulness.

Fig 2. Optos imaging of the right eye in a

patient with pathological myopia and PIC. Note

the atrophic lesions which resemble patchy

atrophy in myopia and lacquer cracks radiating

to the macula

Contact

References

Fig 3. A fluorescein angiogram showing the

left eye of a patient with pathological myopia,

posterior staphyloma and myopic maculopathy.

The retinal vessels terminated at the edge

of the posterior staphyloma with significant

amount of peripheral non-perfusion but no

neovascularisation

Please do not hesitate to reach out to me by email lsheck@

retinaspecialists.co.nz should you have any feedback or want me to cast

an eye over a scan in these often challenging cases.

1. Jorge Ruiz-Medrano, Javier A. Montero, Ignacio Flores-Moreno, Luis Arias, Alfredo García-Layana, and

José M. Ruiz-Moreno. Myopic maculopathy: Current status and proposal for a new classification and

grading system (ATN). Progress in Retinal and Eye Research, 69:80–115, March 2019.

2. Mukesh Jain, Lingam Gopal, and Tapas Ranjan Padhi. Dome-shaped maculopathy: a review. Eye (Lond),

35(9):2458–2467, Sep 2021.

3. Yasushi Ikuno, Kyoko Ohno-Matsui, Tien Yin Wong, Jean-Francois Korobelnik, Robert Vitti, Tummy Li,

Brigitte Stemper, Friedrich Asmus, Oliver Zeitz, and Tatsuro Ishibashi. Intravitreal aflibercept injection in

patients with myopic choroidal neovascularization: The Myrror study. Ophthalmology, 122(6):1220–1227,

Jun 2015.

4. Shymaa K. Hady, Shiqi Xie, K. Bailey Freund, Emmett T. Cunningham, Chee Wai Wong, Chui Ming

Gemmy Cheung, Koju Kamoi, Tae Igarashi-Yokoi, Omar M. Ali, Ehab I. Wasfi, Mahmoud F. Rateb, and

Kyoko Ohno-Matsui. Prevalence and characteristics of multifocal choroiditis/punctate inner choroidopathy

in pathologic myopia eyes with patchy atrophy. Retina, 42(4):669–678, April 2022.

5. Yuichiro Kaneko, Muka Moriyama, Shuichiro Hirahara, Yuichiro Ogura, and Kyoko Ohno-Matsui. Areas

of nonperfusion in peripheral retina of eyes with pathologic myopia detected by ultra-widefield fluorescein

angiography. IOVS, 55(3):1432, March 2014.

6. Yoon Jeong, Young Kook Kim, Jin Wook Jeoung, and Ki Ho Park. Comparison of optical coherence

tomography structural parameters for diagnosis of glaucoma in high myopia. JAMA Ophthalmol,

141(7):631–639, Jul 2023.

Dr Leo Sheck specialises in medical retina, genetic eye disease,

electrodiagnostics for complex retina and optic nerve diseases

and cataract surgery, especially with co-existing retinal diseases.

He consults for Te Whatu Ora Auckland and Retina Specialists and

is a director of the NZ Save Sight Society.

NZOPTICS.CO.NZ | 49

EDUCATION

Putting patients first: DEANZ 2025

By Drs Ally Xue and Kalika Bandamwar

FOR THE PEOPLE living

with dry eye and their

supporters who gathered on

a chilly autumn morning

in Auckland at the Dry Eye

Association NZ’s (DEANZ)

second public education and

networking meeting, it was

more than just an event – it

was a chance to be seen

and heard.

The day drew a full house,

with many attendees being

people with chronic dry eye,

who came ready to learn but

also to share their stories.

Held on 18 May in the foyer

of the Faculty of Medical

and Health Sciences at the

University of Auckland

(UoA), the event created a

warm and welcoming space

for patients to come together

and feel understood by eye

care professionals (ECPs).

One of the most

impactful parts of the

day was the small-group

discussion sessions. In these

conversations, patients spoke candidly about

their experiences and frustrations with dry eye

management – from the constant discomfort

to the emotional strain of a poorly understood

condition. Even DEANZ’ chair Bas Crutzen

spoke about his own journey with dry eye.

Many reflected on the early stages of their

dry-eye experiences, highlighting a lack of

awareness about available resources, including

specialists, support groups and effective

treatment options. Recurring challenges

included insufficient public funding for

treatments, a need for better directories to

Team Dry Eye Association NZ T-shirts, courtesy of Re:Vision

DEANZ chair Bas Crutzen discussing his patient journey

help patients find appropriate care providers,

insufficient sharing of optometry expertise

with other health professionals (eg. GPs and

pharmacists) and poor access to services in

rural communities.

These conversations serve as a real reminder

of the importance of public involvement

across clinical care, education and research,

offering invaluable insights that help ECPs

and researchers build more inclusive, effective

and equitable systems. This patient-driven

perspective is central to DEANZ’s mission:

to improve the lives of people with dry eye

disease through

education and

increased awareness.

Alongside the

patient discussions,

the day featured

informative talks

from leading

researchers and

clinicians. Topics

ranged from the

impact of cosmetics

on the ocular

surface to lightbased

therapies

and the hormonal

influences on dry

eye, nocturnal

lagophthalmos and

the latest research

updates from the UoA’s

Ocular Surface Lab (OSL).

During lunch and

networking sessions, kindly

sponsored by Re:Vision,

attendees connected over

shared experiences, browsed

sponsor exhibits from Bausch

+ Lomb and BioRevive, and

explored ongoing studies at

the OSL.

