Feb 2017

THE MAGAZINE FOR NEW ZEALAND’S OPHTHALMIC COMMUNITY 

FOR OPTOMETRISTS AND EYE CARE PROFESSIONALS 

PO BOX 106 954, AUCKLAND CITY 1143 

Email: info@nzoptics.co.nz Website: www.nzoptics.co.nz 

FEBRUARY 2017 

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2 NEW ZEALAND OPTICS February 2017

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NEW ZEALAND OPTICS 

3

2017 starts with 

a bang! 

EDITORIAL BY JAI BREITNAUER 

Welcome back and happy New Year! The 

team at NZ Optics had a well deserved 

break and we hope you have too. Even 

so, the world keeps on turning and we are excited 

about this jam-packed issue to start 2017. 

First off, though, it’s time for an introduction. 

We are really pleased to announce that Susanne 

Bradley, who many of you know from the OIG, 

has agreed to come on board permanantly, 

growing our team and improving our offering. As 

well as writing some editorial, Susanne will be 

your first port of call for classified ads. You can 

reach her by emailing susanne@nzoptics.co.nz. 

As always, our aim for 2017 is to provide 

interesting, relevant and expertly written 

editorial and this year we will continue to 

introduce new contributors and columnists to 

inform and delight. We will also be making some 

changes over the next few months as part of a 

long-overdue modernisation. Your feedback is 

crucial during this period so please don’t hesitate 

to get in touch and tell us what you think. 

And so, on to the February issue of the 

magazine! We had so much to say it was difficult 

to fit it all in. There’s great news about eyes 

becoming a key part of the ‘Dunedin Study’ (this 

page) and also some awards for the New Year for 

Paul Rose (this page), Dr Shuan Dai (p15) and our 

very own Jo Eaton (p19). 

Don’t miss our overview of the MDNZ-Deloitte 

report revelations (p10) plus a look at the newly 

announced merger between Luxottica and 

Essilor (p6). Stephen Ng gives us RANZCO’s take 

on the ongoing issues around patient care (p8) 

and we also report on RANZCO’s stance on its 

guidelines (p14). 

There’s plenty more tucked away between the 

pages too. We hope 

you enjoy every 

word of it. 

Jai Breitnauer, NZ Optics 

Eyes on the Dunedin Study 

Our understanding about just how much 

our eyes can tell us about what’s going on 

in our bodies is set to become a whole lot 

clearer. A significant part of the next phase of the 

world famous Dunedin Study has been earmarked 

for eyes. 

“It’s very, very exciting,” says Gisborne 

ophthalmologist Dr Graham Wilson, who is 

principal investigator for the eye part of the study’s 

next phase. “It’s tremendous the study’s director, 

Professor Richard Poulton, is keen to incorporate 

more information on eyes into the next phase. 

It should lead to a goldmine of knowledge… 

and generate a host of new hypotheses and 

ophthalmic publications. This is an established, 

world-class study and it’s fantastic to now have a 

really active eye component.” 

The Dunedin Multidisciplinary Health and 

Development Research Study (better known as 

‘The Dunedin Study’) is a detailed research study, 

led by the University of Otago, into human health, 

development and behaviour. The study follows 

the lives and development of 1037 people born 

in Dunedin between 1 April 1972 and 31 March 

1973 and (due at least in part to the strict privacy 

protection of study participants) has an incredible 

95% retention rate. 

Eyes have always been a small part of the 

study, says Dr Wilson: the face and eyes of study 

members have been photographed repeatedly; 

there was a bunch of basic eye tests done when 

study members were aged 5 – 15 years old; and 

study participants’ eyes were photographed (on Dr 

Wilson’s recommendation) to look at their retinal 

blood vessels in the last phase, when they were 38 

years old. 

Dr Wilson first became involved more than a 

decade ago after his brother, Professor Nick Wilson 

from the Department of Public Health at Otago 

University, recommended he knock on the door of 

the Dunedin Study unit to see if they needed any 

help with eye research. 

“The eye is the window to the soul, so the 

question [in the last phase] was what can retinal 

blood vessels tell us about the vascular state of the 

body,” he explains. The retinal photograph data, 

for example, was then used by Madeline Meier, an 

www.contactlens.org.nz 

BY LESLEY SPRINGALL 

assistant professor at Arizona State University, and 

colleagues, to show how schizophrenia sufferers 

were distinguished by wider retinal venules. Their 

conclusion: retinal imaging could be a useful tool 

for further understanding the pathogenesis of 

schizophrenia. 

The success of this part of the study has led 

to retinal imaging becoming a standard part 

of the next phases of the study. Dr Wilson has 

also used data from earlier parts of the study for 

his own research, including studying whether 

amblyopia has a functional impact for his Master 

of Ophthalmology (an honour he achieved in 

2011 with a distinction, grade A+). Together with 

co-researcher David Welch, Dr Wilson concluded 

amblyopia within the cohort had no effect on the 

broad domains of everyday life. He’s currently 

working on the connection between migraine and 

retinal blood vessel changes and how these can 

be a useful biomarker for stroke and heart disease 

as well as the associations between periodontal 

disease and retinal blood vessel changes. 

The next official testing phase of the Dunedin 

Study has been funded by a $5 million Health 

Research Council grant and, given the focus 

on eyes, a further $25,000 from The Buchanan 

Charitable Foundation, run by fellow Kiwi 

ophthalmologist Dr Trevor Gray and his specialist 

breast physician wife Dr Caroline Gray. 

This phase begins in April and will last for more 

than a year as many of the study’s participants 

now have to be flown in from all over the world. 

Dr Wilson’s team will have just 30 minutes per 

patient for their eye studies, he says. 

“Every medical speciality wants to study the 

cohort, so you have to compete for time. The 

challenge for us is what tests are we going to do, 

what are we hoping to learn from the cohort, what 

hypotheses do we want to generate and what do 

we hope we might learn?” 

The last time the cohort had their eyes properly 

examined, nearly 30 years ago, optical coherence 

tomography (OCT) wasn’t even around, so this 

time OCT and OCT angiography and MRI scans (the 

study having just purchased the most advanced 

MRI Scanner in the world, courtesy of an American 

research grant) will be carried out on all study 

participants. 

Dr Wilson says he’s hoping to involve a number 

of colleagues from across the country, both from 

optometry and ophthalmology, to ensure the 

robustness of the data collected; colleagues such 

as A/Prof Jennifer Craig, who’s work on dry eye is 

world renowned; Dr Jesse Gale on how ophthalmic 

findings can be useful biomarkers for disease 

progression in neurodegenerative disorders such 

as dementia; Dr Stephen Ng and Kent Chowon 

on co-existing orbital disease; Prof. David Mackey 

from the University of Western Australia and 

Dr Graham Wilson at RANZCO 2016 

Nishan Ramachandran on how cannabis use might 

impact on the optic nerve; Dr Harry Bradshaw on 

refractive error and axial length; Dr Anmar Abdul- 

Rahman on OCT angiography; Prof. Steve Daikin 

and Dr Nicola Anstice on the role of contrast 

sensitivity as a measure of ageing; and Prof. 

Jonathan Crowston and Dr Peter van Wijngaarden 

from Melbourne on the ageing eye. 

Another person involved in Dr Wilson’s Dunedin 

Study eye research team is his former registrar, 

Dr Hong Sheng Chiong, who’s ground-breaking 

social enterprise oDocs, which developed a 

3D-printed, physical smartphone attachment 

to help optometrists perform basic eye tests 

anywhere in the world, has also been recognised 

internationally. 

“This is the world’s best study of its kind,” says 

Wilson. “It’s the jewel in New Zealand research’s 

crown. There’s simply nothing else like it in the 

world, and it is a privilege to be able to contribute, 

especially from Gisborne. It shows you can 

contribute from anywhere, even small town New 

Zealand, in today’s connected world.” 

To date, data from the study has been analysed 

for a host of different human health reasons and 

compared with local studies across the world, 

making it one, if not the most respected human 

health cohort study in the world. Now in its fifth 

decade, it has led to more than 1150 publications 

and reports, many of which have influenced or 

helped inform policy makers. The study achieved 

popular fame last year following the screening of 

an award-winning, four-part documentary ‘Why 

am I? The Science of Us’ on TVNZ. ▀ 

If anyone from the industry would like to be 

involved and has some useful ideas, please contact 

Dr Wilson at Graham.Wilson@tdh.org.nz 

Paul Rose honoured 

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Hamilton optometrist 

and inventor of 

the Rose K contact 

lens designs and fitting 

system for patients with 

keratoconus, Paul Rose, 

was made a Companion 

of the New Zealand Order 

of Merit (CNZM) in the 

New Year’s Honours list for 

services to optometry and 

ophthalmology. 

Rose, who started his 

own optometry practice in 

Hamilton in 1969, worked 

for more than a decade on 

developing a lens design 

and fitting system that 

would make it easier for 

optometrists with limited 

contact lens experience to fit keratoconic 

patients. 

“Never in my wildest dreams did I imagine it 

would take me where it has,” says Rose, who 

noted before his system became available, 

fitting lenses for keratoconus patients was a very 

specialised area. “It was almost like a cottage 

industry, with each lens being created from 

scratch. There were very few people who did it. I 

just wanted to make it easier.” 

Rose went through 12 prototypes and nearly 

gave up a year before he finally developed a 

solution that worked. Key to his success, he says, 

was the computerised lathe purchased by Corneal 

Hamilton-based optometrist Paul Rose CNZM 

Lens Corporation in the late 

‘80s as this dramatically 

improved accuracy and 

repeatability. 

“The Rose K system has 

five steps, with many of 

the decisions that had to 

be made by the specialist 

before already included 

in the design. It’s a bit like 

paint-by-numbers, and a 

practitioner with limited 

experience in the area of 

keratoconus lens fitting 

can still achieve excellent 

results. Most optometrists 

in New Zealand are able to 

offer this service today.” 

The first Rose K lens 

offered a 75% success rate 

and was made available in New Zealand in 1989. 

Australia followed soon after with FDA approval 

for US distribution gained in 1994. The Rose K 

lens system is also distributed in the UK, Europe, 

Middle East, South America and Asia. Today it is 

the most popular lens for keratoconus across the 

world, prescribed in more than 90 countries with 

a success rate of more than 80%. Despite this, 

Rose says he was still blown away by the honour. 

“I was overwhelmed. I’d been informed in mid- 

November I’d been nominated and then they 

contacted me again in mid-December to say the 

award had been ratified by the Prime Minister 

and the Queen. It’s a great, great honour.” ▀ 


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5

Specialist practice for BOP 

Ortho-k advocate and specialist contact lens 

optometrist Alex Petty has opened his own 

practice in Tauranga. Based in the medical 

suites of Promed House in Tauranga town centre, 

Bay Eye Care will function as a standard clinical 

optometry practice, but without the retail. 

“I decided to move away from the traditional retail 

aspect of the business. I won’t be selling frames or 

spectacle lenses,” says Petty. “I believe we are rare in 

New Zealand in that sense.” 

Petty, who returned from Australia a year ago, 

says he’d originally been looking for a strong 

independent practice to buy in to, but when no 

opportunity arose he and his fiancé shifted to 

Tauranga for the lifestyle. He was encouraged by 

friends and colleagues to go it alone, so decided to 

focus on what he does 

best, he says. 

“I haven’t worked 

full-time for a year, so 

I’ve had a lot of time 

to think. This for me is 

a long-term plan. I’m 

passionate about the 

clinical side of optometry 

and the way optometry 

is going, with an 

increase in prescribing 

Alex Petty 

rights and a shift in 

focus to shared care of patients 

with diseases like glaucoma. It 

makes me feel there is a role for 

a strong, specialist, secondary 

care model.” 

Petty’s practice will focus on general diagnosis, 

the management of conditions like dry eye, 

keratoconus, blepharitis and the use of ortho-k 

for myopia control and other ocular diseases. 

Petty is working toward accreditation as a 

glaucoma prescriber and negotiating shared 

care arrangements with ophthalmologists in the 

area. He’s already had a lot of support from local 

clinicians which he says is reassuring. 

“The success of my business hinges on 

collaborative care. I will be dependent on referrals 

from ophthalmologists, optometrists and GPs. No 

one loses out. If a patient is referred to me from a 

traditional high street optometrist because they 

require some specialist care, I will send them back 

to the primary referrer when their eye glasses need 

updating.” 

Petty’s practice will be entrenched among other 

medical practitioners, with laser eye correction, 

dentistry, GPs, radiology and physiotherapy among 

the other services available in the suites. 

Look out for more from Petty in his quarterly NZ 

Optics’ column ‘Speciality CL Forum’ in March. ▀ 

Luxottica and Essilor join forces 

Luxottica’s executive chair, Leonardo Del 

Vecchio, will control the new giant global 

eyewear entity 

Italy’s Luxottica and France’s Essilor have agreed to 

merge in a 46 billion euro (NZ$68.7 billion) deal. 

The all share deal is one of Europe’s largest crossborder 

tie-ups and will result in a new global eyewear 

giant, EssilorLuxottica, headquartered and listed in France 

and majority-owned by Leonardo Del Vecchio, Luxottica’s 

81-year-old billionaire founder and executive chairman. 

Del Vecchio will hold about a third of the newly merged 

company through Delfin, the Luxembourg-based holding 

company of the Del Vecchio family, which currently owns 

62% of Luxottica. 

In a combined statement, Del Vecchio said the merger 

is a dream come true. “With this agreement my dream to 

create a major global player in the eyewear industry, fully 

integrated and excellent in all its parts, comes finally true. 

University recognises 

“outstanding work” 

The Department of Ophthalmology at 

Auckland University has announced three 

new promotions: Professor Trevor Sherwin, 

Associate Professor Andrea Vincent and Dr Ilva 

Rupenthal, director of the Buchanan Ocular 

Therapeutics Unit, who’s been made senior 

lecturer above the bar. 

The new Professor Sherwin says it’s very rewarding 

to attain the professor title as it requires both 

international recognition of your work as well as 

recognition from peers closer to home. Part of the 

reason for Professor Sherwin’s promotion is the 

exciting work him and his team have been doing 

Professor Tevor Sherwin Dr Ilva Rupenthal Asoociate professor Andrea 

Vincent 

It was some time now that we knew that this was the 

right solution but only today are there the right conditions 

to make it possible. …Finally, after 50 years, two products 

which are naturally complementary, namely frames and 

lenses, will be designed, manufactured and distributed 

under the same roof.” 

The merged entity will have revenues of more than 15 

billion euros (NZ$22.4 billion), combined net EBITDA of 

approximately €3.5 billion (NZ$5.2 billion) and more than 

140,000 employees. It will be co-run by Del Vecchio and 

Hubert Sagnières, Essilor’s chair and CEO, as executive 

chair and vice-chair respectively, though the companies 

said the two will have “equal powers”. 

The transaction will “allow the combined group to 

better seize growth opportunities resulting from strong 

on regenerative medicine in the battle against 

keratoconus and myopia (see NZ Optics’ September 

2016). Professors Sherwin and Colin Green and 

research fellow Dr Carol Greene are in the last phase 

before clinical trials of a new eye drop which can 

reshape, stablise and, potentially, rebuild the cornea. 

“If successful, it could be ground-breaking, a huge 

advance in the treatment of eye disorders,” said 

Prof. Sherwin. The results of a large animal trial are 

expected towards the end of this year or early 2018. 

Associate Professor Andrea Vincent, a specialist 

in the genetics of eye diseases, says her promotion 

is a recognition of her teaching, research and 

services to the university and the 

ophthalmic community. Although 

the promotion doesn’t really 

change what she does or how 

she’ll do her work on a day-to-day 

basis, including current research 

modelling retinal diseases in 

zebrafish models, A/Prof Vincent 

says it will signal her credibility in 

the international ocular genetic 

field, with current and future 

collaborations. ▀ 

demand in the eyewear market, driven by the increasing 

need for corrective and protective eyewear and the 

appetite for strong brands,” continued the companies in 

the statement. 

“The strategic rationale is strong,” said JPMorgan 

Cazenove analysts in a note, adding the deal defuses the 

risk of growing competition between the two companies 

as both fight slowing sales because of a weakening North 

American market, rising competition from cheaper rivals 

and the challenges of online distribution. 

Though the deal is still subject to Essilor shareholder 

approval and clearance from the relevant anti-trust 

authorities, it is expected to close by the end of the year. 

Del Vecchio said he’s confident there will be no problems 

gaining approval from competition authorities. ▀ 

It’s easy to see why 

we love our new 

rooms in the heart 

of Christchurch. 

Dr James Borthwick 

MB ChB, FRANZCO 

Disease and surgery of the retina and macula, cataract 

Dr Sean Every 

MB ChB, MMedSci (Distinction), FRANZCO 

Disease and surgery of the retina and macula, cataract 

Dr Jo-Anne Pon 


Oculoplastics, cataract, neuro-ophthalmology, strabismus, 

general ophthalmology 

Dr John Rawstron 

MB ChB, MPH, GDipM (Refract Surg), FRANZCO 

Cataract, LASIK, corneal transplant 

For the specialist treatment of all eye conditions the new space provides an increase 

in consulting and treatment rooms, state of the art technology, an innovative new layout 

to increase comfort and plenty of free and easily available parking. 

Most importantly, it also provides the home for a proudly local team. As the number one 

South Island provider of specialist ophthalmic care our surgeons are fellowship and New Zealand 

trained sub-specialists. They are the best in their respective fields. They are excited to be 

part of our new city, to be the care behind the change, the insight behind the vision. 

Dr Rebecca Stack 

MB ChB (Distinction), MMedSci, FRANZCO 

Cataract, oculoplastic and reconstructive surgeon 

Dr Allan Simpson 


Cataract, glaucoma 

Dr Robert Weatherhead 

MB ChB, FRCS, FRACS, FRANZCO 

Oculoplastic and reconstructive surgeon 

Dr Logan Robinson 

MB Chb, PG Dip Ophth BS (Distinction), FRANZCO 

Vitreoretinal surgery, diseases of the retina and macula, 

refractive cataract surgery 

128 Kilmore Street, Christchurch ı P: 03 355 6397 ı W: www.southerneye.co.nz 


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7

News 

in brief 

CHANGES AT OPTOMETRY AUSTRALIA 

Andrew Hogan is the new president of Optometry Australia 

following Kate Gifford’s resignation last year. Hogan, an optometrist 

and broadcaster based in Hobart, Tasmania, is former president 

of Optometry Tasmania. He is motivated by the diversity found in 

the industry, he told Optometry Australia’s magazine Australian 

Optometry. “Optometry can take you to so many places and involve 

doing so many different things. I see optometry politics and the 

work of the organisation as just another aspect of the profession.” 

In other news, Optometry Australia is looking for a new CEO 

following the resignation of Genevieve Quilty late last year. Quilty 

led the organisation since 2011. She leaves in mid-February. 

NOVARTIS BUYS PRESBYOPIA POTENTIAL 

Swiss medical giant Novartis, owner of Alcon, is set to acquire 

Encore Vision, a Texas-based company in the early stages of 

developing a drug for presbyopia. Novartis said the acquisition 

would add a “first-in-class” treatment to its ophthalmology 

pipeline, “providing a potentially disruptive innovation to patients 

in a new therapeutic area of high unmet need and high prevalence.” 

Encore Vision was founded 10 years ago by Bill Burns, a former Alcon 

executive. 

FRIZZELL’S SPECS A HIT 

New Zealanders swooped up iconic artist Dick Frizzell’s limitededition 

frames collection, which sold out in less than six weeks. The 

frames were designed by Frizzell and Specsavers as a fundraiser for 

The Fred Hollows Foundation, with $25 from each frame sold going 

to the Foundation to provide cataract kits for the Pacific. 

DR KIM WINS 

Dr Yeri Kim won first place at Auckland University’s School of 

Medicine Doctoral Showcase in December last year for her 

thesis, ‘Characterising the molecular mode of action of connexin 

therapeutics for the treatment of retinal injury and disease’. This 

is the fifth time the Department of Ophthalmology has won the 

Showcase since its inauguration in 2009. 

ALCON NEW MONTHLY CLS 

Alcon unveiled its new Air Optix plus HydraGlyde montly 

replacement contact lenses (CLs) at the American Academy of 

Optometry meeting in California in November last year. The new 

CLs combine Alcon’s SmartShield and HydraGlyde Moisture Matrix 

technologies to improve deposit resistance and provide longerlasting 

comfort, said the company. They will be available in New 

Zealand later this month. 

TESTOSTERONE FOR DRY EYE? 

Testosterone is being studied as a possible treatment for dry eye 

disease (DED). Talking to Ophthamology Times, Dr Terry Dawson 

from Alabama, said his informal study showed most of his female 

perimenopause patients have evaporative dry eye and responded 

favourably to an androgen eye drop. Men with a low level of 

testosterone and experiencing DED can also benefit, he said. 

