MAY 2018

MAY 2018
THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY
PO BOX 106 954, AUCKLAND CITY 1143
Email: info@nzoptics.co.nz
Website: www.nzoptics.co.nz
A NEW GENERATION OF VARILUX ® LENSES
FOR THE MODERN PRESBYOPE

2018 • Voted by New Zealanders • 2018
TRANSFORMING
EYE HEALTH
THE ULTIMATE OPHTHALMIC COLLABORATION
At Specsavers we are focussed on providing the highest
levels of optometry and dispensing care in all our New
Zealand and Australian stores.
Our equipment and technology strategies, our close working relationships
with ophthalmology and various eye disease stakeholders alongside our
major investments into dispensing qualifications all contribute to a singular
purpose – to transform the eye health of New Zealanders and Australians.
So, if you’re concerned at the 50 per cent undiagnosed glaucoma cohort
and the under-indexing of diabetic retinopathy screenings; if you’re worried
that available in-store technology isn’t being used on every patient due to
extra fees and charges; and if you’re alarmed at the under-investment in
professional dispensing programs and technology – then we urge you to
talk to us about how you can make a genuine impact at Specsavers.
We’re on a clear mission to transform eye health in New Zealand and
Australia – and we’d like you to join us on that mission.
To ask about optometry and dispensing roles right across the country at all levels, contact Chris Rickard on 027 579 5499
or chris.rickard@specsavers.com, alternatively visit spectrum-anz.com for all the opportunities.
Reader’s
Digest
2018 • Voted by Australians • 2018
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Voted by New Zealanders
Reader’s Digest
Quality Service
Award
2017
Best Customer
Service in AU
Optometry
2018
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Optometry
Best Talent
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2017
Best Talent
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2017
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Optometry
2017
Millward Brown
Research
No.1 for eye tests
2016
Excellence in
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Retail
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Employer
of the Year
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2018 Transforming eye health
2 NEW ZEALAND OPTICS May 2018

Re:Vision, re-imagining eye care
BY LESLEY SPRINGALL
Auckland ophthalmologist Dr Trevor
Gray has opened Re:Vision, a new subspecialist
surgery in Mt. Wellington,
Auckland offering anterior segment surgery
and medical care to those who can afford to pay
and a sustainable model for those who can’t.
“Re:Vision is my new home. It’s always been
a little bit of a background dream, but I never
thought I’d ever consider leaving the Eye
Institute,” says Dr Gray. “But life changes and
you have to roll with the punches and then
make the most of what comes your way.”
Dr Gray made the decision to leave Eye
Institute and pursue his own dream of a
dedicated anterior segment boutique practice
late last year after what he describes as a
parting of philosophical ways.
Joining him at Re:Vision is most of his
Eye Institute team, including receptionists,
ophthalmic nurses, technicians and
optometrists; 14 in total, he says. The Britishraised
and Moorfields Eye Hospital-trained
cornea and anterior segment fellow Dr Mo
Ziaei, better known as “Dr Mo,” will also be
joining Re:Vision, adding to his existing cornea
clinical research at the University of Auckland.
“Mo was head-hunted by Charles (Professor
Charles McGhee) almost three years ago to be
Charles’ fellow and he has turned out to be one
of the most skilled, naturally-gifted surgeons
we have ever come across,” says Dr Gray. “He’s
also affectionately known as the ‘trainer of the
trainers’ because of how he’s shared his new
Moorfields’ techniques in corneal endothelial
transplantation with the cornea consultants at
“Dr T” and “Dr Mo” – principal surgeons at the new Re:Vision clinic
Re:Vision opens for business in Auckland’s Mt. Wellington
Greenlane Hospital.”
Last month, the new Re:Vision practice and
surgery was busy with final fit-outs before
welcoming its first patient on 23 April.
“We’re just a fledgling little unit and
we’re pure anterior segment, so Re:Vision
is not planning to be involved in glaucoma,
oculoplastics or macular degeneration at this
stage. We’ll essentially be offering more of
what people know me for – patient-centric
anterior segment care and going that extra
mile – as that’s the challenge that my staff and
I enjoy: how we can go the extra mile for every
patient encounter and every referrer encounter;
how we can make each patient’s life a little
easier, a little bit more pleasant, a little bit more
fun.”
Mirroring some of his charitable work at
Eye Institute, where his Buchanan Charitable
Foundation installed a laser theatre ceiling
hoist and funded free laser vision correction
for tetraplegic patients, Dr Gray’s new venture
is also starting off with a philanthropic focus.
Re:Vision will be working with the wider
charitable health and ophthalmic industry to
help plug the ever-increasing gap between
the public and the private systems, he says,
promising to reveal more in a few months’ time,
once a key partnership has been agreed and
signed-off.
“Part of Re:Vision’s philosophy is not only to
be a centre of excellence for patients in our
care, but to provide a philanthropic opportunity
to help society in ways that haven’t been
explored yet. It’s about being part of something
that just feels good. Life is too short not to
enjoy what you do and the nice thing about
enjoying what you do is you naturally do it
better… and that’s how a fledgling unit like
Re:Vision grows.” ▀
Blurring the
boundaries
EDITORIAL
Ophthalmology and optometry: New Zealand is
better than most in breaking down the barriers
between these two, crucially-linked sides of our
industry so they can better work together and share
the increasing workload to protect our nations’ eye
sight and overall health.
This month, particularly, demonstrates the
overlapping areas of responsibility and celebrates
this unique partnership with coverage of the 60th
anniversary conference of the wonderful Cornea &
Contact Lens Society of New Zealand (p8-12); the
increasingly popular Ocular Therapeutics Conference
(p16-17), which also expands this relationship
into pharmacy; and the annual Excellence in
Ophthalmology and Vision Science Awards (p15) that
recognise the achievements of trainee practitioners
from across the eye health spectrum.
We’ve got all the updates from the different
conferences, plus news galore relating to both
optometry and ophthalmology, including a new
ophthalmology surgery (p3), a new charitable
initiative to support kids in need (p5) and the first
electrophysiology workshop, designed to boost the
skill levels and knowledge of eye health practitioners in
this increasingly important diagnostic area (p5).
Perhaps best illustrating the importance of our world
is the incredible story of four-year old Lucas Kiser
(p7) who despite having more than 25 eye-related
surgeries and facing an uncertain future still retains
his fascination for all things new. And if that wasn’t
enough, check out this month’s Focus on Business
column for some crucial tips for all optometry and
ophthalmology practices on how not to fall foul of the
privacy laws in the wake of Facebook’s censure.
Enjoy.
Lesley Springall, editor, NZ Optics
BTP International Designz p: 07 307 2410 e: info@btpid.co.nz
Anterior
Segment
Specialists
0800 55 20 20
www.re.vision.nz
Dr Trevor Gray
Dr Mo Ziaei
May 2018
NEW ZEALAND OPTICS
3

News
in brief
2018 SOVS CONFERENCE
Registration is now open for the University of Auckland’s second
School of Optometry and Vision Science (SOVS) conference on
29 July in Auckland. The conference is aimed at all practicing
optometrists, educators, vision scientists and students,
offering hands-on workshops and up-to-the-minute scientific
presentations. https://sovsconference.org.nz/
LAB-GROWN CELLS FOR CATARACT RESEARCH
Scientists at Western Sydney
University have successfully grown
human eye cells from human lens
epithelial cells. These micro lenses
will provide a powerful platform
for defining molecular disease
mechanisms, anti-cataract drug
screening and clinically relevant
toxicity assays, said lead researcher Dr Michael O’Connor.
RISE IN SYPHILIS CASES
Data from the Institute of Environmental Science and Research
shows the number of syphilis cases reported in New Zealand
has more than doubled to 470 since 2015. Any unexplained
neurological or ophthalmological signs, such as ocular nerve palsy
and uveitis, can be symptoms of syphilis.
DR DIAGNOSIS BY ANYONE?
The US Food and Drug Administration (FDA) has approved the
first artificial intelligence (AI) diagnostic device that doesn’t
require a specialist clinician to interpret the results. The device,
IDx-DR, analyses retinal images to determine whether a patient
has diabetic retinopathy (DR) and can be used by any primary
healthcare provider.
OPTOMETRISTS TO INJECT CHALAZIA
The US state of Virginia has passed a new law allowing
optometrists to perform limited steroid injections to treat
chalazia. To administer the injections, optometrists must be
therapeutically-qualified, be board certified and have passed
certain additional courses and exams.
NEW, NON-INVASIVE EYE DRUG DELIVERY SYSTEM
US-based EyeGate Pharma
has developed a new
ocular drug delivery
system that doesn’t
use needles or drops.
The EyeGate II Delivery
System uses transscleral
iontophoresis, affectively a
low-level electrical current, to deliver a specified drug amount into
the ocular tissue. To date, the system has been used in more than
2,000 treatments, including more than 1,300 for the company’s
lead therapeutic candidate, EGP-437 for anterior uveitis.
SJÖGREN’S DIAGNOSIS TIME HALVED
The time scale for Sjögren’s syndrome to be accurately diagnosed
has more than halved from an average of six years in 2012 to just
under three years today, said the Sjögren’s Syndrome Foundation.
The foundation embarked on a five-year programme to raise
awareness and reduce diagnosis time in 2012.
MYOPIA-SLOWING SPECS WIN GOLD
Professors Carly Sy Lam and Chi Ho To from Hong Kong Polytechnic
University won the grand prize at the 46th International Exhibition
of Inventions of Geneva for their Defocus Incorporated Multiple
Segments (DIMS) spectacle lens for myopia control. In studies, the
DIMS lens provided clear vision for the wearer while simultaneously
slowing down myopia progression in children by 60%, with 20%
demonstrating no increase in myopia over the test period.
OUTCOME INSIGHTS FOR ACANTHAMOEBA KERATITIS?
A 20-year retrospective audit of Moorfield’s medical records
provided risk factor insights for patients with acanthamoeba
keratitis. Of 194 patients reviewed, 93 had poor outcomes,
including corneal perforation, any ocular surgery, duration of
antiamoebic therapy (AAT) of 10.5 months or more and VA of
20/80 or less, plus severe inflammatory complications such as
scleritis or corneal stromal ring infiltrates. High risk patients
included those older than 34 who had used corticosteroids;
had more advanced disease; or had herpes simplex virus (HSV)
keratitis treatment before AAT.
ITALIA INDEPENDENT SIGNS DISNEY
Italia Independent has signed a licensing agreement
with The Walt Disney Company Italy for the
development and distribution of Disney eyewear
collections. The first, including Disney, Marvel and
Lucas Film, will be unveiled in September 2018,
coinciding with Mickey Mouse’s 90th birthday.
UPDATED MYOPIA CALCULATOR
The Brien Holden Vision Institute has updated its free, web-based
myopia calculator, adding new features such as an ‘ethnicity’
option to allow users to switch between ‘Asian’ and ‘Caucasian’.
Photochromic contacts unveiled
Johnson & Johnson Vision (J&J) has teamed
up with photochromic lens developer
and manufacturer Transitions Optical to
develop and launch the first ever contact lens
which automatically adapts to changing light
conditions.
Combining Transitions’ Light Intelligent
Technology and J&J’s Acuvue Oasys technology,
the new lens creates a new category of contact lenses and expands the
photochromic category beyond the now well-known spectacle lenses.
“This breakthrough technology will revolutionise contact lenses
and photochromics by introducing the benefits of light adaptation
to more patients,” said Chrystel Barranger, president of Essilor
Photochromics and Transitions Optical. “(This) first of its kind
contact lens, provides wearers with vision correction and a dynamic
photochromic filter that helps to continuously balance the amount
of light entering the eye… quickly and seamlessly adjusting from
clear to dark in response to changing sunlight conditions; reducing
Drops replace
glasses
A
team of Israeli researchers from
Bar-Ilan University’s Institute of
Nanotechnology and Advanced
Materials (BINA), sent media outlets
and the twitter sphere into a spin with
the announcement they had developed
some revolutionary eye drops that could
replace glasses.
The technology, known as Nano-Drops, was developed by
Dr David Smadja, co-inventor of
the revolutionary Nano-Drops
ophthalmologist Dr David Smadja and Professors Zeev Zalevsky
and Jean-Paul Moshe Lellouche. Patents have been filed by
Birad Research & Development, the commercial arm of Bar-ILan
University.
Nano-Drops achieve their optical effect and correction by locally
modifying the corneal refractive index, said the University in
an announcement. “The magnitude and nature of the optical
correction is adjusted by an optical pattern that is stamped onto
the superficial layer of the corneal epithelium with a laser source.
The shape of the optical pattern can be adjusted for correction
of myopia, hyperopia or presbyopia. The laser stamping takes a
few milliseconds and enables the nanoparticles to enhance and
‘activate’ this optical pattern by locally changing the refractive
index and ultimately modifying the trajectory of light passing
through the cornea.”
In the future this technology may enable patients to have their
vision corrected in the comfort of their own home, said researchers,
as the laser device is small and connects to a smartphone.
So far, the technology has had positive results ex-vivo in pig
eyes, correcting nearly 3 diopters for both myopia and presbyopia.
In-vivo trials are about to begin on rabbits, to determine how
long the effect of the Nano-Drops lasts after initial application. ▀
Essilor unveils Varilux X
Essilor has launched a new lens aimed at digitally-connected
presbyopes who it says are unwilling to compromise their near or
distance vision.
The new Varilux X series lens, described as a technological stepchange,
has 15 patents pending. This includes patents for some new
proprietary technology developed by Essilor that re-shapes a specific
lens zone to overcome that typical progressive wearer frustration
forcing them to adjust their head position to see clearly when they
change from near to far vision.
“The Varilux X series lens is the result of a dramatic shift in lens
design, Xtend technology, that delivers new benefits for today’s
modern presbyope,” said Essilor ANZ in a press release announcing
the launch. “In today’s world, much of our time is spent multi-tasking
within the area of ‘arm’s length’, 40cm to 70cm. Activities range from
reading smartphones, looking at computers, reading documents and
talking with people. Patients need their vision to adjust seamlessly
between each of these tasks without adjusting the head to find the
right zone on the lens.”
Essilor said its Xtend technology controls the level of acuity on the
lens, resulting in the ability of the wearer to focus on multiple objects
within arm’s reach in the same direction of gaze, providing sharp
vision for the patient with no or minimal head movement. More than
www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand
exposure to bright light indoors and
outdoors, including filtering blue light
based on the level of activation and
blocking UV rays.”
The new innovation was triggered
by changing consumer lifestyle needs
and J&J’s commitment to care for human
sight, said Dr Xiao-Yu Song, J&J’s global
head of research and development in a parallel statement released
with Transitions Optical’s. “After more than a decade of product
development and numerous clinical trials involving more than 1,000
patients, we are excited to bring to market a solution to help contact
lenses wearers manage the changing light conditions they face every
day in their modern, active lives.”
The Acuvue Oasys with Transitions lens has received clearance from
the US Food and Drug Administration (FDA). The two-week, reusable,
spherical contact lens will be marketed by J&J and will be commercially
available in first half of 2019, said the companies. ▀
Eylea, close to
funding
As part of its long-running review on funding the
anti-vascular endothelial growth factor (anti-
VEGF) agent aflibercept (Eylea), Pharmac sought
feedback on its latest proposal last month, which
includes amending the current hospital restrictions for
ranibizumab (Lucentis).
Under the most recently proposed funding criteria
for aflibercept, eligible patients with a range of
ophthalmic conditions, including wet age-related macular degeneration
(wAMD) and diabetic macular oedema (DMO), would be eligible to receive
funded access to aflibercept, while patients who are currently receiving
ranibizumab would have the option to switch, from 1 June 2018.
“Patients with wAMD are currently able to access bevacizumab (Avastin;
off-label) and ranibizumab injections for the preservation of vision.
Patients with DMO currently only have access to bevacizumab (off-label)
injections. The current Pharmaceutical Schedule listing restrictions for
both bevacizumab and ranibizumab only enable publicly-funded access
when used in the DHB hospital setting,” details Pharmac’s proposal
document. “This proposal is to list aflibercept in Section B and Section H of
the Pharmaceutical Schedule as the second line anti-VEGF agent for both
community and hospital use. There would be no change to the current
listing of bevacizumab as a result of this proposal.”
Following repeated pressure from some ophthalmologists and the
wider eye health community. Pharmac’s primary clinical advisory
committee, the Pharmacology and Therapeutics Advisory Committee
(PTAC), recommended aflibercept be funded as a second line anti-VEGF
treatment for wAMD after bevacizumab (Avastin) in May 2017, bumping
it above ranibizumab. This was referred to Pharmac’s ophthalmology
subcommittee for further consideration and the latest proposal follows
these discussions. For more, visit: www.pharmac.govt.nz/news/
consultation-2018-03-27-aflibercept-rivaroxaban/ ▀
3,000 presbyopes around the world
participated in the development of
the Varilux X through focus group
interviews, video selfies and new
methodologies for real-life wearer
testing, it said.
“Varilux X series progressive
lenses were developed to meet the
needs of all presbyopes including
Essilor launches Varilux-X for digitallyconnected
presbyopes
a new group, Generation X, who are very active in their personal and
professional lives and who are avid users of digital technology devices,”
said Pierre Longerna, Essilor ANZ’s chief operating officer.
Research by Essilor in France found 95% of Varilux X wearers were
satisfied with their lenses when performing multiple tasks within
arm’s reach and more than 97% said they no longer had to move their
head to see clearly.
Created by Essilor in 1959, Varilux is one of the most popular
progressive lens brands in the world, with more than 50 patent
families protecting its technology.
The Varilux X will be introduced to Essilor’s Platinum Partners in New
Zealand at a special event on 7 May and then rolled out around the
country through a series of roadshows. ▀
For general enquiries or classifieds please email info@nzoptics.co.nz
For editorial, please contact Lesley Springall at lesley@nzoptics.co.nz or +64 27 445 3543
For all advertising/marketing enquiries, please contact Susanne Bradley at susanne@nzoptics.co.nz or +64 27 545 4357 in the first instance, or Lesley Springall at lesley@nzoptics.co.nz
To submit artwork, or to query a graphic, please email susanne@nzoptics.co.nz
NZ Optics magazine is the industry publication for New Zealand’s ophthalmic community. It is published monthly, 11 times a year, by New Zealand Optics 2015 Ltd. Copyright is held by
NZ Optics 2015 Ltd. As well as the magazine and the website, NZ Optics publishes the annual New Zealand Optical Information Guide (OIG), a comprehensive listing guide that profiles the
products and services of the industry. NZ Optics is an independent publication and has no affiliation with any organisations. The views expressed in this publication are not necessarily
those of NZ Optics 2015 Ltd or the editorial team.
4 NEW ZEALAND OPTICS May 2018