PhD candidate Catherine

Jennings led a fun, interactive

proxy blink test activity

for tear film breakup, with

participants competing for

prizes donated by Re:Vision.

Dr Kalika Bandamwar’s

myth-busting session tackled

common misconceptions

about dry eye, keeping the

mood light and engaging,

while Professor Jennifer

Craig, head of the OSL,

conducted a live ocular

surface examination.

Wrapping up the day, Prof

Craig asked, “Would you

like us to organise a similar

event in the future?”. The room erupted in a

unanimous and enthusiastic “YES!”, soundly

confirming that ECPs and patients alike

desire spaces to connect, share and push for

better care.

DEANZ, supported by the US-based Dry

Eye Foundation and originally developed

in the UK by Professor James Wolffsohn

and his team at Aston University’s School

of Optometry, provides accessible, patientfriendly

information on dry eye disease that

ECPs can share with their clients. For example,

its website offers guidance on lid hygiene,

warm compresses and other treatment tips,

as well as links to local support groups via

Facebook and Instagram.

Dr Ally Xue is a therapeutic

optometrist and postdoctoral

research fellow at the University

of Auckland’s Ocular Surface

Laboratory (OSL), with a special

interest in light-based therapies for

dry eye.

Dr Kalika Bandamwar is a

postdoctoral research fellow in

the OSL, with a special interest in

contact lenses and seeking ways to

improve comfortable wear.


CLASSIFIEDS

SCC2025

SHARPEN YOUR FOCUS

SPECSAVERS CLINICAL CONFERENCE 2025

Where clinical excellence comes into focus

13–14 September 2025

Grand Hyatt, Melbourne or join virtually

REGISTER & BOOK TICKETS

www.specsaversclinicalconference.com.au

/2025-registrations/

WHAT TO EXPECT:

✓ World-class speakers

✓ Interactive & therapeutic CPD

✓ NEW in 2025: Advanced dry eye &

binocular vision assessment workshops

Advance your clinical skills. Connect with your

peers. Stay ahead of the curve.

NZOPTICS.CO.NZ | 51

NEWS

IPL pilot offering

expanded in Australia

ONE YEAR AFTER launching its intense pulsed light (IPL) pilot,

Specsavers Australia is rolling out the service to two more stores, taking

the total to 11, with more expected to follow.

IPL treatment has been identified as a highly effective treatment for

dry eye and in particular meibomian gland dysfunction, the leading

cause of evaporative dry eye, said Dr Joseph Paul, head of professional

services for Specsavers Australia and New Zealand.

To date, the nine pilot stores in Australia have provided care for 319

patients, providing over 1,000 IPL applications.

Data showed the treatment was more likely to be taken up by females

than males, with the most common age group receiving treatment

being 51–60 years old. “This is in line with the anticipated uptake of

the treatment, largely following published prevalence rates of dry eye

disease and our core customer demographics for the locations we’ve

piloted in,” Dr Paul said.

While it’s too early to see comprehensive data on outcomes, trends

indicate very good compliance with follow-up treatments and around

90% of patients reporting improvements to their dry eye symptoms

after a full course of treatment, he said. “Ongoing data monitoring

and evaluation of patient outcomes will inform any future decisions

regarding integration into more Specsavers locations, but the initial

positive feedback from practitioners and patients supports the

potential of IPL therapy becoming a cornerstone of Specsavers’ dry eye

management offering.”

In Australia, since IPL treatment is currently not funded by Medicare,

all treatment costs are covered out-of-pocket by the customer. “A key

aim of this pilot was to make IPL therapy as accessible as possible for

patients, leading to enhanced eye health outcomes for Australians,” Dr

Paul said. “Industry-wide, there is an inconsistent adoption or offer of

IPL for the treatment of dry eye, so in the pilot phase we spent a lot of

time determining

a price point that

is good value for

customers, while also

sustainable for our

store partners.”

When asked about

a potential extension

of service to include

New Zealand stores,

Specsavers didn’t

wish to comment.

TFOS DEWS III results

out now

Credit: TFOS

THE TEAR FILM and Ocular Surface Society (TFOS) has

released its much anticipated third report, continuing to explore

the diagnosis and management of dry eye disease.

First presented at the recent British Contact Lens Association’s

(BCLA) clinical conference in Birmingham by Professors James

Wolffsohn, Lyndon Jones, Fiona Stapleton and Jennifer Craig, the

report is now available as an open access special supplement of the

American Journal of Ophthalmology (AJO).

The work of 80 experts from 18 countries, the TFOS DEWS III

report updates the recommendations and conclusions of TFOS

DEWS II and features an updated definition and a streamlined

diagnostic process. It also provides a new treatment algorithm to

follow based on the latest available evidence drawn from global

research. Broken down into three key sections, the report aims

to provide eyecare practitioners with clear guidance to follow to

establish if patients have dry eye disease, find out what’s causing it

and outline the best ways to manage it.

The TFOS DEWS III report also features a digest that highlights

new advances in other TFOS DEWS II topics, including: sex,

gender and hormones; epidemiology; pathophysiology; tear film;

pain and sensation; iatrogenic dry eye; and clinical trial design.

An executive summary of the report will be submitted to the

AJO for publication and will be linked to the supplement.

Also announced at the BCLA conference, Professor Etty Bitton,

the director of the Dry Eye Clinic at the University of Montréal,

Canada, a TFOS ambassador and participant in both the TFOS

DEWS II and TFOS Lifestyle Workshops, was named Dry Eye

Practitioner of the Year.

iStent success in Asian eyes

THE LARGEST STUDY of the iStent inject W

trabecular micro-bypass combined with

cataract surgery for Asian eyes with glaucoma

found it reduced intraocular pressure (IOP) and

halved medication costs.