HAPPY BIRTHDAY CR SURFACING 

CR Surfacing celebrated 40 years in the lens industry in November 

last year. Established in 1976, the company is now the largest 

Australian lens manufacturer and believed to be the third largest 

lens supplier to the Australian market. It opened its New Zealand 

office in Christchurch in 2008. CR Surfacing managing director 

Adam Fletcher told Insight magazine the company had recently 

invested A$3 million in design and manufacturing to continue to 

stay ahead of the 

competition in 

2017. 

Tackling eye care backlogs in NZ 

The demand for ophthalmology services 

in New Zealand is growing year-onyear. 

This is partly due to an ageing 

population and increasing rates of diabetes, 

resulting in a higher prevalence of age-related 

eye disease and diabetic eye disease. 

However, there are also positive reasons 

for increased demand. Recent innovations, 

particularly the use of anti-vascular 

endothelial growth factor drugs for agerelated 

macular degeneration (AMD) and 

other retinal vasculopathies, mean we can 

now treat conditions which previously would 

have resulted in irreversible loss of sight. Of 

course, with the ability to prevent blindness 

comes an inherent responsibility to do so. 

The New Zealand Ministry of Health’s 

waiting time targets primarily focus on first 

specialist appointments. This means that, 

with limited resources available, District 

Health Boards (DHBs) must focus funding 

on these appointments to the detriment of 

follow-up appointments. This causes serious 

delays in follow-up appointments. In some 

DHBs, there have been patients that have had 

their follow-up appointments delayed for 3, 6, 

9 or even 12 months or more. 

With ophthalmologic conditions such as 

glaucoma, diabetes, paediatric eye disease 

or age-related macular degeneration (AMD), 

follow-up appointments are essential for 

monitoring and managing a patient’s eye 

health. These follow-up appointments allow 

ophthalmologists to identify any potential 

worsening of a patient’s condition and adjust 

treatment accordingly. Without monitoring, 

a patient’s condition can worsen with few 

symptoms, potentially leading to irreversible 

vision loss. 

Ophthalmologists across the country 

have all seen the negative effects of underresourcing. 

Despite initiatives such as extra 

clinics, “virtual consults” and up-skilling of 

nurses and optometrists to work as part of the 

collaborative care team, there has simply been 

no way to meet the ever-increasing demand. 

This increased demand for services came 

to a head in 2016 when it became apparent 

that the New Zealand healthcare service was 

in the grip of an eye health care crisis. More 

and more reports of adverse events began to 

emerge – more people losing their sight due 

World-first study at Auckland Uni 

Each year more than 250 New 

Zealanders require a corneal 

transplant, but an innovative new 

study aims to tackle the ever-increasing 

need for donor corneas. 

Dr Jie Zhang is leading a research team 

Dr Jie Zhang 

BY DR STEPHEN NG, CHAIRMAN, RANZCO NZ 

to delayed follow-up appointments. 

The Royal Australian and New Zealand 

College of Ophthalmologists (RANZCO), 

having worked to raise awareness of this 

issue with political leaders for over a year, 

recognised the time had come for a widereaching 

campaign to highlight the plight of 

so many eye patients. 

RANZCO was informed in October that the 

Health Quality and Safety Commission’s 2016 

report was about to release details of large 

numbers of cases where eye patients had lost 

vision due to delayed follow-up appointments. 

RANZCO members worked with colleagues 

from Macular Degeneration New Zealand 

(MDNZ) and Ophthalmology New Zealand 

(ONZ) to bring together information, case 

studies and evidence to support the case for 

action to address these delays. 

RANZCO released this information in 

November. At about the same time, a number 

of DHBs released statements about the 

adverse events in their hospitals. The media 

response was immediate and comprehensive. 

The mainstream media – television, radio 

and newspapers – as well as the trade media, 

including NZ Optics, grasped the urgency 

of the issue and broadcast the message to a 

wide audience. 

Meanwhile, RANZCO wrote to all Members 

of Parliament, including the Prime Minister, 

the Minister for Health and the Opposition 

Spokesperson for Health, to raise political 

awareness of the issue. Again, the response 

was overwhelming. MPs from across all 

political parties offered support for RANZCO’s 

call for immediate action to address this 

important issue and stop people from going 

permanently and avoidably blind. 

RANZCO was invited to meet with the 

Acting Chief Medical Officer (CMO), Dr 

Andrew Simpson, and then with the Minister 

for Health, the Hon. Dr Jonathan Coleman. 

A number of ophthalmologists from DHBs 

across New Zealand attended these meetings, 

which were constructive. RANZCO was 

reassured this issue was being taken seriously 

and that action would be taken. 

Following these meetings, RANZCO 

continued communication with both the 

Minster and the CMO to provide additional 

information and be updated on progress. 

from Auckland University’s Department 

of Ophthalmology looking at how the 

corneal endothelium can be regenerated 

using a particular type of adult stem 

cell, recently discovered in an area of 

the cornea called the transition zone. If 

the study is successful it could lead to a 

number of patients being treated from a 

single donor, rather than the current oneto-one 

relationship. 

“The corneal endothelium does not 

regenerate. When cells are damaged due 

to disease, the other cells simply expand 

to fill the space,” said Dr Zhang. But the 

hypothesis is if these adult stem cells 

are stimulated in the right way, they will 

develop into endothelial cells promoting 

regeneration in the recipient’s eye. “These 

stem cells have only been discovered in 

RANZCO NZ Chair Dr Stephen Ng and Dr Jesse Gale at 

Parliament for the MDNZ-Deloitte report launch (see p10) 

Finally, just days before Christmas, RANZCO 

was delighted to be informed that the 

Ministry for Health was announcing funding 

of up to $2million for DHB ophthalmology 

services to address the backlog in follow-up 

appointments. DHBs are able to apply for this 

money to help develop, improve or implement 

models of care to best support their district’s 

ophthalmology services. 

In the longer term, RANZCO will be working 

closely with the Ministry of Health to develop 

clinical prioritisation tools and processes, 

effective models of care, on-going audits and 

workforce modelling to ensure, in the future, 

the supply of ophthalmology services is able 

to meet increasing demand. 

RANZCO and our Fellows in New Zealand are 

delighted this action has been taken and we 

look forward to continuing to work with the 

Ministry of Health and with DHBs to ensure 

that, in future, no more New Zealanders lose 

their sight due to delayed appointments. 

l Correction: In the December 2016 edition 

of NZ Optics, it was wrongly surmised that 

to assist with the increasing demands on 

eye health services…“Dr Ng… favours some 

form of allied community care…”. RANZCO 

values working with nursing and optometry 

colleagues and has highlighted increasing 

collaborative care as one of the solutions 

to the current eye health care crisis. But at 

present in New Zealand, RANZCO believes 

the most proven, efficient and cost-effective 

solution is to have suitably-trained nurses 

and optometrists working collaboratively 

alongside ophthalmologists, not in the 

community, but within hospital teams. ▀ 

the last three to five years, so we don’t 

know much about them,” she said, adding 

that the process has, however, been 

casually observed. 

Dr Zhang’s team received approval for 

Marsden funding in October. The three 

year, $300,000 grant starts in March. 

“The endothelium is the main roadblock 

to corneal regeneration at the moment. If 

we can overcome that it would change the 

landscape for the treatment of many eye 

diseases,” said Dr Zhang. 

“At the end of three years we hope 

to have laid the foundations for the 

development of stem-cell treatment to 

regenerate the endothelium. Ultimately, 

this will relieve the pressure on the eye 

bank and more people in need can be 

helped.” ▀ 

CR Surfacing’s Christchurch office 

www.nzoptics.co.nz | PO Box 106954, Auckland 1143 | New Zealand 

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 

or Jai Breitnauer at editor@nzoptics.co.nz or +64 22 424 9322 

For all advertising and 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. 

TearLab appoints OIC 

After just over a year of going it alone, 

TearLab Australia has appointed 

Ophthalmic Instrument Company 

(OIC) to manage the distribution and sales 

of its ground-breaking osmolarity system in 

New Zealand. 

The company has created a good base in 

New Zealand but needs support to build 

on that, says George Koukides, manager of 

TearLab Australia. “[OIC managing director 

Tim Way’s] network and understanding of 

the ophthalmology and optometry market 

in New Zealand will take TearLab to the next 

level.” 

The opportunity is there, he says, both 

in ophthalmology where 

the TearLab system is being 

used to pre-screen cataract 

patients, to learn more about 

their tear film prior to surgery, 

and optometry for objective 

diagnosis of dry eye. 

Way says he’s excited to have 

TearLab on board as he’s been 

following them for a while. 

The TearLab system is a great 

addition to the company’s 

dry eye products portfolio, complementing 

other products such as the Medmont E300 

topographer and the eye cleansing product 

OIC’s Tim Way and TearLab’s George Koukides at RANZCO 2016 

Avenova, he says. “[TearLab] has been very 

supportive and we are really looking forward 

to working together.” ▀ 


OUR EXPANSION… 

YOUR CAREER GROWTH 

A MUTUAL OPPORTUNITY 

As the Specsavers network of 370 New Zealand and Australian stores continues to 

experience significant growth, opportunities abound in metro and regional locations 

for career focussed optometry and dispensing professionals. 

For those taking a fresh look at what Specsavers offers as a working 

environment, the scale and format of our store locations continues to evolve 

with exciting results for our partners, our teams and our patients. Take 

Specsavers Ringwood as an example, recently recognised at the Australian 

Retail Awards as the outstanding retail design project of the past year. It is 

more than double the size of its previous location in the same shopping centre, 

with six consulting rooms, 12 dispensing desks, a contact lens teaching zone 

and four pre-testing rooms. Its investment in the latest retail and optometric 

technology is exemplary, offering a glimpse of the future. 

And now, as we look to the next phase of growth, we want to talk to you 

about our plans – and hear about yours. Our growth really can be your 

opportunity, whether you are looking at a store partner or an employed role - 

at every level of experience. 

To get the conversation started, contact Chanelle Coates on 0800 717 350 or by email on chanelle.coates@specsavers.com 

Retail 

Store Design 

Award 

2016 

Retail 

Employer 

of the Year 

2015 

Overall 

National 

Supreme Winner 

2015 

ANZ Customer 

Service Excellence 

Award 

2015 

Franchise 

Innovation 

Award 

2015 

NZ Franchise 

System of 

the Year 

2014 

Retail 

Innovator 

of the Year 

2014 

Multichannel 

Retailer 

of the Year 

2014 

Roy Morgan 

Research 

No. 1 for eye tests 

2014 

FCA International 

Franchisor 

of the Year 

2014 

FCA Social 

Responsibility 

Award 

2014 



9

The cost of macular degeneration 

MDNZ trustees Allan and Viv Jones with MPs Andrew Bayly and Simon O’Connor Taranaki-King country MP Barbara Kuriger being scanned Zeiss’ Chris Money explains the scan process to MP Winston Peters while Dr Kolin Foo looks on 

Macular degeneration cost the country 

$391.1 million in 2016 or nearly $20,000 

per person, according to a new report 

into the true costs associated with this disease. 

The report, ‘Socioeconomic cost of macular 

degeneration in New Zealand’, by Deloitte and 

Macular Degeneration New Zealand (MDNZ) was 

presented to parliament on 15 November 2016 by 

MDNZ with the aid of Professor Alan Bird, surgeon 

at the Institute of Ophthalmology at Moorfields 

Hospital, East London. 

To encourage MPs to review the report and 

understand the true cost of macular degeneration 

(MD) to the country – and to hopefully gain some 

government funding for MDNZ and its vital public 

education work - MPs and Beehive staff were 

also invited to undergo a free screening as part 

of the launch, prior to the official evening event 

(see separate story). Around 50 people attended 

the evening, including many MPs. The launch 

was supported by Tamaki MP Simon O’Connor, 

chair of the Health Select Committee, who even 

posted about it on Facebook, thanking MDNZ for 

bringing the costs to Parliament’s attention and 

the free-screenings (which luckily didn’t pick up 

any incidents of MD). 

Key findings 

In the report, researchers noted age-related 

macular degeneration (AMD) is 

the most common cause of visual 

impairment in people over 50 in the 

developed world, with 50% of all 

blindness in New Zealand attributed 

to AMD - blindness defined as bestcorrected 

visual acuity of

SPECIAL FEATURE: RANZCO 

Record attendance at RANZCO 2016 

RANZCO’s 48th Annual Scientific Congress 

was notable for both its unprecedented 

size and its exemplary programme. 

Bringing around 1500 people together, 

including 85% of the ophthalmologists in 

Australia and in New Zealand, the 2016 Congress 

was RANZCO’s biggest ever. This allowed us to 

deliver a programme of activities which was 

varied, scientifically rigorous and incredibly 

engaging. There were sessions for everyone, 

focusing on both scientific and professional 

developments. And the trade exhibition was 

BY ASSOCIATE PROFESSOR MARK DANIELL, RANZCO PRESIDENT 

both our biggest ever and most successful, with 

a great deal of positive feedback offered. 

The quality of the sessions and the speakers 

was of particular note. In the plenary sessions, 

outstanding named lectures and disease 

update lectures were delivered by some of the 

leading names in the ophthalmology profession, 

including both local and international speakers. 

The focus on innovative scientific 

breakthroughs, which was a defining feature 

of the named and update lectures, continued 

with the posters, papers and films submitted by 

Fellows, trainees and medical students. 

Most importantly, RANZCO’s 2016 

Congress brought together a wide range of 

ophthalmologists and colleagues from the eye 

health sector to learn from each other, helping 

us all to further the quality of eye health care 

here and around the world. Ultimately, the 

success of this Congress will help to improve 

outcomes for all of our patients, now and in the 

future, and we would like to thank everyone who 

took part and made this possible.” ▀ 

PICTURE BY JEFF MCEWAN, CAPTURE STUDIOS 

Associate Professor Mark Daniell, the new RANZCO president. 

RANZCO’s 48th Scientific Congress 

BY DR AARON WONG* 

There are a couple of recurring themes that 

I’ve noticed about Melbourne. The first is 

variety. My first conversation on touching 

down was that inevitable ‘four seasons in one 

day’ chat that every taxi ride into the city seems 

to feature. The second is that us New Zealanders 

can’t get enough of Melbourne. Whether it’s to 

holiday, work or find greener pastures, Kiwis seem 

to gravitate to the “Paris on the Yarra”. 

RANZCO’s 48th Scientific Congress held at 

the Melbourne Convention Centre from 19 - 23 

November, 2016, proved to be no exception to 

my twin observations. The programme featured 

a wide variety of subspecialty topics and a good 

dose of New Zealand presenters, not to mention 

a healthy contingent of Kiwis contributing to 

the 1,500 or so delegates. In fact, 2016 broke 

the attendance record, with almost 85% of all 

Australian and New Zealand ophthalmologists in 

Melbourne for the Congress. 

Day one 

Headlining the opening day was Professor Gerard 

Sutton’s Council lecture. The Sydney-based corneal 

specialist explained how he believed that synergy 

and serendipity were the key ingredients for 

innovation in corneal therapies. Synergy between 

corneal surgeon, scientist and the modern eye 

banker was key to his team’s breakthroughs into the 

pathogenesis of keratoconus. Their current theory 

is that a two-hit hypothesis, by which a genetic 

susceptibility combined with a secondary event, 

perhaps eye rubbing, culminates in the epithelial 

cell migration dysfunction seen in keratoconus. 

After lunch (and a vendor-sponsored coffee) 

delegates dispersed into one of five concurrent 

sessions. At the genetics/paediatrics rapid fire 

session, New Zealand ophthalmologist Dr Andrea 

Vincent from Retina Specialists gave two talks, 

the first about the prevalence of cystoid macular 

oedema (CMO) in rod cone dystrophies; and the 

second about novel genetic change found in a 

population of mainly Cook Island Maori patients 

with ectopia lentis, suggesting a founder effect. 

Dr Jina Han of the University of Auckland talked 

about telemedicine in retinopathy of prematurity 

screening. Her cohort included 1,217 neonates who 

had been screened across four different hospitals. 

Amongst the final sessions of the day was a very 

well attended ‘Controversies in Glaucoma’ session. 

Our own Professor Helen Danesh-Meyer discussed 

the role of lifestyle modifications in glaucoma. 

She explained that although there is little direct 

evidence for the benefit of lifestyle modifications 

in glaucoma, there is some promising indirect 

evidence. Hence when approached by patients she 

would endorse blood pressure lowering, exercise, 

collard greens, flavonoids and gingko biloba. 

Day two 

Professor Keith Martin is the first professor of 

ophthalmology at the University of Cambridge. 

His research team is known for bio-printing 

retinal cells using ink jets. In his glaucoma update 

lecture he talked about the search for the holy 

grail of glaucoma research – the ability to protect 

and regenerate the optic nerve. Although animal 

studies have shown promise for stem cell and 

growth factor-derived treatments, they are a long 

way from clinical use in humans. Professor Dennis 

Wakefield, an immunologist from Sydney, gave the 

Sir Norman Gregg lecture, discussing progress in 

elucidating the pathogenesis of HLA-B27 associated 

anterior uveitis. It would be hard to imagine a talk 

from Professor Boris Malyugin (inventor of the 

Malyugin ring) about complicated cataract surgery 

that did not delve in to techniques for small pupils. 

He described the new Malyugin 2.0 ring that has 

the benefits of fitting through a 2.0mm incision 

and thinner 5-0 prolene material. 

Following morning tea, a range of experts spoke 

at the ‘Clinical Controversies’ plenary. Professor 

Sutton talked about SMILE and its role in refractive 

surgery. Although there was a learning curve, he 

thought SMILE had a role for myopes of more than 

3-4 dioptres as it had equivalent visual outcomes 

to LASIK and slightly less dry eye within the 

first six months. Professor Malyugin presented 

his thoughts on a controversial new surgical 

technique for corneal endothelial dystrophies such 

as Fuchs. Descemetorhexis is essentially stripping 

the central endothelial layers of the cornea and 

not replacing them as you would traditionally with 

a corneal graft. In his experience most patients 

improved vision after months of corneal oedema, 

however some still required secondary grafts. 

In the public health rapid fire session Dr Riyaz 

Bhikoo and Dr Sid Ogra (both training registrars) 

gave accounts of their involvement in volunteer 

organisations in the Pacific. Both talks highlighted 

the challenges faced in delivering good eye care 

to these populations and the effort involved in 

keeping sustainable solutions in place. Akilesh 

Gokul a PhD candidate from Auckland highlighted 

issues closer to home, talking about the Aotearoa 

Research into Keratoconus (ARK) study. 

In the late afternoon, an instructive anterior 

segment course was co-chaired by Professor 

Charles McGhee, head of ophthalmology at 

the University of Auckland. Dr Sue Ormonde, 

a University of Auckland senior lecturer and 

consultant ophthalmologist at Greenlane Clinical 

Centre, spoke about the importance of primary 

repair in ocular trauma in order to restore the 

RANZCO new Fellows 2016, including New Zealand’s new Fellows Drs Rachael Niederer, Robin Jones, Shenton Chew, Rasha Altaie and Anu Mathew 

PICTURE BY JEFF MCEWAN, CAPTURE STUDIOS 

integrity of the globe, allow resolution of hypotony 

and restore a bacterial barrier. Auckland University 

colleague Dr Jay Meyer shared his corneal surgery 

‘life hacks’, including techniques for removing 

Salzmann’s nodules and applying cyanoacrylate 

glue for small corneal perforations. While Professor 

McGhee rounded out the session talking about 

surgical techniques for patients with compromised 

irises and lenses. As always, prevention is the 

best treatment and clues such as advanced age 

should alert a surgeon to factors such as zonular 

weakness. 

Day three 

Day three started with the prestigious best paper 

presentations. The University of Auckland’s 

Samantha Simkin was amongst the top three 

junior researchers selected to present their 

research. She spoke about a prospective study 

of a universal newborn screening service using 

RetCam imaging. Over 300 babies were screened 

in Auckland (including my son when he was born 

six months ago) and in a few instances long-term 

conditions were picked up early because of it. 

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ADV_Eurotimes_FM300_QR_ESCRS16_V1.indd 1 27.10.2016 12:14:14


Registrars Drs Verona Botha, Ken Ng and Aaron Wong 

FROM ON PAGE 11 

Professor Ursula Schmidt-Erfurth from Vienna 

gave the retina update lecture. She hopes that 

improvements in technology allowing machinelearning 

OCT will help us predict visual outcomes 

in the future. 

Professor Mourits, an ophthalmologist from 

Amsterdam who first described the clinical activity 

score in thyroid eye disease, gave the Ida Mann 

lecture. He explained how in Graves’ orbitopathy 

both muscle and fat volumes increase within the 

orbit due to activity of orbital fibroblasts. 

Peter Savino, clinical professor of ophthalmology 

and neurosciences at San Diego’s Shiley Eye 

Institute, and Professor Danesh-Meyer convened 

the always entertaining neuro-ophthalmology 

challenges session. The cases were a mix of the 

common and the obscure and served as the 

catalyst for sparking audience discussion about 

diagnostic dilemmas in neuro-ophthalmology. 