Electrophysiology
meeting - all welcome!
Medical retina specialist Dr Dianne Sharp
and the Ophthalmic Instrument Company
(OIC) are hosting a special Roland Consult
Electrophysiology Users Meeting at the Greenlane
Clinical Centre on 13 May, the Sunday after the
RANZCO NZ 2018 conference in Auckland.
The role of electrodiagnostic testing in
ophthalmology has expanded as a diagnostic
tool for retinal, macular and optic nerve disease
and is now an important adjunct to genetic
testing, says Dr Sharp. “It is used to monitor
response to therapy in posterior uveitis, diagnose
acquired retinal conditions, such as autoimmune
retinopathy, and monitor at risk patients
for signs of early toxicity to drugs, including
hydroxychloroquine.”
Dr Sharp is convening and coordinating the
OIC-sponsored meeting and will be supported
by ophthalmic electrodiagnostic technician,
Juliet Ware, Roland Consult’s Oskar Stasche from
Germany, and Tim Way from OIC.
“The German-designed Roland system has been
ideal for New Zealand, with excellent support
from the German designers who have frequently
visited to install and update units,” says Dr Sharp.
There are now seven Roland systems in New
Zealand at the Greenlane Clinical Centre, Auckland
University, Retina Specialists, Hamilton Eye Clinic,
Wellington Hospital, Christchurch Hospital and
Dunedin Hospital.
This inaugural users’ meeting will be split into
two halves. The morning session is specifically
for Roland electrodiagnostic system users
(technicians and ophthalmologists) to gain greater
familiarity with the equipment and discuss
specific user issues. While the afternoon session
is aimed at all ophthalmologists, registrars and
technicians who have been invited to participate
in clinical case discussions, which highlight the
uses of electrodiagnostic testing, and share their
diagnostic dilemmas.
The day is an opportunity to gain further training
to ensure the most accurate and reproducible
results, to review setups for specialty tests, to
address paediatric testing and to discuss reporting
techniques, says Dr Sharp. “This is not to achieve a
single standard (ISCEV provides the international
standards) but to have some degree of uniformity
across the country in the testing setups and
reporting, so that complex cases and our collective
experience can be shared with other users.”
Anyone wishing to attend the day should
contact Tim Way at Tim@oic.co.nz and cc. in Dr
Sharp at dianne@retinaspecialists.co.nz ▀
HDC report released
The Health and Disability Commission (HDC)
has released a report finding the Southern
District Health Board (DHB) breached the
Code of Health and Disability Services Consumers’
Rights, when a man suffered irreversible vision
loss after the DHB’s ophthalmology service failed
to arrange timely follow-up care.
The lack of follow-up ophthalmology care within
DHBs across the country, made headline news in
2016 and 2017 after the Royal Australian and New
Zealand College of Ophthalmologists (RANZCO)
revealed the extent of the problem. The HDC report
is the latest part of that process to change the
system to better prioritise treatment for patients
with the greatness risk of going blind.
RANZCO welcomed the report and called upon
the government to release the report they
commissioned EY to do last year, on developing
a pathway of care for age-related macular
degeneration.
While applauding the work undertaken so far,
Dr Brian Kent-Smith, RANZCO NZ Branch chair,
stressed more still needs to be done. “Releasing the
EY report will be a good step in enabling the DHBs
to better meet clinical need and help more patients
to have their sight preserved and restored.” ▀
Eye Institute’s new
community trust
BY LESLEY SPRINGALL
Eye Institute is formalising its social endeavours
under a new community trust, which initially
will be focused on providing assistance to
Auckland-based families by funding up to 400 eye
examinations and providing subsidies of up to $250
towards glasses over the next 12 months.
The new community trust will officially be
launched at the Eye Institute’s next seminar, after
work on 22 May at the Ellerslie Event Centre in
Auckland, by trust co-chairs, and Eye Institute
ophthalmologists, Professor Helen Danesh-Meyer
and Dr Shanu Subbiah.
“Eye Institute and its doctors have been involved
in many levels of community service for a long
time. The Eye Institute Community Trust is a way
of framing our activities as well as providing us
with the opportunity to expand our community
service in a more structured manner,” explains Prof
Danesh-Meyer. “At this stage, our focus is on our
Auckland community. There is so much that can be
done right in our own backyards, so this is where
we are launching this new initiative.”
Dr Subbiah says the idea to focus the trust’s
first efforts on children came from Wellingtonbased
optometrist Ravi Dass who he met last
year on a Voluntary Ophthalmic Services Overseas
(VOSO) trip to Fiji. Dass, together with his wife
Stephanie Hill, take a more philanthropic approach
to business, donating a pair of glasses to kids in
need from their practice, Mr Foureyes, every time a
patient buys a pair of glasses.
“I had always assumed, incorrectly, that eyecare
for children in New Zealand was comprehensively
covered by the health boards,” said Dr Subbiah,
who undertook a lot of his training in the UK
where children’s eye care is covered under the
National Health Service. After speaking to
Greenlane’s orthoptic department, he says he
realised that a lot of children who require glasses
don’t have them because of the cost, especially
those who were at high risk of visual loss from
amblyopia, so it seemed like the ideal starting
point for the trust’s work.
Professor Helen Danesh-Meyer and Dr Shanu Subbiah, co-chairs of the
Eye Institute’s new Community Trust
The trust will work with others also engaged in
this area, such as Essilor’s Vision Foundation, and
Eye Institute doctors have already presented their
aims for the trust to vision and hearing technicians
(VHTs) at their national conference, resulting in
some encouraging feedback, says Dr Subbiah.
Though the initial focus of the trust is on
Auckland and on children, so that it can finetune
the logistics of what it does, it is hoped
the trust’s work will be expanded nationally, he
says. “We will be working closely with VHTs and
primary school teachers to identify children that
would benefit the most from this initiative. As a
socially responsible company we are very excited
to be able to give back to our community and we
look forward to making a positive difference to
hundreds of children in the years to come.”
Prof Danesh-Meyer says everyone at Eye Institute is
very excited about the trust’s launch. “We have been
overwhelmed by the immense enthusiasm that this
initiative has received. We are very excited to see it
underway and we are open to new opportunities to
serve the community as the programme evolves. We
hope it will grow organically.”
Any Auckland-based optometrist can apply to
the Eye Institute Community Trust for additional
funding for exams or glasses on behalf of their
patients. The programme will be reviewed
regularly to ensure the trust’s focus fits with the
needs of Aucklanders, initially, and then nationally,
with the aim of extending its support to adults
who fall through the cracks of the publicly-funded
health system, said Prof Danesh-Meyer. ▀
Come to the official launch
at our 2018 May Seminar!
1.75 CPD
and 0.25
GC points
available
For many years the team at Eye Institute
has been offering pro bono cases under the
radar across Australasia, the Pacific Islands
and beyond. The Eye Institute Community
Trust has been formed to formalise our
longstanding commitment to helping those
in need.
A significant proportion of New Zealanders
do not qualify for often life changing
Opthalmic care, and the Eye Institute
Community Trust is working to change that.
One group that falls through the cracks the
most is children, and that is where our first
pursuit begins.
With your help, we aim to identify children
with the greatest risk of permanent vision
impairment due to Amblyopia, and provide
assistance to families by funding 400 eye
examinations and a subsidy of up to $250
towards glasses for the next 12 months.
BOOK ONLINE NOW! https://www.eyeinstitute.co.nz/optometry/
May Seminar - FREE!
Tuesday 22nd May 2018
6.30pm - 8.45pm
Ellerslie Event Centre, Racecourse
80 Ascot Ave, Ellerslie, Auckland
5.45pm - 6.30pm Light Meal &
Beverages provided
August Seminar
Tuesday 14 Aug 2018
6.30pm-8.45pm
Ellerslie Event Centre
Racecourse, 80 Ascot Ave
Ellerslie, Auckland
Optometry
Conference
Sunday 4 Nov 2018
8am-5pm
Waipuna Conference Centre
Mt Wellington, Auckland
For more information email
amy.w@eyeinstitute.co.nz
and be sure to register for
our May Seminar.
BOOK ONLINE NOW
Or register by
Phone 09 522 2125
Fax 09 522 5770
conference@eyeinstitute.co.nz
May 2018
NEW ZEALAND OPTICS
5

APAO 2018 in Asia’s world city
BY DR STUTI MISRA*
New Zealand still struggling to fill orthoptist vacancies
EARLY BIRD
REGISTRATION
OPEN NOW!
UP TO
42
This year, the 33rd Asia-Pacific Academy of Ophthalmology
(APAO) Congress was held in “Asia’s world city”, Hong Kong,
where we were welcomed by unseasonably cold weather.
The congress itself, however, warmed up the atmosphere quickly
with more than 5,200 delegates from 87 countries attending;
predominantly ophthalmologists, but also optometrists and vision
scientists from across the world. Perhaps in honour of own Professor
Charles McGhee, chair of ophthalmology at the University of
Auckland and new APAO president, delegates were warmly welcomed
by kilt-wearing, bagpipe players at the opening ceremony.
This year’s meeting lived up to its theme, ‘Creativity and technology
without boundaries’, offering many opportunities for young clinicianscientists
to interact with their seasoned and experienced peers
across the spectrum of ophthalmology and lots of news about new
technological advances.
The use of artificial intelligence (AI) using ‘deep learning’ –
complicated software algorithms that allow powerful computers
to “learn” from large datasets – is expected to revolutionise retinal
examination. Deep learning uses artificial neural networks that
allow machines to process and perceive the world in a similar way
to humans, but with far, far greater speed and accuracy and without
any bias. A research study in Thailand used this modality for diabetic
retinopathy screening studies. According to the Thai researcher Dr
Paisan Ruamviboonsuk, the very same technology may also be able
to process retinal images to predict refractive errors, cardiovascular
risk and cancer biopsies. AI certainly became a virtual theme (pun
intended!) of the conference. In fact, one session was dedicated
just to AI-based screening with presentations focusing on diabetic
retinopathy, glaucoma and age-related macular degeneration.
Another entertaining yet equally educational session from this
year’s APAO meeting, was the ‘Ophthalmic premier league’, where
four teams, in team jerseys no-less and accompanied by music galore,
discussed challenging and complicated cataract cases together with
different, potential lines of action. The resulting laugh-riot was full
of confusion yet still delivered some excellent pearls to deal with
unusual characters and cataracts.
As APAO president, Prof McGhee had a busy schedule with a
number of different speaking engagements, including seven
scientific lectures! These ranged from the truly educational, on iris
melanoma and corneal transplants, to some more entertaining ones,
including, ‘Chevalier Taylor’, the oculist who blinded Handel and
Bach: self-promoting quack or the target of fake news’. The lecture
was as informative as its intriguing title!
Technological advances were also on the menu of the corneal
surgery symposium where advances in corneal endothelial surgery
were discussed at great length. Although several ‘improved’ versions
of endothelial keratoplasties have emerged, it is not clear whether
they lead to better outcomes in terms of vision, according to Dr
Sanjay Patel (Mayo Clinic, USA). Professor Donald Tan of Singapore
National Eye centre also explained about alternative surgical
approaches including ‘no touch’ and ‘hybrid-’.
There were a significant number of invited lectures by New Zealandbased
ophthalmology professors, lecturers and post-doctoral fellows.
The anterior segment and cornea was well covered by Auckland’s clinical
and laboratory-based research team. Professor Dipika Patel discussed
imaging the inflamed cornea; Dr Rasha Al-Taie lectured on corneal
transplantation in a paediatric population; Dr Akilesh Gokul tackled the
biomechanical properties of the cornea and keratoconus management:
Professor Trevor Sherwin and Dr Jie Zhang delivered lectures on stem
cells; while I presented on imaging the cornea with systemic diseases.
New Zealand’s contingent was not only a significant part of this
internationally-renowned conference in terms of lectures and
free paper presentations, but we also won a couple of awards! Dr
Samantha Simkin won the best scientific free paper award for, ‘Widefield
Digital Imaging and
Telemedicine for Retinopathy
of Prematurity: The Auckland
Experience’ in the Paediatric
Ophthalmology & Strabismus
category; while Salim Ismail,
Jane McGhee and Prof Sherwin
won the best video award,
‘Die Another Day: The Journey
of a stem cell sphere to fulfil
the promise of regenerative
medicine’.
The conference also played
host to some star-studded
social events! While the
opening ceremony was a
colourful musical event, the
gala dinner had a few hearttouching
performances by a group of blind musicians and a cheerful
band of school kids. To conclude the evening, a seven-course dim sum
meal delighted our pallets! APAO also organised its third charity run
to raise funds for Blind Sports Hong Kong and the new APAO Satellite
Congress educational programme.
Overall, the 33rd APAO had numerous glitzy moments of science,
innovation and entertainment. I am particularly looking forward to
UP TO
28T
The New Zealand delegation to APAO 2018 with Dr Stuti Misra (centre, in red) and Professor Charles McGhee, APAO president (fourth)
finding out more about the role of artificial intelligence and deep
learning in ophthalmology at the next APAO annual meeting in
Bangkok, Thailand, from 6-9 March 2019. ▀
About the author
*Dr Stuti Misra is a lecturer in the Department of Ophthalmology at the University of
Auckland. Her research revolves around ocular surface and imaging in corneal disorders
and systemic diseases.
Orthoptists demand unrecognised
BY ELLA EWENS
The orthoptics profession is in high demand in New Zealand
with a staggering one fifth of the clinical positions (five of 26)
nationwide currently vacant. Yet the orthoptics profession
does not appear on the skilled shortage list in New Zealand.
Carly Henley, president of the New Zealand Orthoptics Society
Incorporated (NZOSI) says orthoptics’ services are extremely
stretched geographically and, recognizing the need, NZOSI has
asked the government to add the profession to the skilled shortage
list.
In Australia, orthoptics is listed on the short-term skilled
occupation list. There are currently 500 orthoptists practising
and demand is predicted to exceed output in the next few years.
In New Zealand there are currently two vacancies for orthoptists
in Auckland, two in Dunedin, one in Hamilton and one in
Christchurch, all within district health boards, except one in a
private eye hospital.
As there is presently no orthoptics training institute in New
Zealand, orthoptists that practice in New Zealand have trained
ether in Australia or the UK. In Australia, the course is a twoyear,
full-time technical course with a clinical placement, which
is offered by the University of Technology in Sydney or La Trobe
University in Melbourne. In the UK, the course comprises three
years full-time study with a six months honours extension offered
at the Universities of Liverpool or Sheffield. The courses equip
graduates with the skills to diagnose and manage eye conditions,
including strabismus, amblyopia, traumatic injuries, tumours, head
injuries, diabetes and strokes, in a range of patients from newborns
to the elderly. In New Zealand, almost all orthoptists practicing
have been trained in the UK.
With only 26 orthoptic positions countrywide a training
institute is currently not a viable option, but Henley admitted
the geographical gaps and the busy, stressful clinics for those
New Zealand still struggling to fill orthoptist vacancies
few practicing orthoptists across the country are a problem. “The
situation is concerning and getting a course registered is tricky,”
she said, adding she would like to evaluate distance learning and
hospital placements as an option for at least part of an orthoptics
course here in New Zealand.
She would also like to see more continuing professional
development options for orthoptists in New Zealand. “Orthoptists
are a very important group of clinicians who play an essential role
in the management of ocular muscle imbalances and paediatric
eye conditions.”
For related news, see story on the latest Squint Club meeting in
Sydney on p19.
World orthoptic day – June 4, 2018
The International Orthoptic Association (IOA) is the
global voice of the orthoptic profession and is made up
of 15 national professional organisations and six associate
organisations. The IOA World Orthoptic Day aims to boost the
visibility of the orthoptic profession and promote the activities
of orthoptists locally, nationally, and internationally.
World orthoptic day and the associated week-long
celebrations help to increase the awareness of orthoptists
and the association and the truly global impact of orthoptics.
A key part of this is the annual, international photography
contest, where all
orthoptists and
orthoptic students
are asked to take
out their cameras
and cellphones
and join in the fun.
Previous
competition
entries have
shown real flair
and creativity,
using lots
of different
Last year’s winning photo entry
techniques to
stage the perfect orthoptic-themed photo, said the Association.
This year’s theme is ‘Reflections in orthoptics,’ which can be
interpreted in any way as long as the image represents an
aspect or aspects of orthoptic science. Entries for this year’s
contest close on 20 May 2018. This year, the Association is
also running a ‘World Orthoptic Day Selfie Contest’ where
orthoptists are asked to send in a photo of themselves relating
to orthoptics in clincial practice, such as wearing a patch, using
a prism or an occluder, or anything. The prize for the most
original entry is an 16GB iPad mini. Entries open on World
Orthoptic Day on Monday 4 June and close at 11.00pm GMT on
Friday June 8th.
6
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NEW ZEALAND OPTICS May 2018
12/04/2018 10:30 AM