The two-year post-market surveillance

study of Glaukos’ minimally invasive

glaucoma surgery (MIGS) device included

214 eyes of Japanese patients with primary

open-angle glaucoma (POAG) (48.6%) or

normal tension glaucoma (NTG) (46.3%) who

underwent phacoemulsification.

Writing in Clinical Ophthalmology, researchers said the overall cohort

experienced IOP reductions of 2.0mmHg and 1.9 in mean number of

medications; in NTG eyes, IOP reduction was estimated to be 2.0mmHg

with mean medication reductions of 2.6.

“The clinical benefit of reducing glaucoma

medications translated into a 50% reduction in

average monthly medication costs; NTG eyes

had a 63% cost reduction,” they said.

Minimal adverse events were reported 24

months post-surgery and only 2% of eyes

required additional glaucoma surgery, they

concluded.

“Given the high prevalence of NTG in Japan,

the observed IOP and medication reductions in

this OAG subgroup – along with lower hazard

of failure compared to the POAG cohort – provide confidence in the use of

this MIGS as a suitable interventional glaucoma treatment option for the

Japanese population,” reported the research team.


CLASSIFIEDS

Education/news

DEANZ day sill

and/or

GNZ Programme launch,

BLENNZ, Specsavers IPL

NZOPTICS.CO.NZ | 53

BUSINESS

Brought to you

by the IOGroup

BEST PRACTICE, MADE EASY

The importance of adequate insurance

By Finn Judson

IN THE WORLD of eyecare,

precision and trust are

everything. Whether you’re

diagnosing a complex vision

issue or helping a patient

choose their first pair of

glasses, your work is built on

accuracy, professionalism

and care. But while clinical

excellence is front of mind for

most practices, one area that

can be overlooked is business

risk – specifically, insurance.

For eyecare providers in New

Zealand, insurance isn’t just

a formality, it’s a vital part of

running a resilient, compliant

and sustainable practice.

Understanding the risks

Eyecare businesses face

a unique mix of clinical,

operational and digital risks. These include:

• Professional liability: even the most

experienced practitioners can face claims

of negligence or misdiagnosis. Medical

malpractice insurance helps cover legal costs

and potential damages

• Equipment and property damage: damage

to diagnostic tools and optical equipment from

fire, theft, or accidents can disrupt operations

and lead to significant costs

• Cybersecurity threats: with patient records

increasingly stored digitally, the risk of data

breaches is growing. The Health Information

Privacy Code sets strict standards for

data protection

• Business interruption: natural disasters,

infrastructure failures or even a burst pipe can

force a clinic to close temporarily affecting

income and patient care.

New Zealand’s small and medium-sized

businesses – especially in healthcare – often

operate with limited financial buffers.

Insurance provides a financial safety net that

allows them to recover from unexpected

events without compromising their long-term

viability. It also supports compliance. Health

professionals are subject to various legal

and ethical obligations, so having the right

insurance helps meet those responsibilities

while protecting patients and staff.

While every practice is different, there are

several core policies that most eyecare

businesses should consider:

• Medical malpractice insurance covers claims

related to errors, omissions or negligence in

the delivery of professional services specifically

in the medical industry

• Public liability insurance protects against

claims of injury or property damage caused to

third parties on your premises

• Business interruption insurance helps cover

lost income and ongoing expenses if your

practice is forced to close or relocate due to a

material loss

• Cyber insurance covers costs associated

with data breaches, ransomware attacks and

system recovery

• Contents and equipment insurance ensures

that essential tools and technology can be

repaired or replaced quickly in the event of

damage or theft.

Tailoring coverage to your practice

A solo optometrist in a suburban clinic will

have different insurance requirements from

those of a multi-location optical retailer or a

mobile vision service. Factors like the size of

your team, the value of your equipment and

the nature of your services all influence the

type and level of cover you need. It’s worth

reviewing your policies

regularly, especially

if your business has

grown, added new

services or invested in

new technology.

For example, a clinic

affected by a flood or fire

may be able to relocate

and reopen quickly

thanks to business

interruption cover.

Another may recover

from a cyberattack

without losing patient

trust because they had

appropriate insurance

in place. On the other

hand, practices without

adequate cover can

face long closures, legal

disputes or reputational

damage that’s hard to repair.

In eyecare, your focus is on helping people

see clearly, but it’s just as important to see

the risks that could affect your business and

prepare for them. Insurance isn’t just about

protecting assets it’s about ensuring continuity,

maintaining trust and supporting the longterm

health of your practice.

Now is a good time to take stock of your

cover. Understanding and mitigating your risks

are the most practical steps you can take to

safeguard your business and your patients.

Finn Judson (FSP 668471) is a senior

commercial broker at Clarity Insurance

Brokers clarityinsurancebrokers.co.nz.

Contact Finn at finn@clarityinsurance.

co.nz

Disclosure: This article is provided by Clarity Insurance

Brokers Ltd for information purposes only, it is

subject to change and doesn’t constitute financial

or professional advice, which you should seek before

relying on it. Clarity Insurance Brokers Ltd cannot

warrant the accuracy, completeness, or suitability

of this article for your intended use. To the extent

the law allows, Clarity Insurance Brokers Ltd doesn’t

accept any responsibility or liability for any direct

or indirect loss or damage arising from any act or

omissions by any person relying on this material. See

our financial advice disclosure on our website: https://

clarityinsurancebrokers.co.nz/disclosure-information/.