The day finished on a high note with the 

conference dinner at the hallowed Melbourne 

Cricket Ground. Although the dinner included a 

tour around the largest cricket stadium by capacity 

in the world, many Kiwis preferred not to relive the 

pain of the 1981 underarm bowling incident and 

the 2015 cricket world cup final. 

Day four 

The final day of Congress started with a session 

on keeping your cool during complicated cataract 

surgery. Auckland University Associate Professor 

Dipika Patel started by reassuring the audience 

that complication rates such as posterior capsule 

rupture have improved over the last few decades. 

In part, this is due to improvements in equipment 

360˚ 

Pachymetry 

Refraction 

Jina Han, Professor Charles McGhee, Dr Hannah Kersten and 

Samantha Simkin 

Drs Graham Wilson, Nick Mantell, Stephen Ng and Justin Mora 

and, as Dr Mo Ziaei explained in the 

next talk, this includes the treatment of 

small pupil and floppy iris. Dr Ormonde 

spoke about a dreaded fear for most 

cataract surgeons, posterior capsular 

rupture with vitreous loss. Professor 

McGhee’s express vignettes provided 

insights into dealing with iris and 

zonular deficiencies. He advocated for 

a good understanding of the modern 

tool kit and plenty of surgical and wet 

lab experience to prepare surgeons 

for dealing with these cases. While Dr 

Bia Kim spoke of the importance of 

pre-operative risk stratification scoring 

prior to cataract surgery. A modified risk 

stratification score is to be trialed at 

Auckland DHB in 2017 so watch this space. 

Associate Professor Fiona Costello from 

the University of Calgary gave the neuroophthalmology 

update lecture and explained how 

TRK-2P 

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Himanshu Wadhwa, A/Prof Dipika Patel, Aki Gokul, Dr Divya Perumal 

and Professor Trevor Sherwin 

Drs Simon Dean, Andrea Vincent, Michael Merriman, Hannah Kersten and 

Andrew Riley 

Bayer’s Christie Murzello with Professor Anthony Molteno and 

Dr Tahira Malik 

Drs Graham Wilson and Shuan Dai 

the eyes are in fact the window to the soul (or 

perhaps in this case the central nervous system). 

Her dual training as a neurologist and neuroophthalmologist 

give her a unique insight into how 

assessment of the eye can give you important 

information about diseases of the brain such as 

multiple sclerosis. In particular OCT may play a 

bigger role in neurological disease in the future 

as more is understood about how the neuronal 

structure in the eye reflects changes in the brain. 

Dr James Muecke from the South Australia 

Institute of Ophthalmology gave the Hollows 

lecture and talked about his experience in 

working in more than 10 developing countries. 

In countries such as Myanmar, cataracts have 

become such a problem that nearly one in 10 

adults over the age of 40 are blind or severely 

visually impaired. The Sight for All charity, which 

Dr Muecke chairs, aims to make it possible 

for ophthalmologists working in developed 

countries to have the same skill and knowledge 

as those in developed countries. 

The afternoon’s rapid fire session covered 

a range of topics including uveitis, ocular 

oncology, neuro-ophthalmology and 

oculoplastics. Dr Ken Ng spoke about 

the unique spectrum of uveitis in elderly 

patients presenting to clinics in Auckland. 

Drs John Beaumont and Kevin Taylor with OptiMed’s Rob Nyenkamp 

Drs Peter Hadden, John Ah-Chan and Ross Neville-Lamb and 

Steve McConnell 

Old ophthalmology equipment on the 

RANZCO museum display 

Dr Rachel Niederer discussed risk factors for 

choroidal neovascularisation in punctate inner 

choroidopathy. Treatment with oral corticosteroids 

may help to reduce the risk of choroidal 

neovascular membrane development. Dr Hannah 

Kersten spoke about eye findings, including 

downbeat nystagmus and temporal retinal nerve 

fibre layer thinning, in the recently described 

neurological syndrome CANVAS (cerebellar ataxia, 

neuropathy and vestibular areflexia). 

The Congress was brought to a close with the 

annual awards for best paper, poster and film. Dr 

Elisabeth de Smit won best junior presentation 

for her study of the genomic associations of giant 

cell arteritis and Associate Professor John Landers 

won best senior presentation for presenting the 

findings of the Central Australian Ocular Health 

Study. The other speakers in the session, including 

Samantha Simkin, were highly commended for 

their excellent presentations. As always there was 

some New Zealand representation within the 

prizewinners with Dr Shong Min Voon winning 

best film for ‘A Novel Method for Rapid Production 

of Basic Diagnostic Ophthalmic Equipment’. ▀ 

*Dr Aaron Wong is an ophthalmology trainee at the University 

of Auckland. He was helped in the writing of this article by Dr 

Hannah Kersten, a lecturer and research fellow at the University 

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Orthoptics at 

RANZCO 2016 

BY ELIZABETH GATELY-TAYLOR AND CLAIRE FITZGERALD* 

We were fortunate enough to attend 

the Orthoptics Australia 73rd Annual 

Scientific Meeting in November held 

with, but separate to, RANZCO’s 2016 Congress 

at the Melbourne Convention Centre. The 

programme was full and varied and we were 

also able to attend RANZCO’s Congress sessions. 

Connecting in 

person and online 

Orthoptists are 

so small in number 

in New Zealand it 

is important we 

stay in touch with 

orthoptists around 

the globe. The role 

of an orthoptist 

has expanded, 

particularly in 

Australia, taking on a 

more technical slant. 

However, there was 

still plenty of content 

on traditional 

orthoptics - binocular 

vision and ocular 

motility. 

Connecting was 

also a topic of one of 

the sessions looking at the importance of social 

media, both the good and the bad. We are often 

quick to criticise the misinformation available 

online, but we all need to work to replace this 

with professional advice. We were interested 

to hear that Google is falling away from being 

the go-to search engine with millennials 

increasingly turning to groups on Facebook 

and YouTube to find health advice instead. 

Digital healthcare is not well funded and it is 

hard to regulate but people are keen to access 

healthcare apps. The positive implications of 

better compliance with medications this digital 

approach can provide are beginning to become 

apparent, with some clinicians increasingly 

getting left behind. Plus, the current change 

in funding for disability services in Australia 

means people are starting to make more 

choices about their healthcare provider. They 

are doing their own research, using online 

profiles to influence their decision. 

Looking back to look forward 

A theme that came through clearly at the 

meeting was looking back in order to look 

forward. A couple of sessions concentrated on 

the history of orthoptics and it was interesting 

to reflect on past research trends and how these 

impacted on clinical practice. 

Technology-based treatments for amblyopia 

continue to be a hot topic, although it is clear 

work needs to continue to validate its use. 

Interesting feedback from some of the study 

groups is that many patients find the games 

boring. This highlights the fast changing 

expectations people have around technology. 

As a consequence, there was no real 

improvement in compliance between occlusion 

therapy and dichoptic therapy, however, 

it is still an area that’s showing exciting 

developments and it will be interesting to see 

the results of current studies. 

The expanding role of an orthoptist 

The meeting provided an opportunity to hear 

about the results of research from across a wide 

range of topics. In addition to the detective 

work involved in investigating complex squint 

cases, we heard about the variety of orthoptic 

work in today’s world, from orthoptist-led 

The Blind Foundation’s Elizabeth Gately-Taylor and Claire Fitzgerald with Dr Sean Every 

Orthoptists Elizabeth Gately-Taylor and Claire Fitzgerald in Federation Square, Melbourne 

diabetic screening clinics to the ongoing 

management of glaucoma suspects. 

Orthoptists build a close relationship with 

their patients over time. This is obvious in the 

paediatric setting and also valuable in adult 

clinics, where the orthoptist can be the one 

constant for the patient who may be examined 

by a different ophthalmologist at each visit. 

This relationship-building was reflected in many 

of the presentations, especially in the area of 

vision impairment. Jess Boyle, a PhD candidate 

at La Trobe University in Melbourne, shared 

a thought-provoking evaluation of patient 

experience and perceptions when undergoing 

repeated anti-VEGF injections for AMD. Of 

note, patient satisfaction increased when given 

the opportunity to view the OCT results. Jess 

also looked at the provision of information 

about vision rehabilitation and patient 

support groups. She found many patients felt 

uninformed about what 

support services were 

available to them. Barriers 

to the referral of patients 

to low vision services and 

support groups included: 

• patient identified: 

timing of referral, financial 

outlay, perceived benefit 

and accessibility 

• orthoptist identified: 

practical factors, 

knowledge-based factors, 

patient factors, clinical 

protocol. 

The role of the orthoptist 

in Australia is firmly 

embedded in adult and 

paediatric low vision 

services across the 

spectrum of government 

funded, not-for-profit 

and private habilitation 

and rehabilitation services. Attending this 

conference was a valuable opportunity for us to 

learn from Australian low vision orthoptists and 

share some insights about what we do well in 

New Zealand. 

Often we become so busy in our clinical 

practice we forget why we became orthoptists. 

Hearing the passion of the presenters, both 

through case studies and the tabling of new 

research, helps to spark that excitement again. 

We certainly recommend attendance at the 

next Orthoptics Australia Annual Scientific 

Conference to New Zealand orthoptists. There 

was much to learn and share, and the Aussies 

are a friendly bunch! ▀ 

* Claire Fitzgerald and Elizabeth Gately-Taylor are both 

orthoptists working with The Blind Foundation, which 

supported their attendance at the Meeting. Elizabeth also 

works with the Terrace Eye Centre in Wellington 

RANZCO 2016: Practice 

Managers Conference 

The 2016 RANZCO 

Practice Managers 

conference in 

Melbourne kicked off 

with a fun networking 

session, which saw 

many of us initially quite 

bleary-eyed and not 

so ready to share our 

thoughts and ideas early 

on a Sunday morning! 

Once the caffeine kicked 

in, however, the creative 

juices began to flow 

and so did some lively 

discussion on issues 

affecting ophthalmology practices in today’s 

competitive and busy environment. 

The key themes of the 2016 conference were 

the importance of ensuring ongoing quality staff 

development and education; updating patient 

management systems and other medical software 

to best meet the needs of the practices for now 

and into the future; and ways to attract and retain 

good staff to ensure a seamless quality service. 

As someone fresh off the boat (plane really) from 

Wellington, the key areas for me were disaster 

management and uninterrupted power supply! 

The panel discussion following this session was 

very informative and helpful with ideas on how 

to ensure your aged-debtors were kept to a 

minimum and useful tips on marketing practices. 

The importance of continuing to send clinic letters 

to GP’s and optometrists, both as a way of sharing 

information about patients and as a valuable 

marketing tool for the practice, could not be 

stressed enough. Quotes were also in high use and 

this one, attributed to Richard Branson, struck a 

chord with this conference attendee: “Train them 

(staff) well so they are good enough to leave. Treat 

them well, so that they want to stay.” 

BY SYLVIA HEWISON* 

Sylvia Hewison and Judith Parnell at the Practice Manager’s conference 

LEAVE A LEGACY 

OF VISUAL FREEDOM. 

TECNIS ® 

PRESBYOPIA-CORRECTING IOLs 

Inservio’s Katarina 

Steele gave a thoughtprovoking 

talk on 

‘Customer Service, 

Connection and 

Empathy’. Her video, 

designed to make us 

all remember that 

everyone we meet 

has a back story that 

shapes the way they 

behave at any given 

point in time, brought 

some in the room to 

tears. There was much 

emphasis on what 

empathy is and the different types of empathy. 

All were amused by Katarina’s description of the 

selfie stick as “the wand of narcissism”! 

Simon Thiessen from The Real Learning 

Experience had a lot to say on managing 

challenging patient conversations and focusing, 

in particular, on emotional self-management with 

the timely reminder that you can’t deal with other 

people’s “stuff” unless you have your own “stuff” 

together. 

The update on accreditation from RANZCO was 

timely. Key points included: the process to gain 

accreditation requires a huge effort, not only from 

the practice manager but every member of the 

healthcare team from the business owner through 

to the person cleaning the bathrooms; it is a great 

process for continuous quality improvement; and 

practices need to be realistic in setting timeframes 

for completion of this process, recognising it could 

take upwards of 12 months to achieve. 

The other big topic on the conference agenda 

was “going paperless” or, as most interpreted it, 

creating less paper waste. The upshot of these 


TECNIS is a trademark owned by or licensed to Abbott Laboratories, its subsidiaries or affiliates. All other trademarks are the intellectual property of their 

respective owners. AMO Australia Pty. Limited. Level 3, 299 Lane Cove Road, Macquarie Park, NSW 2113. AMO Australia Pty. Limited (Incorporated in 

Australia) PO Box 401, Shortland Street, Auckland, 1140. © 2017 Abbott Medical Optics Inc. | www.AbbottMedicalOptics.com | PP2016CT1775 

AMO20468 Tecnis Symfony Adv NZ-Optics.indd 1 



4/1/17 10:59 am 

13


FROM PAGE 13 

discussions was there is no magic bullet in patient management 

systems and time is needed to find the system that works 

best for the individual practice. Ideally having a system that 

integrates well with other software, to enable all data in one 

repository to be viewed, is the way to go, however no one 

system has all this functionality, so do your homework and 

choose a system that works best for you and your practice. 

The advice from one practice that has gone down this route is 

to be realistic, as one of the key requirements is to be able to 

scan and create an electronic version of the current paper file; 

use professional people to do the job; and recognise the cost is 

money well spent. 

Other highlights included Australian Health Industry Group 

managing director David Wenban’s talks on ‘Handling HR 

Headaches’ and ‘OH&S - What Every Practice Manager Needs 

to Know’. David always manages to deliver his invaluable 

messages in a thought-provoking and entertaining way. His take 

home messages: “process protects everybody” and “document 

everything”. Australian Association of Practice Management’s 

Colleen Sullivan always willingly shares her vast knowledge 

and experience and this year was no exception with her talks 

on ‘Success Skills’ and ‘Tactics for Inspiring and Engaging 

Your Practice Team’. Marcus Wilson from Focus Eyecare also 

gave us plenty to think about with his talk on ‘Workplace 

and Automation’. Marcus also hosted a very successful and 

enjoyable practice manager’s dinner, which gave us the 

opportunity to meet each other in a setting that involved good 

food, decent wine and plenty of laughter! 

The ‘Strategic Planning in Ophthalmology’ group talk from 

Moira McInerney, Dr Stephen Best and Dr Bill Glasson was a 

timely reminder that many of our practices have grown from 

a “cottage industry” into a business; mainly the business of 

people - both staff and patients. The words of wisdom they 

shared were invaluable, recognising the importance of good 

strategic planning and management for ophthalmology 

practices to be successful now and into the future. 

For future RANZCO conferences, it would be great to have 

many of these topics revisited and combined in sessions with 

our ophthalmologists, as both practice managers and business 

owners need to work in partnership if our ophthalmology 

practices are to continue to grow in a meaningful way. 

For this conference attendee, the biggest highlight was 

the people – not only the speakers, who willingly and often 

entertainingly shared their knowledge and skills, but the other 

delegates who collectively had vast knowledge and expertise, 

and shared the common goal of wanting to do their job well 

and look after their staff and patients with equal amounts of 

empathy and professionalism. 

While the Melbourne weather was a mixed bag, at least it was 

warmer than Wellington and earthquake free! And then there 

were the additional highlights outside of RANZCO, including 

the David Hockney and Viktor&Rolf exhibitions at the National 

Gallery of Victoria and the Glamour Puss Tap Dancing Academy 

end of year concert at The National Theatre in St Kilda! If you are 

in Melbourne at this time of year, this show is a ‘must see’! ▀ 

*Sylvia Hewison is a registered nurse, specialised in ophthalmology, and practice 

manager at the Terrace Eye Centre in Wellington 

EasyRet launched at RANZCO 

Taking pride of place on the busy Device 

Technologies stand at RANZCO was 

Quantel Medical’s new Easyret fullyintegrated 

577nm yellow photocoagulator 

laser for macular and peripheral retinal 

pathologies. This was the first time the new 

technology had been shown in Australasia 

after its worldwide launch at the European 

Society of Cataract & Refractive Surgeons 

(ESCRS) in Copehagen just two months earlier. 

Franck Morand, Quantel’s Asia Pacific sales 

manager, said EasyRet is particularly novel 

because it utilises fibre laser technology so 

requires no reflecting mirrors in its main 

cavity (which in other laser systems often 

require adjustment) allowing the company 

to offer a unique five-year warranty on the 

entire system. Plus the whole kit is integrated 

into the table with one large touchscreen 

and foot pedal control, so it’s easy to control, 

there’s no wires to get in the way and there’s 

no swapping from technology to technology, 

said Morand. Feedback on previous laser 

technologies also means Quantel has 

integrated an “intelligent, resume mode” 

which allows the surgeon to stop and 

continue from the same spot to finish off 

the desired laser pattern 

should the patient move. 

According to the official 

marketing material, the 

Easyret has a broad range 

of settings for treatment 

of pathologies such as 

diabetic retinopathy, 

macular oedema 

and central serous 

chorioretinopathy. “In 

addition to SingleSpot 

treatment mode, 

surgeons can select 

Multispot mode for a 

pattern of simultaneous 

targets or the 

subthreshold Micropulse 

mode, which enables 

them to customise a train of short pulses 

to precisely manage the thermal effect on 

targeted tissues.” The system also allows 

the surgeon to store treatment images so 

they can be compared over time, which is 

particularly important for micropulse laser 

treatment when you can’t see the impact 

straight away, said Morand. 

Oculo partners with GTS 

Ophthalmic 

communications 

platform Oculo has added 

another technology firm to its 

growing partnership list, Global 

Transcription Services (GTS). 

GTS is an online medical 

typing service, designed to 

reduce practice costs and 

enhance operational efficiency. 

Ophthalmologists and other 

medical specialists can use 

any mobile device or tablet 

for dictation, review and edit 

drafts and electronically sign 

correspondence. 

The new partnership means 

transcribed correspondence 

can be transmitted through Oculo’s secure 

cloud-based clinical communication platform 

to referring optometrists and general 

practitioners. 

“GTS enables ophthalmologists to 

outsource the transcription of dictation and 

Franck Morand and Dr Rodney Keillor 

Oculo’s Dr Kate Taylor (left) with another recent Oculo partner BP Software’s Johanna Monson and 

Paul Ansley on either side of Dr Mike Mair at RANZCO 2016 

then to manage correspondence portably. 

Outsourcing and secure cloud-based 

technology increase busy practices’ efficiency 

and flexibility,” said Mark Silbermann, GTS’ 

CEO in a statement. 

Kate Taylor, head of Australian-based 

In a press release announcing the launch, 

Jean-Marc Gendre, CEO of Quantel Medical, 

said EasyRet was a new revolution in fibre 

laser technology. “Quantel engineers worked 

closely with surgeons to design a fullyintegrated 

system with an intuitive interface 

to ensure optimal ergonomics and ease of 

use.” ▀ 

Oculo, added she is excited about 

this new integration and what it 

means for Oculo’s clients – currently 

325 ophthalmologists and 900 

optometrists. 

“The build is underway and 

will be released with the next 

upgrade,” she said, adding this 

is one of a series of integrations 

Oculo are looking at with a view to 

improving patients eye-health care 

and making practice management 

easier. 

“As correspondence goes back 

and forth it effectively builds an 

e-eye health record, which helps 

with continuity of care. This is 

particularly good for patients with 

chronic eye disease where you want to look at 

progression over time when making decisions 

about treatment. It’s about bringing it all 

together in one secure but accessible place.” 

The long-anticipated launch of Oculo in 

New Zealand is scheduled for early 2017. ▀ 

Referral guidelines “unabashedly” RANZCO’s 

BY LESLEY SPRINGALL 

RANZCO’s 2016 Scientific Meeting opened 

on a comical note as outgoing President Dr 

Brad Horsburgh told the audience it wasn’t 

a good time to have an eye problem in the region 

as 85% of Australasia’s ophthalmologists were in 

Melbourne for the conference. But the humour 

quickly turned to more serious matters with the 

somewhat controversial (for some optometrists 

anyway) new clinical referral guidelines from 

RANZCO being thrust front and centre into the 

opening speeches. 

The new guidelines represent a default standard 

of care for the whole eye care profession, said Dr 

Horsburgh, a language by which ophthalmology 

will engage with optometry and general practice. 

“It is a branding strategy, undoubtedly…we want 

to be the Microsoft of ophthalmology; we want to 

be the default language that everyone uses, the 

default standard of care.” 

RANZCO launched the first of its planned 

series of referral guides for optometrists and 

GPs, on glaucoma management, in July last 

year. Two further “Referral Pathways” for 

diabetic retinopathy and age-related macular 

degeneration were released just prior to the 

RANZCO conference in November to coincide with 

training on the guidelines for optometrists and 

GPs at the conference. 