Seeking help for Stickler’s
BY JAI BREITNAUER
In rural Taranaki, on a dairy farm that looks just
like any other there is a boy playing with his dad’s
tractor. Just four years old, he marvels at the giant
wheels and squeals with delight when the engine
starts. It’s a scene endemic to rural New Zealand, but
this particular little lad, Lucas Kiser, is not like other
four-year-old boys. In fact, he’s very rare indeed.
“Lucas was diagnosed with Stickler Syndrome,
infantile glaucoma and severe myopia when
he was four months old,” says his mum Sonia,
who is married to Michael and has another son,
Andre, now three. “He had pressures of 38 in his
right eye and 24 in his left the day we saw the
ophthalmologist, and he has been as high as 48.’’
Stickler Syndrome is rare but not unheard of in
New Zealand. Characterised by structural problems
of the eye and unusual facial features, the biggest
optical risk for the patient is usually retinal
detachment. However, Lucas has an especially rare
version of this recessive genetic disorder that walks
hand-in-hand with glaucoma and is estimated to
affect just 5%-10% of people with the condition.
“He wasn’t a happy baby. The first four months
were hard,” admits Sonia. “He cried a lot, rarely
slept, didn’t feed well and was sensitive to light so
we couldn’t go outside much.”
The family went to their GP frequently for what
everyone thought was repetitive conjunctivitis, but
when Michael saw the cloudy film on Lucas’ eye
he decided enough was enough and they bundled
Lucas off to see their local ophthalmologist, Dr
Ross Neville-Lamb who referred them directly to
paediatric specialist Dr Justin Mora in Auckland
with suspected glaucoma.
Having seen a patient with Stickler before,
Dr Mora recognised the characteristics of the
condition and sent a blood sample to the USA
where the diagnosis was confirmed by geneticists.
“We’ve been so lucky to have Dr Mora, he’s
amazing,” says Sonia. “He’s seen Lucas over 40 times
in the last four years and he’s brilliant with him.”
To date Lucas has had over 25 surgeries,
anaesthetics and sedations, including three
goniotomies; a molten tube insertion; a lens
implant, later removed following a detached
retina; cataract; and cry and laser therapy. He has
Lucas’ Give a Little page
May is for macula
Mirroring its counterpart across the
Tasman, the Macular Degeneration New
Zealand (MDNZ) team is gearing up for
‘Macula Month’ from 1-31 May.
Originally started by the Macular Disease
Foundation Australia, Macular Month (well, it used
to be a week) is an annual campaign designed to
raise awareness of macular disease both directly,
through an annual consumer campaign, and
through eye health practitioners who are at the
cutting edge of catching the disease early and thus
preventing blindness.
In New Zealand, supplements company
Blackmores and pharmacy chain Health 2000 are
running a promotion through Health 2000 stores
throughout New Zealand to promote awareness
and raise funds for MDNZ. The charity receives 5%
of all sales of Blackmores’ eye health products.
MDNZ has written to all optometrists and
ophthalmologists reiterating the need to keep
patients informed of the dangers of macular
degeneration and the importance of Macular
Month, with the hope they will get involved. It
is providing free consumer cards to give away
to at risk patients and is talking to media and
advertising organisations with the hope of
encouraging some support.
eye drops every day, has had months of patching
and can currently only see out of one eye, and it’s
not clear if he will be able to see out of it again.
On top of his eye problems he has a hearing
impairment and could suffer early-onset arthritis
as he grows older.
“He’s a trooper and hasn’t let it stop him,” says
Sonia. “He loves doing jobs on the farm and goes
to kindy a couple of days a week. He’s such a happy
boy, loves his friends, and loves his tractors!”
When the Kiser family heard about the Stickler
conference in Portland, Oregon, in July this year
they were instantly keen to go. It will be packed
full of specialists from across the globe, plus other
families the Kiser’s can relate to.
“There are two other families in New Zealand
who have been in touch with us, who have
Stickler,” says Sonia. “But as far as I’m aware they
don’t have glaucoma as well. We feel so alone.
To be able to meet people who are actually living
through this, to talk to their specialists and learn
how we can support Lucas, and how we can
support his teachers when he starts school, that
would be amazing.”
Sonia notes how isolated New Zealand is, not just
geographically but in terms of Stickler experience.
“Dr Mora and other specialists have been learning
with us on this journey. (At the conference) we
could find contacts and information that could be
essential to their continued help with Lucas and
other Stickler patients in New Zealand.”
The airfares alone will cost $10,000 so the family
has reached out to their local community for help.
They’ve received donations from two local charities,
Team Hope and Little Fighters Trust. They also have
a Give A Little page that has raised $4525 so far.
“We’ve had amazing support from our friends,
family and our community so far,” says Sonia. “This
is such a great opportunity for us, and we feel so
grateful and humbled by the help that we’ve been
given.”
The ophthalmologist’s view
NZ Optics spoke to Lucas’ lead medical
professional, ophthalmologist Dr Justin Mora from
Auckland Eye, about this case.
“Stickler syndrome is not uncommon, but to have
infantile glaucoma and Stickler syndrome is very
rare. There are three cases in the
literature of children who were
diagnosed with Stickler syndrome
based on these characteristics.
Lucas Kiser is the only confirmed
genetic case in medical history. He
is unique.
“While Stickler syndrome is
a connective tissue disorder, a
major characteristic is a structural
abnormality of the eyes causing
severe myopia. Invariably Stickler
patients are very short-sighted.
In some children, there is also
an abnormality of the anterior
segment, which can lead to
glaucoma.
“It’s been interesting for me to
look after Lucas, from a medical
perspective. He’s a very challenging
case. As a paediatric specialist, I see a
1 in 7 people over 50
will get Macular
Degeneration
At Risk
1,500,000
We need to
reach these
people early
Diagnosed
160,000 Vision
Loss
33,000
So that
effective
treatment is
given
Meaning
less
become
blind
With one in four people expected to be aged over
65 by 2030 and 41% still unaware they could be at
risk of macular degeneration, this is not something
Early detection saves sight
that can wait, says Phillippa Pitcher, MDNZ general
0800 622 852 mdnz.org.nz
manager in her letter to eye care professionals. “To
halt a potential epidemic of blindness, we need to
be proactive to save sight so that New Zealanders
can live well in old age.”
So, for the month of May at least, when you think
‘May’, think ‘macula’ too. For more about MDNZ
and how you can become a “professional friend”,
visit, http://mdnz.org.nz/ ▀
Michael, Lucas, Sonia and Andre, looking for help for Lucas
lot of children with infantile glaucoma, but not with
a refractive error of -17, which is what Lucas had.
When we removed his cataract in the right eye we
had to answer the question as to what to do with the
left, which still had a -16 refractive error. Do you leave
him unbalanced? Do you remove a healthy lens?
There have been some tricky questions to answer.
“There are other Stickler cases in New Zealand,
and it can be diagnosed in young adults as well as
children. Severe short-sightedness at a very young
age should raise the question, ‘is there something
else going on?’ Always refer such cases to a
paediatric ophthalmologist. Retinal detachment is
the main risk for Stickler patients.
“The Kisers have been up to Auckland countless
times and Lucas has had several surgeries under
anaesthetic, but they’re such a positive family and
he’s a happy boy. I’d love to see them participate
in this conference. Any family with a child with a
rare condition will value meeting other families
with similar problems, knowing they’re not alone.
It could also open up future treatment options to
Lucas as the family develop networks with families
and practitioners in the US. It would be a great
thing for them and I fully support it.
To help the Kiser family make it to the Stickler
conference in the US, please visit www.givealittle.
co.nz/cause/help-get-lucas-and-his-family-thestickler
Editor’s note: Writer Jai Breitnauer was so moved
by Lucas’ story she has donated part of her writing
fee to the family’s cause.
Stickler Syndrome – The facts
• Stickler Syndrome is the umbrella name for
a group of hereditary conditions. The main
characteristic is a distinctive facial appearance
• Abnormalities include eye structure issues,
joint problems and hearing loss
• Cleft palate and small lower jaw can also lead
to breathing and feeding problems in infants
• Patient joints can be loose and hypermobile.
Arthritis and osteoporosis can occur early in life
• It’s an inherited condition, but the more severe
type that Lucas has is recessive
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May 2018
NEW ZEALAND OPTICS
7

SPECIAL FEATURE: CCLS
Celebrating 60 years with warmth and style
BY ROBERTA MCILRAITH AND ADELE JEFFERIES*
This year the Cornea and Contact Lens Society
celebrated its 60th birthday. Though the
educational content and knowledge has
dramatically evolved over the last 60 years, the
high standard of clinical learning and warm
collegial environment never changes, making it
always one of the better conferences to attend.
Following a popular OCT and glaucoma workshop
(see story p10) on the Saturday and a night’s
quizzing (with prizes kindly donated by specialty
and custom contact lens manufacturer Precision
Contact Lenses) this year’s one-day conference
was opened by CCLS president Jagrut Lallu who
introduced our first speaker, Associate Professor
Jennifer Craig.
Dry eye advances
Jennifer discussed the widely-anticipated findings
of the Tear Film and Ocular Surface Society’s
second Dry Eye Workshop (TFOS DEWS II), which
will no doubt become the basis for our in-office
classification and care models for patients affected
with dry eye symptomatology. She also explored
the predisposition of the Asian eye to dry eye
disease, with meibomian gland dysfunction and
incomplete blinking being the main culprits, and
discussed the dry eye elixir that is manuka honey.
Research in the area of cyclodextrin-enhanced
manuka honey-based ophthalmic products used
to treat blepharitis and demodex-related issues
has shown huge benefit and we now eagerly await
these products becoming commercially available.
Optometrist-turned-doctor, Dr William
Shew then discussed the early results of his
chalazion study and the potential link between
chalazia (or meibomian cysts) and dry eye,
demonstrating how chalazia significantly alter
lid anatomy. The majority resolve within six
months, but a proportion require either steroid
injection or incision and curettage. “This has
important implications for those undergoing
repeat procedures as meibomian glands have no
regenerative capacity,” he said.
Dr Ilva Rupenthal continued the dry eye theme
later that morning, introducing NovaTears, the
most recent addition to the ocular lubricant
market. This product is both lipophobic and
lipophilic, arranging itself to offer the best
contact to the ocular surface (lipophillic) and
the atmosphere (lipophobic) without the use of
H2O. By not having H2O, the product remains
preservative free and carries no buffers, spreading
readily across the eyes, feels like silk and remains
longer on the eye than other ocular lubricants. For
more, see p11.
From iris reconstruction to Down Syndrome
and keratoconus
Professor Charles McGhee wowed us with
impressive surgical procedures that can be
employed to reconstruct irises and regional areas
of the cornea, such as in cases of corneal limbal
thinning. He also presented some interesting and
worrying figures on keratoconus rates among
individuals with Down Syndrome tested at the
Special Olympics. Prevalence as high as 37% may
well suggest a need for screening with a view to
cross-linking in this group of Kiwis.
An update on the economy
Having our ears trained on eyes all morning, it
was delightful to see the return of Tony Alexander,
chief economist at the BNZ, who provided an
upbeat update on the New Zealand economy.
In 2016 he discussed the effect on the economy
of the Auckland housing crisis and the reduced
dairy payouts, but this year his talk centred
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Richard Newson, Jonathan Foate and Miriam Foate
Speakers Dr William Shew, Professor Charles McGhee, Dr Ilva Rupenthal and A/Prof
Jennifer Craig
Sanje Munathanthiri, Situ Thakersi and Eleisha Dudson
around increasing migration and investment in
infrastructure, which are keeping us employed and
house prices high.
Ortho-k to coating CLs and keratometry
After a break for lunch and time to catch up with
colleagues, optometrist Alex Petty, always an
enthusiastic speaker with clinically-relevant pearls,
offered a commentary on a variety of everyday
complications we see with specialty contact
lens fitting, including ortho-k and the now more
frequently used scleral lenses. It is always reassuring
to find that those minor epithelial desquamations
are being experienced by other speciality contact lens
fitters, but also that they have fairly simple causes
and solutions, such as dealing with solution toxicity
and re-fitting techniques.
Auckland optometrist Emilie Langley then
discussed the rates of ortho-k regression in
patients coming out of their lenses, noting
that regression rates are more rapid for higher
prescriptions and female candidates in general.
Overseas guest speaker, Professor Heather
Sheardown, from the chemical engineering
department and optometry school at Waterloo
University, Canada, talked about the benefits of
coating contact lenses with different compounds.
This included the use of hyaluronic acid to lower
deposition and protein build-up to increase
the lubricity and wettability of contact lenses
to enable a more comfortable and tolerant
experience for the contact lens wearer – the
ultimate goal of her work.
Dr Dean Corbett spoke to us about new
techniques employed in patients with radial
keratotomy (common in the ‘80s and ‘90s) who now
present with cataracts. This is a complex situation
where patients have relatively unstable corneas,
meaning the biometric data is compromised and
thus their outcomes can be unpredictable.
Lifetime membership awards
To honour the 60th year of the CCLS, two lifetime
memberships were awarded to Dr Malcolm
McKellar and Alan Saks both of whom have
contributed enormously to this Society and in the
area of contact lenses.
Dr Malcolm McKellar was the one of the first
optometrists to retrain as an ophthalmologist. He
trained in New Zealand and then gained further
subspecialty experience in treating diseases of
the anterior segment, cornea
and external eye in Israel and
England. He helped established
the Cornea Clinic at Christchurch
Public Hospital, is a founding
member of the New Zealand
Ocular Tumour Service, has
helped and continues to help
train both optometrists and
ophthalmologists and has served
as an active Society councillor.
He’s also been very active in
charity work, donating his
time and skills to the Volunteer
Ophthalmic Services Overseas
(VOSO) in Vanuatu and Fiji, and
further afield in the Gaza Strip.
Leith O’Connor and Peter Turner
Dharshie Hughes, Joy Hoshek and Sandhya Mathew
Kent Napier, Richard Johnson and Greg Nel
Alan Saks is a South African-born and trained
third generation optometrist who worked for
many years in New Zealand. A long-serving
consultant and advisory board member to Johnson
& Johnson Vision Care, he’s an advocate for new
CL technologies, pushing for higher Dk lenses,
safer systems and better performance. A former
president of the Society, he now lives in Australia,
where he continues to take part in workshops,
international panels and conferences and write on
all things contact lens.
We were lucky to have them among us.
A look back and forward to the next 60
years
After accepting their awards, Alan then went
on to round out the weekend, regaling us with
memories and wisdom from his years in practice
and as a member of the Society. He reminded us
how important the relationships are that we build
in the profession and the role that the Cornea
and Contact Lens Society has played for him, and
continues to play for us.
After 60 years, it appears the CCLS is still going
strong and we look forward to the next 60 years
of friendship with colleagues who care for the
anterior eye, contact lenses and, most importantly,
the patients they’re attached to.
*Roberta McIlraith is a CCLS councillor and Christchurch-based
optometrist, specialising in specialty contact lenses, ortho-k,
myopia control and fitting keratoconic corneas. Adele (Ralston)
Jefferies is a therapeutic optometrist and national clinical manager
for Matthews Eyewear Eyecare. She has a special interest in
contact lenses, dry eye and other ocular surface disease, ocular
therapeutics, ophthalmology co-management, patient education
and optometric education.
Drs Chris Murphy, Malcolm McKellar, awarded a lifetime membership of CCLS for services to the
industry, and Reece Hall
8 NEW ZEALAND OPTICS May 2018

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May 2018
NEW ZEALAND OPTICS
9

SPECIAL FEATURE: CCLS
Stephen Hill, Peter Grimmer and Aniell Esposito DFV’s Ralph Thompson and Will Robertson flank Sarah Lord and Stephanie Wallen Claire McDonald and Dr Dean Corbett
Wielding the power of OCT
BY DR CHRIS MURPHY*
A
one-off, all-day workshop providing a full
overview of OCT technology and its clinical
uses was arranged immediately before the
CCLS one-day conference on Saturday 17 March
2018.
More and more optometry practices across
the country are either considering or have
purchased OCT machines. OCT investigations
and OCT-assisted monitoring lead to a dramatic
improvement in clinical care, so the board of CCLS
thought it was timely to arrange a workshop to
provide an insight into OCT technology and the
interpretation of results.
I opened the workshop and presented the
first lecture, which discussed the basics of
OCT technology: how the initial time domain
technology created a relatively poor image and
how technological advances have led to the
newer spectral domain technology, which is now
the technology of choice for nearly all OCT’s on
the market. I also discussed swept-source OCT
technology, the latest advancement, which is more
expensive but has a number of benefits, such as
greater clarity of images and greater penetration,
allowing the choroidal vasculature to be visualised.
While this technology is currently only available
with the Topcon Atlantis OCT machine, other
manufacturers are in the process of developing
their own swept-source OCT machines, which
should be available soon.
Dr Jesse Gale, an ophthalmologist and glaucoma
subspecialist from Wellington, then provided
a comprehensive overview of OCT use in the
diagnosis and management of glaucoma. He gave
many helpful hints about how to maximise the
use of OCT in this area and interpret the glaucoma
assessment printout. This allows for a much more
accurate diagnosis, and thus management of the
disease, rather than the simple “red is bad, green
is good” guide. Jesse then went on to cover many
of the pitfalls of glaucoma and ocular hypertensive
monitoring techniques and reinforced appropriate
referral guidelines. He discussed the benefits and
weaknesses of some scans, including ganglion
cell patterns, which are available with some
machines such as Zeiss’ Cirrus, and the need
to incorporate the information into an overall
glaucoma assessment. He ended his presentation
with a look at where OCT can be helpful in neuroophthalmology
diagnosis, such as identifying
papilloedema.
This was followed by an hour-long lunch with
much socialising and catching up with colleagues
from around the country.
I then presented another lecture, this time
on the uses of OCT in the anterior segment,
discussing the assessment of the angle in
multiple axis, which the new swept-source OCT
scans do particularly well, and providing some
examples of corneal surgery where the depth
and accuracy of the incisions can be
easily assessed. As an aside, at the
request of the CCLS President Jagrut
Lallu, I also discussed the current
uses of Avastin in the treatment of
corneal neovascularisation, which
is a very difficult condition to treat.
Examples include vascularisation of
the cornea from severe limbal vernal
keratoconjunctivitis or vascularising
hydrops. Avastin is a simple,
inexpensive and effective treatment
and is now available publicly from
many hospital eye departments
including Waikato.
The next speaker, Richard Johnson, a well-known
optometrist working in the Greenlane Clinical
Centre in Auckland, gave an informative and
entertaining lecture on OCT uses in medical retina
treatment, in particular, macular assessment. He
covered many of the common conditions that
optometrists are likely to encounter, explaining the
“normal range” which could not be assessed before
OCT scans were available.
Complementing Richard’s talk was a presentation
by Auckland-based ophthalmologist Dr Andrew
Riley, who gave a comprehensive review of medical
Tim Eagle, keynote speaker BNZ’s Tony Alexander and Simon Rose
retina conditions, including macular pathology,
treatment and referral guidelines. In a wideranging
and engaging talk, Andrew also discussed
OCT assessment of vitreoretinal conditions and
their treatment.
On behalf of the CCLS board, I would like to take
this opportunity to thank the speakers for their
time and efforts, the Capital Vision Research Trust
for the faculty and the 53 attendees for their
participation. We hope you found it useful for your
continuing clinical practice.
*Dr Chris Murphy is a Hamilton-based ophthalmologist and CCLS
councillor.
Craig: 027 565 7200 Robert: 027 565 7720 P: 0800 657 720 info@oppmed.co.nz
Renata Watene and Nick Burbery
Radiant Health ramps up
B+L team
Radiant Health’s Bausch+Lomb (B+L) team
has been reorganised and expanded to
include two more people chosen for their
skills to help practices.
Key account manager Yvette Beattie has been
promoted to national sales representative and
will be supported in her role across the country
by Conor Fitzgerald and Leanne Fierro.
Fitzgerald has been with Radiant for nearly
three years, having first been employed to sort
out a new customer relationship management
system. This included bringing the B+L customer
service in-house, which has been good, he says,
as it’s given Radiant more control, providing a
far better service. With a background primarily
in marketing, including some consumer
healthcare, he admits, however, that the world
of eye health is new to him. “There is a lot to
learn, but I’m enjoying getting into it.”
Beattie says Fitzgerald will help provide
support in the field and tailor campaigns and
merchandising to what optometrists actually
need. “It’s great to have him on board because
he’s young and dynamic and he’s tapped into
using social media and marketing.”
Fitzgerald will be helping B+L practices with
their social media, specifically to target new
Kylie Dreaver and Andrew Black
Yvette Beattie and Conor Fitzgerald
and existing local customers, and is currently
trialling the new initiative with one practice
before rolling it out to others.
It’s also great to have Fierro join the sales
team, says Beattie, as she has more than 25
years’ experience in sales and advertising. “She
has a lot of merchandising experience with
pharmacies so she will be able to help practices
with in-store merchandising and window
displays, while remaining part of the customer
service team. So, we’ve got a really nice little
team now.”
10 NEW ZEALAND OPTICS May 2018