To learn more about the IOGroup, contact Neil Human:

0210 292 8683 neil.human@iogroup.co.nz


THE INDEPENDENT

OPTOMETRY GROUP

NEWS

APPOINTMENT

GNZ’s new clinical educator

GLAUCOMA NEW ZEALAND (GNZ) has appointed Shubhneet

Nanda as clinical educator to manage its newly launched Sightwise

patient education and support programme (see p42).

Previously a relationship manager with Auckland Eye, Nanda

brings a valuable combination of clinical and business skills, said

GNZ general manager Pippa Martin. “Shub is perfect for the role

as she is an optometrist with experience from establishing a new

programme, extensive networks within the eye industry and a

passion for improving patient knowledge.”

Shubhneet Nanda

Nanda said the role holds personal significance as she has

close relatives at different stages of their respective glaucoma journey. “Witnessing their

experiences, I’ve come to understand how vital it is for patients to feel supported and

informed beyond the clinical setting.

“Each individual’s journey is unique and, what struck me most, is how empowering

education can be. I wanted to be part of something that provides people with more than

just medical facts – a source of ongoing encouragement, clarity and reassurance. That’s

exactly what Sightwise offers,” she said.

Nanda said she is looking forward to working closely with optometrists,

ophthalmologists, GPs and pharmacists across the country to raise awareness about GNZ

and encourage referrals to the Sightwise programme. “Together, we can help ensure

that every New Zealander diagnosed or being monitored for glaucoma feels equipped,

empowered and never alone in their journey.”

When not busy running the Sightwise programme, Nanda enjoys working as a locum

optometrist. “It’s a great way to explore different clinical environments and connect with

diverse communities,” she said, adding that outside of work she’s a keen gardener. “Growing

beautiful hydrangeas and edible plants brings me a lot of joy!”

SS-ASOCT value

for kids

RESEARCHERS IN INDIA found using sweptsource

anterior-segment optical coherence

tomography (SS-ASOCT) to analyse the

trabecular meshwork (TM) helped identify

early-onset childhood glaucoma.

For the diagnosis of childhood glaucoma,

the current standard of care is an examination

under anaesthesia, said Drs Sylvia Groth and

Rachel Kuchtey, Vanderbilt University, US,

noting that the expense and risk of anaesthesia

is not insignificant.

Writing in JAMA Ophthalmology, researchers

from Chandigarh Advanced Eye Centre said

they compared the SS-ASOCT features of 23

paediatric patients without and 30 paediatric

patients with early-onset childhood glaucoma.

The TM shadow was clearly visible in all

patients without glaucomatous eyes (100%),

but only in eight patients with glaucomatous

eyes (26.7%) (sensitivity of 73.3% and specificity

of 100%), they said.

Although the patients with glaucoma had

greater anterior chamber angle measurement

values than those without, the visibility of

the TM structure was the most specific sign

for glaucomatous eyes in this relatively small

cohort, they concluded.

Empowering

multifocal success

NZOPTICS.CO.NZ | 55

STYLE MATTERS

Inspiring confidence with frame choice

By Lou Heller

EYEWEAR IS NO longer just

a tool for vision correction; it

has evolved into an essential

accessory that can make a

significant statement about the

wearer’s personality and style.

The right frame can transform

a customer’s appearance,

complement their features and

even boost their confidence.

But how do you help them pick

the right frame, especially when

there are so many options?

Choosing the perfect pair of

glasses can feel overwhelming.

With so many shapes, colours

and materials to choose from,

it’s easy to feel unsure of

where to start. But once you

understand the basic principles,

the process becomes much

more straightforward.

Face shape matters

One of the most important

factors to consider when selecting frames is

face shape. The key is to find spectacles that

either contrast with or complement the face’s

features.

• Oval faces: these are considered versatile and

suit a variety of shapes. Angular frames, such

as square or rectangular, provide contrast and

highlight features

• Round faces: frames that add angles (such as

square or rectangular shapes) work best. These

frames help elongate the face and provide a

balance to the softer features of a round face

• Square faces: frames that are round or

oval can soften the angles and create a more

balanced look. They add softness and contrast

with the sharpness of the jawline

• Heart-shaped faces: this face shape is

characterised by a wider forehead and a

narrower chin. To balance this, opt for frames

that are wider at the bottom (like aviators or

round frames) to draw attention away from the

upper face.

Consider personal style and preferences

Spectacles should always complement the

wearer’s overall personal style. The frame

should reflect who they are, whether they

prefer a minimalistic look or want to make

a bold fashion statement. For the former

group, classic and timeless styles are often

understated and include thin metal or acetate

frames in neutrals such as black, tortoiseshell

or silver. Bolder, eye-catching styles include

oversized or brightly coloured frames. This is

an opportunity for your customer to show off

their personality, so experiment with unique

patterns, geometric shapes or frames that

incorporate fun textures.

When helping someone pick out frames,

the key is to dig deeper to identify their style

preferences, the image they want to project

and their lifestyle. Are they always on the go?

Do they work in a creative industry? Do they

prefer minimalist aesthetics or something

bolder? The answers will guide your selection.

For example, someone with a professional

career may prefer classic frames that convey

sophistication and reliability, while someone

in a creative field might embrace experimental

and artistic designs.

Take a look at your customer’s style. Are they

more into casual, comfortable clothes or do

they prefer to dress up? Ask them about their

secret style desires. Someone with a laid-back

style may feel more comfortable with simple,

understated frames, while someone with a

fashion-forward sense of style might be open

to oversized or statement frames.

Encourage experimentation

Sometimes, people might shy away from a

bold choice because they’ve never considered

it before. This is where you can help them

explore new options. If they usually go for

subtle frames, suggest trying something

more colourful or geometric. Be sure to point

out how different shapes and colour can

accentuate different features, allowing them to

see the potential of new styles.