Initially the guidelines are being reviewed 

in a two-year pilot study in partnership with 

Specsavers. Though RANZCO says feedback 

from other optometrists has on the whole been 

positive and is welcome, it also says at this stage 

it doesn’t have the ability to collate and assess 

data from multiple sources, all using different 

assessment equipment and techniques and 

software systems, though it recognises these 

differences will need to be considered in the 

longer-term to ensure the referral guidelines are 

accepted by the eye care profession as a whole. 

Unhappy about being left out of the design of 

the referral guidelines, Optometry Australia (OA) 

issued a stinging rebuke about the glaucoma 

guidelines in a statement in October saying 

the guidelines failed to reflect the diversity of 

optometry expertise, clinical circumstances 

and scope of practice in Australia. “The RANZCO 

referral pathway instead encourages potentially 

unnecessary referrals and an increased burden 

on Medicare, as well as an unnecessary financial 

burden for patients in clinical, travel and timerelated 

costs,” said OA National President Kate 

Gifford in the statement. “The pathway appears 

to be more compatible with practice in the UK 

and omits gonioscopy from the standard baseline 

examination, which is an entry-level competency 

in Australia.” 

When asked why OA wasn’t involved in the 

design process at the conference, Dr Horsburgh 

said the College had been down this path at 

least three times in the past, with the last time 

resulting in a drawn out legal battle. 

This legal battle was settled in November 2014 

after 18 months of court action and an initial 

win by the ophthalmology bodies after they 

challenged the Australian Health Practitioner 

Regulation Agency (AHPRA) and the Optometry 

Board of Australia’s decision to extend the scope 

of practice of optometrists to diagnose and 

treat glaucoma without ophthalmic oversight. 

The eventual settlement led to a rewrite of the 

controversial optometry guidelines, allowing 

therapeutically-qualified optometrists to still 

diagnose and treat glaucoma independently, 

but ensuring they referred patients to an 

ophthalmologist within four months of their 

diagnosis so it could be confirmed and a 

management plan agreed. 

At the conference, Dr Horsburgh proudly 

admitted the guidelines are pure RANZCO. “The 

reason it has not worked [in the past] is it has 

tended to degenerate into straight politics….As 

we receive feedback and feel we are informed 

about what works well and what doesn’t work 

well, we will adjust accordingly but, yes, these 

are evidence-based and unabashedly RANZCO 

guidelines, they are the language we choose to 

deliver it.” 

The pilot programme with Specsavers is just 

the beginning, however, he said, a way to collect 

data relatively quickly from a uniform group and 

smooth out initial wrinkles. “We have to start 

small, because the history of antipathy and at 

times unhelpful behaviour between optometry and 

ophthalmology goes back decades.” But given that 

the guidelines are designed to lead to a registry 

of information, the process will go on for years 

as more data is collected, collated and analysed, 

and the results used to educate and improve 

the current system for patients, for all eye care 

professionals and for the public purse, he said. 

Last year RANZCO changed its tagline to 

“collaborative eye care” because it wanted to 

collaborate with everyone, added Dr Horsburgh. 

“We need to formalise that and we need to 

formalise the systems with which we collaborate… 

and I have a dream that this College will live out 

the meaning of its tagline. It’s not enough to say 

we are the leaders in collaborative healthcare, we 

Former RANZCO president Dr Brad Horsburgh and Dr Guy D’Mellow 

must live it out, we must do it and we must prove 

it to our patients and to the government, and 

that’s what this is about.” 

RANZCO plans to release further referral 

guidelines next year, including one on paediatrics 

based on current guidelines penned by New 

Zealand’s Dr Shuan Dai. It also expects to appoint 

a project officer next year to assist with the pilot 

studies and ensure that as time goes on, the 

whole of the optometry profession is consulted 

to ensure the guidelines are as effective and 

accepted as they can be. ▀ 


Glaucoma treatment 

first in NZ 

A 

team 

from Oasis Sugical have carried 

out the first micropulse trans-scleral 

cyclophotocoagulation (mTSCPC) treatment 

for primary glaucoma in New Zealand. 

Previously managing glaucoma was restricted to 

medicated drops or invasive surgery, said Dr Justin 

Mora, the Oasis team leader who carried out the 

first procedure in October last year. “Now with 

the development of the mTSCPC treatment, there 

is a new innovative, minimally-invasive way for 

ophthalmologists to treat open angle glaucoma 

that can help reduce and, in some cases, eliminate 

the need for medicated drops.” 

The procedure uses the Iridex Cyclo G6 Laser 

System and a proprietary MP3 Laser Probe 

(supplied by OptiMed in New Zealand) to deliver 

micropulse laser energy to the eye in a slow, 

repetitive circular motion in a 180-degree arc for 

approximately 80 seconds. Once completed, the 

second 180-degree arc is then treated. 

The Micro-Pulse Trans-Scleral 

Cyclophotocoagulation procedure works by 

delivering very short pulses (micropulses) of 

810nm laser energy to the Ciliary Process. Because 

the micropulses don’t cause any thermal damage 

or scarring, and because it is minimally invasive 

and does not require any incisions to be placed 

Dr Justin Mora and fellow Oasis team members, Maryanne Considine and Julian Blakley, 

with the Iridex Cyclo G6 Laser System 

in the eye, there is less inflammation and less 

likelihood of post-operative infections, explained 

Dr Mora. 

Singapore-based ophthalmologist Professor Paul 

Chew, the pioneer of mTSCPC treatment, recently 

presented his 78-month study into the procedure. 

Results for 14 patients, from his initial study group 

of 23, showed the procedure was effective and 

safe in lowering IOP by ≥30%, with consequent 

reduction in medications 1 . Other US surgeons 

Dr Justin Mora conducting the first mTSCPC procedure in NZ 

have demonstrated similar results. Connecticut 

ophthalmologist Dr Robert Noecker reported a 

62% IOP reduction in 50 patients with follow-up, 

up to six months 2 . The results are looking positive 

here as well, with an IOP drop from 28mmHg preop, 

to 10mmHg at one-week post op. 

“I have known Professor Paul Chew for years 

and I have watched with interest his work with 

micropulse cyclodiode,” said Dr Mora. “At the 

World Ophthalmology Congress in Guadalajara 

in February, I had the opportunity to look at the 

new unit and catch up with the latest results. 

They suggested to me that this could be a major 

step forward with a low risk, quick and relatively 

straightforward procedure for 

lowering the IOP that avoids any 

intraocular penetration. As we 

all know there is no universally 

successful glaucoma procedure but 

the mTSCPC data show a good IOP 

lowering effect with no cases of 

phthisis and much less inflammation 

than standard CPC. 

“Traditionally we have reserved the 

latter for end-stage or very severe 

glaucoma as it is so destructive and 

because of the risk of phthisis. Paul 

believes that the pulsed application 

not only reduces aqueous production 

but also increases uveo-scleral 

outflow which might explain how it 

can be so effective without severely 

damaging the ciliary body.” 

The procedure can also be used 

for patients who have had previous 

glaucoma treatment but where the 

surgeon wants to reduce or even eliminate their 

need for medicated drops, and it can be completed 

at the same time as other eye surgery, such as 

cataract removal. ▀ 

References 

1. Long-term Efficacy of Micropulse Diode Transscleral 

Cyclophotocoagulation in the Treatment of Refractory 

Glaucoma – Poster presentation at ASCRS 2016 

2. Micropulse P3 Glaucoma Device Revolutionises 

Cyclophotocoagulation – Glaucoma Today Insert March/April 

2015 

Pharmac drops Eylea 

Following consultation, 

Pharmac has decided 

against accepting 

aflibercept (Eylea) as an 

additional treatment listed 

for wet age-related macular 

degeneration (wAMD) despite 

noting a strong preference for 

it from some clinicians over and 

above ranibizumab (Lucentis). 

The government’s 

Pharmaceutical Management 

Agency (better known as 

‘Pharmac’) consulted on a 

proposal to list ranibizumab and 

aflibercept in Section H of the 

Pharmaceutical Schedule for the 

second and third line treatment (respectively) of 

wAMD last year. The proposal arose following a 

Request for Proposals (RFP) for the supply of antiendothelial 

growth factor (anti-VEGF) agents in 

May. 

But in a statement in December, Pharmac said, 

“Having reviewed all the consultation feedback 

the Pharmac Board resolved to not accept any 

proposal and to terminate the RPF process.” 

In practice this means the proposal will not 

Accolade for Dr Dai 

Dr Shuan Dai was awarded 

the 2016 Distinguished 

Clinical Teacher Award 

from the University of Auckland 

in recognition of the valuable 

contribution to teaching he has 

made across the University’s 

Faculty of Medical and Health 

Sciences. 

According to the Department of 

Ophthalmology’s staff newsletter, 

Dr Dai “has an admirable 

dedication to providing topquality, 

interactive teaching that 

few can equal. Indeed, he has been 

an absolute stalwart in providing 

Dr Shuan Dai 

be progressed; provisional 

agreements with Novartis 

(for ranibizumab) and Bayer 

(for aflibercept) will not come 

into effect; and the current 

listing of ranibizumab in 

Part II of Section H of the 

Pharmaceutical Schedule as 

a second line treatment for 

wAMD will remain unchanged. 

Sarah Fitt, Pharmac’s director 

of operations said, “It’s back 

to the drawing board, but it 

was really good to get such a 

detailed and useful response 

to the consultation. We 

would like to thank everyone 

who took the time to provide feedback on the 

proposal.” 

PHARMAC intends to seek further advice from 

its clinical advisory committee(s) on the issues 

raised in consultation feedback and to consider 

the appropriateness of running a new RFP in the 

future for anti-VEGF agents for the treatment 

of both wAMD and diabetic macular oedema 

(DMO). ▀ 

For more on Eylea see p16. 

teaching in aspects of paediatric 

ophthalmology to medical 

students, optometrists and nurses 

at a personal time-cost, which 

often sees him teaching and 

coaching in his own free time.” 

Dr Dai thanked Professor 

Charles McGhee and his team at 

the Department saying he was 

deeply honoured to receive the 

award: “I enjoy the interaction 

with students and younger 

doctors coming through the 

Ophthalmology Department…and 

feel proud of being able to share 

my experiences with them.” ▀ 

BOOK REVIEW: 

Video Atlas of Oculofacial Plastic and 

Reconstructive Surgery, 2nd edition 

by Bobby S. Korn, Don O. Kikkawa. Published by Elsevier 

REVIEWED BY DR BRIAN SLOAN* 

I am old enough to consider this ‘Surgical Atlas’ 

as a text book that includes free web access to 

multimedia. Younger readers will doubtless see 

themselves as buying the multimedia access 

and getting a free printed book thrown in, and 

they are probably right. The authors have chosen 

to illustrate this surgical technique multimedia 

reference exclusively via photos and videos. With 

over 1600 illustrations, most of the photos in the 

textbook are necessarily small. Standardisation 

of style is relatively good (especially so for a 

multi-author text), but the well-annotated 

photos are more effective in the online version, 

where they are of sufficient resolution to enable 

magnification up to full-screen. Pre and postoperative 

photo pairs are well matched for 

composition and lighting. 

Diagrams are used sparsely and largely to 

illustrate anatomy. Drawings do have the ability 

to remove the “visual noise” and show the 

essence of a situation, and there are some places 

where this atlas might have benefitted from 

more of these. 

The chapters are commendably structured, 

with separate tables for indications, pre-operative 

assessment, 

complications 

and consumables 

used for all 75 

procedures 

covered. The online 

version also allows 

you to make notes 

in association with 

specific sections, 

and of course 

allows searches, 

although the paper 

Dr Brian Sloan 

version rejoices in a 

20-page index. 

This Atlas would make a worthy addition to 

any departmental library, and is a useful resource 

for the ophthalmologist who is an “occasional 

oculoplastic surgeon”. It is probably more than 

most ophthalmic trainees require, but would suit 

trainees with an interest in oculoplastics as well 

as those undergoing fellowship training in the 

area. ▀ 

*Dr Brian Sloan is an ophthalmologist specialising in 

oculoplastic surgery after training in Auckland, Melbourne, 

Cincinnati and Vancouver. He is based at Greenlane Clinical 

Centre and in private practice in Auckland. 

IRIDEX 

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F : facebook.com/OptiMedNZ 



15

Focus on 

Eye Research 

Three glaucoma studies 

Relationship between Optical 

Coherence Tomography Angiography 

Vessel Density and Severity of Visual 

Field Loss in Glaucoma 

YARMOHAMMADI A, ZANGWILL LM, DINIZ- 

FILHO,A ET AL 

Ophthalmology 2016;123:2498-2508 

Review: The aim of this study was to assess the 

association between vessel density measurements 

using optical coherence tomography angiography 

(OCT-A) and severity of visual field loss in primary 

open-angle glaucoma. 

An observational cross-sectional study was 

performed and included a total of 153 eyes from 

31 healthy participants, 48 glaucoma suspects, and 

74 glaucoma patients enrolled in the Diagnostic 

Innovations in Glaucoma Study. All eyes underwent 

imaging using OCT-A, spectral-domain OCT and 

standard automated perimetry (SAP). Retinal 

vasculature information was summarised as vessel 

density, the percentage of area occupied by flowing 

blood vessels in the selected region. 

Associations between the severity of visual field 

loss, reported as SAP mean deviation (MD), and 

OCT-A vessel density was evaluated. Compared 

with glaucoma eyes, normal eyes demonstrated a 

denser micro-vascular network within the RNFL. 

Vessel density was higher in normal eyes followed by 

glaucoma suspects, mild glaucoma, and moderate to 

severe glaucoma eyes (P < 0.001). Each 1% decrease 

in vessel density was associated with a 0.66 dB loss 

in MD. In addition, the association between vessel 

density and severity of visual field damage was 

found to be significant even after controlling for the 

effect of structural loss. 

Comment: Optical coherence tomography 

angiography is a promising technology in glaucoma 

management. This study identified that decreased 

vessel density was significantly associated with 

the severity of visual field damage independent 

of the structural loss. Applications include clinical 

monitoring of vascular changes in glaucoma as well 

as potentially enhancing our understanding of the 

pathophysiology of the disease, specifically any 

underlying vascular mechanism. 

High rate of incidental glaucoma 

detection in New Zealand 

LAHOOD BR, ERCEG J, BEVIN TH ET AL 

New Zealand Medical Journal (online) Dec 2016: 

33-37,5. 

Review: In this study the authors investigated how 

glaucoma is initially detected in a New Zealand 

population and what factors lead to suspicion of 

the disease. They conducted a postal survey of 500 

randomly selected members of the Glaucoma New 

Zealand database. The overall response rate was 80% 

(376/468) of eligible participants. The average age of 

respondents was 76 years, 64% female and 84% NZ 

European. 

Before a diagnosis of glaucoma was made, 80% of 

participants did not report a history of suspicion for 

glaucoma. The majority of theses patients (82%) had 

their initial assessment with an optometrist and the 

vast majority (96%) were spectacle wearers. 

If there was a suspicion of glaucoma (13% of 

total sample), having a positive family history for 

glaucoma was the most common reason (65%) 

Heidelberg founder honoured 

Dr Gerhard Zinser, cofounder 

and managing 

director of Heidelberg 

Engineering, became the first 

non-clinician to be awarded 

the Founders’ Award of the 

Optometric Glaucoma Society 

(OGS). The award was presented 

by Society co-founder Dr John 

Flanagan at the Society’s Annual 

Scientific Meeting in Anaheim, 

California on 8 November last year. 

In his laudatory speech, Dr 

Flanagan, dean of the School 

of Optometry at UC Berkeley, 

BY DR HUSSAIN PATEL* 

followed by symptoms (27%). After diagnosis, 95% 

(357/376) of respondents reported that they had 

informed family members of their diagnosis and 

advised them to have regular eye exams. 

The authors concluded that in New Zealand the 

majority of glaucoma was discovered through 

incidental findings and a positive family history was 

the most risk factor prompting an assessment. 

Comment:This study reports that the vast majority 

of glaucoma patients do not have a prior suspicion 

of glaucoma or family history prior to their 

diagnosis. For patients without a prior suspicion for 

glaucoma they are most likely to diagnosed by their 

optometrist during a routine vision assessment 

hence confirming the importance of including a 

glaucoma screen as part of this process. 

Optic disc haemorrhage in glaucoma: 

pathophysiology and prognostic 

significance 

KIM KE, PARK KH 

Current Opinion in Ophthalmology (online) Dec 

2016, DOI:10.1097 

Review: In this article the authors provide a 

review of the recent findings with regard to the 

pathophysiology and clinical signficance of optic disc 

haemorrhage in glaucoma. 

The underlying mechanism of disc haemorrhage has 

been extensively investigated but remains unclear. In 

this review the authors report that recent evidence 

as a result of advances in OCT, suggest a possible 

mechanical vascular disruption as the most likely 

mechanism. In particular – microvascular damage 

occurs as a result of alterations in the structure of 

the lamina cribosa at the optic nerve head. However 

they conclude that underlying vascular factors are 

also likely to be playing a role still. 

The review also confirms the association between 

optic disc haemorrhage and higher rate of glaucoma 

progression both in terms of visual field loss and, in 

more recent studies, retinal nerve fiber layer thinning. 

The authors comment that consideration should 

be given to more intensive treatment and more 

frequent follow-up after disc haemorrhage episodes. 

Additionally, treatments or clinical plans should be 

tailored patient-by-patient, as each individual has 

different risk factors other than disc haemorrhage, a 

different progression rate, a different disease status 

and a different level of compliance. 

Comment: The underlying mechanisms of optic disc 

haemorrhage are still not fully understood but are 

most likely to be a combination of both mechanical 

and vascular factors. Although the exact role of disc 

haemorrhage in glaucoma is not yet known, their 

incidence remains of clinical importance and are an 

indication for more intensive glaucoma treatment 

and follow up to prevent progression occuring. ▀ 

ABOUT THE AUTHOR: 

PHOTO BY ANDIE PETKUS PHOTOGRAPHY 

* Dr Hussain Patel (MBChB, MD, 

FRANZCO) is an ophthalmologist 

based at Auckland’s Eye Surgery 

Associates and senior lecturer 

in ophthalmology with the New 

Zealand National Eye Centre, 

University of Auckland. He has a 

special interest in glaucoma, and 

is actively involved in glaucoma 

research, supervision of research 

fellows and teaching. 

emphasised Dr Zinzer’s 

significant and long-standing 

contribution to diagnostic 

imaging in eye care. 

l In other news, Heidelberg 

Engineering announced its 

OCT-angiography module for 

Spectralis OCT is now available 

outside the US. 

Spectralis OCT2 registered 

owners can download it directly 

from the web. ▀ 

Dr Gerhard Zinser (right) 

with Dr John Flanagan of the 

Optometric Glaucoma Society. 

Bangkok’s Exotic Allure 

A report on the Asia-Pacific Vitreo-retina Society (APVRS) 

conference, including the latest study findings in the battle 

against macular degeneration 

BY DR ANDREW THOMPSON* 

The city of angels, great city of immortals, 

magnificent city of the nine gems and 

seat of the royal family, Bangkok hosted 

the 10th APVRS Congress in conjunction with 

the 38th Annual Meeting of the Royal College 

of Ophthalmologists of Thailand from 8-10 

December. 

I attended this meeting with Drs Dianne Sharp, 

Peter Hadden, Kolin Foo and Stephen Guest. Over 

200 invited regional and international speakers 

from more than 20 countries addressed a range 

of current medical and surgical ophthalmology 

challenges. Here are just some of the highlights. 

Drs Kolin Foo, Peter Hadden, Dianne Sharp and Andrew Thompson at the Bayer trade 

stand, respectfully attired in black and white as Thailand mourns the king’s death 

Named lectures 

China’s Professor Xiaoxin Li, who identified a new 

gene UBE3D that plays a role in the pathogenesis 

of neovascular AMD and may be a potential 

target for therapy, gave The Tano Lecture. In 

the Constable Lecture, India’s Dr Jay Chhablani 

reported on the efficacy and safety of zivaflibercept, 

an inexpensive alternative to Eylea. 

Ziv-aflibercept requires further investigation 

comparing efficacy and safety against currently 

approved anti-VEGF agents, he concluded. While 

Chicago’s Dr Paul Chan highlighted the Optos, 

RetCam and PanoCam imaging systems that 

better accommodate children and paediatric 

retinal pathology in the Rutnin Lecture. More 

information enables better treatment decisions, 

may influence disease classification and provide 

prognostic markers for paediatric vitreoretinal 

disease, he said. 

Pathologic myopia 

With the increasing worldwide prevalence of 

myopia, medical and surgical treatments for 

pathologic myopia were highlighted. Further 

research is recommended to determine the 

relationship between school and pathologic 

myopia to see if early intervention reduces 

pathologic myopia and associated blindness. 