From the exhibitor’s hall
As one of the main events in the New Zealand ophthalmic
calendar for both optometrists and anterior segment
ophthalmologists, the Cornea and Contact Lens Society (CCLS)
of New Zealand’s annual conference is well supported by sponsors.
This year’s one-day conference was no exception with some of the
industry’s best-known companies on-hand to demonstrate and
discuss their latest technical advances with delegates.
The following is a brief snapshot of what was new and was
attracting attention at the 2018 CCLS NZ conference in Wellington.
AFT Pharmaceuticals – NovaTears
Kiwi-based pharmaceuticals company AFT’s latest eye product,
NovaTears, manufactured by Novaliq, was attracting a lot of
attention in the exhibitor’s hall following a talk about it by Auckland
University’s Buchanan Ocular Therapeutics Unit director Dr Ilva
Rupenthal.
There are more than 100 artificial tears products on the market
today, but most are aqueous-based and so have little effect on
the lipid layer, she told the audience, disclosing how her unit was
involved in some of the research on NovaTears. “But NovaTears is
a disruptive technology, completely different to anything on the
market today... It lubricates the eye and stabilizes the lipid layer.”
NovaTears incorporates Novaliq’s proprietary EyeSol technology, an
innovative multi-dose, non-aqueous and preservative-free topical eye
drop, which forms a thin and smooth protecting film to support the
lipid layer and prevent tear evaporation, thus relieving dry eye and
irritated eye symptoms. The special formulation allows the drop to
spread over the surface of the eye quickly, with less “spill-over” and
no vision blurring, explained Dr Rupenthal.
This technology is now being applied across Novaliq’s clinical
pipeline, which includes variations on NovaTears, combining it with
other well-known eye health benefactors, such as Omega 3. The
EyeSol technology is also being tested with some of Novaliq’s other
eye health drug products, all of which could potential be exciting
treatment options for the other ophthalmic indications, she said.
OptiMed
Taking pride of place on the OptiMed stand was the Optopol REVO
OCT and the REVO NX model, providing scanning speeds faster than
any other OCT in the world, said Craig Norman from OptiMed NZ.
“You get far more reference points and higher resolution in a much
shorter period of time. It’s so fast, the patient barely has a chance to
move their fixation, so you minimise any artefact errors, just better
quality results!”
The new REVO also has the optional extra of OCT-angiography
(OCT-A) to visualise the microvasculature of the retina. With the
latest upgrade, it can now combine these images into a detailed,
12x12mm widefield mosaic to allow eye health practitioners to
view a far larger area of the eye than was previously possible, said
Norman. “So, this can take OCT-A images of the retina, the macula
plus the disc and knit them together to give you the big picture; all in
one view, rather than having to look at several smaller images.” Plus,
the new REVO has the option of OCT biometry, allowing practitioners
to combine their OCT data with axial length measurements, which
can be important for looking at myopia progression in children, for
example, he explained.
Corneal Lens Corporation (CLC)
Echoing one of the main themes of the conference, CLC has
introduced a new range of preservative-free solutions for mild to
moderate and severe dry eye. The new Lumecare Camellose 0.5% and
1% concentrations are both available in single dose applications and C
are a good alternative to Thera Tears until the latter comes back into
M
the market later this year, said CLC director Graeme Curtis. “Each has
its own uniqueness, both with low osmolarity.”
Y
Lumecare also offers a broad spectrum, multi-dose, preservativefree
range called Evolve, for all severities of dry eye, favoured by
CM
MY
the UK’s National Health Service. These products have a unique
delivery system; a generation two, blue-tip technology, which
CY
uses a one-way valve to deliver a measured dose, while preventing
CMY
any contamination, said Curtis. “It’s very patient friendly so you
don’t have to plunge solution into the eye. These bottles deliver a K
measured drop, with one touch, so no wastage and no concerns
about putting the plunger in your eye. Arthritic patients love them
because they are so much more user-friendly.”
This next generation delivery system is also being employed for
other drop products, some of which CLC hopes to introduce to the
market soon, he added.
Ophthalmic Instrument Company (OIC)
OCT technology was a key talking point for OIC at this year’s
conference. It’s Spectralis system, combining scanning laser fundus
with high-resolution OCT, made by Heidelberg Engineering, featured
prominently in the CCLS NZ’s OCT Workshop day, run by Dr Chris
Murphy (see page 10), while Nidek’s Retina Scan Duo, providing highdefinition,
3D auto-tracking and auto-shot functions in a compact
machine was attracting attention on OIC’s main stand.
“Picking the right OCT depends on the practice, whether they are
starting out or have had OCT before, or if they have specialised in
some way,” explained OIC’s Tim Way. “The Duo, for example, is a
great screening tool for general optometry practices. It offers a lot of
flexibility for different pathologies yet is still very simple to use.”
Given the dry eye theme of this year’s conference another product
attracting attention was OIC’s Eye Doctor Hot/Cold Eye Compresses
which are reusable, have a removeable, washable cover and can be
heated in the microwave or oven, or cooled in the freezer. The Eye
Doctor Compress is used to alleviate the symptoms and discomfort of
Meibomian gland dysfunction, eyelid cysts and dry eye disease.
CooperVision
CooperVision’s Joe Tanner and Cherie Norton were focusing on the
company’s MyDay and MyDay Toric daily disposable lenses and Biofinity
Energys, the latest lens in the Biofinity
range designed specifically to help manage
and alleviate digital eye fatigue.
According to the company, the
technologically-advanced silicone
channels in the MyDay material transport
oxygen so efficiently that less raw silicon
is required, sustaining wettability and
optimal water content. Whereas Energys
has been digitally engineered with
multiple front-surface aspheric curves
to distribute power evenly to simulate
more positive power centrally. Energys’
‘Digital Zone Optics’, when combined
with Biofinity’s Aquaform Technology (which improves the lenses’
moisture, breathability and deposit resistance) help combat dryness
and tiredness, two key symptoms associated with digital eye fatigue.
Also attracting attention was CooperVision’s Optomism, which
is currently being presented to practices across the country.
This packages CooperVision’s products and services together to
support practice growth and explains CooperVision’s international
commitment to more sustainable practices and charitable support.
Designs for Vision
Dry eye was the main theme of the Designs for Vision (DFV) stand at
this year’s CCLS conference, with the company’s complete suite of dry
eye products on display.
It’s Oculos Keratography 5M is well-known to dry eye researchers,
CooperVision Half Page NZ Optics May 2018.pdf 1 11/04/2018 11:33:44 AM
CONTINUED ON PAGE 12
REASON FOR
MiSight ® 1 day:
available now *
Are you ready
to take on myopia
management?
• Daily disposable soft contact lenses
• Proven to significantly slow
the progression of myopia 1
Live Brightly.
Roberta McIlraith and CLC’s Whitney Ferguson
Andrew Sangster, Kathryn Steeman and Adele Jefferies
William Shew, Richard Ng and Teresa Hsu
* Available for practices who meet accreditation criteria. Contact misight1day@au.coopervision.com for more information. 1. Chamberlain P, Back A, Lazon P, et al. 3 year effectiveness of a dual-focus 1 day soft
contact lens for myopia control. Presented at the 40th British Contact Lens Association Clinical Conference and Exhibition; 10 June 2017; Liverpool, United Kingdom. © 2018 CooperVision 03/18 EMVCOO0663
May 2018
NEW ZEALAND OPTICS
11

SPECIAL FEATURE: CCLS
Andrew Sangster, Frances Misich and Anne Matheson
CONTINUED FROM PAGE 11
having been the preferred tool for dry eye analysis for a number of
years. It easily and efficiently integrates complex examinations such as
meibography into ophthalmological and optometric practices, revealing
morphological changes in the glandular tissue and evaluating the tear
film. This is complemented by other products such as the Blephasteam,
which provides moisture heat therapy to relieve symptoms of
meibomian gland dysfunction (MGD); Optimel’s manuka honey dry
eye drops; and the Eye-Light intense pulsed light (IPL) technology for
treatment of both the bottom and top lids.
DFV has been in the dry eye space for more than six years, so it’s
something the company really understands, said DFV’s William
Robertson. “The biggest thing for optometrists when it comes to dry
eye is to actually make the psychological leap to ‘I’m really going to
treat my patients’, rather than ‘here are some drops’, because it is
Recommend ACUVUE® Brand contact lenses
Always read the label. Use only as directed.
John Veale, Dharshie Hughes, Jeremy Fox and Iris Xu
and give your patients the power of choice
a commitment in time,
and dry eye patients can
be quite testing.” But for
those who do invest in
it, it adds another string
to their bow, which can
attract a number of new,
long-term, loyal patients,
he said.
Johnson & Johnson Vision Care, a division of Johnson & Johnson Pacific Pty Ltd, 45 Jones Street, Ultimo, NSW, 2007, Australia.
Phone: 1-800-736-912. www.acuvue.com.au
Johnson & Johnson Vision Care, a division of Johnson & Johnson ( New Zealand ) Ltd., 507 Mt. Wellington Highway, Mt. Wellington, Auckland,
New Zealand. 0800-466-173. www.acuvue.co.nz
CCP 8907/18 TAPS PP2169
Alcon
The “SmarTears”
technology of Alcon’s
Dailies Total 1 contact
lens range was the main
topic of conversation on the Alcon stand this year. According to the
company literature, SmarTears helps stabilizes the eye’s tear film to
reduce dryness and provide better contrast sensitivity by releasing
phosphatidylcholine (PC), an ingredient found in natural tears,
which, together with Dailies water gradient technology and oxygen
transmissibility, helps provide extra moisture and restore the lipid
layer.
“PC is present in natural tears. It adheres the lipid layer to
the aqueous layer… providing a more comfortable contact lens,
especially for our presbyopes,” said Caroline Perkinson, Alcon’s
business development manager for New Zealand. “There are a lot of
presbyopes out there, and people do experience more discomfort as
they get older, so for optometrists, being able to give provide better
multifocal technology, which their patients can wear for longer helps
them grow that side of the business.”
Alcon will be demonstrating this technology directly to practices
later this year in a series of roadshows around the country.
J&J new NZ recruit
Johnson & Johnson Vision’s professional affairs manager and
optometrist Dr Emma Gillies was manning the J&J Vision
stand to explain the benefits of Acuvue Oasys 1-Day, and
its unique
Hydraluxe
technology,
and
introduce
new recruit
Alisha
Walker.
A trained
dispensing
optician,
Walker was
formerly
employed
by Paterson
Burn
optometrists
in Auckland
before
joining J&J
Vision in
August last
year. A 20-
year veteran
in New
J&J’s Emma Gillies and Alisha Walker
Zealand’s
optometry
industry, she says she’s greatly enjoying her new role as a J&J
customer development manager in New Zealand, especially as
it allows her to travel around the country and share some of the
skills she’s learnt managing different practices.
“It’s more than just a sales role, it’s about business support.
I bring a lot of frontline understanding about the challenges
of growing and maintaining a practice’s success, which
involves everything from staff training and discussing the right
language to use for patients to helping optometrists identify
opportunities to maintain and improve their patient database.”
Dr Gillies says she’s also delighted to have Walker on board.
“Alisha brings a breadth of experience and level of enthusiasm
to the role which is refreshing and I just know she’s going to do
very well in the New Zealand industry.”
BHVI disproves CL
theory
Single vision contact
lenses with optical
designs that aim to
reduce inherent spherical
aberrations (SAs) of the
eye are not effective
in improving visual
performance, according to
a recent study¹ by the Brien
Holden Vision Institute
(BHVI).
The results of the study,
published in Clinical Optometry, show the assumption among
manufacturers that reducing the inherent SA of the eye will improve
vision is wrong, said study co-author, Dr Cathleen Fedtke, a senior
research fellow at BHVI, adding there are also no known published
studies to support this assumption.
To test the assumption, BHVI researchers randomly selected nonpresbyopic,
adult myopes, aged between 18 and 33 years, and asked
them to wear either a lens with minimal or no spherical aberration
or a commercial lens designed with negative SA.
Visual acuity measures and binocular vision assessments were
conducted and a questionnaire completed after the lenses were
fitted. Responses on vision quality (clarity and lack of ghosting for
distance, intermediate, near, and driving vision in day and nighttime),
vision stability, overall vision satisfaction and ocular comfort,
were rated. After five days of wear, the same tests were conducted
and the survey repeated.
“We found that the introduction of negative SA into contact
lenses did not produce appreciable visual performance gains in
terms of visual acuity or subjective metrics,” said Dr Fedtke. “This is
the first study to show that inducing negative SA, as done in many
commercial single vision contact lenses, does not improve visual
performance.”
Furthermore, the authors warned that power profiles of soft
contact lenses with negative SA “can induce measurable changes in
peripheral refraction (including relative peripheral hyperopia)”, and
“this could have a negative consequence on the myopia progression.”
Consequently, they suggest that, “given current clinical interest
in the peripheral retina in relation to myopia, clinicians should be
aware of the insignificant visual performance gains when fitting soft
contact lenses of this design on young and progressing myopes.” ▀
Reference
1. Kho D, Fedtke C, Tilia D, Diec J, Sha J, Thomas V, Bakaraju RC, Effects of relative
negative spherical aberration in single vision contact lens visual performance.
Clinical Optometry, 2018:10 9-17.
12 NEW ZEALAND OPTICS May 2018
9562 NZ Optics - Half Page Poster-OUTPUT.indd 1 17/4/18 9:26 am

THE CONTACT LENS
FAMILY UNBEATEN
ON COMFORT 1
Warning: UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not
completely cover the eye and surrounding area. You should continue to use UV-absorbing eyewear as directed.
Always read the label. Use only as directed.
1. JJVC data on file 2017. Claim for the family of ACUVUE OASYS® Brand Contact Lenses (2-week reusable) using clinical trials cited on www.clinicaltrials.gov website.
Johnson & Johnson Vision Care, a division of Johnson & Johnson Pacific Pty Ltd., 45 Jones Street, Ultimo NSW 2007, 1-800-736-912. www.acuvue.com.au
Johnson & Johnson Vision Care, a division of Johnson & Johnson ( New Zealand ) Ltd., 507 Mt. Wellington Highway, Mt. Wellington, Auckland. New Zealand ,
0800 466 173. www.acuvue.co.nz May CCP8908/18 2018 NEW ZEALAND TAPS OPTICS PP2166
13

Focus on
Eye Research
DSAEK, DMEK, epitheliumoff
crosslinking and
blepharitis treatments
EFFICACY AND SAFETY OF DMEK
VERSUS DSAEK: A SYSTEMATIC REVIEW
AND META-ANALYSIS
Saiqun Li, Liangping Liu, Wei Wang,
Ting Huang, Xingwu Zhong, Jin Yuan,
Lingyi Liang
PLoS One. 2017; 12(12): e0182275.
The surgical management of corneal
decompensation has traditionally
been with full thickness corneal
transplantation or penetrating
keratoplasty (PK) and more recently with
lamellar transplantation techniques
such as Descemet stripping automated
endothelial keratoplasty (DSAEK), in
which the Descemet’s membrane
endothelial complex is transplanted
with a sheet of stroma, and Descemet’s
membrane endothelial keratoplasty
(DMEK), in which the Descemet’s
membrane endothelial complex is
transplanted in isolation and attached
in a suture-free method through gas
tamponade.
In this meta-analysis, the authors
evaluated 19 published articles
comparing the outcomes of DSAEK and
DMEK. The overall pooled estimates
demonstrated a significantly superior
post-operative best corrected visual
acuity, a comparable endothelial
cell density, and an increased graft
detachment rate in the DMEK group
compared with the DSAEK group.
Comment: Endothelial keratoplasty is
now the gold standard procedure for
endothelial disease comprising 31%
of corneal transplants performed in
New Zealand in 2015. There is now
increasing evidence to suggest that
whilst technically more challenging,
DMEK surgery provides better visual
outcomes following surgery compared
to more traditional DSAEK surgery,
but further surgical refinements are
required to shorten the learning curve
and improve potential intra-operative
and post-operative complications. Results
of the currently running, multicentre,
randomised clinical trial comparing
DSAEK and DMEK are keenly awaited.
PATIENT SATISFACTION WITH
EPITHELIUM-OFF CORNEAL
CROSSLINKING
Price M, Feng M, Price F
J Cataract Refract Surg. 2018 Mar 28
Crosslinking is the creation of bonds that
connect one polymer chain to another.
Corneal collagen crosslinking (CXL) is a
technique used to strengthen corneal
tissue utilising riboflavin (vitamin B2)
as a photo-sensitizer and ultraviolet-A
(UVA) to increase the formation of intra
and inter-fibrillar carbonyl-based covalent
bonds through the process of photopolymerisation.
In this article, the authors evaluate the
satisfaction rate of 448 patients after
a mean period of 3.5 years following
epithelium-off CXL. The mean satisfaction
score was 8.8 ± 1.7 (SD) on a scale of
1 (would not recommend CXL) to 10
(definitely would recommend) among
those treated for keratoconus. The
authors also demonstrate that 93% of
patients felt that the treatment halted
the progression of the disease with
younger patients reporting a higher
efficacy rate. Regarding vision, 87%
reported an improvement or stability of
their vision following treatment. Only
1.7% of the 644 eyes treated required
keratoplasty.
Comment: Keratoconus is a debilitating
BY DR MO ZIAEI*
condition with a disproportionately
high-impact on public health resources
and vision specific quality of life. CXL
has revolutionised the management of
keratoconus in recent years by effectively
stabilising the underlying ectatic process
and in some cases reversing the disease
as quantified by key topographic,
refractive and visual outcomes. More
than a decade after being introduced,
this minimally invasive treatment
modality is now fulfilling the promise of
treating keratoectasia at an earlier stage,
preventing the morbidity associated with
disease progression and precluding the
need for the more invasive keratoplasty
procedure. This article demonstrates that
CXL is viewed by patients as effective in
halting the progression of their ectatic
disease and also stabilising or improving
their vision.
RANDOMIZED DOUBLE-MASKED TRIAL
OF EYELID CLEANSING TREATMENTS
FOR BLEPHARITIS
Sung J, Wang MTM, Lee SH, Cheung
IMY, Ismail S, Sherwin T, Craig JP
Ocul Surf. 2018 Jan;16(1):77-83.
Blepharitis is complex ocular disorder
characterised by an imbalance in ocular
flora, meibomian gland dysfunction
and eyelid/ocular surface inflammation.
Blepharitis is one of the most prevalent
ocular disorders encountered by eye
care professionals. In this randomised,
double-masked trial, the authors
compared the efficacy of two lid hygiene
techniques by asking patients to use a
commercial eyelid cleanser in one eye
and conventional lid hygiene technique
using diluted baby shampoo in the other.
The results showed that whilst both
treatments reduced the patient reported
SPEED symptom score and improved
lash crusting and trichiasis, the eyelid
cleanser was the preferred treatment
of choice for most patients (53% vs. 9%,
p < 0.001). The cleanser also resulted in
superior improvements in clinical features
such as tear lipid layer and ocular surface
inflammatory markers such as MMP-9
expression. In a concerning finding, the
authors reported that baby shampoo
treatment was associated with adverse
outcomes such as meibomian gland
capping and MUC5AC expression (a
marker of goblet cell density and function
within the conjunctiva).
Comment: Blepharitis is a common
ocular disorder that can lead to
significantly altered quality of life. All
eye care professionals are well aware
of the challenges associated with
satisfactorily treating patients with this
chronic disease. This article provides an
insight into the potential advantages
of using commercial cleansing products
over traditional methods of lid hygiene
and highlights the need for further
studies looking into the effects of
using household products such as baby
shampoo on the ocular surface.
ABOUT THE AUTHOR:
*Dr Mo Ziaei has undergone quadruple fellowship
training in the field of cornea, ocular surface
disorders and anterior segment surgery at
Moorfields Eye
Hospital, London, and
New Zealand National
Eye Centre, Auckland.
He is an honorary
senior lecturer at the
University of Auckland
and a cornea and sight
correction specialist at
Re: Vision clinic and
surgery centre (see
story p3).
Eye Doctors provide a warm
start to autumn
BY SUSANNE BRADLEY
The arrival of autumn heralds the Eye Doctor’s first
Grand Round of the year. Held at the Novotel in Ellerslie,
Auckland, this year’s inaugural seminar on 28 March was
a warm and welcoming affair with many local optometrists
attending keen to kick off their annual cpd hunt and hear the
latest surgical updates from Eye Doctors’ surgeons.
Wobbly eyes
Paediatric eye specialist, Dr Shuan Dai kicked-off proceedings
this year with a talk about childhood nystagmus or “wobbly
eyes”, a disorder distinguished by involuntary eye movement.
He presented examples of different types of wobbly eyes,
explaining how to reach the correct diagnosis, which is
important not only for treatment but because the disorder
can be a sign of something more sinister, like multiple
sclerosis or a brain tumour, requiring further investigation
such as neuroimaging.
When the condition is associated with photophobia or
vision loss, this can be caused by albinism, aniridia, retinal
dystrophies, Leber’s congenital amaurosis, optic atrophy/
hypoplasia, foveal hypoplasia and retinopathy of prematurity
(ROP). Occasionally, systemic conditions such as ataxia (acute
onset) and hydrocephalus can cause nystagmus.
Dr Dai told the audience if you suspect nystagmus in a
patient with normal ocular examination results, remember
“in medicine, nothing comes in isolation”, you need to
look for other symptoms and patterns, such as laterality
(monocular must exclude central nervous systems gliomas),
jerk/pendular, horizontal/vertical/mixed movements,
amplitude, frequency and other abnormalities such as head
nodding to direct you to the likely diagnosis and further
investigations.
After establishing the reason for the nystagmus and making
a full diagnosis, including any link to secondary central
nervous system diseases, managing the patient includes
offering treatment of amblyopia, low vision services and,
possibly, nystagmus surgery.
Ditch the lingo
Next up, Dr Andrew Riley took to the podium on a mission
to stop what he calls our “secret language”, or using medical
terminology when prescribing.
With 396 recognised abbreviations, it’s no wonder patients
and sometimes even pharmacists and doctors get it wrong
when eye health professionals discuss conditions using a series
of ophthalmic acronyms, argued Dr Riley. Worryingly, according
to some statistics presented, 20% of all medical negligence
treatment claims result from the incorrect use of a treatment
drug and that can result from simple miscommunication.
There are guidelines available on good prescribing practice
from the New Zealand Medical Council, said Dr Riley,
admitting sometimes he too was guilty of too much lingo,
but if you follow the guidelines and write in plain English,
using for example “every second day” rather than QOD (que
otra dia), this will help reduce errors. If the prescriber, the
patient and the pharmacist can read the script fewer errors
will occur.
Computer-derived scripts are also helping to solve the
miscommunication problem, he said, as well as better patient
knowledge through improved education, familiarity with
the therapeutic goal and the drug in question, plus ongoing
monitoring of side effects and adverse events.
In summary, you need to get the five rights, right: the right
patient, the right drug, the right time, the right dose and the
right route, he said, and if in doubt, ask!
Glaucoma drops and complications
After a short break, Dr Mark Donaldson shared three cases
illustrating how different glaucoma eye drop treatments can
cause unexpected and undesired complications.
One case involved a myopic, 70-year-old engineer who
presented with suspected cystoid macular oedema (CMO),
after post-operatively using a topical prostaglandin
analogue/beta-blocker combination.
The patient had been treated for epiretinal membrane
left eye vitrectomy in 2014. He had open angle glaucoma.
The concern was the patient’s intraocular pressure, said Dr
Donaldson, which was why beta-blockers were prescribed. But
the patient’s vision began deteriorating. Test results showed
that CMO, which is statistically associated with post-operative
Dr Andrew Riley, Lizette Jordaan, Vandana Kumar and Anna Maitland
Ilana Gutnik, Shelley Brannigan, Debra So and Richard Johnson
Dr Mark Donaldson, Isla Hills, Hue Bullen and Dr Shuan Dai
use of topical PGAs – relative risk (RR) 1.86, 95% CI 1.04 to 3.32
and topical beta-blockers (RR) 2.64, 95% CI 1.08 to 6.49.
The post-operative use of each bimatoprost (RR 2.73, 95%
CI 1.35 to 5.53%) and travoprost/travoprost/z (RR 3.16, 95%
CI 1.42 to 7.03) in the year prior to diagnosis had been shown
to have a statistically significantly association with the
prevalence of pseudophakic CMO. This association, however,
said Dr Donaldson, was not observed to be statistically
significant with the post-operative use of latanoprost (RR
1.55, 95% CI 0.84 to 2.88). Interestingly, however, his patient
responded to having the hysite (latanoprost) stopped.
Pterygium surgery
Pterygium surgery has come a long way in recent decades,
said the final presenter of the evening, Dr Penny McAllum,
with surgeons changing to techniques providing lower
recurrence rates, such as conjunctival autografting with a
2-18% rate of recurrence. This compares with the old-school,
five-minute scraping the sclera process which resulted in up
to a hefty 88% recurrence.
There is also a method called P.E.R.F.E.C.T, Dr McAllum
said, now considered the gold standard in some centres,
with reported recurrence rates of less than 0.1%. So far,
this procedure (pterygium extended removal followed by
extended conjunctival transplant) has been successfully
carried out in Australia and comparable results have been
shown in a recent European study.
To further reduce recurrence, Dr McAllum said she prefers
tissue glue to sutures. When used correctly, a meta-analysis
shows it reduces the recurrence rate by 47% due to less
postoperative inflammation, she explained.
The main problem with current surgery is the lack of
standardisation in and recording of the techniques used and
the resulting outcomes, she said, adding that there was a
healthy debate on the topic at the recent Australia and New
Zealand Cornea Society meeting (see NZ Optics’ April issue).
Some surgeons, who have developed a new surgery technique,
using a femtosecond laser to harvest the conjunctival graft, are
suggesting this will improve results by avoiding undertaking a
technically challenging part of the surgery manually. A point Dr
McAllum explained using the analogy, “if you’ve got a hammer,
everything will look like a nail”.
With proper training and standardising measured cosmetic
and medical outcomes, pterygium surgery results will
continue to improve, she said, ending the evening on a
resounding upbeat note.
The next Eye Doctors’ Grand Round will be held at Ormiston
Hospital on 13 June by invitation only, given space
constraints, while the final Grand Round for the year will be
held on 31 October. ▀
Linda Zhang, Trevor Skinner and Anh-Dao Le
14 NEW ZEALAND OPTICS May 2018