Encouraging someone to be brave in their

choice can lead to an exciting transformation

in how they see themselves and how others

perceive them. Let them try on a variety of

frames – both familiar styles and ones they

might not typically consider. Encourage them

to step outside their comfort zone and remind

them that eyewear is a fun way to experiment

with different looks. One way to do this is to

show them how embracing different styles of

glasses has worked for you or others you know.

Sometimes, seeing someone else confidently

wear a certain type of frame can help them feel

more comfortable with the idea of trying it out

for themselves.

Ultimately, choosing the right frames is

an art that involves understanding your

customer’s face shape, personal style, lifestyle

and budget needs. It’s also an opportunity to

help them express their individuality through

eyewear. Encouraging bravery in frame choices

is about making them feel empowered to

embrace new styles, experiment with different

looks and, above all, to feel confident in the

way they present themselves to the world.

After all, glasses are more than just a tool –

they’re an extension of who you are.

Lou Heller is a personal stylist

and style commentator. With

a background in fashion and

intuitive therapy, she takes a

relaxed, no-rules approach to

style, guiding clients to embrace

what truly suits them. She’s

all about making fashion feel

fun, effortless, and personal.

www.louheller.com


NEWS

O-Show 2026 returns

to Melbourne

THE INDUSTRY’S OWN boutique event, O-Show, is returning to

Melbourne in 2026, following successful Sydney editions in 2022

and 2024.

The move to Melbourne marks a welcome return of a major trade fair

to Victoria, the first since O=Mega23, said organiser Amanda Trotman,

CEO of Australia’s Optical Distributors and Manufacturers Association

(ODMA). “The decision now seems obvious, but it took considerable

planning and reflection to ensure we did what’s right for the industry.”

The 2026 approach offers a more boutique show in a year when

buying groups will be running their major biennial conference, while still

delivering strong exposure and access to a broad audience, with great

options for smaller and non-custom build stands, Trotman said.

The Melbourne Convention and Exhibition Centre offers more space

compared to Sydney’s Hordern Pavilion and is familiar to exhibitors and

visitors alike, she said, adding the move to August from May was also made

with the industry in mind. “Suppliers face increasing cost pressures, from

tariffs to freight and wages. Anything we can do to support them helps

them support practices which are also navigating rising operational costs.

“The new August timing also allows more new-release products to be

available, particularly as some launches align with Silmo Paris (at the end

of September). It also avoids the busy end-of-financial-year period and

gives suppliers the option to allocate budget across two financial years, if

needed,” she said.

The roomy Melbourne Convention and Exhibition Centre

The 2026 event will introduce the new ODMA Mastery Event, full of

practical sessions to boost growth by leveraging a to-be-confirmed

major industry topic. The plan is also to run a myopia mastery event, an

evidence-to-implementation programme.

“Past O-Shows have always had a real buzz on the floor, with people

coming together and doing business in a vibrant setting,” said ODMA

board chair Craig Chick. “We’re excited to bring that same energy to

Melbourne and we hope to see whole practice teams getting involved to

explore new ways of growing their businesses.”

The 2026 event will run from Sunday 16 to Monday 17 August. For more,

contact events@odma.com.au.

Sight is New Zealand’s most valued sense

ALMOST NINE IN 10

New Zealanders (89%)

value sight as their most

important sense and 77%

would choose a shorter life

with all their senses intact

over a longer life without

vision, a new survey found.

Commissioned by

Roche, the survey found

the value placed on sight

was especially strong

among those aged 70–80,

with more than eight out

of 10 (85%) saying they’d

rather live a shorter life

than lose their vision.

While nine out of 10

New Zealanders recognised

the importance of regular eye check-ups, only two out of five actually

have them, the survey found. Age and finances play significant roles

in the ability and desire to maintain eye health, according to the

findings, with those receiving regular check-ups more likely to be

older, financially comfortable and more concerned about vision loss.

A notable difference in the frequency of eye check-ups was also

found between different regions and ethnicities, with Māori and

Pasifika and those in the Auckland or lower North Island regions

(excluding Wellington) being less likely to get regular check-ups. The

primary barrier to regular eye check-ups, however, was identified

as lack of perceived need. “This is evident as only a quarter of New

Zealanders are extremely or very concerned about vision loss in the

future,” the report said.

Commenting on the findings,

Dr Francesc March de Ribot

(pictured below) said regular eye

examinations to detect issues are

often neglected and investment

in eye health services remains

inadequate, all contributing to

New Zealanders

suffering

preventable,

irreversible vision

loss. “Timely

access to eye

healthcare prevents

more than 80% of

permanent visual

impairment and

blindness, which may otherwise

become irreversible,” he said.

Despite the high value placed on vision, access to care and

treatment is increasingly challenging in New Zealand. In 2023, the

average wait time for a first ophthalmology appointment reached

88 days, representing a 27% increase over five years, according to a

report by Hong et al.

“Vision loss can have a profound effect on a person’s

independence and quality of life – but its impact extends beyond

the individual, affecting carers, family and the wider community,”

Dr March de Ribot said.

Conducted by Kantar, the survey comprised 1,500 members of the

public and is nationally representative by age, gender and region. It

was completed using a Kantar panel between Wednesday 2 April and

Monday 14 April 2025.

NZOPTICS.CO.NZ | 57

STYLE NEWS

JF Rey turns 40

Driven by

passion and

creative freedom,

Marseille-based

JF Rey has grown

to international

recognition

during the past

four decades.