The sensitivity of OCT angiography (OCT-A) for 

detecting myopic choroidal neovascularisation 

(CNV) is only 63% in quiescent eyes. Although 

OCT-A is not always helpful diagnosing CNV in 

this situation, it is useful as an initial non-invasive 

investigation. Otherwise, multimodal imaging is 

required. 

Early anti-VEGF therapy for myopic CNV results 

in better visual outcomes than delayed treatment. 

Avastin and Lucentis are considered equally 

efficacious. Delayed treatment still improves vision, 

but not to the same extent as early treatment. The 

MYRROR trial using Eylea also supports the premise 

that early treatment is better. 

Dome shaped macula (DSM) occurs in 20% of 

high myopes, and up to 50% of these have serous 

retinal detachment without CNV. Anti-VEGF 

therapy is ineffective and most cases resolve 

spontaneously. Photodynamic therapy (PDT) is 

useful in cases with poor vision. 

Surgical treatment of myopic foveoschisis 

focused on the lack of elasticity of the internal 

limiting membrane (ILM). Vitrectomy/ILM peel/ 

gas can be effective but up to 28% of cases 

develop macular hole. Modified ILM peeling 

is recommended to avoid foveal damage and 

involves centripetal ILM peeling from outside to 

in leaving a 500-micron circular area of ILM at the 

fovea (foveal sparing maculorrhexis). Face down 

posturing for one week is recommended. 

Scleral shortening with vitrectomy/PVD 

induction/ILM peel/gas is effective in managing 

myopic traction maculopathy and preventing 

macular hole development. Secondary toric IOL 

implantation can manage any surgically-induced 

astigmatism. 

Treatment of myopic macular hole/retinal 

detachment (MHRD) utilising vitrectomy/Cshaped 

ILM flap/gas without intentional 

subretinal fluid drainage is effective in achieving 

a good anatomical result with restoration of the 

ellipsoid zone and improved vision. 

Retinal and choroidal vasculopathies 

There are no generally accepted therapies for the 

non-proliferative stages of macular telangiectasia. 

PDT is recommended for the proliferative stage. 

Anti-VEGF treatment requires further study. 

Dr Susan Bressler, professor of 

ophthalmology at John Hopkins 

Medicine in Maryland, presented the 

HOME study and showed how patients 

using the ForseeHome device, that 

detects wet AMD at its earliest stage, 

lost less vision than the standard 

care group. Earlier CNV treatment is 

associated with better vision. 

The pachychoroid spectrum 

includes PCV, with the upper limit of 

normal subfoveal choroidal thickness 

accepted to be 200 microns. In PCV, 

dilated choroidal vessels precede 

polyp development. PCV has a high 

recurrence rate and risk factors for 

recurrence were male gender, thick 

choroid, history of CSC, smoking and 

hypertension. 

The origin of hyperreflective foci in AMD/PCV 

remains uncertain, but most likely represents 

activated microglial cells. Seen mainly in 

subretinal fluid, and abundant at the top of 

each polyp in PCV, the initial number of foci may 

predict final VA in patients with AMD/PCV. 

In the treatment of PCV, EVEREST II showed 

PDT and Lucentis were superior to Lucentis 

monotherapy in achieving improved vision and 

complete polyp regression. 

The Bayer Symposium and associated press 

announcement revealed the findings of the 

PLANET study, showing that at 52 weeks Eylea 

monotherapy led to a 10.7 letter gain compared 

to 10.8 letters with combined Eylea and PDT. There 

was no significant difference between the groups 

in VA, proportion of patients losing < 15 letters, 

reduced central subfield thickness and proportion 

of patients with complete polyp regression. 

Aflibercept monotherapy can be used first for 

patients with visual impairment due to PCV. 

OCT angiography (OCT-A) 

OCT-A featured strongly for CNV/PCV diagnosis 

and uveitis. Typically used to image the posterior 

segment, OCT-A can image iris vessels in uveitis. 

Changing the OCT focus to 28 dioptres and scanning 

nasal and temporal iris vessels can demonstrate 

vascular dilation and tortuosity allowing iris 

vascular volume to be measured. Posterior segment 

OCT-A has identified new pathophysiology such 

as granulomata compressing the choriocapillaris 

resulting in ischaemia. 

Whilst FFA remains the gold standard for 

vascular imaging, OCT-A provides greater vessel 

detail mainly because dye leakage obscures 

vessels during FFA. OCT-A is also better at 

detecting RAP lesions. OCT-A is unlikely to 


Bayer’s virtual reality experience showing delegates catching VEGF 

molecules with Eylea controlled by their hands 


FROM PAGE 16 

replace ICG angiography because the latter is 

a dynamic study. It is likely that multimodal 

imaging will now become commonplace. 

Angioanalytics is a function of OCT-A whereby 

a perfusion density map is combined with OCT-A 

to provide an OCT-A perfusion map. Blue areas 

represent nonperfusion and red shows where 

the vessels are. This is useful for demonstrating 

ischaemia in diabetic retinopathy, FAZ 

enlargement, new vessels and microaneurysms. 

Vessel density decreases with disease progression 

and this concept may have a future role in 

evaluating diabetic eye disease. 

Intraoperative OCT (iOCT) can be fully 

integrated with an operating microscope to 

provide real-time information to guide surgical 

manoeuvres. iOCT increased surgical time by only 

4.9 minutes and, in the DISCOVER study, showed 

that 22% of cases had residual membranes that 

required peeling. 

Uveitis 

The Multicentre Uveitis Steroid Treatment (MUST) 

trial showed steroid implants and standard 

immunosuppression to be equally effective with 

similar visual outcomes. After five years, 91% of 

steroid implant recipients had cataract (45% in 

the standard immunosuppression group) and 

53% (18% respectively) had raised IOP. The steroid 

pellets are also falling off and many require 

surgical removal. Whilst unpublished seven-year 

data suggests the systemic group is doing better, 

steroid implants may be better for unilateral 

disease or patients intolerant of systemic 

immunosuppression. 

Diabetic macular oedema 

Anti-VEGF treatment works well for some patients 

with DME but not others. University of Sydney 

Professor Mark Gillies’ research showed for every 

anti-VEGF injection, patients gained one letter in 

their first year of treatment, and eight injections 

gained eight letters, for example. 

Protocol T has shown Avastin, Lucentis and Eylea 

all improve visual acuity at one year with Eylea 

superior at year one, but no significant difference 

between the three agents at two years. Half 

the number of injections given in year one was 

required in year two. 

Protocol I suggests the response to three 

anti-VEGF injections is a strong predictor of 

final VA and the Bevordex study showed anti- 

VEGF and steroid treatment to be comparable 

over two years. Data from these trials suggests 

it is reasonable to switch anti-VEGF to steroid 

treatment early, even at three months, in order to 

maximise outcomes. 

For PDR, Protocol S showed Lucentis is an 

effective treatment alternative to PRP. 

Retinal surgery advances 

The digitally-assisted vitreoretinal surgery (DAVS) 

platform NGEUNITY 3D incorporates a 3D camera 

attached to the operating microscope and a high 

definition 4K OLED monitor. The surgeon sees 

a 3D stereoscopic image of the surgical field 

through passive glasses. Benefits include higher 

magnification, enhanced depth of field and 

increased image brightness that permits reduced 

endoillumination levels which should be better for 

maculae and lead to better visual outcomes. 

Augmented reality (AR) is another novel 

technology, based on a fighter pilot’s helmet and 

visual screen that uses a head and eye tracker for 

seamless surgical control. Two ultra-resolution 

cameras replace the operating microscope and 

project to a display worn by the surgeon that 

shows the camera view but can also add in real 

time data such as iOCT. 

Other updates 

Multiple concurrent sessions were running 

that made it difficult to attend everything of 

interest. Other updates included improvements in 

choroidal tumour imaging and therapy, managing 

complications of anterior segment surgery, stem 

cells and artificial vision and advances in retinal 

surgery such as endovascular surgery for retinal 

vein occlusion. 

Highlights outside the conference 

One cannot visit Bangkok without seeing the Royal 

Palace, Emerald Buddha, Reclining Buddha and 

the Jim Thompson House for some respite from 

Bangkok’s heat and attack on the senses. But one 

or two congress delegates ended up in the long 

line of Thai nationals entering the Royal Palace to 

pay respects to the deceased king and missed the 

tourist entry. ▀ 

* Dr Andrew Thompson is a consultant ophthalmologist at 

Tauranga Eye Specialists with special interests in medical 

retina, glaucoma and cataract. He is a member of the American 

and the Australia and NZ Societies of Retinal Specialists and 

chair of the RANZCO Ophthalmic Sciences Board of Examiners. 

High-noon on the high street? 

As we head into 2017, NZ Optics’ Jai Breitnauer takes a personal look at the changing face 

of the optometry business 

I 

go to a lot of conferences, and admittedly I 

struggle a bit with in-depth clinical analysis, 

video clips of cataract surgery and that perilsome 

little organism, the Demodex mite. But last year’s 

Eduvisionz conference was absolutely my cup of 

tea. Listening to the various speakers talk about 

marketing, practice design, using social media and 

other related topics made me feel quite excited 

about the future of our industry. 

There is this one word though, that came up time 

and time again. I know it’s contentious to some, so 

I’m going to say it quickly, like ripping off a plaster… 

retail. 

Along with e-tail and me-tail, retail makes up 

the essential trilogy of selling anything in this 

modern world and, whether we like it or not, being 

successful in any business means selling stuff. What 

optometrists are here to sell (healthcare or fashion 

products) and how they do it (retail-forward or 

essential service), however, still engenders serious 

debate. 

“How you see yourself, largely depends on which 

hat you have on,” says Stu Allan of Optics NZ. “In 

the examination room itself you will be healthcare, 

outside the examination room it’s a retail 

environment.” 

That latter isn’t just driven by the necessity of 

selling product, but by the location of a practice, 

which is often positioned in an area where the 

business is highly visible and trying to attract 

passing traffic, like a high street or mall. 

“Optometrists are increasingly located next to 

other retailers, in a business where normally 85% 

of the revenue is through the sale of products,” says 

Allan. “Ask the patient where they think they are, 

that is more important than what we might think.” 

How the patient – or customer – views the 

optometry business is indeed very important, 

according to other speakers at Eduvisionz. Retail 

guru Juanita Neville-Te Rito constantly reminded us 

that businesses and business strategy are driven by 

the customer. The service you provide will make or 

break you, she said. 

“Independent optometrists need to differentiate,” 

says Daniel He from Australian new concept brand, 

Dresden. “Find out exactly what you do better than 

any other optometrist and go do that, because in this 

changing industry it’s no longer okay to be vanilla.” 

The seed for Dresden was planted in the year 

2000, when co-founder Bruce Jeffrey’s went to 

a music gig in Amsterdam - at an optometrist’s! 

That experience made him reconsider the whole 

experience of glasses for the consumer, he said. 

He went on to create, with his business partner, 

designer Jason McDermott, a simple, modular 

eyewear system that is completely interchangeable, 

even the lenses. All Dresden’s frames and lenses are 

manufactured in Sydney and are 100% recyclable 

and, given how affordable they are, means Dresden 

is looking to sell its consumers not just one or two 

pairs of glasses, but several, in a variety of colours. 

Once upon a time glasses were a necessity. They 

were expensive, you owned one pair and you 

upgraded them when your prescription changed. But 

the changing pace of technology means the price of 

frames is plummeting – even many designer pairs 

come in at an affordable price for an average income 

earner. Then there’s advances like 3D printing, which 

is making new, affordable products even more viable. 

The current generation of under 30s is also being 

touted as one of the most narcissistic in history, the 

‘generation-selfie’. This image-focused but cashstrapped 

troupe want affordable, quality eyewear 

they can switch about on a daily basis. 

“I think it is fair to say that optometry continues 

to change and that there is a greater retail focus 

across the board, whether that’s from us or OPSM 

or even most independent practices – and that’s 

Kiwi keynote at 

Harvard Fall Festival 

Professor Helen Danesh-Meyer 

was a visiting professor at the 

Massachusetts Eye and Ear Glaucoma 

Fall Festival and Neuro-Ophthalmology 

Fall Festival in September last year, the 

first time a speaker from Australasia has 

been invited to attend. The theme of the 

2016 conference was the overlap between 

glaucoma and neuro-ophthalmology. 

Professor Danesh-Meyer, from the 

Dresden Optics’ founders Jason McDermott (standing) and Bruce Jeffreys are two of an increasing number of entrepreneurs determined to break 

the mould of traditional high street optometry 

because customers are asking all of us for value, 

more affordable pricing and constantly refreshed 

product ranges,” says Brendan Thompson, a director 

at Specsavers. 

“We’ve made optometry services more affordable 

and more accessible to New Zealanders, that’s why 

the number of New Zealanders having an eye test 

over the past eight years has gone through the roof.” 

With that affordability has also come a demand 

for increased and varied access points. Over the 

last decade, opening hours have extended and 

weekends have become just another opportunity 

to do business. Dresden even has a solar-powered 

mobile unit to go to remote areas. Flexibility and 

availability are key touch points for the millennial 

customer-base, says Thompson adding he believes 

this change will have the biggest impact in the 

independent sector. 

“We are going through another period of change 

in the industry now as people find their place – 

and that’s in all forms of location, from online to 

the traditional bricks and mortar store. You have 

newcomers like Bailey Nelson with a fresh-looking 

offer, and OPSM are going down the road of enticing 

customers into store with value.” 

Another strongly emerging competitor, says 

Thompson, is the internet, with outlets like 

glassesonline and Essilor-owned Clearly. “As in 

all other segments of our market, the traditional 

independent way of doing things won’t last forever. 

People change, and business changes and we’re 

seeing it now, as many independents adapt to a 

more retail-focused model, which in part they’ve 

learned from Specsavers.” 

Bay of Plenty-based behavioural optometrist Keith 

Miller, however, feels we might be thinking about 

the picture all wrong. 

“I don’t think it is right to say optometry has a 

more retail-focused approach. The whole optical 

industry has moved forward and it is better to 

say optometry has become more medical and 

professionally-focused, while the dispensing 

optician area has become more prominent. [New 

Zealand now has] excellent dispensing opticians 

who have taken the retail part of providing 

spectacle solutions to a higher profile.” 

Miller says there is confusion among the public 

about the role of an optometrist that needs to be 

cleared up. 

“It is fair to say there has always been a blurred 

understanding of the professional and dispensing 

parts of optometry by the wider public and, apart 

from a basic understanding that having a medical 

eye evaluation is a good idea, the public just 

assumes the person selling them the glasses is the 

University of Auckland’s Ophthalmology 

Department, presented two keynote 

lectures including ‘The Crossroads of 

Glaucoma and Neuro-ophthalmology’, 

and ‘Mistakes, Lies and Lessons’. One 

of the highlights of the conference 

was a session when challenging cases 

were presented to the panel who were 

expected to solve the mystery in front of 

the audience, she said. ▀ 

optometrist.” 

This confusion has a public health impact, he 

says, as there is less perceived value in an eye 

examination when discounted or free eye tests are 

heavily marketed. “Optometrists may run the risk of 

becoming just ‘refractionists’, in the public mind.” 

Miller doesn’t sell product, preferring to focus on 

patient health. He will give a patient a prescription 

post-exam so they can ‘chase the cheapest deal 

on eyewear’. As technology around diagnosis and 

vision correction improves, the demand for services 

that focus purely on eye-health will increase, he 

says, running concurrent with the increasingly 

fashion-focused retail model. 

“I see the future of optometry recognising 

specialisation and those willing to take on extra 

learning and fellowship programmes. Demand 

from people with less than perfect visual skills or 

eye health will grow. People will seek options to 

allow better visual comfort and endurance such 

as corrections with low cyls., plus lenses, prisms, 

filters and a plethora of occupational lenses. Good 

optometrists will add value by offering medical 

therapy, functional therapy and appliance options 

tailored to the patient’s needs as a care plan where 

a patient can participate in and understand their 

choices.” 

Miller notes we are already seeing more 

collaboration between optometry and 

ophthalmology and says he would like to see 

more cross-referral within optometry as well for 

optometrists who wish to fulfil their professional 

potential by taking a step-up from refractions. 

“Using retailing to subsidise a technology-rich 

and skilful vision consultation will not survive. 

Basic refraction services will be taken over by 

technology…so up-skilling in expanded areas of 

therapeutics, perceptual learning/vision therapy, 

myopia control and customised/hybrid contact lens 

technologies will be necessary. If optometry does 

not step up, then others will move in to fill the void.” 

Whether you have a retail hat on or find your 

business more healthcare driven, there is one 

consensus – the need for value. 

“We all want value and the value equation 

is simple,” says Allan. “The benefit bundle is a 

mixture of genuine levels of care and empathy 

from professionals that can engage, understand 

customer need and provide solutions. 

“Value means different things to different 

people, but you can find it by delivering genuine 

care, engaging with people as individuals, treating 

them with respect and giving them confidence. 

Then they will follow you for life and help grow 

your business.” ▀ 

Professor Helen Danesh-Meyer (centre front) with other speakers at the Harvard Fall Festival - Drs 

Mark Moster, Heather Moss, Sashank Prasad, Dean Cestari, Joe Rizzo and John Gittinger 



17

What’s new in 2017… 

NZ Optics’ top five predictions for what’s going to be optically hot in the Year of the Rooster. 

BY JAI BREITNAUER 

1. Artificial intelligence (AI) 

If you were excited by the self-driving cars in sci-fi 

classics like I, Robot and The Minority Report, then 

2017 is the year for you, says Professor Steven 

Dakin, head of the School of Optometry and Vision 

Science at the University of Auckland. 

“The year 2016 ushered in several significant 

developments in artificial intelligence, with 

machines getting much better at performing 

everyday tasks like driving cars, recognising objects 

and translating foreign languages. Such systems 

use “deep learning’ to perform tasks that have 

long been considered impossible to automate. This 

trend is set to continue in 2017.” 

Vision and vision science is key to the success of 

AI, as those machines need to be able to ‘see’ in 

order to learn and process information about their 

environment in real time. 

Professor Dakin predicts we will see more 

collaborations between corporations and 

healthcare providers to explore how AI innovations 

can help patients in 2017. 

One such example is the collaboration between 

Moorfields Eye Hospital in London and Google 

DeepMind, which is developing systems to 

automatically detect symptoms of diabetic 

retinopathy using OCT imagery, he says. “Such 

collaborations are a win-win for both parties: 

Moorfields gets a tool that has the potential to 

deliver more reliable diagnosis of this condition 

and Google gets to be the nice guy (while gaining 

access to a hugely valuable set of patient records). 

Given the flexibility and power of such systems, it 

seems inevitable we will see them being applied 

to other areas of healthcare that currently require 

human expertise.” 

2. 3D printing and customisation 

Advancements in 3D printing techniques are going 

from strength to strength and are now making their 

way into the more mainstream world of optics. 

Monoqool, the 3D-printed frames pioneer based 

in Denmark, was hot at Silmo Paris and continues 

to attract a host of copycat companies. Monoqool’s 

new designs weigh just four grams and are due 

to be launched this year. The lightness and design 

strength of 3D-printed frames are just two of the 

amazing benefits of today’s 3D technology. 

The other area 3D printing has thrown open 

is customisation. Dutch company Sfered has 

partnered with Monoqool to offer patients a 

customised fit on their chosen frame. Once the 

customer has settled on a stock design, the 

optomestrist scan’s the patient’s face and the 

data is used to print frames that offer them an 

exclusive and highly comfortable fit, they claim. 

The service will be rolled out in Holland this year 

and internationally next year. Meanwhile, French 

start-up Netlooks has taken this a step further with 

technology that actually creates an avatar for the 

patient for fitting and testing frames. 

Visual customisation is also a popular theme, 

with companies like Feb 31st offering customers 

various ways to customise their wooden frames and 

Paperstyle offering handmade paper frames to a 

personalised design. 

3. Round and retro 

When it comes to picking eyewear off the rack 

though, the trend this year will be more vintage 

than futuristic, with John Lennon-style lenses all the 

rage again. General Optical, for example, have just 

revealed their new range by Chloe offering oversized 

round frames in sand and peach hues that look 

like they’re straight off the set of Charlie’s Angels. 

While Face à Face have a new range of eye wear in 

round or ‘cat-eye’ shapes, with metal and walnut 

effect finishes, that will have you channelling 

that sexy 1960’s secretary from the get-go. And 

Xavier Garcia’s take on the old aviator style offers 

sophistication combined with rogue - imagine 

George Clooney in a Top Gun remake! 

4. Myopia control 

Myopia control is a hot topic and increasingly a key 

theme at many conferences, including the American 

Association of Optometrists (AAO) meeting at the 

end of 2016 which focused on the active treatment 

of myopia, rather than simple management with 

eyeglasses. Orthokeratology specialist and NZ 

Optics’ popular contributor Alex Petty says many 

optometrists are now recognising myopia control 

is a big issue that they need to raise with their 

patients. Just prescribing eyeglasses isn’t going to 

cut the mustard anymore, he says. 