Ophthalmology wall of fame
BY ELLA EWENS
The annual Excellence in Ophthalmology and
Vision Research prize evening celebrates
talented personalities early in their
ophthalmic careers as well as remembering
ophthalmologists from yesteryear whose names
grace a number of the awards.
This year’s event was held at the medical and
health sciences campus at the University of
Auckland in March and was well attended by staff,
researchers, benefactors, students and the friends
and families of the award winners.
Professor Charles McGhee, head of the
ophthalmology department, opened the evening
by welcoming everyone and thanking benefactors
and clinical contributors, including Associate
Professor Bruce Hadden and Dr Wendy Hadden,
for their contribution to the department and to
furthering ophthalmology in New Zealand. He
updated the audience on the annual activities of
the department, detailing how with nearly 300
undergraduates and a growing number of PhDs, the
department continues to grow and evolve each year.
William MacKenzie Medal
This year, the William MacKenzie Medal was
presented to Himanshu Wadhwa by Professor
Trevor Sherwin.
This award is for early excellence in eye research
and recognises a significant contribution made by
a medical student towards a research project that
has reached publication status. Judges consider the
recipient’s contribution, originality and importance
of the article (as well as the standing of the journal
in which it is published).
Wadhwa, a previous recipient of the Tom Cat
Trust summer studentship award, undertook a
fascinating research project investigating how
corneal stem cell-enriched spheres implanted
into keratoconic tissue behave to assess their
therapeutic potential.
He presented his research at the Healthex
conference, a student-organised conference designed
to promote research activity and excellence among
postgraduate students, and the Royal Australia and
New Zealand College of Ophthalmologists (RANZCO)
conference last year, and was the top-ranked student
during his 2014 thesis year.
Arthur Thomas Paterson Scholarship
The Arthur Thomas Paterson Scholarship was
presented to junior research fellow Dr CheeFoong
Chong by Dr Shaun Dai.
This scholarship was set up to assist newly
qualified Kiwi ophthalmologists continue their postgraduate
studies overseas, so they can return with
new skills to serve the New Zealand population.
Dr Chong has published research on visual
impairment among New Zealand children and
produced one of the best databases of it’s type
in the world, explained Dr Dai. He has also
published several other publications in paediatric
ophthalmology while completing his medical
training.
Calvin Ring Prize
The Calvin Ring Prize was presented to fifth year
medical student, Lize Angelo by Dr Peter Ring,
son of Calvin Ring, one of the forefathers of
New Zealand ophthalmology whose own father
fortuitously won a horse race and was able to pay
for his son to attend medical school.
The Calvin Ring Prize recognises the best allround
undergraduate medical student in clinical
ophthalmology and was established to encourage
interest and awareness of ophthalmology among
medical students in memory of Dr Calvin Ring who
believed ophthalmology in Auckland needed an
academic focus. Selection for the award is based
on excellence in examination, clinical knowledge
and diagnostic and management skills.
Angelo, who was also a summer studentship
recipient in 2016, undertook her schooling in
England, New Zealand and South Africa and was
described by Ring as a ‘well-rounded student”,
involved in volunteer work at hospices and also
the charity, Habitat for Humanity.
On accepting the award, Angelo said she had
been inspired by the many passionate people she
has met in ophthalmology and hopes to continue
her endeavors and see where ophthalmology will
take her.
Gordon Sanderson Scholarship
Professor Helen Danesh-Meyer presented the
first Gordon Sanderson Scholarship to Hillary Goh
for her research investigating nailfold capillary
abnormalities in glaucoma (see full story in April’s
NZ Optics).
The scholarship was set up last year in memory
of the late and much-admired Associate Professor
Gordon Sanderson to further research into
Some of the evening’s award winners: Catherine Tian, Hilary Goh, Hannah Ng, Himanshu Wadhwa, Lize Angelo and Joyce Mathan.
glaucoma. It is available to students from Auckland,
Otago or Sydney Universities, recognizing A/Prof
Sanderson’s former teaching hubs.
PhD Presentation
The invited PhD presenter for this year’s Excellence
in Ophthalmology awards was Dr Akilesh Gokul
who took to the podium to discuss his research on
keratoconus.
Summarising three years of research in 10
minutes is no easy feat, but Gokul conquered
it well, describing how his ‘Aotearoa Research
into Keratoconus (ARK)’ project looked at the
demographics and clinical characteristics of
keratoconus in New Zealand.
The research surveyed Kiwi optometrists and
showed that a large number of keratoconics reside
in Auckland and Wellington with Maori and Pacific
island patients having the highest mean corneal K
readings and more severe disease. Corneal crosslinking
can stabilise the disease for at least 10
years by creating more covalent collagen bonds
and strengthening the cornea. Gokul’s research
evaluated an accelerated cross-linking methodology,
which he illustrated elegantly in his presentation.
While cross-linking can prevent disease progression
and reduce the corneal transplant rate, Gokul
explained “early detection is a major challenge in
keratoconus with many patients presenting too late
to benefit from the procedure.”
Summer Studentships
Dr Ilva Rupenthal, director of the Buchanan
Ocular Therapeutics Unit at Auckland University,
presented this year’s Summer Students with their
awards. The award recipients were:
• Spheres of Influence, Catherine Tian (Tom Cat
Trust)
• Influence of high glucose and inflammation on
barrier properties of retinal pigment epithelial
(ARPE) cells, Charisse Kuo
• Differentiation of transition zone stem cells into
corneal endothelial cells, Hannah Ng (Eye Institute)
• Comparison and review of visual field referrals to
ADHB glaucoma clinic, Catherine Kwak
• Crystallin protein modification and spatial
mapping in an aging lens model, Jerry Shen
• Evaluating the long-term usability of ex-vivo
bovine corneas for drug delivery applications,
Darshan Shrestha (Buchanan Charitable
Foundation)
• The effect of erythropoietin on the vasculature
of the premature sheep retina: a cellular and
molecular characterisation, Muthana Noori
• Nailfold capillary abnormalities in glaucoma,
Hilary Goh (Gordon Sanderson Scholarship from
Glaucoma New Zealand)
• Review of glaucoma referrals to ADHB glaucoma
clinic, Tess McCaffrey
• Confirmation of UV filter distribution in the
aging human lens, Arwa Ibrahim (Molecular
Dr Penny McAllum
FRANZCO
Professor Charles McGhee, Dr Raisha Altaie and Jina Han (photobombed by Dr Stuti Misra) Drs Shuan Dai and Peter Ring. Photo by Alec Lou Hin
Ophthalmology department benefactor and former staff member Joan
Ready with some award winners in the audience
Han Li, Joyce Wong and Jasmine Feng
Vision Laboratory)
• To give or not to give? Should I provide feedback
during acuity measurement, Maggie Xu
• Monitoring age-related changes of the vitreous
of the eye using MRI, Louisa Howse
• Evaluating the utility of an eyelid massage
device for the management of meibomian gland
dysfunction, Jasmine Feng (NZAO Education and
Research Fund)
• Effect of temperature on the thickness of the
human ocular choroid measured with optical
Eye Doctors Grand Rounds 2018
. Wed 13th June, Ormiston Hospital
(invitation only)
. Wed 31st October, Novotel, Ellerslie
Dr Shuan Dai
FRANZCO
. No registration fee
. CPD points available
. www.eyedoctors.co.nz
Dr Andrew Riley
FRANZCO
Dr Ilva Rupenthal (right) presenting Joyce Wong with her award.
Dr Akilesh Gokul presenting his PhD research
Dr Jie Zhang, Nigel Brookes and Ismail Salim
coherence tomography, Sungyeon Kim
• The effect of virtual reality on the tear film and
ocular surface, Joyce Wong
• Adaptation of jumping spider behaviour to a
modified focal environment, Aimee Aitken (Paul
Dunlop Memorial Research Scholarship, NZAO)
• Visual impairment in stroke in a New Zealand
context: patient characteristics in the CBR Stroke
Recovery Clinic, Carla Fasher ▀
For more, including pictures, please see April’s
NZ Optics.
ASCOT CLINIC (09) 520 9689 - BOTANY JUNCTION (09) 277 6787
Dr Mark Donaldson
FRANZCO
EYE 0810
MOST PHOTOS BY ALEC LOU HIN
May 2018
NEW ZEALAND OPTICS
15

Information packed Ocular Therapeutics Conference
BY ELLA EWENS
The Waipuna Hotel and Conference Centre
in Mount Wellington, Auckland on a March
summer’s day was the setting for the
third Ocular Therapeutics Conference, run by
the Buchanan Ocular Therapeutics Unit at the
University of Auckland.
Once again, this increasingly popular conference
boasted a mix of short, informative and exciting
talks from local and international specialists, as
well as an arena for optometric and pharmacy
colleagues to catch up and share their different,
but related worlds.
Meds: the good, the bad and the ugly
The morning’s lectures covered both oral and
topical medicines with Dr Jay Meyer kicking off
proceedings with a talk about oral medications for
ocular conditions. He warned his audience about
the potential risk of death from anaphylaxis with
many medications, however, oral antihistamines,
which work on H1 receptors, are quite safe and
available over the counter, he said.
He covered anti-virals for use in herpes simplex
and herpes zoster infections, noting that
valacyclovir, which has greater bioavailability
and a less frequent dosage, is not funded in New
Zealand, and touched on alternative treatments
to anti-virals, such as turmeric and lysine. Next,
he covered oral medications for meibomian
gland dysfunction (MGD). Azithromycin has
become popular with optometrists for its antiinflammatory
and antimicrobial effects, however
it is contraindicated in those with any significant
cardiac history or heart arrhythmia. Doxycycline
with its shorter half-life, can also be used and is
contraindicated in children and pregnancy.
Next, Dr Taras Papchenko tackled toxicity
of common medications in the eye. He took a
systemic approach, first looking at medications
effecting the anterior eye, the iris and pupil (eg.
tamulosin and venlafaxine), before moving to
the lens (steroids, chlorpromazine) and on to the
retina (cholorquine, tamoxifen) and the optic nerve
(amiodarone). His take home message was that all
structures in the eye require oxygen and nutrients,
provided by capillaries or tears, and so systemic
drugs can cause a wide range of ocular side effects.
A thorough history is required to identify all the
medications a patient is on, he said.
Professor Charles McGhee provided a synopsis
of avoiding and managing corneal transplants,
discussing the pathophysiology of graft rejection
and the drugs used such as steroids, cyclosporine
and mycophenolate. In general, you should just
“believe the patient if they say they are worried
about their graft” and see them as soon as possible
as a precaution, he said.
Dr Nicola Anstice, who had returned home from
her new role as the University of Canberra’s head
of discipline for its new five-year optometry course,
Kent Napier, Tim Eagle and Chris Edwards
SO MUCH MORE
THAN JUST A FAIR
presented data on the prescribing trends of New
Zealand optometrists.
Auckland was disproportionately represented
in prescribing with 11% of the population being
based in Auckland and 21% of the therapeutic
prescribing-authorised optometrists living there.
The Bay of Plenty was also over-represented
while Canterbury showed lower levels of
prescribing when compared with its population.
The most prescribed medications in New Zealand
were topical anti-invectives and anti-virals
followed by anti-allergy (olopatadine was a
favourite). Dry eye and anti-glaucoma medications
each made up 8% of the total, with anti-glaucoma
predicted to increase in the near future. Oral
medications currently make up only a small
proportion of those prescribed, she said.
The final talk of the session was given by
community pharmacist and Auckland University
lecturer and researcher Maree Jensen, who
discussed and explained the pharmacist’s role
and responsibilities in managing and triaging
eye conditions. “Pharmacists know their patients
well (especially frequent users) and we use our
interactions with them as a opportunity to make
a difference to their lives and refer them to the
appropriate person,” she said.
Pharmacists see a large number of patients
with conjunctivitis, dry eyes, tired eyes,
medications that cause dry eyes, sub-conjunctival
haemorrhages and styes, she added. “We have
a major part to play in the management of eye
disease. There is a huge disconnect between
pharmacists and optometrists even though there
is a huge amount of synchronicity of the role.”
Regarding the posterior segment
During the next session, Professor Colin
Green looked at oral treatments targeting the
inflammasome pathway for the treatment of
diabetic retinopathy and macular degeneration.
Xiflam is a small
molecule that blocks
the hemi-channel
opening that inhibits
the release of the
cell’s high-energy
molecule adenosine
triphosphare (ATP)
and in turn the
perpetuation of
inflammasomes and
cytokine release.
So far, this new oral
medication, which
addresses vascular
integrity, has proven
safety in 100 patients
and there are further
FROM SEPTEMBER 28 TH
TO OCTOBER 1 ST 2018
PARIS NORD VILLEPINTE
silmoparis.com
trials planned.
Next, Dr Narme
Deva explained
the use of topical
medications for
cystoid macular
oedema starting
with non-steroidal
anti-inflammatories,
which work
by inhibiting
cyclooxygenase
enzymes (COX 1
and 2). Diclofenac is
subsidised in New
Zealand and has some
side-effects such as
burning and punctate
epitheliopathy.
Diclofenac is
contraindicated
in pregnancy and
Shelley Brannigan and Leesa Stuart
those with NSAID-sensitive allergies. Steroids
are often used synergistically in this condition
and prednisolone acetate is the pick of the
bunch due to its ocular penetration. These drugs
work in many ways to reduce the inflammatory
response, decrease oedema, fibrin formation,
capillary dilation and proliferation. An increase in
intraocular pressure in response to steroids (in one
third of patients) is something to be mindful of,
she explained.
Associate Professor Andrea Vincent led an
interesting talk about new gene therapies
for conditions such as retinitis pigmentosa,
choiroidemia and Leber’s hereditary optic
neuropathy. There are many advances in gene
therapy on the horizon which aim to use
optokinetics to circumvent the gene defect,
however, they are expensive and limited to gene
specific eye disease, she said.
Next up, Dr Emma Sandford, an ophthalmologist
studying natural medicine, discussed nutrition
and supplements for posterior eye disease such
as diabetic retinopathy, epiretinal membrane
and even retinitis pigmentosa. Sandford urged
her audience not to see progression as a fait
accompli, explaining we can affect our patient’s
gene expression and disease progression. She gave
a historical perspective on age-related macular
degeneration (AMD) and discussed good (olive and
coconut) and bad (refined vegetable and seed) oils
and fats.
“A good diet is a traditional diet” said Dr
Sandford, giving examples from the traditional
Mediterranean diet rich in vegetables, fruits, nuts,
seeds and olive oil and the traditional Maori diet
featuring seaweed, fern shoots, kumara, taro,
berries and huhu grubs.
Dr David Squirrell provided a practical
presentation about ocular coherence tomography
(OCT) interpretation of macular disease, taking
us through a systematic set of questions to help
identify the type of macular disease. Firstly, what
is the clinical context? Where is the pathology (pre,
intra or sub-retinal)? Is there oedema or subretinal
fluid? How is the macula functioning (integrity of
the inner segment/outer segment layer)?
OCT, he said, can take a “minute to learn and
a lifetime to master.” It’s another weapon in our
arsenal of imaging techniques, such as fundus
autofluorescence, which can be used to accurately
identify retinal disease such as atrophy, oedema
and schisis, amongst many other conditions, he
said, using many examples to demonstrate both
OCT’s uses and shortfalls.
Anterior segment pearls
Dr David Squirrell, Fiona Bamforth, A/Prof Andrea Vincent and Dr Rasha Altaie
Professor Heather Sheardown from Canada (see p8)
presented on the surface modification of contact
lenses to improve their function and comfort. She
began by explaining the main reason for the lack of
Angela Garner, Nikki Hewitt and Raewyn Hart
adoption and continuation of contact lenses among
patients – discomfort. There are many patient and
lens factors that influence comfort, she said, but
one of the most important is improving surface
wettability, which can be achieved through surface
modification, internal wetting agents, migratory
polymers, packaging and/or lens care products.
Hyaluronic acid (HA) as an alternative wetting agent
was explored, including the use of HA as a method
to facilitate the release of drugs such as atropine
and dexamethasone.
Dr Rasha Altaie then discussed the hot topic of
myopia control in children, from the pathological
end-stage effects of high myopia to some of the
methodologies currently being researched, such
as orthokeratology and peripheral defocus contact
lenses and atropine.
Professor Dipika Patel treated us to a talk about
the problems of tackling the rising scourge of
acanthamoeba keratitis. She outlined her sevenyear
review of the presentation and outcomes with
58 eyes.
In this review, it was found that 96% of cases
involved contact lenses, the mean duration of
symptoms at presentation was 21 days and
in only 12% of cases was the initial diagnosis
acanthamoeba keratitis. Steroid treatment at
diagnosis was associated with a poor prognosis
and this occurred in 10% of cases.
Prof Patel used photos to discuss some of the
clinical signs such as the radial keratoneuritis,
stromal ring infiltrates and hypopyon.
Acanthamoeba keratitis requires aggressive
therapy with propamidine isethionate and either
polyhexamethylene biguanide or chlorhexidine,
she said. Poor yields from corneal scrapes and
the difficulty or delay of diagnosis are some of
the challenges faced in treating this devastating
corneal disease.
‘Challenging glaucoma cases’ was the title of Dr
Hussain Patel’s talk. His cases ranged from a severe
steroid-responder, with retinitis pigmentosa and
cystoid macular oedema, to a patient with glaucoma,
soaring high pressures and severe dry eye. He showed
that a creative and persistent approach is required in
handling these tricky patients.
Ending with dry eye
The post-coffee sessions addressed dry eye and
reviewed some of the latest results from the Tear
Film and Ocular Surface Society (TFOS) second
Dry Eye Workshop (DEWS II). Associate Professor
Jennifer Craig, who was vice-chair of DEWS II,
showed how the Workshop’s findings had redefined
and reclassified dry eye. If based on signs only, dry
eye could have a prevalence as high as 75%.
Risk factors can be classified into modifiable
(such as computer use, contact lens wear,
environment and medications) and un-modifiable
(age, female sex, Asian race and Sjogren’s
16 NEW ZEALAND OPTICS May 2018