“Today, this anniversary not only allows us to celebrate the path we’ve

followed, but also to reaffirm our bold, ever-evolving vision for the

future,” the company said. Inviting customers, partners and JF Rey

enthusiasts to join the celebrations, JF Rey will host a series of events and

talks, culminating with a special event at Silmo Paris in September.

Distributed by Dynamic Eyewear.

Boosting performance eyewear

Reinventing a design icon, Maui Jim has revealed a contemporary

sporty evolution of the perennial best-seller Ho’okipa, the Ho’okipa

Ultra. The new iteration is updated with curving temples and the

signature wavy pattern on the nose pads and temple tips. The highperformance

eyewear comes with the Maui Ultra lens with PolarizedPlus2

lens technology, engineered to be ultra-durable and ultra-light while

delivering an ultra-intense colour resolution, the company said.

Distributed by Maui Jim.

Classic lines

Sophisticated optical style Lacoste L2311 is crafted from lightweight

metal and boasts a classic modified rectangular front. The temples are

embellished with a ribbon detail extending to the end pieces with an

elegant green enamelled line. Positioned on the acetate temple tips, the

Lacoste logo completes the look of this frame, presented in matte silver

in the latest advertising campaign with France’s top-ranked tennis star

Arthur Fils (pictured).

Distributed by Marchon’s NZ agent, Titan Optical.

Face à Face x Jessica Poundstone

Celebrating its 30th anniversary this year, Face à Face has teamed

up with Jessica Poundstone, a renowned American artist celebrated

for her dynamic use of colour, for a special anniversary concept

collection – Faces.

Poundstone’s Power Colour collection – particularly Love is Real,

with ivory, deep blue, bubble gum and burgundy – deeply influenced

the colours used in Faces, where tones blend and contrast to evoke

powerful emotional responses, the company said. According to Face

à Face’s designers, the dynamic colour vibrations from her art shaped

the creative process, creating a seamless connection between art and

wearable design.

Distributed by Eyes Right Optical’s NZ agent, MSO.

Dutz mid-year release

Dutz’s latest range masterfully blends retro design with modern colours.

For the man who appreciates sophisticated, trend-forward styling, the

DZ2367-47 featured here is the ideal choice. This acetate model in cobalt

blue is elevated with a striking top rim in black weave, with red temple

trimmings adding contrast and interest.

Distributed by Dynamic Eyewear.


Blinx’s charming kids

BLINX IS AN innovative range of eyewear

accessories designed to help children feel

confident and positive about wearing their glasses.

The importance of children wearing their

glasses is well documented, as are the challenges

of ensuring they keep them on, said UK-based

founding designer Stephanie Collier. “I have worn

glasses since I was a small child, but when a friend

of mine, who has never worn glasses, told her

daughter she would need multiple pairs of glasses in all sorts of colours

to match her outfits, I knew that was going to be expensive… And not

just for all the frames, but each time the prescription changed!”

The episode got Collier thinking about ways to help kids adapt to

wearing glasses in a positive way, without breaking the bank. So she

designed a range of soft rubber charms (similar to Crocs Jibbitz),

primarily for use on the arms of spectacles and, just like that, Blinx

was born.

The Blinx eyewear charms slide on and off glasses’ temples, allowing

children to mix colours and styles to match their clothing, mood or

interests. “Affordable in price, the charms are collectable, encouraging

young patients and their parents to visit their local practice on a

regular basis rather than just once or twice per year,” said Collier.

The increase in store visits presents

opportunities for stockists to build a

relationship with the families they serve,

encouraging customer loyalty. “Let’s

face it – getting your child to keep their glasses on can be a challenge,

and parents are likely to think positively of a store that can reduce the

struggle, hopefully returning to the store for their own eyewear needs

as well as their child’s,” Collier said. “Some stockists offer the charms

free to boost business in quieter periods. For example, here in the UK,

December tends to be a quieter time for test appointments, so some

stockists offer free Christmas charms for all children’s appointments

booked for that month.”

Established in 2014, Blinx has grown from being a ‘kitchen

table’ business to one that has products being sold in over 300

stores in the UK, plus 30 other countries. Blinx currently has no

New Zealand distributor but charms can be ordered direct from

www.myblinx.co.uk.

Stars

Stella Rimington

& their eyes…

Optique Line lands Milo & Me

Optique Line is introducing Milo & Me’s kids optical eyewear range

designed for adventure, play and personality. Founded by Hilco Vision in

2018, the Milo & Me eyewear range offers a sturdy, lightweight and superflexible

design. The range is available for kids aged two to 15 years in many

models and trendy colours. Model Sara in bright red (featured) will no

doubt please preschool princesses as well as fashion-conscious pre-teens.

Distributed by Optique Line.

Ripples on the water

On a mission to create

designs to suit all

personalities and characters,

not bound by gender or age,

Albert I’mStein has released

a successor to its popular

Cocktail series. Continuing

the crystal flute inspiration,

model Minami (pictured) is a

more ‘zen’ style, with narrower

flute lines reminiscent of

waves on the surface of water.

Distributed by

Phoenix Eyewear.

BRITISH AUTHOR AND former

director general of MI5 Dame

Stella Rimington told RNZ her

12th and latest novel, The Hidden

Hand, may be fictional CIA agent

Manon Tyler’s last outing.

At 90 years old, Rimington said

she’s finding it harder to keep upto-date

and feel inspired by world

events, plus writing is becoming

harder as her dry macular

degeneration (MD) progresses.