“In my view orthokeratology is the best way to 

slow myopia progression (in children). This year I 

think we will see more optometrists raising myopia 

control as a real thing with their patients. Even if 

they’re not orthokeratologists they realise myopia 

control is something we need to be thinking very 

seriously about.” 

Petty notes that laser eye correction and 

implantable lenses are both legitimate treatments 

for adults with myopia whose prescriptions 

have remained steady. However, for those with 

a changing prescription and those who have 

developed myopia at a young age, it’s important 

to offer a treatment that can actually slow the 

progression of an elongating eye. 

“Ortho-k is the one I’d rate as having the best 

overall desired outcomes and it can be used in older 

patients with different refractive problems too. After 

that, I’d probably suggest atropine drops which offer 

a reasonable level of myopia control, but of course 

the patient will also have to wear glasses and the 

cost of the compunded drops is quite high. Beyond 

that, there are other things like CooperVision’s 

MySight lens, a myopia control soft daily lens that is 

more preferable for some young people who don’t 

like a rigid lens or wearing a lens at night.” 

Whatever treatments and control options 

optometrists offer, it seems myopia is going to be 

an important issue for patients in 2017, who will 

increasingly demand more sophisticated solutions. 

5. Glaucoma treatments 

Aerie Pharmacuticals are reportedly on track to 

revolutionise glaucoma care with its new rhokinase 

(ROCK) inhibitors Rhopressa and Roclatan 

(a fixed dose combination of Rhopressa and widely 

prescribed PGA latanoprost) going through FDA 

approval and Phase III trials at the end of last year. 

Rhopressa is a novel, once-daily eye drop designed 

to significantly lower intraocular pressure in 

patients with glaucoma or ocular hypertension. 

Aerie were hoping to have Rhopressa ready for the 

US market by January 2017, but issues with their 

manufacturing plant in Florida have delayed the 

necessary FDA inspection. An inspection should go 

ahead this month however, leaving them on track to 

release the drug this year. This is the first of a wave 

of new treatments expected to hit the market over 

the next few years as other new companies look 

to shake up the US$5.6 billion global market for 

glaucoma with new treatments. ▀ 

France Medical’s Kiwi now 

France Medical, the exclusive 

distributor of E>Eye medical IPL 

systems in Australasia, has expanded 

its business partnership with optometrist 

and low-vision specialist John Veale to 

boost its operations in New Zealand. 

“We launched around September 

2015, with John as our partner in New 

Zealand,” said Aurelien Coursodon, 

managing director of France Medical ANZ, 

adding it made sense to have someone 

on the ground in New Zealand, as it was 

considered a new growth area for France 

Medical’s business. 

The new partnership means France 

Medical can now distribute its entire range 

of products in New Zealand, which includes 

virtual reality systems for strabismus and 

amblyopia and a large range of diagnostic 

instruments and ophthalmic furniture. 

Previously, only the E>Eye was available to 

New Zealand customers. 

“Purchasing an E>Eye device for the 

treatment of MGD (meibomian gland 

dysfunction) has been one of the best 

business decisions made in my professional 

life,” said John Veale, explaining why he 

decided to take on the E>Eye device’s New 

Zealand distribution. “The treatment 

is so successful…not only solving dry 

eye symptoms but also helping people 

who struggle with discomfort due to 

contact lens wear. The innovative treatment has 

introduced many new patients to my new practice 

in Merivale.” 

Veale, a well-known and respected optometrist 

in Christchurch, said however it was time for him 

share the workload. “Helping France Medical 

in Australia to sell the E>Eye in New Zealand 

has been a wonderful opportunity to catch up 

John Veale 

Aurelien Coursodon 

with so many people in the ophthalmic world. 

But it is time for me to move on. I have joined 

France Medical NZ who will take over the sale of 

ophthalmic equipment and consumables from Dry 

Eye Technology Ltd.” 

David Monsellier has been appointed sales and 

accounts manager for France Medical NZ and is 

based in Auckland. ▀ 

MDNZ 2017 RACE DAY: 

Have you bought your tickets yet? 

Tables and tickets are selling fast for the 

popular annual Macular Degeneration 

Race Day at Ellerslie Racecourse in 

Auckland. This year the event is being held 

on Saturday 18 February so there’s still 

time to secure a seat and enjoy a great 

day with family, friends and colleagues 

while fundraising for MDNZ’s vital work 

in the macular degeneration community. 

Ten races will see fast-paced entertainment 

for the entire day with back-to-back action 

as the main stars of the day, the horses, 

thunder along the track in a bid to win one 

of the day’s rousing races. 

Take part in this wonderful 

event, enjoying good food 

and wine while contributing 

to a worthwhile cause! 

For more information or to buy tickets ($140 each) or a table ($1,250) please contact Grace Jones 

on 022 675 3880 or book online http://www.mdnz.org.nz/race-day-ticket-purchase/ 


To ophthalmology and beyond 

As little as 18 months ago, Sunny Li was just 

another medical student fighting to meet 

the demands of her degree. But when she 

mistakenly entered the wrong operating theatre 

while on an anaesthetics rotation, the course of 

her studies – and life – changed. 

“The surgeon, [Dr Tracy Wong], was so 

welcoming. Despite being busy, she invited me 

to stay and let me look through the microscope 

when she was performing cataract surgeries,” 

says Li. 

At one point, Li remembers looking through the 

microscope at a bright blue patient’s eye. 

“It was the most beautiful thing I’d ever seen. 

I felt really emotional. All the patients – who 

were awake during their cataract surgery – were 

so grateful and I realised how rewarding and 

worthwhile this work could be. I could visualise 

myself in Dr Wong’s shoes.” 

Li’s sudden interest in ophthalmology was 

encouraged by Dr Wong, who invited her to 

Greenlane Clinical Centre to see some of the 

equipment and ask some more questions. After 

spending time with Dr Wong, Li’s mind was 

very much made up; she wanted a future in 

ophthalmology. 

Around the same time as she was coming to 

this conclusion, she attended the Festival for 

the Future conference and heard Wellington 

ophthalmology registrar Dr Sheng Chiong Hong 

(better known to all as Hong), one of the cofounders 

of ethically-inspired eye technology 

company oDocs, speak. 

“I felt very inspired by him. His sentiments 

really resonated with what I believe in. Surgery is 

cheap, yet every minute a child goes blind. I feel 

doctors have a social responsibility to improve 

healthcare outcomes not just for their patient, 

but on a wider scale.” 

Li sought out Hong and asked him what 

she could do. As a medical student she was 

unable to provide help in a surgical or medical 

care capacity, but her natural curiosity about 

technology inspired Hong to pair her up with 

software developer Harikrishnan Jayaramen. 

“They’d been working on an idea to develop an 

app, Mobile Eye, to help those already living with 

low vision,” says Li. “The app would use artificial 

intelligence to help people with everyday tasks.” 

Since Li has been working with the oDocs team, 

two American apps have become available, so 

they’ve altered their Mobile Eye plans slightly. 

“We don’t want to compete. But there is 

definitely a need for something New Zealandspecific, 

and for something very feature focused.” 

Li has also been working with Blind Foundation 

clients who have told her text 

recognition is a priority. Struggling to see 

a menu in a restaurant or missing the 

bus because you can’t see the number 

on the front are real issues There’s also a 

need for something that recognises New 

Zealand currency and local cards, like Fly 

Buys, and they have said they would like 

the ability to share images via the app so 

friends and family can answer questions 

if the tech falls short. 

Li is planning to spend some time in 

the home environments of low vision 

people in the next few months to 

identify more areas the app can help 

with. “It’s still very much a work in 

progress but I’m really passionate about 

it. You need to empower people who are 

blind so they can live the best life they 

can.” 

Li and oDocs hope to have an initial 

form of the app ready for the market by 

mid-2017. ▀ 

For more on Sunny Li and Low Vision go 

to p25. 

Sunny Li, tackling low vision via a Kiwi-made app 

Lumenis appoints 

Kiwi rep 

The Australian arm of 

energy-based medical 

device company Lumenis 

has appointed Mike Mckenzie as 

its national sales manager in New 

Zealand. 

Mckenzie, who is based in 

Auckland and was previously 

sales director for cosmetics 

company Revlon NZ and national 

sales manager for Allergan in the 

UK, will have responsibility for 

selling all Lumenis’ products in 

New Zealand. On the ophthalmic 

side this includes the company’s 

M22 system, combining its 

Jo’s a qualified 

DO! 

Our hugely talented 

style columnist, 

Jo Eaton, is now 

a qualified dispensing 

optician. Kiwi Jo, who 

now lives in Melbourne, 

has had a passion for 

eye wear for many years 

before turning it into 

her profession. She runs 

a blog, eyeheartglasses. 

com, works in the industry, 

writes for us and has been 

studying for the Certificate 

IV in Optical Dispensing 

Jo: it’s official now! 

at RMIT University in 

Melbourne since February. 

“In Australia [because of] deregulation, anyone can work as a 

dispenser. I did [the qualification] because I wanted to learn as much 

as I could,” said Eaton. “It’s useful in the workplace and I’m the one 

people come to in the practice when they have tricky questions. I 

suspect it will put me in a good place professionally in the future.” 

Congratulations Jo, and best of luck with your career, from the NZ 

Optics team. ▀ 

Read Jo’s style column on p22 

Mike Mckenzie, Lumenis’ new NZ 

representative 

unique Optimal Pulse Technology with Intense Pulsed Light (IPL) 

technology; Selecta II, its selective laser trabeculoplasty (SLT) 

technology; and Lumenis’ photocoagulators and photodisruptors. 

Talking to NZ Optics at RANZCO 2016, after just four months in 

the role, Mckenzie said his move to Lumenis was driven by Lumenis’ 

commitment to improving the quality of patients’ lives and its 

technological reputation, which he was already familiar with through 

his “aesthetics” background. “I’m still getting my knowledge of the 

eye world up-to-speed, but the principles of laser remain the same as 

these systems do far more than dry eye. 

“Lumenis invests more than 20% of its revenue on R&D and the 

technology is evolving quicker all the time, as more and more data is 

collected, which is very exciting.” ▀ 

SAFETY, 

DRIVEN BY VISION. 

Confidence behind the wheel with Rodenstock Road driving glasses. 

See better. Look perfect. 

GREATER SAFETY COMES FROM 

1. UNRESTRICTED FIELD OF VISION FOR RAPID CHANGE OF FOCUS. 

2. LESS GLARE AND MORE CONTRAST. 

3. EXCELLENT NIGHT VISION. 

4. SAFE ASSESSMENT OF DISTANCES. 

Without Rodenstock Road: Restricted peripheral vision with conventional 

progressive lenses. 

With Rodenstock Road: Perfect overview of traffic and rapid change of focus 

between dashboard, GPS and mirrors thanks to optimal fields of vision. 

For more information speak to your Rodenstock Account Manager or visit www.rodenstock.com.au 

COMING SOON 



19

Behold – Ocula! 

The December opening the new Ocula 

practice in Queenstown was attended by 60 

plus guests, including the mayor Jim Boult, 

local business owners and previous Bridgman 

and Dean patients. The new practice is owned by 

Danielle Ross and John Winstone, who rebranded 

their Wanaka store, Eyes on Ardmore as Ocula and 

added Queenstown to the business by buying 

Bridgman and Dean’s Queenstown practice last 

year (see December’s NZ Optics). 

We asked Ross about the changes and the new, 

high-end store fit-out. 

This is a big change for you – how long 

have you been planning it? 

Actually the opportunity to expand into 

Queenstown came about unexpectedly in 

October, so we had just 10 weeks from initial 

discussions to opening the new store. But we 

had been thinking of ways to improve the use 

of space and design in our current store, so have 

been inadvertently conceptualising our ‘dream’ 

store for some time now; it just took the project 

manager and builders to turn it into a reality. 

How did you come up with the idea 

behind the rebrand? 

The name ‘Ocula’ is a play on the Latin medical 

term ‘ocular’. Our brand name is designed to 

be a little obscure to the general public and 

we purposefully did not include the terms 

optometry, eyewear or eyecare in the name, as 

we didn’t want to be pigeonholed into traditional 

optometry. We wanted a name that wasn’t going 

to limit us and would allow us to continue to 

expand the retail sector of the business. 

Since purchasing Eyes on Ardmore in 2011, a 

rebrand and renovation was always on the cards. 

We had dreams of where we wanted to take the 

business and we felt the Eyes on Ardmore brand 

was too restrictive – not just for location, but 

also for growth. In 2015, we developed Ocula 

with a branding specialist and started to plan the 

Wanaka renovation. Soon after, the Queenstown 

opportunity presented itself. Whist perhaps 

timely, the situation quickly became a pressurecooker! 

Already committed to the Wanaka 

rebrand, we had many sleepless nights managing 

the Wanaka renovation, building a new website, 

implementing the new Optomate Touch platform, 

managing the Bridgman and Dean acquisition, 

and negotiating the Queenstown retail store build 

and business set up. Let’s just say we’ve got a few 

more grey hairs! 

What is the inspiration behind your store 

design? 

We [wanted] a boutique retail store that 

encouraged shopping and browsing and, 

specifically, a space that was far removed from a 

typical medical reception and waiting room. On 

the premise one buys an experience and walks 

out the door with a product, we aimed to create a 

unique and beautiful experience that we feel truly 

reflects the product suite we offer. The design 

brief was to be simple, but not sterile; classy but 

not exclusive. 

The retail fit-out, including the internal build, 

furniture and styling, cost approximately 

$150,000. John (Winstone) is an architectural 

draftsman, with a keen eye for design and 

functionality, and we both had a clear idea of 

what we wanted. We bounced ideas off my 

interior design sister and Lynn Parker, from Parker 

and Co. to ensure we were on the right track. 

We also really appreciated looking through John 

Kelsey’s practice, Optik Eyecare, which is very 

DT’s Christmas at Mantells 

Device Technologies had 

more RSVPs than it could 

handle this year, with the 

medical equipment company 

forced to say “no” to some last 

minute replies to its December 

Christmas get together. But 

still many health professionals, 

including a few ophthalmic 

specialists (pictured), enjoyed 

some delightful canapés and 

wines at Mantell’s in Auckland’s 

Mt Eden suburb in December. ▀ 

Silmo Sydney has arrived! 

A 

brand 

new event on the Australasian 

optics calendar, the inaugural Silmo Sydney 

optical fair, opens its doors in just under six 

weeks. 

Organisers Expertise Events are promising three 

days of exciting events and stylish soirees from 

the 9 – 11 March at Sydney’s new International 

Convention Centre in Darling Harbour. The new 

fair has partnered with Optometry Australia’s 

NSW and ACT Super Sunday conference and the 

National Retail Association to offer educational 

elements to all those involved both from an 

optometry and a business perspective. Other 

highlights to look out for include: 

• The Silmo Village, where designers from 

Europe, America and beyond will be profiling 

what’s hot for 2017. Visitors can see the winners 

Dr Penny McAllum 

FRANZCO 

. Wed 29th March, Novotel, Ellerslie 

. Wed 28th June, Ormiston Hospital 

of the prestigious 2016 Silmo D’Or Awards for 

innovation and design, which are being flown out 

to Sydney especially for the show. 

• The Brand Arcade, where exhibitors can design 

a shop window and learn how to style a particular 

product campaign. 

• The Retail Power programme, which is a series 

of quick-fire sessions with some high-profile 

business experts from optics and retail, offering 

practice owners their own secrets to success. 

Load-up on advice for business strategy and 

structure and then visit the trends wall to see 

what looks you should be stocking in 2017. 

• The Mega Rox Party with more than 500 tickets 

already sold, the event is proving to be a popular 

way to spend the show’s Saturday night. Being 

Ocula Queenstown throws open its door for the launch party 

thoughtfully designed with a clever use of space. 

Have you used any sensory design 

principles? 

Our stores play a Spotify music playlist chosen 

to appeal to our key clientele and an Oakmoss 

George & Edi fragrance to heighten the sensory 

experience. The artwork was chosen to be 

aesthetically beautiful to look at and intentionally 

not industry related to further enhance the visual 

experience and retail store concept. We keep a 

clean aesthetic by creating our own point-of-sale 

for the product brands to ensure uniformity, 

which in turn highlights the differences in the 

actual product and takes the visual emphasis off 

the displays. 

How has the redesign improved the 

functionality of the store? 

The Wanaka renovation allowed us to create more 

retail and office space, as well as bring the store 

design into line with the new brand concept. The 

concept we really wanted to achieve with the 

Queenstown design was to have the ‘working’ 

parts of the business (waiting room, lab, offices 

and consultation rooms) hidden from the retail 

Claus and Kerstin Doering, Campbell Gordon, Tracy Richmond and Andrew Schwamm Dr Dean Corbett, Janet Wigmore, Tracey Molloy and Jasha Morarji 

Eye Doctors Grand Rounds 2017 

held at 

the Italian 

Village in 

The Rocks, 

whether 

you would 

like to 

dance the night away or just catch up in a quiet 

corner with friends, organisers are promising no 

speeches or awards, just the chance to network 

and have a bit of fun. 

Silmo Sydney is also supporting the Royal 

Institute for Deaf and Blind Children. The show 

will be formally opened on 10 March by Jillian 

Skinner, the NSW health minister. ▀ 

Read Chalkeyes take on Silmo Sydney vs 

ODMA2017 on p27 

. Wed 8th November, Novotel, Ellerslie . www.eyedoctors.co.nz 

ASCOT CLINIC (09) 520 9689 - BOTANY JUNCTION (09) 277 6787 

Dr Shuan Dai 

FRANZCO 

. No registration fee 

. CPD points available 

Dr Andrew Riley 

FRANZCO 

Dr Mark Donaldson 

FRANZCO 

EYE 0810 

John Winstone, Danielle Ross and Queenstown Lakes Mayor Jim Boult 

Interior of the new Queenstown store 

floor to accentuate a hero space for the retail 

product. Though a similar size to Wanaka, we 

managed to achieve two consultation rooms in 

the Queenstown store, which we may not need 

for a while yet, but allows us room to grow and 

expand. ▀ 

Vision screening 

success 

Since 2014, the School of Optometry and 

Vision Science has been building its school 

screening programme for children in the 

greater Auckland region. Bachelor of Optometry 

students tested 700 children in that first year, 

increasing to 1500 in 2015. In 2016 the School 

screened a record 2000 children with more than 

100 referred on to clinic. 

The focus of the programme is to ensure all 

children have access to comprehensive eyescreening 

to help improve academic performance 

and to provide the undergraduate optometry 

students involved in the testing programme with 

vital work experience in the field. 

The programme is set to continue its expansion 

in 2017 as partnerships with additional schools 

and local optometrists are nurtured. As part 

of the University of Auckland’s ‘For All Our 

Futures’ fundraising campaign, the School is 

looking to purchase and run a mobile optometry 

clinic, allowing the provision of full on-site eye 

examinations. This will be used in the schools 

programme and for rural and underfunded 

areas. ▀ 

Obituary – 

David Ren 

BY BELINDA WAY, DIRECTOR, OPHTHALMIC 

INSTRUMENT COMPANY (OIC) 

OIC was 

advised by 

David Ren’s 

family of his sudden 

passing on 12 

November 2016 at 

the age of 53. David 

emigrated from 

China with help of 

OIC’s sponsorship 

and worked with 

OIC from 2004 till 2011, when he left to start 

his own prescription lens laboratory with Nidek 

Edging equipment. He continued to work for 

OIC and service Nidek edgers. He was a very 

loyal and conscientious worker and many will 

remember his smiling face. David leaves a wife 

and three children. He was very close and proud 

of his family. His elder daughter is studying 

medicine in Brisbane. ▀ 


A/Prof Rob Jacobs retires 

BY PROFESSOR STEVEN DAIKIN* 

Associate Professor Rob Jacobs’ career is 

defined by a path of continuing achievement. 

Following a PhD in optometry at the 

University of Melbourne (1978), he was appointed 

to one of only three optometry lectureships at 

the University of Auckland in 1984. This was 

followed by promotion to Associate Professor, Clinic 

Director, Coordinator of Clinical and Professional 

Programmes, Academic Director and Head of the 

then Department of Optometry and Vision Science. 

When passing the headship to me in 2014, it was 

my great fortune that Rob agreed to continue in his 

role as Academic director and in that period I have 

been privileged to witness at first-hand what many 

people know to be the defining characteristics of 

Rob’s work. To every task Rob brings an extraordinary 

level of diligence, humility and generosity - both of 

spirit, and of time. His achievements fall into several 

categories. 

The first has been his ability to provide advice 

on vision (especially colour vision) and visual 

ergonomics to many national bodies. These have 

included the development of vision standards for 

Police officers who have undergone eye surgery. 

He advises the NZ Civil Aviation Authority and 

has helped establish a credentialing system for 

optometrists to undertake eye examinations for 

pilots and air traffic controllers, here and in Australia. 