Squint Club 2018
BY DR MALISA AMI*
Dr Andrew Collins and Alex Petty
Amanda Snedden and Kate Blackett
syndrome). A/Prof Craig detailed the vicious cycle
of factors that perpetuate dry eye and discussed
the classification flow charts, showing conditions
with symptoms and without signs and the
converse, which are not considered dry eye, and
explaining how these charts can aid practitioners
in their clinical management of dry eye.
Dr Stuti Misra looked at dry eye diagnostic
methods, suggesting that clinicians start with
triaging questions, before conducting risk factor
analysis, diagnostic tests (non-invasive tear
breakup time, osmolarity and staining) and finally
tests that grade aqueous deficiency or evaporative
dry eye subtypes. While Dr Trevor Gray looked at
iatrogenic dry eye in refractive surgery.
Though iatrogenic dry eye is increasingly
recognised, it is still underestimated, he said.
SMILE, LASIK and PRK are all techniques that
temporarily increase dry eye. Dr Gray provided
some tips for prophylaxis before laser vision
correction, including lubricants, azithromycin
and steroids, lid massage, and omega-3
supplementation. Treatment should not only
address lubrication but also denervation,
inflammation and other elements of this condition.
Senior lecturer and director of the Buchanan
Ocular Therapeutics Unit, Dr Ilva Rupenthal
discussed the science of ocular lubricants.
Lubricant eyedrops aim to replace some tear
components, reduce osmolarity and also
dilute inflammatory cytokines. Dr Rupenthal
demystified the vast array of ocular lubricants
available today, classifying water-based
lubricants, ointments and liposomal sprays and
outlining the technology of some of the latest
drops to hit the market.
Lastly, Dr Maria Markoulli presented a lecture
about future management and therapy of dry
eye. Markoulli explained the four-step treatment
algorithim which includes all the latest research
from TFOS DEWS II and extends in a step-wise
manner covering everything from education
and lid hygiene to punctual plugs and amniotic
membrane grafts.
Starting with methods for aqueous deficiency,
Markoulli then looked at the various warm
compress methods and treatments for blepharitis
and Demodex. She covered anti-inflammatory
interventions, manuka honey eye-drops and
surgical interventions. ”Dry eye treatment is
an art, but classification is essential in order to
develop a targeted treatment approach,” she said.
A final panel discussion was held and closing
remarks were said before delegates came
together for drinks and networking to discuss the
day’s learnings. ▀
Next year’s Ocular Therapeutics Conference will
again be held again at the Waipuna Hotel in
Auckland in March 2019.
This year’s meeting of the Australian and
New Zealand Strabismus Society (ANZSS),
better known as the Squint Club, was held
at the Sydney Eye Hospital, the oldest hospital in
Australia dating back to 1788. Set in the historic
sandstone Victorian building with ornate metal
balustrades and stained-glass windows, it was a
magnificent juxtaposition of the old and the new
with the vibrant and modern city of Sydney being a
few steps away.
This year’s event was well attended by 129
participants including ophthalmologists, registrars
and orthoptists from the Australasia region and
one delegate from China. International guest
speakers included: Dr Ramesh Kekunnaya, head
of paediatric ophthalmology, strabismus and
neuroophthalmology at LV Prasad Eye Institute
in Hyderabad, India, and a member of the
executive bureau of the World Society of Paediatric
Ophthalmology and Strabismus; and Daisy Godts,
chief orthoptist at the University of Antwerp in
Belgium and council member of the International
Orthoptic Association.
The 2018 meeting kicked off with a welcome
address by Dr Craig Donaldson, president of ANZSS,
followed by a series of complex strabismus case
presentations with an expert panel discussion
consisting of Dr Kekunnaya, Godts, Dr Donaldson
(Sydney), Associate Professor James Elder
(Melbourne) and Dr Wendy Marshman (Melbourne).
This session was filled with “what to do”, “what
not to do” and “what I should’ve done instead”,
carried out in convivial manner where even senior
ophthalmologists shared their learning pitfalls.
Dr Kekunnaya shared his experience in
performing strabismus surgery under topical
anaesthesia which is usually reserved for adult
squint cases. It can be performed successfully
with minimal discomfort, but patient selection
is key, he said. Patients who can comfortably
tolerate a cotton tip applicator soaked with topical
anaesthesia on their conjunctival limbus are
suitable candidates. Effective haemostasis can be
aided by vascular vasoconstriction with topical
brimonidine or phenylephrine at the beginning of
surgery. Topical anaesthesia surgery can be useful
in re-operation cases within 10 to 15 days of the
first surgery, for example in cases of a slipped
muscle, he added.
Motility examination of neurological patients
is one of the least understood and inadequately
performed ocular assessments for most
ophthalmology trainees. This was succinctly
covered in a practical and step-by-step manner by
Daisy Godts in her refreshing back-to-the-basics
lecture.
Dr Lionel Kowal from Melbourne presented, ‘MRI
in Strabismus’, interestingly highlighting the role
of radiological imaging of the extraocular muscles
and its pulley system in squint assessment and
surgical planning. It is particularly useful in cases
of superior oblique palsy, abduction deficits
and strabismus in high myopia to establish
the underlying pathophysiological cause of
each condition, which will help determine the
appropriate surgical strategy, he said. Most
importantly, is the interpretation of extraocular
muscle system imaging and the need to further
educate both ophthalmologists and radiologists
on what is normal versus abnormal and
whether the abnormal findings have any clinical
significance.
Age-related distance esotropia which may be
part of sagging eye syndrome is now a wellrecognized
diagnostic entity. Godts gave a
comprehensive lecture on its diagnosis and longterm
follow up where prismatic correction can be
an effective initial therapy. However, the angle
of deviation typically increases over time and
larger doses of standard bilateral medical rectus
recessions have been successful in Belgium.
The William Gillies Lecture was delivered by
Dr Kekunnaya in a two-part series on Duane
retraction syndrome (DRS), where he outlined
the esotropic and exotropic types. He shared his
review of an impressive 400+ patients with DRS
and the principles of DRS strabismus surgery
which is based on primary position of deviation,
degree of anomalous head posture (AHP), severity
of globe retraction and overshoots, degree of
limitation of ductions and forced duction testing
(FDT). Superior rectus transposition to the
lateral rectus (LR), with or without medial rectus
(MR) recession may be considered as an initial
procedure in esotropic DRS as it has the advantage
of improving abduction. However, there is a risk of
inducing vertical or torsional deviation. Exotropic
DRS is commonly associated with globe retraction
and overshoots, hence LR and MR recessions in the
affected eye with Y-splitting of LR are effective in
Drs Malisa Ami and Stuart Carroll with Tammy Miller, Dr CheeFoong Chong, Nia Stonex, Noirin Kelly, Drs Justin Mora, Shuan Dai and Sigal Zmudjak
addressing these issues.
The unique ‘live cases’ presentation
was undeniably the crowd puller for
this meeting where patients were
examined by senior strabismologists
including Professor Glen Gole (Brisbane)
and Drs Lionel Kowal (Melbourne),
Shuan Dai (Auckland), Ross Fitzsimons
(Sydney), Kekunnaya and Daisy Godts,
and video projected for the audience.
Six highly-puzzling strabismus patients,
including one who had travelled from
Auckland, with either a diagnostic
dilemma or challenging surgical
management or both, were presented.
A fruitful discussion between the
experts and members of the audience
helped formulate the best management strategies
for these patients, be it active or inactive.
The social aspect of the meeting was not left
unattended with the conference dinner being held
at the iconic Sydney Tower, standing 1014 feet above
the central business district and offering spectacular
views of Sydney and its harbour. Participants enjoyed
a delectable meal in a most amiable atmosphere
with old and new acquaintances.
Overall, this year’s Squint Club meeting has
Keynote speaker Dr Ramesh Kekunnaya (middle) with Drs Malisa Ami and Sigal Zmudjak
maintained its reputation as a highly educational,
engaging and congenial affair, and much credit goes
to the organising committee, volunteer patients and
ANZSS members. I hope the tradition continues and
wish the Squint Club more prosperous meetings
in the future under the new presidency of our own
Auckland-based expert, Dr Shuan Dai. ▀
*Dr Malisa Ami is currently on one-year study leave from
the National University of Malaysia as a fellow in paediatric
ophthalmology at the University of Auckland.
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NEW ZEALAND OPTICS
17

for optometrists and eye care professionals
with
Professors Charles
McGhee & Dipika Patel
Series Editors
Post-cataract endophthalmitis
BY ASSOCIATE PROFESSOR
PHILIP POLKINGHORNE*
A
great deal has been learnt in the last 10
years about the prevention of cataract
endophthalmitis, making it a relatively
uncommon complication in New Zealand. While
it is difficult to isolate all the factors that account
for this change in frequency, there are interesting
parallels with other types of surgery, including
reduced morbidity associated with small incisions,
reduction in surgical times, use of gloves, masks
and disposable and adhesive drapes.
In addition to these soft changes there have
been other well-documented changes in
practice. For example, a recent report conducted
by the University of Auckland showed the usage
of intracameral antibiotics as prophylaxis had
increased from 24% in 2007 to approximately
50% by 2016. This change in pattern was no
doubt based on the multiple studies performed
in the US and Europe which showed a decrease
in endophthalmitis when intracameral
antibiotics were administered. Other common
prophylactic measures used in New Zealand
include the use of aqueous betadine iodine as
a surgical wash, attention to pre-existing risk
factors such as blepharitis and diabetes and, in
many cases, topical antibiotics for the first postoperative
week. Chlorhexidine is substituted for
patients allergic to iodine and many facilities
use sub-conjunctival vancomycin if the patient is
allergic to cephalosporins, the preferred class of
antibiotics for intracameral use.
In spite of the best attempts to prevent postcataract
endophthalmitis, however, infection can
still occur.
Some years ago, we analysed the common
symptoms and signs of endophthalmitis and
some previously thought reliable symptoms
such as ocular pain were not universal. Equally
hypopyon was not always present. In short,
the diagnosis is often difficult and the clinical
features vary enormously. The continuum
includes eyes that have undergone apparently
uneventful cataract surgery with a normal
post-operative course, yet proven to be culture
positive when the aqueous is sampled, and eyes
that appear to have “more inflammation” than
normal, yet still settle with standard topical
treatment protocols to those eyes that are
diagnosed as having endophthalmitis. Plus there
is the exceptionally rare case, usually neglected,
that progresses to panophthalmitis.
This test could
save your sight
0800 622 852
mdnz.org.nz
18 NEW ZEALAND OPTICS May 2018
Fig 1. A patient with panophthalmitis following cataract surgery. A delay in treatment of this patient’s
endophthalmitis led to dehiscence of the cataract section, partial extrusion of the intra-ocular lens and
ultimately removal of the eye
For nearly 25 years, the treatment of postcataract
endophthalmitis has been relatively
well accepted. A randomised study called the
Endophthalmitis Vitrectomy Study, published
in 1995, showed for eyes presenting with a
clinical diagnosis
of endophthalmitis
following recent
cataract surgery,
and providing the
presenting acuity
was better than PLO
(perception of light
only) then there was no
difference in outcome
for eyes undergoing
tap and inject as
opposed to vitrectomy.
Conversely, certain
subsets such as diabetic
patients did fare
better with vitrectomy
surgery. Another
significant outcome
of that study was the
finding that intravenous
administration
of antibiotics was not
helpful in either of the
two treatment groups.
Tap and inject,
involves (as the name
suggests) inserting
a needle, connected
to a syringe into
the eye followed
by aspiration of a
vitreous sample, which
is then sent to the
microbiology laboratory
for examination.
Antibiotics are then injected into the vitreous
cavity, selected to treat empirically both
gram-positive and gram-negative bacteria.
This technique has not changed in 25 years
and neither has the outcome; meaning
approximately 15% of patients will have acuities
less than 6/60, and 5% will have no perception
of light. Conversely vitrectomy surgery has
advanced greatly over the last 25 years with
both the speed and efficiency of the cutter
having been improved greatly and the size of
the vitrector becoming significantly smaller.
Typically, 25 gauge instruments are used,
equating to less than 0.5mm. Furthermore, the
viewing systems have greatly improved. So,
the tide of technology has created a trend to
perform vitrectomy on all eyes with presumed
endophthalmitis following cataract surgery.
The hurdle to perform such surgery has also
lessened, as the surgery is less invasive. The
surgery is usually performed under local
anaesthesia; there are more centres in New
Zealand that undertake VR surgery and
importantly greater access to oncall VR surgeons.
Anecdotally, our experience suggests vitreous
biopsies are more likely to be culture positive than
those cases where the vitreous has been aspirated
into a syringe. That, potentially, is an important
consideration when antibiotic resistance appears
to be increasing. There is also the suggestion that
there is a decreased need to perform additional
surgeries with a primary vitrectomy as opposed to
the traditional tap and inject. Our local experience
also indicates that the functional improvement
is better with vitrectomy surgery and that may
be related to better clearance of contaminated
vitreous with removal of the toxic soup in the eye.
We have also found eyes that have undergone
vitrectomy have faster rates of recovery and
become culture negative more quickly.
Twenty-five years ago those differentials
Fig 2. Post-cataract endophthalmitis. This diabetic patient had complicated cataract surgery and presented three
days after surgery with a painful eye. The cornea is oedematous and a hypoyon is present
Fig 3a and 3b. The presence of fibrin and a hypoyon often makes the view of the posterior segment difficult. Fig 3a demonstrates this difficulty and fig 3b illustrates the utility of removing this material
didn’t exist, but if the current trend and shift
to vitrectomy is substantiated with better
outcomes then we can be more optimistic about
the future when managing eyes with postcataract
endophthalmitis.
There are still multiple questions unanswered
about endophthalmitis and some of the most
puzzling include, why is the anterior chamber
culture often negative relative to the vitreous
culture? Is that due to bacteria in the anterior
chamber existing in planktonic form whereas
in the vitreous, the bacteria form biofilms? Why
do some patients with bacteria in the anterior
chamber at the end of cataract surgery not
progress to a clinical infection? Is there as yet
an unidentified systemic factor that facilitates
the conversion to endophthalmitis? Does that
risk factor translate into increased mortality for
patients undergoing cataract surgery?
Hopefully some of these questions and
improvements in therapy will lead to a
continuing improvement in management
for patients undergoing cataract surgery
and a lessening in the risk of post-cataract
endophthalmitis. ▀
About the author
*Associate Professor
Philip Polkinghorne
specialises in retinal,
vitreo-retinal and
cataract surgery. He has
subspecialty training
in both medical and
surgical retina and is
active in clinical and
basic science research.
He has published over
70 papers in peer
reviewed journals, edits
ophthalmology journals
and contributes as a
reviewer to a number of
international journals.