“My eyesight has been gradually

Credit: Bloomsbury

deteriorating over the last few years. When I

started the book, I could still use the typewriter and could read

what I wrote but, as the book went on, I had to recruit members

of the family to type what I was dictating. I’m not sure they’re

keen on or well placed to continue to do that.

“I expect the longer I go on living, the worse my eyesight will

become. At the moment, my eyesight is blurry. I can see, but it’s

not detailed; apart from very close, everything is blurred and it’s

very difficult to get glasses that can solve that problem. I hope

that one day they will have a cure for MD.”

Rimington was the first woman in charge of MI5 (1992–96)

and the first director general whose name was publicised upon

appointment. Her role in the service was considered a model for

Dame Judi Dench’s portrayal of the first female M in the James

Bond franchise, first appearing in 1995’s GoldenEye.

In 2011, Rimington published her memoirs, Open Secret,

followed by her first novel, At Risk (2004) about female

intelligence officer Liz Carlyle.

NZOPTICS.CO.NZ | 59

Chalkeyes presents…

…And a little child shall lead them

By Trevor Plumbly

IN MY EARLY days of cane use

I was always struck by people’s

reaction to the thing. I suppose

wheeling along three feet or so

at the back end of a white stick

separates the user a bit from the

norm. The adults were a study

on their own – everything from

polite consideration to a wariness

more suited to contact with a

suicide-bomb suspect – but,

as ever, it’s hard to trump kids

when it comes to getting to the

point. Recently, over coffee on

Ponsonby Road, I got a refresher

from a six-year-old at the next

table who decided exercising

her curiosity was more fun than

sitting still.

“What’s that for?” she asked, pointing at the cane. Sensing this one

wouldn’t buy the ‘magic wand’ story, I fronted up and said it stopped

me falling over things. She hit straight back with an almost accusatory

“Why?”. Sticking to the theory that simple was the way to go with a halfpint

version of the Spanish Inquisition, I said it was because I couldn’t

see anything, whereupon she hit me with another “Why?”. This forced

me into a muttered apologetic retreat, vowing to submit a new chapter

on ‘Out of the Mouths of Babes and Innocents’ in The Cynic’s Handbook.

But, as they say, the enquiring mind knows no rest and once back

in the armchair, it occurred to me that perhaps ‘Why?’ wasn’t a

bad question.

In the beginning was the Word

Lots of words are concerned with delivering the nuts and bolts of sight

loss, including cause and effect, but not the elusive ‘Why?’ or, more

importantly as far as I was concerned, ‘Why me?’.

I decided a little personal reflection might add some foundation to

my research. It’s not that I didn’t appreciate all the information offered

in those early years, I just didn’t understand most of it. Then there was

the social thing – I found some people get a bit uneasy getting close

to someone suffering from something with a Latin name. Apart from

priests, surgeons and the odd lawyer, not many bother with that stuff

these days, so the mention of retinitis pigmentosa often proved a bit of a

wet blanket. I found it far better to use ‘RP’, which seemed to somehow

alleviate the fear of contagiousness.

…for they shall inherit

Genetic inheritance, according to the white-coat fraternity, is how the

thing gets about. I guess that simplifies things for some, but not for me

– it just dumped me at a crossroads. I was happy with the knowledge

that, unlike Covid, it wasn’t possible to get RP in McDonald’s or by

touching a public access door, but the family aspect could get a bit

dodgy. With my parentage best described politely as sketchy, that

practically eliminated identifying the hereditary angle. So instead of

rummaging through grubby skeletons, I decided I could better address

the issue directly. Let’s face

it, I already have the thing,

so that made the test-tube

folks’ ‘how’ a little redundant,

forcing my thoughts back

to the little horrors of ‘why’

and what proved to be the

pursuit of futility. I’m usually

too busy coping with reality

to bother too much with the

philosophical, but I suddenly

found myself considering the

‘what ifs’.

I discovered when you get

into the ‘what ifs’, it’s pretty

hard to find firm mental

footing. It seemed pretty clear

that my RP couldn’t have

sprung out of a laboratory, so

science and logic got shoved out of the way, leaving room for all sorts of

avenues, among them the possibility it could have been sent down from

on high as a way of balancing my Earthly account. This thought was

so radical it needed a couple of sips of Highland galvaniser to consider

objectively. I usually avoid religion and politics as non-productive

but, nevertheless, I felt a look ‘upstairs’ couldn’t hurt. What if the old

boy kept track of my occasional back-pedal and decided delivering

something nasty but non-fatal would balance the books? But why? Most

of my adult transgressions were pretty mundane, the sort of stuff you

feel guilty about one day and forget the next.

Suffer little children

All of which brought me to my schooldays, which, since I was in

honesty mode, could best be described as chequered. Certainly, there

were punishable episodes, not least being caught exploring the contents

of Spot Simpson’s sister’s blouse. It was scarcely uncharted territory, by

all accounts, but certainly a sin of sorts which I felt was dealt with by

the ‘six of the best’ I received at the time. I wasn’t choirboy material; I

nudged a couple of commandments and tested a few of the seven sins,

which thus far I’m pleased to report haven’t turned out to be deadly.

Sadly though, despite exhaustive thought, the ‘why’ remains a mystery

and as such the prospect of this piece being published in The Lancet or

such is remote. My understanding is that they prefer evidence-based

research rather than thoughtful speculation. So, in closing, I can only

pass on a piece of advice gleaned from my deliberations: if ever you get

grilled by an interrogator posing as a curious child, stick to the magic

wand story – it’ll simplify things!

Keep smiling, it’s good for you!

Born in the UK, our ‘white-caner’ columnist, retired Dunedin

antiques dealer Trevor Plumbly, was diagnosed with retinitis

pigmentosa more than 20 years ago and now lives in Auckland.