Rob has also advised NZ children’s organisations 

such as Ministry of Health Well-Child – Tamariki 

Ora and the See Here project for the JR McKenzie 

Foundation. His advice to the Ministry of Health 

Diabetic Retinopathy Screening Forum contributed 

to the development of national standards for 

managing this disease. He has also served as an 

Yes! e-yes now 

in NZ 

expert witness to District and Supreme Courts 

on issues involving colour vision, driving, and 

visual issues arising from aircraft laser strike. He 

has chaired or participated in organisations too 

numerous to list in full but including the directorship 

of the Optometry Council of Australia and New 

Zealand, and chair of the International Fellowship 

Admittance Committee of the American Academy of 

Optometry. 

Rob’s second area of achievement is in research. 

Rob serves as an associate editor of the professions’ 

Australasian Journal: Clinical and Experimental 

Optometry. He has published more than 70 research 

articles, as well as the first comprehensive evidencebased 

textbook on ocular prosthetics. He has built 

numerous national and international collaborations 

across disciplinary boundaries and was also involved 

with establishing a research partnership with Essilor, 

the world’s largest manufacturer of corrective lenses. 

Rob’s third and crowning area of achievement 

relates to the training of optometrists. For more 

than a generation he has led development of 

optometry teaching in New Zealand through 

ongoing modernisation of the Bachelor of Optometry 

programme, and through his mentoring of staff 

to ensure quality teaching. Notable contributions 

include his work revising the curriculum in 1996 to 

allow optometry graduates to use certain diagnostic 

medicines, and in 2003 to contributing to the 

curriculum change that allowed optometrists to 

prescribe 

medicines to 

treat a wide 

range of eye 

conditions. 

In recent 

years, Rob’s 

Cardinal Eyewear has introduced e-yes lightweight frames 

and polarised magnetic clip-ons to New Zealand. 

The new frames range is made from ultem, a very light, 

heat and solvent resistant polymer material, and incorporates 

metal hinges with embedded steel rods in the tips to enable 

adjustments. The clip-on magnets are invisible from the front 

of the frame, yet have a strong, positive grip onto the clip while 

the clips have no protrusions, are light and easy to carry, said 

Cardinal’s John Wedlake. 

“We had been looking for a frame range that used magnetic 

clip-ons for a couple of years. I am a fan because I believe that 

polarised clip-ons 

are an excellent 

solution for people 

just like me: 

people who use 

progressive lenses 

and are in and 

out of cars and 

buildings all day.” 

Wedlake said 

he found e-yes at 

Mido last year and 

selected it because 

it offered a good 

range of models 

and colours that 

suit the Kiwi 

lifestyle. He 

also particularly 

wanted a product 

that didn’t have 

protruding 

Cardinal Eyewear’s John Wedlake modelling his own e-yes 

frames and clip-ons, now in NZ 

magnets, which tend to catch on clothing and can break off. 

“I was convinced that technology would come up with a better 

solution and sure enough we found it. The sleek design of the 

hidden magnets is the outstanding feature of e-yes frames. They 

fit so perfectly that they look like they are part of the frame.” 

All the clips are polarised and come in grey, brown or green 

tints with the tint colour matched to the frame fronts; some are 

also graduated and some mirrored, and the clip sub-frame can be 

re-glazed for specific customer requirements. 

The e-yes frames and clips will appeal to anyone who wears 

glasses, but especially those who don’t like the inconvenience 

and cost of having both a pair of glasses and a pair of sunglasses, 

said Wedlake. “Wearers of progressive lenses will really 

appreciate these frames because they are particularly light 

weight so designed for all day use. The clip-on is also extremely 

light and can simply slip into a shirt pocket or into the cloth 

pouch that is provided.” 

Additional clips are available for customers who need a pair 

in the car and one in the boat, he said, adding that Cardinal 

Eyewear has also asked the brand owner to develop some smaller 

models, more suited to ladies. ▀ 

innovation in the B Optom programme has set the 

template for training for years to come. 

Because the School of Optometry and Vision 

Science (SOVS) is the only accredited training 

programme for optometrists in the country, it would 

be no exaggeration to say that Rob has guided the 

education of virtually every New Zealand-trained 

optometrist practicing in the country today. These 

people – and the way they have improved Kiwi’s 

lives – are in some sense Rob’s greatest contribution. 

Former students describe his teaching style as 

‘exemplary’, ‘dedicated’, ‘meticulous’, ‘motivating’ 

and that he has ‘extreme patience’ with all his 

students. Although our school has a small staff we 

train optometrists to a standard that is recognised 

to be among the very highest within Australasia. 

Our ability to deliver this training has been a direct 

consequence of Rob’s dedication. Anyone who spent 

any time in the School quickly realises that Rob 

serves not only the academic director role, but is also 

the glue that held the programme together. It is Rob 

who continues to mentor staff members who have 

problems writing exams, using new educational 

software, or navigating the sometimes bewildering 

bureaucracy that surrounds modern university 

degree programmes. It is Rob who always steps up 

to sit on committees, to develop new courses, to lead 

initiatives to recruit more Maori/Pasifika students to 

the programme, or to write and edit reports for the 

myriad review processes that SOVS undergoes. All 

of these things Rob 

does with a level of 

quiet expertise and 

modesty that is his 

trademark. 

Others have also 

recognised this 

achievement. Rob 

was the recipient 

A/Prof Rob Jacobs 

of the Bott Medal 

in 2007 from the New Zealand Optometric Vision 

Research Foundation and was awarded the HS 

Gilberd Medal in 2014 by the NZAO, an organisation 

that conferred honorary membership to Rob in 2002. 

In short, Rob truly has a lifetime of achievement 

characterised by an unparalleled dedication to 

his field. To quote Head of Ophthalomlogy, Prof. 

Charles McGhee, “no other individual … has made 

such positive and wide-ranging contributions to 

the profession” in New Zealand. I personally have 

worked in many universities and I have never 

experienced commitment to academia – be it in 

teaching, service or research – to match Rob’s. To 

have advanced one’s discipline to the extent he has, 

with the resources at his disposal, and to remain 

the nicest guy in optometry is a trick only Rob could 

achieve. This contribution is one any academic would 

be proud to have made. ▀ 

* Professor Steven Daikin is head of Optometry and Vision Science 

at the University of Auckland. 

SILMO 2017 – MIX BUSINESS WITH PLEASURE 

AND DISCOVER THE NEXT BIG SELLERS. 

KICK-START YOUR SALES WITH SILMO 2017 AND GIVE YOUR 

BUSINESS AN IMMEDIATE COMPETITIVE EDGE. 

The new year is a restocking period coinciding with the availability of new release products fresh from 

around the world. Come over and celebrate with the visionaries and see: • SILMO PARIS D’OR winners 

SILMO VILLAGE showcasing the latest in international and local trends •FREE RETAIL POWER 

SESSIONS by industry experts •MEGA ROX – the party of the year•Earn a year’s CPD points in one 

day with Optometry Australia Super Sunday Conference •TRENDS WALL – showing the latest designs 

for the year ahead. So book your flight and register your interest today at www.silmosydney.com 

Organised by: 

events 

March 9 – 11, 2017, International Convention Centre Sydney 

For more information contact us on +61 2 9452 7575 or email info@silmosydney.com 

Supported by: 



21

Style-Eyes 

BY JO EATON 

When children head back to school this month, unnoticed 

problems with their vision should be picked up either by teachers 

or a screening programme. If they need glasses, there are several 

things to take into consideration. For example, rapidly growing 

children might have their pupillary distance (PD) widen and that 

means that lenses or frames could need changing more often. 

Both frames and lenses need to have the durability to withstand 

kids’ rough-and-tumble lifestyles. Kids always want to look good, 

too. So with this in mind, I’ve explored a few brands taking on the 

style versus function balance for children. 

Tomato Glasses 

South Korean dad Sungjoon Kim’s son needed glasses and he had 

trouble finding suitable frames, so in 2003 he started Tomato 

Glasses. Tomato Glasses frames are highly flexible, durable and 

adjustable, while still managing to be adorable and brightly 

coloured. 

Tomato glasses make frames suitable for newborns through to 16 

years of age. For very small children, the shapes are simple - oval, 

rectangular and round. For older kids, they’re more fashionable. The 

frames are made out of TR90 nylon, which is a ‘shape intelligent’ 

material – when twisted, it springs back into shape. 

The glasses come in a kit with two spare nosepads, spare 

ear tips, a headband, case and a cloth. Both the nosepad 

position and temple length is adjustable by unscrewing and 

moving these parts. It’s very clever! Check out their website for 

plenty of diagrams and instructions of how this works. www. 

tomatoglasses.com.au 

Nike 

Nike frames are a brand recognition no-brainer for label conscious 

kids. Nike Vision have a wide range of sunglasses and optical 

frames in a variety of materials. Simple metal, fashionable acetate 

shapes and many of them are accented with child-friendly bright 

colours. 

Ogi 

Ogi’s Ogi Kids range is now available. There are four frame designs, 

all made out of TR90 nylon and in different vibrant colours. The 

IN100 and 101 come with adjustable temple tips so the glasses 

grow with the child. The IN102 and 103 are for older children and 

come in different tortoiseshell patterns and two-tone colours. 

These are great grown-up looking styles for precocious kids. 

Safilo 

Safilo’s Kids By Safilo range claims their eyewear does “not weigh 

on the nose, they don’t hurt behind the ears, and they are never 

tiring, even if worn all day: resistant to perspiration, dirt and 

sometimes harmful curiosity.” They also claim to stay firm on the 

nose while kids are active. With no metal parts or exposed hinges, 

kids with nickel allergies will be just fine. They’re made of biobased 

non-toxic materials. There are plenty of colours and styles 

available to satisfy the choosiest young customers. “For little ones 

who want to make their own choices”, as they say! 

Very French Gangsters 

For the tiny style icons, Very French Gangsters 

(veryfrenchgangsters.com) are perfect. I don’t think I’ve seen more 

delightful and on-trend frames for children anywhere else. French 

founders Anne Masanet and Karoline Bothorel-Bolzinger are selfdescribed 

glasses addicts and it shows in their products. Founded 

in 2012, Very French Gangsters also make sunglasses to protect 

our little friends’ eyes. 

Zoobug 

Zoobug are super cute, but don’t have New Zealand distribution 

at this point. Their frames are designed by eye surgeon Dr Julie 

Diem Le for kids aged 0-12. A lot of their frames for the youngest 

children come with built-in elasticised straps that go around the 

back of the head to hold the glasses in place. 

And… 

There are plenty of other brands available. Check out Miraflex 

(miraflexglasses.net), Australia’s Frankie Ray sunglasses 

(frankieray.com.au) and Anne et Valetin’s ‘Enfants Terribles’ & 

‘Superkids’ ranges for starters and Luxottica’s Ray-Ban also do 

children’s eyewear. 

May 2017’s back-to-school season be fashionable and practical 

for our littlest customers! ▀ 

* Jo Eaton is a native Wellingtonian, now working as a qualified DO in Melbourne. 

She runs eyewear fashion blog, eyeheartglasses.com 

2017 fashion update 

The new ranges’ press releases were flying into our in-boxes 

at the end of 2016 and the beginning of 2017. Here’s our 

‘most newsy for New Zealand’ top picks. 

Xavier Garcia 

Xavier Garcia has released 

his autumn/winter 

collection, ‘Barcelona’. The 

clean lines and vibrant 

colours of the contemporary 

Barcelona collection are 

inspired by the elegance 

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23

with 

Prof Charles McGhee 

& A/Prof Dipika Patel 

Series Editors 

Central serous chorioretinopathy 

update 

BY DRS MOAZ ALSHAIKHI AND DAVID SQUIRRELL* 

Central serous chorioretinopathy (CSCR) 

is a retinal disorder characterised by 

localised macular serous detachment of 

the neurosensory retina and, often, with retinal 

pigment epithelium (RPE) detachments. CSCR 

is the fourth most common retinopathy after 

age-related macular degeneration (AMD), diabetic 

retinopathy and retinal vein occlusion. Initially 

thought to be an inflammatory condition, it was 

called “central recurrent retinitis” before the term 

CSCR was coined by Gass in the 1960s 1 . CSCR was 

perceived as a disease of young males, but recent 

population-based and retrospective studies report 

the average age of presentation is between 40 

and 51 years 2,3 . A five-year retrospective review of 

CSCR cases of two retinal specialists in Auckland 

District Health Board’s Ophthalmology Department 

revealed an overall mean age at presentation of 

47 years. CSCR can also present in the elderly and 

can mimic neovascular “wet” AMD. Older patients 

are more likely to present with diffuse loss of RPE 

and, to confuse the issue, may also have secondary 

choroidal neovascularisation (CNVM). Whilst not 

always a “disease of the young” CSCR is six times 

more common in males, with an observed annual 

incidence of 9.9 per 10,000 compared to 1.7 per 

10,000 in females 2 . 

Risk factors and pathophysiology 

Elevated levels of corticosteroid has long been 

recognised as a risk factor and these corticosteroids 

can be from both exogenous and, less commonly, 

endogenous sources. Oral corticosteroid therapy 

is the most commonly reported route of 

administration, however, other routes have also 

been documented including topical, inhalers, 

intranasal and intra-articular. Steroid-induced CSCR 

seems to act in an individually dependent manner 

rather than a dose-dependent manner, as a very low 

dose of corticosteroid can be enough to trigger the 

formation of subretinal fluid (SRF) in susceptible 

individuals 1,3 . Steroid-induced CSCR is more likely 

to be bilateral with atypical features and shows 

less predilection for males. Whilst corticosteroids 

are generally used in medicine to treat oedema in 

different conditions, it is believed to increase the 

permeability of the inner choroid in CSCR leading 

to the accumulation of SRF. It has recently been 

suggested that the pro-oedematous effect of 

glucocorticoids in CSCR is due to the binding and 

activation of the mineralocorticoid receptors (MR) 

responsible for fluid retention 3 . A recently published 

meta-analysis of risk factors reported significant 

associations between CSCR and hypertension, 

H. pylori infection, obstructive sleep apnoea, 

autoimmune disease and type-A behaviour 4 . 

Pregnancy is another risk factor, with the condition 

often occurring in the third trimester and usually 

resolving within two months of birth 1,3 . 

The pathophysiology underlying CSCR remains 

poorly understood, however advances in retinal 

Fig 1. A case of non-resolving multifocal CSCR with an underlying micro break of the RPE. These leaks 

were successfully treated with focal argon laser. Colour photo: Blue arrows reveal the extent of the serous 

detachments. Fluorescein angiogram: Yellow arrows reveal the site of two focal leaks. High resolution EDI 

OCT: Yellow arrow reveals a small micro-break at the level of the RPE. 

24 NEW ZEALAND OPTICS February 2017 

imaging modalities 

have given us 

some insights into 

morphological 

abnormalities. 

It has long been 

recognised that CSCR 

is the result of a 

localised breakdown 

of the blood-retinal barrier with the subsequent 

development of a leak of fluid from the choroid 

to the subretinal space. This leak may be focal, 

multifocal or diffuse and is caused by micro 

breaks within the RPE (fig 1). Spectral domain 

OCT studies have also consistently demonstrated 

that CSCR is associated with a thick choroid, or 

“pachychoroid” when compared to healthy subjects 3 

(fig 2). Patients also have evidence of increased 

choroidal permeability on both fluorescein and 

ICG angiography. A “hyper-vascular” choroid 

therefore appears to be a risk factor for the 

development of CSCR and the co-localisation of 

pigment epithelium detachments in many cases of 

CSCR, supports this hypothesis 3 . Nevertheless, the 

underlying mechanism of the choroidal disease, 

and whether the RPE dysfunction can be explained 

by these observed changes or whether there is 

an independent pathology at the level of the RPE 

remains to be determined. 

Fig 2. A case of bilateral, recurrent non resolving multifocal CSCR. (Normal 24 hour urinary 

cortisol levels). a. Colour photo: Note the central pigmentary disturbance consistent with 

“chronic recurrent CSCR”. b. Fluorescein angiogram: Reveals a perifoveal leak that is not 

Clinical presentation and classification 

The term “CSCR” is used to describe several clinical 

presentations and has until recently been classified 

into “acute” and “chronic”. Acute CSCR describes the 

form that typically presents unilaterally in younger 

patients with symptoms related to SRF under the 

central macular, including a relative central scotoma 

and a patch of blurred vision. Best-corrected visual 

acuity is usually reduced to between 6/7.5 and 

6/60 and can be improved in some cases with a 

weak plus lens, which corrects for the hypermeropic 

shift caused by the elevated photoreceptor layer 1 . 

Other symptoms include dyschromatopisa, reduced 

contrast sensitivity and micropisa. 

The “acute” form of the disease usually refers to 

the first presentation of the disease in an otherwise 

healthy macular, but the definition of “chronic” CSCR 

has been somewhat ambiguous, (used to refer to 

CSCR with persistent SRF of duration longer than 

four to six months as well as cases with diffuse 

RPE atrophy formally known as “diffuse retinal 

epitheliopathy”). A recently published review of 

CSCR suggested the use of “non-resolving CSCR” 

to describe patients with persistent SRF with no 

signs of diffuse RPE atrophy 3 . “Chronic” CSCR 

usually affects older patients and is characterised 

by RPE changes (fig 2) and permanent visual loss 

which can be severe. Less common forms of CSCR 

includes bullous CSCR, which is characterised by 

multiple areas of exudative SRF with subretinal 

fibrin deposits. Bullous CSCR tends to be more 

aggressive in nature, 

often aggravated by 

corticosteroid treatment 

and more common in 

Asian populations 1,3 . 

Prognosis 

CSCR has often been 

regarded as a relatively 

benign retinal disease as 

spontaneous resolution 

is observed in the 

majority of cases (56%- 

90%) 3 . Although best 

corrected, high-contrast 

visual acuity mostly 

appears to return to 

normal, residual deficits 

in colour vision and/ 

or contrast sensitivity 

are often reported. 

Recurrence is also 

common with rates of 

between 31% and 50% 

being reported. Typically 

recurrences are within 

the first year 3 . Whilst visual recovery after an episode 

of CSCR is the rule, patients with recurrent disease, 

non-resolving disease or the bullous form of the 

disease often experience significant and permanent 

visual impairment. Long-standing, chronic CSCR can 

be associated with the development of a secondary 

CNVM but such cases often have a characteristic 

pachychoroid which helps distinguish them from 

“typical” AMD. 

Management 

Initial Assessment and Investigation: 

Observation remains the appropriate first-line 

management in most cases of acute CSCR as it is 

typically a self-limiting condition. Although there is 

no general agreement of the management of CSCR 

and the optimal time of intervention, treatment is 

usually recommended in those cases where there 

is a threat of permanent visual impairment 1 . It is 

therefore appropriate to refer all cases of suspected 

CSCR for specialist review. In the majority of cases 

of CSCR, serial observation with OCT, documenting 

resolution of the SRF, is all that is required. However, 

if the patient falls into one of the high risk categories, 

fluorescein angiography will determine the location 

and nature of the leak. 

In the meantime, modification of risk factors such 

as discontinuation of steroid use should be attempted 

when practical, to assist with the resolution of SRF 

and prevent complications of chronic disease. Rarely 

CSCR can be the presenting symptom of serious 

underlying systemic disease and the physician 

needs to be prepared to investigate beyond the eye 

in atypical cases. We would advocate that 24 hour 

urinary cortisol levels be assessed in patients who 

present with bilateral, multifocal disease with referral 

to an endocrinologist if elevated. 

Oral medications: 

Small, non-randomised case series over the last five 

years, looking at the effectiveness of oral medications 

including aspirin, Rifampicin, and omeprazole have 

offered underwhelming conclusions. It is recognised 

that over-activation of the mineralocorticoid 

receptors (MR) plays a role in some cases of CSCR 

and MR antagonists’ spironolactone and eplerenoe 

have therefore been used for the treatment of nonresolving 

CSCR with encouraging results 9 . Whilst 

their exact role is yet to be defined MR antagonists 

offer a promising non-invasive option. 

Laser photocoagulation: 

Although often over-looked, Argon laser focal 

photocoagulation can be very effective in sealing the 

leak associated with CSCR and hasten the resolution 

of the SRF 5 . Argon photocoagulation does cause focal 

RPE damage and is therefore not an appropriate 

treatment option in cases where the leak is under 

or close to the fovea. Argon photocoagulation is 

relatively cheap, readily available and therefore an 

effective option in cases of extrafoveal persistent 

CSCR (fig 1). More recently, Diode micropulse laser 

has also been used in CSCR. Although the initial 

results are promising, six more studies are needed to 

evaluate the long-term outcomes. 