Change of guard at VOSO
Long-serving Volunteer
Ophthalmic Services Overseas
(VOSO) board member,
optometrist Michael Brown is retiring
from the board, while Drs Jesse Gale
and Hussain Patel have cemented
their commitment to helping those
less able in the Pacific by becoming
trustees.
VOSO chair Dr Andrew Riley
welcomed Drs Gale and Patel and paid
tribute to Brown’s three decades of
service. It has been a pleasure having
him on the team, he said. “Michael
has been an incredibly hard-working
trustee who led many VOSO teams to
Labasa in Fiji. He also worked closely
with the Lions Club in Labasa and
Rangiora, helping with fundraising
and logistics. Michael will be missed
by the team, both here and in Labasa.”
Drs Gale and Patel both formed part
of the VOSO trip teams in 2017. Dr
Gale is a consultant ophthalmologist
at Wellington Hospital and Kenepuru Community
Hospital and a senior clinical lecturer at the
University of Otago. Dr Patel is a glaucoma and
cataract surgery specialist who practises at
Greenlane Clinical Centre and in private practice in
Auckland.
Kylie Dreaver, VOSO secretary, says while they
will all miss Brown, everyone on the team is very
excited to have two new ophthalmologists joining
their ranks.
Michael Brown reflects
Michael Brown is not just stepping down from
VOSO but from his practice, Rangiora Eyecare, after
being a working optometrist for more than 40
years.
He’s sold his share in Rangiora Eyecare, a fourperson
partnership with three optometrists and
one dispenser, to Kimberley Shea, who joined the
clinic three years ago after graduating.
Brown says he has loved being an optometrist,
especially the relational aspect of the job:
relationships with patients, often spanning over
several generations, and with staff. “If I was to
give any word of advice to the next generation of
optometrists it would be that relationships are key.
If you’re emphatic and listen to your patients, as
well as being focused on solutions for their needs,
they will know you care and come back.”
Drs Jesse Gale and Hussain Patel in Labasa for VOSO last year
For more
personalised
eye care, talk to
Eye Surgery
Associates
SERVICES INCLUDE:
• Cataract surgery specialists
• Glaucoma
• Medical & Surgical Retina
• Acute & General Ophthalmology
Clinics on the North Shore,
Central and South Auckland
Phone 0800 750 750 or Fax 09 282 4148
info@eyesurgeryassociates.co.nz
BY SUSANNE BRADLEY
www.eyesurgeryassociates.co.nz
Michael Brown helping a patient in Fiji on his last trip with VOSO
Eye Surgery Associates are a Southern Cross Health Society Affiliated Provider
Brown developed an interest in eye health
early in his life after his mother had a retinal
detachment and later became blind in one eye.
So, when it was time to decide on a career path,
optometry stood out. Plus the prospect of being
your own boss was a key driver, he says.
When asked about the highlight of his career,
without hesitation, Brown says when the scope of
practice changed for optometrists in New Zealand,
giving them greater freedom to discuss and comanage
eye health care and prescribe ophthalmic
medications for their patients.
“When I was a graduate, we had to ring a GP
if we wanted to put dilating drops in a patient’s
eyes and we weren’t allowed to say the word
“cataract” to a patient because of the fear factor
associated with it.” This was all very challenging,
he recalls, adding it is deeply satisfactory to see
how the relationship between optometry and
ophthalmology has improved.
Looking to the future, Brown says he’s going
to enjoy spending more time in the garden,
cultivating his hobby developing plant breeds,
especially roses and daffodils.
As to a leaving party, he hasn’t had an official
send-off yet, but rumour has it that this may
coincide with the 40th anniversary celebration of
Rangiora Eyecare on 1 August later this year. ▀
Dr Hussain Patel
Ophthalmologist
MBChB, MD, FRANZCO
Dr Monika Pradhan
Ophthalmologist
MS, DOMS, FCPS, MRCOphth
Focus on Business
sponsored by
Independent spirit, collective strength
Privacy FOCUS ON in the BUSINESS wake of
How the Facebook to become scandal a better
independent
they protect patient privacy?
Should practice managers and owners rethink how
BY BY JENNIFER JANE SMITH* DANN*
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data. That person should be familiar with the
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iusam eiur, officaeratus peruntium et eates
cumenem and-codes/privacy-principles/collection-of-
information-from-subject-principle-three/
volupti sit, ne la quosam soluptate
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Sub unauthorised headingaccess to or disclosure of, personal
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eationem. your patients. Ehendit, illuptae porehendit, nihitat
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del erunto etur? Sum aciet etur, inulpa deles
Me
doluptas volo blabore optam, sundit optaers
peritati commoloribea volorenis debistia cum,
que si cor rehenih illam, tem harcimagnis erum
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vulnerable. con pa voluptatur? So does this Moditatis mean niasi small consequam,
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systems acium facitae or enlist sequas the services explabo of rrovidu an independent citaquibus,
data corpore specialist? nullaccabo. Norris Eveleni says that’s ssimus, unnecessary esenis ea
for corum SMEs. que “You excea can quam still run faccatiam your business eumquo on
a que laptop. asitium As long experfero as your ma system adias is magnam password non
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Emails and text messages also come under
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enrolment si inum dolorpo form has rrovidit a box dolorisci they can derest tick if et they’d
like pratioratur? to receive further information and updates
about Us inis your aut business. quam autatio You also et a need consecabora to provide nest, a
clear imus and dolorem easy way facepta for people sincid quodi to unsubscribe temquunte or
stop nobis receiving modi omnis them. milla https://www.dia.govt.nz/
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New-Zealand#FactSheet
Cumquia
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ommoles
being privacy
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volupta
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quatquatiis
means
more
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tiissunt estrum
Business
dunt
owners
should
voluptatur?
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database.
Sub heading
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effective Optae essedita than selling dit ipsam to a new enihiciet client. ab Keep in pernatq
people uistemquia in touch dolo with dentecta your business, voluptas new ilit, suntiis ideas,
products mossust and eicia services. ipitate consectur Let them feel sam part ut hilit of your fuga.
business. Adit imint, That’s te doluptiur? how businesses Iciunt am grow.” eum nonsecus
autem A common in remposam, method that omnis small qui businesses
solorempero et,
use iditi to ulluptio find new earum customers ut ulpa is nis by dolore going to nobita a list
broker sum liquam, for a list ommoluptatur of potential customers audam fuga. who Os ant
can liquo be magnim contacted earchil with lupitatur? promotional Qui material nonsed by ex et
addressed volore nones mail de or sus phone. volorecab ipsum ea voloren
imillores Norris says porum it’s important ne nullestis to volorro have a qui written dolupit,
contract pos repudanda with the list dus broker sunti which quis archillenti clearly states
that tem the eni aditior people mod on the magnatis list consented as assinctenest to receiving
marketing quat fugiae information. cuptas restibuscit, “Unwanted utaturit contact accum will
mean hilignisquam any goodwill fugitae you nihilitatam might’ve had aritatq with that
potential uatquae. customer Ipsum necum is entirely aceperr lost,” uptaspietus he says. vent.
Um facimusam la doluptatum About the quae. author: Erspe
sandae ex estiores pa Jennifer dollitiuste Dann pro is a quaturiat freelance
ellaut alit et dolore ni writer doluptatiur? for the NZ Osamus Herald and
arciant. Um facimusam various la doluptatum publications. quae. She has
Erspe sandae ex estiores 20 years’ pa dollitiuste experience pro as an
award-winning journalist for
quaturiat ellaut alit et the dolore likes of ni Radio doluptatiur? New Zealand
Osamus arciant.earit volecus. and the Sunday Star Times.
About the Author
Ga. Ad es dolo corem ea
dolo etur re omnihilique
pa voloreptat. Caes que se
nihiliquodi bea sequatur?
Atio. Lorrovidia peliquamus
utenderat enimpore
exerorepuda parum re id
quidi distr? Atio. Lorrovidia
THE INDEPENDENT OPTOMETRY GROUP, PROVIDING THE ADVICE
AND SERVICE INDEPENDENTS NEED TO THRIVE.
To find out more contact Neil Human on 0210 292 8683
or neil.human@iogroup.co.nz
peliquamus utenderat
enimpore exerorepuda
parum re id quidi dist
May 2018 NEW ZEALAND OPTICS
THE INDEPENDENT OPTOMETRY GROUP, PROVIDING THE ADVICE
The AND Independent SERVICE Optometry INDEPENDENTS Group, NEED providing TO THRIVE. the advice
19

Fashion update
Style-Eyes
Embarrassed to enticing:
a personal glasses journey
La Matta
La Matta’s new capsule collection is sophisticated
and striking with gems, stones and bracelet-styled
details. The LM3230 model has three small round stones
on a metal base, giving a fabric effect. The LM3228’s
decoration recalls the mesh of a watch strap and, thanks
to its strong chromatic contrasts, creates a highly striking
visual effect. Distributed by BTP International Designz.
BY COURTNEY ELDER*
It seems that most adolescents go through
their own “ugly duckling” phase, and while
it might be an awkward growth spurt, a
difficult to deal with complexion, or something
else altogether, it happens to all of us. For me,
being a school nerd with frizzy hair and braces
wasn’t enough when I was in middle school, the
universe had to bestow upon me the unwanted
gift of glasses.
Around age 12, I started having a hard time
seeing the chalkboard from the back of the
classroom and, like any good parents would,
mine took me to the local optometrist for a
vision test. Low and behold, I needed specs to
address my nearsightedness. While I didn’t have
to wear them all of the time, the classroom was
one of the places where I’d be donning them the
most.
That ‘90s fashion!
Just to set the record straight, I’m 33, so when I
got my first set of glasses at age 12 it was 1996,
when optical fashion was quite different than
today’s far more engaging trends. Nowhere
to be found were cute and bold styles like the
collection I own today, instead, round metals
dominated the landscape.
My husband probably remembers this pair
well, as I opted to re-lens it time and time again
despite being in the industry and knowing that
frames only hold up for so long. A rectangular
black style with thicker temples (the epitome of
cool in 2007), I finally felt like I could accept the
fact I was a glasses wearer.
Subsequent pairs of glasses after these
don’t even come to mind, so I’m sure they
were nothing special. It was only around 2012
that I finally heard the message I’d obviously
been waiting to hear. A frame sales rep visited
the office I was working in and showed me a
plethora of really cute frames, telling me to just
“go for it.” I instantly noticed a bright purple
frame in an oversized shape and knew I had
to have it. This frame by Kensie became my
“signature look” for years to come.
Xavier Garcia
Xavier Garcia’s new sunglass collection takes us
back to the ‘60s with retro elegance. The collection
is characterised by its original shapes, reinterpreting
vintage design with a modern touch. They stand out
for their amazing colour combinations, which match
the lenses. For this collection, all models have antiglare
coating at the back to avoid any discomfort
caused by sunlight. All lenses are adjustable and are
subtly layered and mirrored. Distributed by Cardinal
Eyewear.
Kaos
The new, bold and colourful Kaos collection in
metal and acetates moulded into boxy or round
shapes results in young, easy-to-wear frames. The
key bridge model featured here is characterised
by a combination of different acetates along the
frame front and/or the temples and by a twotone
airbrushed effect decoration at the hinges.
Distributed by BTP International Designz.
Going for gold with Carter Bond
Australian swimmer Mack Horton, winner of the
Commonwealth Games men’s 400m freestyle, proudly
received his gold medal, standing tall and sporting
Carter Bond specs, made by the Australian-based team
at Jono Hennessy Group. Horton’s double bridge model
features wood-look highlights on the end pieces and
temples. Distributed by Phoenix Eyewear.
My current glasses are all modern and fun
I recall so vividly asking my mother if there
were other options available, as I didn’t feel
comfortable in any of the choices in front of me.
A few weeks later we returned for me to pick
up my very first pair of glasses: you guessed it,
round metal with a slight tortoise-shell print.
Although I was a straight-A student, I opted
to go without my glasses as often as possible.
When I needed to see the board, I’d wear them,
but the moment the bell rang and class was
over, I took them off in a heartbeat. After all, a
12-year-old girl doesn’t need any more reason to
feel embarrassed in front of her peers.
Onward and upward
The funny thing is that my relationship with
glasses didn’t change until much later in life,
even when fashion trends changed for the
better. The first acetate frame I ever purchased
was a cute purple little number by CoverGirl that
actually got me to wear them full time, but I
wasn’t in love. As the mid-2000s approached and
frames got smaller and smaller, only then did I
find comfort in the ability to wear my glasses
and feel slightly stylish.
Finally, happy in my purple peepers!
How can we make the difference?
At the end of the day, my journey isn’t unlike
many others that millennials have faced when
it comes to eyewear. We didn’t have amazing
choices way back when, and it somehow
has jaded our perception of what wearing
glasses means. Once we see ourselves looking
unattractive in spectacles, we can’t ever seem to
believe anything different.
Thankfully, awesome frame styles now abound
that can help make the sales process not just
easier, but fun too. But it takes a talented
individual to get through to the more difficult
patients.
Try asking them about their experience with
glasses and find out why they’re opposed to
certain styles. Develop trust and a rapport with
them before opening them up to the idea that
a super funky colour or unique shape might,
actually, really look great on them.
It’s a process to get to a place where you love
your glasses like I do, especially considering how
my journey started. If I hadn’t taken up a career
in optics, I might never have gotten to where I
am now.
When working with patients who are
hesitant to try a new style or who simply “hate
themselves in glasses,” remember what it was
like for me at age 12. It’s really about making
your patient feel comfortable in their own skin
and selecting a set of frames that accents their
true style. Tap into the compassion needed to
get through to your patient, so you can make a
difference and, believe me, when you get it right,
you really do make an incredible difference to
someone’s life!
*Courtney Elder has
more than 10 years
of optical experience
and loves wearing
fashionable eyewear in
Portland, OR, USA. Today
she owns a content
creation company with
her husband. Visit www.
author-eyes.com for
more info.
Stars and their eyes…
Paris Jackson
Ever wondered why Paris Jackson, daughter of Michael
Jackson, has eyes that are so strikingly blue? According
to an interview in Teen Vogue with Jo Baker, a Jackson
makeup artist, the colour is due to a “rare eye condition”.
Although Baker doesn’t name the condition in the
interview, she said it wasn’t impacting Jackson’s eyesight,
fuelling media speculation that Paris has Waardenburg
syndrome (WS), a rare genetic condition affecting one in
40,000 people. WS can cause hearing loss and changes in
pigmentation of the hair, skin and eyes. It is associated with
the underdevelopment of tissue fibres in the eye that make
up the iris, causing the striking blue colour. Jackson has
neither confirmed nor denied the WS claims, though she
has repeatedly defended her status as Michael Jackson’s
biological daughter.
My blurry baby face and favorite frames circa 2007
20 NEW ZEALAND OPTICS May 2018

DokoMotto’s difference
comes to NZ
After being wowed at Mido, Beni Vision is
shaking things up with the introduction
of it’s new capsule collection of genuinely
different frames handcrafted by DokoMotto of
France.
“We have a limited collection of 12 pieces in
stunning acetates restricted to only 500 pieces
worldwide,” said Dennis van der Maas, director of
Beni Vision, which specialises in importing exclusive
European eyewear. “These are truly unique frames
and are all individually numbered and produced by
the artist craftsman Florent Grellet.”
Grellet honed his design skills in the Jura, an area
in east France named after the Jura Mountains,
famed for being the birthplace and home to many of
France’s top eyewear design houses. He established
DokoMotto
in 2011 to
allow him
to produce
his own
uniquelyshaped
glasses in audacious colours or, as he
describes them, “rare pieces that give style to the
ones who are wearing them.”
A limited collection of DokoMotto frames are now
available in New Zealand through Beni Vision. ▀
The flying optometrist
The Brien Holden Vision Institute (BHVI)
and the National Library of Australia
have published a new book, The Flying
Optometrist, to help introduce good eye health
practices to young children and celebrate the work
of eye health practitioners, especially those who
work in remote regions in Australia.
The book has been written by author Joanne
Anderton and is based on the adventures of her
dad, flying optometrist Dr Phil Anderton.
‘I really liked hearing Dad’s stories when he came
back from these outback visits,’ Joanne said in an
interview with Optometry Australia. “Also, I was
one of the first to get glasses at school and it was
hard being a bit different so I wanted to help kids
understand how it is normal and wonderful, and
an adventure to wear glasses.”
Professor Brian Layland, BHVI chair, said The
Flying Optometrist is an important educational
tool that will help raise awareness about vision
problems, in particular myopia. “This book will
help reach children, parents and teachers living in
remote areas of Australia and educate them about
eye health issues such as myopia. It also highlights
the important role that optometrists can play in
safeguarding children’s health and enabling better
future life outcomes simply through having better
vision.”
The story is about Stephanie, a little girl who
lives in a remote part of Australia on a large
farm, near a very small town, which relies on the
healthcare provided by Australia’s flying doctor
and optometry services. Stephanie has broken her
only pair of glasses and can’t see well, so she can’t
play cricket or play with her friends. She’s one of
several people in the town who really need to see
Phil and Joanne Anderton
the optometrist, but the weather is closing in. Will
Dr Phil’s little red plane make it through? Other
characters featured in the book are inspired by
real life Wanaaring residents, including pub owner
Narelle, stockman Reg, plumber Bill and Aboriginal
elder Auntie Pat, all of whom have their own eye
issues to deal with.
The book highlights the isolation of Australian
outback towns and includes informative sections
at the end on the Visiting Optometrists Scheme,
the BHVI and its Aboriginal Eye Care Programme
and the Royal Flying Doctor Service.
It is illustrated by Karen Erasmus who based
her pictures on Phil’s own photos. The Flying
Optometrist can be purchased from book stores or
online at Booktopia.
New locum biz for NZ
Optom Locum Service, formerly known as the
Phillip Fent Locum Service, is expanding its
services from Australia into New Zealand.
Optometrist Philip Fent established the company
back in 2002, after he had trouble getting
optometrist cover for his Warringah Mall practice
in Sydney. Since then the company has grown from
a one-man band to employing five staff covering
Australia and, now, New Zealand.
Although Optom Locum Service has often placed
New Zealand optometrists in roles in Australia,
Fent says his operations in New Zealand hadn’t
been formalised until now. He is hoping to attract
both New Zealand optometrists to locum in
Australia and Australian optometrists to locum
in New Zealand, allowing both to travel and work
either in New Zealand or Australia.
Many locums on both sides of the Tasman enjoy
the freedom locuming brings as well as offering a
great opportunity to travel and meet all types of
Vision Expo East
people, both optometrists and patients,
he says, adding that, best of all,
it’s really easy. “Travel and
accommodation is organised
on your behalf and
paid for. All you need
to do is fly in and
fly out.”
For optometrists
looking to work
in Australia,
you will
need to
register
Phillip and Sally Fent of Optom Locum Service
with the
Australian
Health Practitioner Regulation Agency (AHPRA). ▀
For more information and how to register, see ad
on p20.
Vision Expo East at
Kiwi frame distributors
the Javits Centre
Trish Orr and Caron Bowe
New York in March,
from BTP International
wrapped up its 32nd show
Designz, who count De
reporting it once again
Rigo as one of their brand
had earned a ‘top show’
partners, attended the
plaudit from the Trade
fair. “Expo New York
Show News Network
was fantastic for us. We
(TSNN). With a total of
have developed some
715 exhibitors, including
new business partners
190 new to the show, and
alongside our current
more than over 16,000
ones, Ogi, Seraphin and
visitors, organisers said it
Bon Vivant, which all
was a hugely successful
had a very busy show as
and busy four days. For
always. The fair had a great
the first time at Vision
atmosphere and the Irish
Expo East, attendees
band playing music for St
voted for their favourite
Patrick’s Day added to the
exhibitors in two
ambiance in the halls.”
BTP’s Caron Bowe (right) selecting Safarro frames
categories.
As to what stood out as
The winner in the category of ‘Most Creative the latest trend at the fair, team BTP picked pastel
Booth Design’ was De Rigo.
tones and metallic gold and silver as top of the list. ▀
New appointments
Optique Line NZ new account manager
Vicki Evans has joined
Optique Line as their New
Zealand national account
manager, replacing Bob
Graham who is retiring
after 38 loyal years in the
optical industry.
John Nicola, Optique
Line director welcomed
Evans to the team,
“Although we are sad to
see our much-admired
Bob Graham retire, we are
excited to see the new energy Vicki brings to the
team. Coming from an optical retail background,
Vicki understands the New Zealand market and
the challenges practices face day-to-day. Also, she
comes with the knowledge and experience of the
Optique Line brands, which is a big bonus for us.”
Before joining Optique Line, Evans was an
optical assistant with Visique Rotorua where she
gained first-hand experience working with the
Optique Line brands. “The Optique Line range is
my favourite, I particularly like the Convertibles
which to me stand out as a really good, quality
solution. I also know from experience that Optique
Line’s customer service is great which allows me to
confidently promote the brands to our customers.”
Evans kicks-off with training in Melbourne in
April, after which she hits the road straight away.
She’s most looking forward to meeting all the
new clients, she says, and taking on the territory
responsibility for Optique Line New Zealand.
BP Software strengthens NZ leadership
Software developer Greg Wood is joining Best
Practice Software’s management team based in
Hamilton. Wood will oversee delivery operations
in New Zealand and will be a member of the
company’s global management team.
Craig Hodges, BP Software’s chief operating
officer, says he is delighted to welcome Wood to
the team. “Greg has extensive experience as a
senior technical advisor in the public and private
sectors in New Zealand.
He is also a certified
scrum master and is very
familiar with leading agile
environments. We look
forward to having him
on board with us to lead
our very committed and
experienced local New
Zealand team.”
Wood will take up his
new position in mid-May. ▀
INTRODUCING
VICKI EVANS
YOUR NZ ACCOUNT MANAGER
Contact Vicki Evans now
027 220 2954
vicki@optiqueline.com.au
0508 678 478 | optiqueline.co.nz
May 2018
NEW ZEALAND OPTICS
21