NZOPTICS.CO.NZ | 61

NEWS

Zeiss acquisition boosts myopia portfolio

STEPPING UP ITS myopia suite, Carl Zeiss Vision International is

acquiring Brighten Optix, a Taipei-based “leading player” in the field of

orthokeratology (ortho-k) and specialty contact lenses.

Zeiss is proud of its spectacle lens portfolio – clinically proven to

slow the progression of myopia – but recognises the need to offer

more options to its partners to protect and improve the vision of many

more children, said Sven Hermann, Zeiss Vision Care CEO and Zeiss’

executive board member. “Brighten Optix products are widely available

and used by eyecare professionals in Greater China and across Southeast

Asia. Their proven and innovative portfolio of specialty contact lenses

CLASSIFIEDS

will complement Zeiss Vision Care’s

existing myopia control offerings.”

Brighten Optix is known for its

commitment to research and development,

Hermann said. “With Zeiss’ heritage of

leading innovation, I am confident this

Sven Hermann

common strength will be of even greater

advantage in our joint future.”

The acquisition is expected to close early 2026. It remains subject to

completion of conditions and regulatory approvals.

YOUR PASSION, YOUR EXPERTISE

Unleash your full potential with OPSM. With our unwavering

support and experience, you have the freedom to pursue an

area of expertise and practice full-scope optometry. Choose

the field you love and thrive with OPSM.

ACCELERATE YOUR CAREER ASPIRATIONS WITH OPSM.

Visit careers.essilorluxottica.com today.

For sale / vacancies

To advertise in

NZ Optics classified

section contact

Susanne Bradley

susanne@nzoptics.co.nz

OPTOMETRIST/PARTNERSHIP OPPORTUNITY

Fitzroy Optometrists, New Plymouth, Taranaki

Mountain, surf and an outstanding cultural environment.

We are looking for an experienced Optometrist to join our long

established independent family practice of sixty years plus. This is a

partnership opportunity for the right candidate.

Our well-equipped practice has an exceptional reputation for service,

an awesome Dispensing Optician with over 30 years experience and an

ancillary staff like no other!

Weekends are a no no and our hours are flexible for the right applicant.

Full-time or part-time considered.

Our ethos - ‘Service Matters - People Matter ‘. Sounds like you? Apply

to Michael in the first instance, fitzroyopticians@gmail.com.

For more, ring 06 7584974.

CALLING ALL OPTOMETRISTS, OPTOMETRY

STUDENTS & DISPENSING OPTICIANS!

Are you ready to make a meaningful impact, grow your

clinical skills and be part of something truly rewarding?

Join a team of passionate eyecare professionals dedicated

to improving vision for Special Olympic athletes.

2025 SPECIAL OLYMPICS NATIONAL SUMMER GAMES

10th Dec - 14th Dec 2025

Parakiore Recreation and Sports Centre, Christchurch

Help us make a real difference in the lives of athletes with

intellectual disabilities and be part of a heartwarming and

energising event!

PLEASE REGISTER YOUR INTEREST HERE

https://forms.gle/odiR2g9Rf4XXX2ECA

Special Olympics Lions Club International

Opening Eyes (SOLCIOE)


IT’S THE

FEELING

of being able to grow your own way

Develop your skills

through continuous

learning. Unlock

leadership potential

for career advancement

and business ownership.

Find your purpose

at Specsavers?

spectrum-anz.com/

careers-at-specsavers

NZOPTICS.CO.NZ | 63

After thousands of years, the Silk Road delivers again

Evolve® Silk

Corneal epithelial healing occurred

within 24 to 48 hours in all subjects (n=15)*

Evolve® Silk

Promoting the physiological repair

processes of the corneal epithelium

in the event of trauma or surgery 1

Evolve ® Silk contains Silk Proteins and Cross-linked Carboxymethyl Cellulose in a Preservative-Free Multi-dose pack.

*In an unpublished case series, Fasciani R, et al (2024) evaluated Evolve Silk's effect on corneal re-epithelialisation after photorefractive keratectomy (PRK), corneal

cross-linking (CXL), or corneal abrasion. Fifteen patients (aged 15 to 57 years) applied the drops 3 times daily from 3 days pre-procedure until 2 days post-procedure.

All subjects achieved complete corneal re-epithelialisation within 24 to 48 hours after the procedure. 2 This was faster than the usual 3 to 4 days (72 to 96

hours) timeframe post-PRK or CXL. 2,3,4

References:

1. Evolve ® Silk. Instructions for Use, September 2024. 2. Fasciani R, Scarinci F (2024). Cross-linked CMC and Silk proteins in corneal re-epithelialisation. Manuscript submitted for

publication. 3. Hashemi H, Alvani A, Aghamirsalim M, et al. Comparison of transepithelial and conventional photorefractive keratectomy in myopic and myopic astigmatism patients: a

randomised contralateral trial. BMC Ophthalmol. 2022;22:68. doi:10.1186/s12886-022-02293-2 4. Bonzano C, Cutolo CA, Musetti D, Di Mola I, Pizzorno C, Scotto R and Traverso CE

(2021) Delayed Re-epithelialization After Epithelium-Off Crosslinking: Predictors and Impact on Keratoconus Progression. Front. Med. 8:657993. doi: 10.3389/fmed.2021.657993

Corneal Lens Corporation NZ

2 Ballarat Way, Wigram, Christchurch,

8042, New Zealand.

03 366 6247

reception@corneal-lens.co.nz

0830m DOP: May 2025

July 2025

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