MORE CLASSIFIEDS ON PAGE 24
OPTOMETRIST
NEW PLYMOUTH
We are looking for an experience TPA qualified, full-time Optometrist
to join our team at Browning & (Matthews), New Plymouth. This is a
busy, well equipped practice with a great support team.
Please contact Michelle Diez on 027 246 7499 or email
michelle.diez@matthews.co.nz
PART-TIME DISPENSER/
OPTICAL CONSULTANT
1-2 week-days per week plus 2-3 Saturdays
per month.
Hours: 10 -5.30pm week days, 10 -5pm Saturdays
Hourly rate $25-40 depending on experience
Become part of the team at Parker & Co, Newmarket, Auckland, selling
fabulous eyewear. You will be working with a small team of experienced
consultants/Dispensers and Optometrist who love eyewear and helping
people to find the perfect fit of eyewear and lenses.
We are not a chain, we don’t pressure sell. We love what we do, and
we need someone to join the team. If you have two or more years
experience in the industry and this sounds like you please email
lynne@parkerandco.nz
by
A day in the life
of a new,
21st century
optometrist (sort of)...
Chalkeyes
LOCUM OPTOMETRISTS
WORK IN AUSTRALIA
A change is as good as a holiday! Take control of your professional life
and earn $120+ (AUD) per hour, + travel and accommodation.
30 Minute appointments. Choose where and when you want to work.
Email us on info@optomlocumservice.com.au to join our obligation
free mailing list and let us tell you about the work we have available
from Hobart to Broome, from Adelaide to Cairns, from Canberra to
Perth, Auckland to Gold Coast and everywhere in between.
For over 16 years we have been finding well paid and interesting
work for optometrists.
www.optomlocumservice.com.au
FULL-TIME OPTOMETRIST
BUCHANAN OPTOMETRISTS
CHRISTCHURCH
Boutique optometry destination within a medical centre with an
excellent dispensing support and state of the art equipment.
The practice has a strong interest in specialty contact lenses, including
ortho-k and while experineced optometrists are preferred, new
graduates are welcome to apply.
The practice supports independent optometric practice and values an
optometrist who has a passion for clinical excellence and patient care.
The Matthew group prides itself on being a family owned and
operated business and professional growth in all optometry subspecialties
is encouranged.
We are the largest independent optometry group in NZ, with plans
for future growth. We are looking for someone to join us in our
Christchurch practice who is passionate about optometry and wants
to be part of a company striving for excellence.
Please contact John Grylls, john.grylls@seekapiti.co.nz or
Michelle Diez, michelle.diez@matthews.co.nz for more information.
Confidentiality is assured.
7.12am. Eeek, I forgot to put the wash
on again on. That’s the trouble with this
job: What normal person is able to have
their assigned, five uniform shirts (in
mustard yellow of all colours) cleaned
and dried in time for the following week?
Dave, my retail executive, said any more
would be excessive and wasteful. With
the number of patients and their relatives
that cram into my short-form exam room
every quarter of an hour (some of which
with less than optimum hygiene habits)
I really need a spare to change into at
lunchtime. Dave said he would see if he
could arrange some air freshener.
8.29am. Ready for the first patient of
the day. McDonald’s next door have
half-price frozen cola on a Thursday,
which starts my morning off with sugary
big bang. I’m not too sure about the
new fit-out, however, that head-office
‘strongly suggested’ we undergo last
month. They said it was about creating
consistency across the country. I’m quite
sure I’m sitting in the same chair, just
with a darker trim. Dave says the new
furniture allows our patients to move
from autorefractor to the frame stands
3% quicker, which is a good thing I guess.
10.12am. Laura, one of the new front
staff, foolishly interrupted my fifth
patient of the day to confirm whether
left eye meant the patient’s left eye or
the eye on the left when she looked at
them. Fortunately, it didn’t matter as
the patient had chosen one of our new
reversible frames. She had sold them a
second pair in pink as a backup too, which
will please Dave. Maybe Laura won’t
resign in a few months like most frame
minions tend to.
11.40am. Another young patient asked me
about contact lenses again, today. I was
running a little behind time so fortunately
she was happy with just the new
tortoiseshell frames I suggested she try
instead. I sort of see the point of contact
lenses, but as soon as I open my (nowexpired)
trial lens cases, I just run even
further behind schedule, so it’s not really
worth it – is it? I asked Dave about it and
he said sunglasses are a better alternative.
Dave is always thinking about patient
well-being; there is a lot of UV around
these days, he says.
12.47pm. In my lunch break, I had
enough time to whip across the road
from the mall to the little sushi place I
love. All the staff there are patients of
ours, including their young kids. They
look so cute in their little frames! Dave
always reminds me what a great service
we provide – being able to update their
glasses affordably as soon as their
prescription gets a little worse, is pretty
special!
3.30pm. A lady just saw me complaining
that she was seeing her long dead cat
walking around in front of her. The silly
old thing had saved up her hundred
bottle caps from her Anchor milk for
her complimentary examination and
then completely wasted my time with
her foolish imaginings. It’s almost as if
they think Fonterra actually pays us for
their consult! I politely told her she was
making it up and sold her another pair
of dark sunglasses to help her bilateral
macular degeneration. Hopefully she
sees a locum when she has next saved up
enough caps.
5.27pm. Dave squeezed in a patient for
a check at the end of the day again. He is
always doing that. The guy had a loose
nylon on his rimless frame that keep
waving and distracting his peripheral
vision. Talk about rude though – the guy
had the nerve to ask if I was qualified
to test his eye health! Apparently,
he was overdue for a check with his
ophthalmologist. It was a bright evening
outside so I whacked in some tropicamide
and phenylephrine to teach him a lesson.
Fortunate I did though – when I looked,
both of his eyes had retinoschisis in the
far temporal retinal periphery! I took
some photos and scans to show the chap
and he was amazed, no one else had ever
mentioned it before. The guy looked me
in the eye, shook my hand and said ‘thank
you for being so thorough’. Somewhat
embarrassed I said ‘don’t mention it – I’m
just doing my job’.
In the end, the guy only bought a single
pair of affordable hobby glasses. Dave
was not pleased. But I felt pretty good
driving home today. That is what I get up
every morning to go to work for – to help
people with their vision and eye health.
I just wish they would let us have a few
more shirts to use...
DESIGNER FRAMES FOR SALE
Spectacle frame inventory for sale. Designer frames offered at below
wholesale prices. Prefer to sell entire lot to single buyer. Fendi,
Marchon, Flexon, Coach, Calvin Klein etc. About 350 in total. Please
contact seller at tyghbn73@gmail.com or 0210483139
CUSTOMER SERVICE
SUPERSTAR
Are you a Customer Service Superstar?
Would you like to join one of the leading frame suppliers in NZ
representing many of the best performing brands in the independent
market? Then we have a wonderful opportunity for you here at
Phoenix Eyewear!
Based from our offices on Auckland’s North Shore, the role offering
sales support to our sales team and large customer base can be varied
at times but is very heavily customer service focussed. You will need
to be organised, self-motivated and happy to work within a small but
dedicated team.
Experience using MYOB or similar a must, as are outstanding
communication skills.
We are offering a competitive salary package complete with car park
and no weekend work.
If you see yourself becoming part of our exciting future then please
submit your CV under strictest confidence to Mark Collman at
mark@phoenixeyewear.co.nz
Ophthalmology trainees:
a step closer
Eye Institute has been helping prepare
ophthalmology registrars for their final
exams for about 15 years, running two mock
Objective Structured Clinical Exams (OSCEs) during
the trainees’ fourth year of specialist training.
The OSCE is a performance-based assessment
measuring candidates’ clinical competence.
Trainees are observed and evaluated as they
go through a series of stations in which they
interview, examine and treat standardised patients
who present with some type of medical problem.
Dr Peter Ring initiated the annual mock OSCEs
after requests for help from registrars when he
was a part 2 examiner, and continues to run
then to this day. “It gives the candidates practical
experience of an OSCE without the added pressure
of a formal exam,” he says. “Also, they may see
clinical cases they may not have seen before as we
try to set up less common cases, but not rare ones.”
Particularly valuable is the discussion with the other “mock”
examiners about the cases they have just seen, said Dr Ring, giving
Dr Peter Ring explains this year’s mock OSCE to trainee ophthalmology fellows
the registrars some great insight and extra knowledge before they
sit their final exams. ▀
22 NEW ZEALAND OPTICS May 2018

2018 • Voted by New Zealanders • 2018
UNSURE OF WHAT’S AROUND
THE NEXT CORNER?
SECURE YOUR FUTURE WITH SPECSAVERS
Are you looking to secure your future with New Zealand’s leading provider of eye care services? At Specsavers, we offer
some of the best rates of pay in the market, giving certainty to our employed optometrists, partners and locums.
And while monetary reward is important, there are other critical factors to
consider. We’re taking investment to a new level with a multimillion dollar rollout of
the latest technology and an extended professional development program, while
our optometry support team is developing ever closer working relationships with
ophthalmology and other eye disease stakeholders. You will also be supported by
an experienced team of dispensers and optical retail staff, providing you with the
best environment to develop your clinical skills and advance your optometry career.
A range of both metro and regional opportunities are currently on offer across New
Zealand, including full-time and part-time roles. Due to continued growth, we also
have a number of opportunities for optometrists seeking to lead their own store as
Joint Venture Partners.
Either way, why not find out how you can make the most impact at Specsavers.
We’re on a clear mission to transform eye health in New Zealand and Australia –
and we’d like you to join us on that mission.
Alternatively, if you know an exceptional optometrist with a passion for delivering
high quality eye care who is seeking career progression, ask us about our ‘Refer a
Friend’ referral bonus.
For a confidential chat about the various opportunities we have available,
contact Chris Rickard on 027 579 5499 or email chris.rickard@specsavers.com
VIEW ALL THE OPPORTUNITIES AVAILABLE ON SPECTRUM-ANZ.COM
Reader’s
Digest
Quality Service
Award
Voted by New Zealanders
Reader’s Digest
Quality Service
Award
2017
Best Customer
Service in NZ
Optometry
2018
Millward Brown
Research
No.1 for eye tests
2018
Best Talent
Development
Program
2017
Best Customer
Service in NZ
Optometry
2017
Excellence in
Marketing
Award
2016
Retail
Employer
of the Year
2015
Overall
National
Supreme Winner
2015
Franchise
Innovation
Award
2015
NZ Franchise
System of
the Year
2014
Retail
Innovator
of the Year
2014
Transforming eye health
May 2018
NEW ZEALAND OPTICS
23

MORE CLASSIFIEDS ON PAGE 22
For all your optical and ophthalmic needs
nzowa.org.nz
OPTOMETRIST
INVERCARGILL
We are looking for a friendly and enthusiastic Optometrist to
join our busy and growing optometry practice in Invercargill. This
position would suit someone who is seeking:
Excellent work-life balance. With a short, 5 to 10-minute drive to
work, and a 9 to 5, Monday to Thursday working week, you can
enjoy more free time with family and friends.
An opportunity to get ahead. With an extremely competitive
remuneration package and an average house price in Invercargill
of only $260,000, this position represents a great opportunity.
A great place to live. Invercargill is only a few hour’s drive/
ferry from some of New Zealand’s most beautiful destinations,
including Queenstown, Milford Sound, Stewart Island and the
Catlins.
Professional development. Our friendly and supportive team,
with over 70 years of combined optometry experience, and over
60 years of combined dispensing experience, can help take your
career to the next level.
If this sound like the ideal role for you, please email your CV and
cover letter to 7720store@opsm.co.nz
CENTRAL AUCKLAND PRACTICE FOR SALE
Demand for well-operated, consistently profitable independent
practices in central Auckland is high, OpticsNZ is proud to bring
this practice to the market. Operating with two examination
rooms, double testing 5.5 days per week. The optometry
equipment is ideal, the location and product offering are
superb. In the heart of Auckland, strategically this is an excellent
opportunity in so many ways.
For more information, please contact (confidentiality assured)
Stuart Allan at OpticsNZ on (03) 5466 996, 027 436 9091 or email
stu@opticsnz.co.nz
LOCUM OPTOMETRIST
Maternity cover required for east Auckland optometrist.
Up to 20 hours a week over three days May through August.
Work alongside a team of well trained professionals and in a well
equiped practice.
Email any enquiries to outeastoptom@gmail.com
DISPENSING OPTICIAN
/ OPTICAL ASSISTANT
This is an opportunity to join our professional fun-filled team at
Eyes of Howick. Being an independent practice we pride ourselves
on our client service and personalised optical solutions.
We require a star team player who also thrives in an autonomous
environment. If you have an eye for detail and organisation, have
a passion for eyewear and fashion and enjoy the sales challenge
then we would love to discuss the position with you further.
Optical experience essential.
Hours include a late night and some Saturday work on a rostered
basis.
Email your CV to Kristine on kjensen@eyesofhowick.co.nz or
phone 0274824477.
OPTOMETRISTS
WAIUKU / THAMES
Ready to settle down in the beautiful Coromandel town of
Thames or more drawn to the country living in Waiuku? Paterson
Burn Optometrists have exciting opportunities for passionate TPA
endorsed Optometrists to work in our Waiuku / Thames practices.
Working with Paterson Burn Optometrists will offer you the
ability to develop your clinical skills to its full potential and the
opportunity to specialise in your desired field. You will have
the ability to work independently and, with fourteen other
optometrists in the group, you will be part of a larger group of
highly-qualified, experienced and dedicated optometrists. Our
Optometrists have special interests in Low Vision, Children’s Vision,
Ortho K, Specialised contact lens fits, Dry eye and Irlen lenses. You
will also have the opportunity to meet regularly for peer review
sessions while gaining CE points within our practice.
This position can be part-time in Waiuku / Thames or full-time if
willing to travel between the branches.
Please send your CV with a covering letter to
sandri@patersonburn.co.nz or call 07 9035406 for more
information.
BAILEY NELSON
CHRISTCHURCH
Here at Bailey Nelson, we see things a little differently. We believe eye
care doesn’t have to be boring, and that’s why it’s our mission to have
passionate and caring Optometrists who ensure all patients enjoy an
experience worth remembering. Our eye tests are tailored for each
individual so everyone walks away feeling and looking different.
Bailey Nelson is opening a new store in Christchurch CBD. If you
want to further yourself as a leader and business contributor, all
while delivering amazing eye care then get in touch.
Please contact Maddy Mortiaux on
maddy@baileynelson.co.nz or 021 351 401
DREAM OF
TRAVELLING
Have you ever wanted to travel NZ? Do you like
flexibility and crave variety? OPSM New Zealand is
looking to expand its relief team with a combination
of area and regional floats. As a float you will be
exposed to lots of different patients and locations
across New Zealand. We are looking for Optometrists
who share our passion, and want to join our customer
focussed teams in making a difference to how people
see the world.
We are looking for optometry floats in these
key locations:
• GREATER WELLINGTON AREA
• AUCKLAND & WAIKATO AREA
• NATIONAL (NZ WIDE) REGION
Alternatively OPSM NZ is also on the lookout for locums
willing to service the Wellington, Bay of Plenty and
Waikato regions.
JOIN OUR TEAM
If interested in joining our fun loving team, please contact
Jonathan Payne
Jonathan.Payne@opsm.co.nz or call 021 195 3549
OPSM.CO.NZ/CAREERS
READY FOR
A CHANGE?
When you join OPSM, you work within a team who
are committed to providing the best possible eyecare
solution with exceptional customer service. You will
work with world class technology and have many
opportunities for professional development. You can
also make a real difference in the way people see
the world by participating in our OneSight outreach
program. OPSM New Zealand is looking for passionate
Optometrists to join the team in these locations:
NEW PLYMOUTH
Where the mountain meets the sea; New Plymouth is
a vibrant city of culture, art, and the great outdoors.
Our exciting practice is looking for an equally exciting
optometrist to join this high-performance store. With a
great community vibe and strong optometry network,
New Plymouth is an excellent place to either start or
enhance your career.
THAMES
Located on the doorstep of the Coromandel, Thames is
a gateway to outdoor adventures and fantastic beaches.
An opportunity has arisen for a full time optometrist to
join an amazing team in our community based store with
interesting and appreciative clientele. Only 1 hour outside
of South Auckland, Thames is close enough to enjoy the
big city, without the traffic or house prices!
LOWER HUTT
A rare vacancy has arisen in our much sort after Lower Hutt
practice. We are currently looking to expand our energetic
and vibrant team. Only 15 minutes from the capital, Lower
Hutt is close enough to enjoy the sport, culture and cuisine
that central Wellington has to offer.
JOIN OUR TEAM
If you are interested to find out more about joining the
team, contact Jonathan Payne for a confidential chat.
jonathan.payne@opsm.co.nz or call 021 195 3549
OPSM.CO.NZ/CAREERS
Thinking of selling your practice - we have buyers
Considering buying - we’ll give you all the options
OpticsNZ specialises in optometry practice sales,
we've helped dozens of Optometrists buy and sell their practices
For more information contact Stuart Allan on: 03 546 6996
027 436 9091 stu@opticsnz.co.nz www.opticsnz.co.nz
• Locum Service
• Recruitment Services
• Practice Brokering
• Business Consultants
24 NEW ZEALAND OPTICS May 2018