Photodynamic Therapy (PDT) 

It has long been accepted that Photodynamic 

therapy (PDT) both hastens the resolution of SRF 

and reduces the likelihood CSCR recurrence. The 

free radicals released by stimulating verteporfin 

induce choroidal vascular remodeling and reduce 

choroidal thickness, thus reversing the underlying 

pathology. However, significant complication rates 

were reported with standard “full dose/ full fluence” 

PDT, including permanent choriocapillaris ischemia 

and RPE atrophy, secondary CNVM formation and 

reduced visual acuity 3 . As a result, the treatment 

amenable to focal argon laser treatment. c. High resolution EDI OCT reveals persisting SRF and 

an underlying ‘pachychoroid.” The fellow eye’s choroid was similarly thick. d. High resolution 

EDI OCT six weeks after ½ fluence PDT with complete resolution of the SRF. 

was “safety-modified” by altering either the dose 

of verteporfin (half-strength PDT) or the fluence of 

the laser that was applied (half-fluence PDT). Safety 

modified PDT regimens have subsequently been 

confirmed as effective compared to standard PDT. 

As a result, safety modified PDT has now established 

itself as the treatment of choice for non-resolving 

foveal involving CSCR 7 . 

Anti-VEGF factors and Oral medications: 

Investigators studied the role of anti-VEGF in the 

treatment of acute and chronic CSCR. No significant 

differences have been found in terms of final visual 

acuity, macular thickness and duration of SRF8. Anti- 

VEGF therapy was also inferior to PDT in treating 

patients with chronic CSCR. The role of anti-VEGF 

therapy is limited to cases with CSCR-related CNVM. 

Summary 

CSCR is a common retinal condition that all 

optometrists and general ophthalmologists 

should be aware of. Whilst mainly a self-limiting 

condition, it is not as benign as once assumed and 

the conventional approach of waiting months and 

months before intervening is no longer accepted 

practice. After excluding an exogenous source of 

steroids, most retinal specialists would be happy 

to observe a typical case of CSCR for up to three 

months before intervening, but in cases where the 

SRF is clearly not resolving within eight to 10 weeks 

a fluorescein angiogram would be appropriate. 

If the CSCR leak is focal and extrafoveal, a gentle 

focal argon laser can be safely applied. If the leak is 

central and/or diffuse, oral MR antagonists or safety 

modified PDT would be offered. ▀ 

References 

1. Nicholson B, Noble J, Forooghian F, et al. Central Serous 

Chorioretinopathy: Update on Pathophysiology and Treatment. 

Survey of Ophthalmology 2013;58(2):103-26. 

2. Kitzmann AS, Pulido JS, Diehl NN, et al. The Incidence 

of Central Serous Chorioretinopathy in Olmsted County, 

Minnesota, 1980–2002. Ophthalmology2008;115(1):169-73. 

3. Daruich A, Matet A, Dirani A, et al. Central serous 

chorioretinopathy: Recent findings and new physiopathology 

hypothesis. Progress in Retinal and Eye Research 2015;48:82- 

118. 

4. Liu B, Deng T, Zhang J. RISK FACTORS FOR CENTRAL SEROUS 

CHORIORETINOPATHY: A Systematic Review and Meta- 

Analysis. Retina 2016;36(1):9-19. 

5. Ficker L, Vafidis G, While A, et al. Long-term follow-up of 

a prospective trial of argon laser photocoagulation in the 

treatment of central serous retinopathy. British Journal of 

Ophthalmology 1988;72(11):829-34. 

6. Verma L, Sinha R, Venkatesh P, et al. Comparative evaluation 

of diode laser versus argon laser photocoagulation in 

patients with central serous retinopathy: A pilot, randomized 

controlled trial [ISRCTN84128484]. BMC Ophthalmology 

2004;4(1):15. 

7. Liu H-Y, Yang C-H, Yang C-M, et al. Half-dose Versus Half-time 

Photodynamic Therapy for Central Serous Chorioretinopathy. 

American Journal of Ophthalmology 2016;167:57-64. 

8. Lim JW, Ryu SJ, Shin MC. The Effect of Intravitreal Bevacizumab 

in Patients with Acute Central Serous Chorioretinopathy. 

Korean J Ophthalmol 2010;24(3):155-58. 

9. Bousquet E, Beydoun T, Rothschild P-R, et al. Spironolactone 

For Nonresolving Central Serous Chorioretinopathy: 

A Randomized Controlled Crossover Study. Retina 

2015;35(12):2505-15. 

About the authors 

* Dr Moaz Alshaikhi is an ophthalmology non-training registrar 

at Waikato Hospital and, formerly, Greenlane Clinical Centre. 

With a degree in genetics, he is interested in retinal disorders 

and ophthalmic genetics and is looking forward to further 

training and research experience 

* Dr David Squirrell is an ophthalmologist with Auckland District 

Health Board and Milford Eye Clinic. His primary interest is 

medical retina 

and AMD. Dr 

Squirrell has served 

as the principle 

investigator for 

numerous studies 

in AMD, including 

the IVAN trial. 

Dr Moaz Alshaikhi 

Dr David Squirrell

Tackling low vision 

In November 2016 the NZ Wholesalers 

Association (NZOWA) held a fantastic Visionz 

event at Ellerslie, including the Eduvisionz 

educational programme and the ADONZ 

conference, which was run concurrently (see NZ 

Optics December issue). For the first time, NZOWA 

also offered a separate Low Vision Conference. Here 

are some of the highlights. 

LogMar principles 

Dr Alan Johnston, an associate professor in the 

optometry department at Melbourne University, 

kicked off the day with a talk on visual acuity and 

logMAR principles. 

He mentioned Snellen charts, but noted they 

are irregular. The spaces between the lines are not 

consistent so can’t be used at separate distances. In 

contrast, logMAR helps with the definition of legal 

blindness – many people have terrible vision but 

can still see a Snellen chart quite well. 

A/Prof Johnston reminded the audience that any 

three-line improvement on a logMAR test is two 

times better vision, which gives predictability. He 

showed the audience how to use his Near Visual 

Acuity Calculator and then shared some interesting 

cases, which challenged the diagnostic tools and 

principles and can change the way low vision aids 

are prescribed. 

Lighting research 

Dr Mary Butler, principal lecturer at the school of 

occupational therapy at Otago Polytechnic offered 

an overview of the research she and her colleagues 

have been working on over the last few years, 

looking at lighting, teaching around digital devices, 

using mobility scooters with low vision and visual 

impairment after an acquired brain injury. Dr Butler 

noted people over the age of 60 required three to 10 

times as much light as those aged 20 or younger to 

perform the same visual tasks, and younger people 

with low vision underestimate their needs. 

Otago Polytechnic’s lighting project looked at 

the difference between the types of bulbs on the 

market and how it affects low vision patients. It was 

a participation-based study with low vision clients 

from all walks of life. 

There is a wide variety of digital devices available 

to help low vision patients, said Butler, such as 

the lightchooser app – a little black box that helps 

adjust the lighting environment to your prescription 

needs. But with many low vision patients at the 

older end of the spectrum, they need to be taught 

to use digital devices. At age 74 the percentage of 

people with access to the internet drops to 29% 

compared to 92% of 15 – 64 year olds (2013 census 

stats). Yet digital literacy is a significant pathway to 

overcoming issues related with low vision. 

Dr Butler also noted there are big issues around 

public transport in New Zealand making the use of 

mobility scooters an essential lifeline for many. 

Game changer apps 

Fifth year medical student Sunny Li talked us 

through a project she is working on developing a 

low vision app (see separate story p19). Apps, she 

said, can be a game changer for people with low 

vision especially as smart phones and mobile apps 

are now household items. Li conducted a survey last 

year, which showed that 85% of Blind Foundation 

members had access to a smartphone. 

There are a variety of apps that are designed to 

help those with low vision complete everyday tasks, 

while phones themselves have accessibility options 

like the talkback setting that allows your phone to 

speak to you when you tap on the icons. 

There are also two assisted-sight apps: Aipoly, 

an object and colour recogniser free on the Apple 

store; and TapTapSee, a similar app, which analyses 

your photos and tells you what they are with the 

talkback function, available on Android and iPhone. 

Li’s app, Mobile Eye, is being developed together 

with ethical eye technology company oDocs. The 

aim of the app is to produce something that caters 

for New Zealand audiences and improves on current 

available technologies, she said. 

Avoiding falls 

Professor Stephen Lord, senior principal research 

fellow at Neuroscience Research Australia, talked 

about falls in older people, running through 

research that involved participants being asked 

to stand steady on a foam mat. No one can stand 

steady, but they constantly correct their balance 

allowing data to be collected, he said. Depth 

perception, contrast and visual acuity are major risk 

factors around balance. He ran through a series of 

vision tests designed to be a predictor of falls, such 

as the Melbourne Edge Contrast Test or the Howard 

Dolman depth perception test. 

Vision-related disability can lead to social 

isolation, depression, anxiety and reduced 

activity, particularly if paired with an additional 

impairment like hearing loss. These associated 

disorders are all risk factors for falls, said Professor 

Lord. Glasses, while designed to help, can also 

be a concern, he said, especially multifocals. The 

number one environmental cause of falls is footpath 

misalignment and if part of your visual field is 

blurred that will more than double your risk of 

misjudging the footpath and falling. 

Exercises that challenge balance control have 

proven to be one of the most effective programmes 

for combating fall rates, he said, noting that Otago 

has a world famous balance training programme. 

Tai Chi is also useful. Professor Lord recommended 

pharmacy education around drugs, as antidepressants, 

sleeping tablets and anxiety agents 

all double the risk of falls. If you can reduce the 

intake, then you can reduce the risks, he said. While 

seeing a good podiatrist if you have foot pain or foot 

problems is essential; vitamin D is also useful as it 

helps with muscle movement, receptors and the 

like and many older people in residential care are 

vitamin D deficient. 

Always a highlight, Dr Mike O’Rouke closed the 

morning with a talk about the CentraSight mini 

telescope procedure (see NZ Optics’ June 2016 

issue). 

Low vision rehab course 

After lunch, Dr Butler returned to share her 

journey in developing the country’s first Low Vision 

Rehabilitation Course for allied health professionals 

and what a great success it’s been with occupational 

therapists, who can see the real difference it’s 

making to their patients. Retina NZ has also got 

behind the course, sponsoring an honours student 

to attend, and offering work placements. For more, 

she referred the audience to the Vision Matters OT 

Facebook page. 

CCLS heads to Nelson 

Registration is now open for the 2017 Cornea 

and Contact Lens Society (CCLS) conference, 

which this year is being held in sunny Nelson 

from Thursday 23 to Saturday 25 March. 

“When it comes to conferencing, the Cornea & 

Contact Lens Society has an enviable reputation of 

facilitating world-class conferences – right in your 

back yard,” says Anne Matheson, CCLS president, 

adding this year’s conference has a particularly 

strong programme, which will be of interest to both 

optometrists and ophthalmologists. “With four 

keynote speakers of international repute, we will 

deliver a diverse range of topics, aimed at corneal 

health and contact lens developments.” 

Keynote speakers include Dr Marc Bloomenstein, 

a founding member of the Optometric Council 

on Refractive Technology and adjunct assistant 

professor at the Southern California and New 

England Colleges of Optometry; Professor Ken 

Nischal, head of Paediatric Ophthalmology at the 

Children’s Hospital of Pittsburg; Professor Fiona 

Stapleton, head of the School of Optometry and 

Vision Science at the University of New South 

Wales; and our own Professor Charles McGhee, 

chair of ophthalmology at the University of 

Auckland. Other local speakers include Auckland 

optometrist, CL specialist 

and researcher Grant 

Watters, Professor 

Trevor Sherwin and 

ophthalmologist Dr 

Trevor Gray. 

As usual, the conference 

also offers four 

workshops, each with 

limited numbers ensuring 

the participants a handson 

experience. Places are 

CCLS President Anne Matheson 

allocated on a first-come, 

first-served basis. 

The conference is being held at the Rutherford 

Hotel and opens with a welcome function at 5.45 

pm on the Thursday. It includes a Best-of-Britishthemed 

conference dinner on the Friday night, 

featuring one of Nelson’s top bands, Cover Me, and 

is due to end around 4.30 pm on the Saturday. 

“These conferences are a little bit legendary, 

offering terrific learning, a relaxed atmosphere 

and plenty of networking opportunities,” says 

Matheson. ▀ 

For more, see the ad on p4 or visit www. 

contactlens.org.nz 

Low vision clinics in 

practices 

Well-known low vision 

champion, Merivale 

optometrist John Veale, 

showed how easy it was for 

practices to instigate their 

own low vision clinics. “Don’t 

reinvent the wheel…there is 

all the material out there if 

you want to help low vision 

people.” He also pointed 

out that many of the larger 

chains aren’t geared up to 

help low vision patients, so 

you can contact them and 

suggest they refer those 

patients to you, especially 

as this often leads to their 

friends and families becoming patients of yours 

too. He then went on to demonstrate the resources 

available and encouraged the audience to contact 

him to obtain many of the charts and other tools 

useful for starting a low vision practice. 

Dealing with the day-to-day 

Occupational therapist Gail Hughes, who works 

with John Veale, shared many tips for making a low 

vision person’s life easier. “Low vision isn’t an illness, 

so I don’t like to call them patients, but it can steal 

their independence, so our work is all about giving 

them back that independence.” 

She noted low vision often leads to depression, 

so she shared some tips for identifying depression 

early and for dealing with it. This included regular 

exercise, to stimulate the body’s endorphins; 

exposure to sunlight (the importance of vitamin D 

was a recurring theme); drinking plenty of water; 

eating plenty of Omega-3 fatty acids; having 

daily social contact with people other than your 

immediate family or partner; getting plenty of 

sleep; and doing some sort of regular, meaningful 

activity. 

Friends and family can also be an obstacle in a 

low vision person’s journey back to independence 

as they tend to do too much for them. We have an 

“arsenal” of other senses, low vision people just 

need to learn how to use them, she said. There’s 

a plethora of tools to help, including those for the 

important three Bs – bigger, bolder, brighter, such as 

large universal remotes; black on yellow keyboards; 

and special book reading illuminators. Finally, you 

need to do home visits, said Hughes. “When you see 

Low vision speakers Claire Fizgerald, Dr Mary Butler, John Veale and Gail Hughes 

what they have to overcome every day, it’s a whole 

new ball game.” 

Blind Foundation reaches out 

Orthoptist Claire Fitzgerald, from the Blind 

Foundation, reiterated the Foundation’s goal to 

reach and help more low vision people and spread 

the word that the Foundation is not just about blind 

people anymore. “Only 4% of our 12,500 clients are 

totally blind.” 

Yes, people still have to have an assessed visual 

acuity not exceeding 6/24 or serious limitations 

in the field of vision to become a client, but the 

Foundation’s Prevalence Study indicated there are 

more than 29,000 people eligible for its help, and it’s 

currently not even reaching half of that. 

Fitzgerald also stressed the Foundation is now 

more open to monitoring or at least keeping a list 

of those who aren’t eligible today, but are likely to 

be eligible in the short to medium term, so they can 

also receive help. 

The seven ages of low vision 

Associate Professor Gordon Sanderson from the 

Department of Ophthalmology at Otago University, 

closed the day with an amusing speech looking at 

the seven ages of low vision from the difficulties of 

identifying it in the very young, through to dealing 

with it through the school years, the working years 

and finally into old age. 

“Low vision is not just about trying out lots of 

equipment…it’s all about what fits,” he said, adding 

that it’s appalling how little is spent on road safety 

for low vision people in New Zealand. ▀ 



25

My Cambodian Journey 

BY MIKE WEBBER* 

Rose Charities New Zealand, part of Rose 

Charities International in Canada, have been 

involved in improving facilities and eye care at 

an eye clinic in Phnom Penh, Cambodia, since 2005. 

Some background 

The clinic was started in the late 1990s by Rose 

Charities International founder Dr William Grut 

of Canada and Dr Basant Sharma, a Nepalese eye 

surgeon, who went on to employ former Cambodian 

gynaecologist, Dr Hang Vra, who they re-trained in 

basic ophthalmology and extracapsular cataract 

surgery. The clinic was robbed of all its surgical and 

examination equipment in 2002, but struggled on 

with basic equipment supplied by Rose Canada. 

This situation was remedied by Kiwi optometrist 

John Veale, a Rose Charities NZ trustee, who was 

passing through Cambodia in 2004 and saw 

the difficulties the clinic was working under. 

He persuaded Rose Charities NZ to take up the 

challenge of supplying new and better equipment 

and upskilling Dr Vra and his team in all areas 

of ophthalmic examination, treatment, surgery, 

refractive skills and prescribing. 

Dr David Sabiston and I, both new Rose Charities 

NZ trustees at the time, then went to Cambodia on 

what was basically a fact-finding trip. We found a 

very poorly equipped clinic being run by a wonderful, 

dedicated man, Dr Vra, and good staff. David set 

about upskilling Dr Vra in examination techniques 

and increasing his knowledge of ophthalmic 

pathology and cataract surgery, commenting at the 

time that he had never seen a better pair of hands 

undertaking eye surgery. I spent my time teaching 

refraction techniques and the prescribing of 

spectacle Rx’s to other members of the team. David 

and I also made a list of equipment required to help 

improve the clinic’s ophthalmic capabilities. At that 

time there were only 14 registered ophthalmologists 

and 12 registered optometrists to service a 

population of 15 million people in Cambodia. 

We made another trip over in 2006 with new 

equipment, bought with funds raised in New 

Zealand, when we supervised the upgrading of the 

operating theatre, which had been in a very poor 

condition, and set about further upskilling the staff. 

The reputation of the clinic had spread and we were 

now seeing between 60 and 100 patients a day, with 

about 10 to 15 cataract operations performed each 

afternoon. There were two tables in the theatre, and 

visiting eye surgeons would help Dr Vra with the list. 

The support 

Over the intervening years, some $300,000 

worth of new and used equipment has been 

sourced and sent from New Zealand, with many 

noteworthy donations including a Millennium 

Phaco machine from Dr Jim Borthwick and his 

colleagues a few years back and an A-scan from Dr 

Geoff Duff. I also managed to score a Moller-Wedel 

operating microscope in perfect order from the Eye 

Department at Wanganui DHB after it had upgraded 

to a newer model. 

Since 2005, I have made 13 visits to Cambodia and 

have sometimes been accompanied by volunteer 

ophthalmologists. David made four trips until 2008 

when for health reasons he had to give up; Dr Ewan 

Fraser made two trips in 2012 and 2013 to teach 

vitreoretinal treatment and surgery; while Dr Rob 

Weatherhead came in 2015 to teach oculoplastics. In 

2015 and 2016, Dr Muhammad Khalid accompanied 

me to teach vitreoretinal treatment and surgery; and 

last but not least, John Veale made three working 

trips during this time. 

All this has resulted in Dr Vra and his recentlyqualified 

ophthalmologist wife Dr Natalia, a former 

Ukranian nurse, becoming reasonably highly-skilled 

practitioners in their country. 

Rose Charities NZ is very grateful to the 

aforementioned ophthalmologists who voluntarily 

have given their time and services to enhance this 

project and help the people of Cambodia. 

Over the years some major advances have 

taken place in the eye care scene in Cambodia. 

Two of note, both in 2008, were the inception 

of a three-year ophthalmology training course, 

which included significant input from RANZCO, 

and a course to train ophthalmic nurses in basic 

refraction techniques, started up, with some 

encouragement from me, by the team at the 

Brien Holden Research Institute, which still has 

an office in Phnom Penh, and some Cambodian 

agencies. 

Another event of note occurred in 2012, when 

Introducing the new NZOSS exec 

BY ALICIA HAN, NZOSS 2017 PRESIDENT 

Hello and welcome from the 2017 New 

Zealand Optometry Students Society 

(NZOSS) executive. 

The NZOSS was established in 2013 and serves 

as a platform between our peers, past students, 

future colleagues and professionals in the wider 

optical industry. From a great initiative, and 

perhaps humbler beginnings, the NZOSS has 

flourished and grown steadily with every year. 

Now here we are in 2017. We have added two 

new roles to the executive committee and, despite 

it being not so long ago when we 

first started working together, we 

are already running like a welloiled 

machine - our meetings filled 

with fresh ideas, enthusiasm and 

refreshing puns. 

The new executive team is 

excited and ready to continue the 

tradition of fun and academia, 

including annual events such 

as camp, Round The Bays, 

educational seminars, quiz nights 

and the EyeBall, to name but 

a few. The first-ever monthly 

NZOSS newsletter is currently 

in production and we have 

introduced a wine and cheese 

night, networking evenings and the Auckland 

Marathon, with regular training during the year 

via an optometry run club. We have also created 

an “Optom Buddy” system for supporting newer 

students and to bridge the gaps between year 

levels. 

If you have suggestions, ideas, would like to 

contribute to our newsletter or find out more 

about our events, please email us at nzoss.uoa@ 

gmail.com. All welcome! 

It is looking to be a promising year, and we look 

forward to sharing it with you. ▀ 

The 2017 NZOSS executive (L to R): Darina Khun, Nick Stuhlmann, Nick Lee, Gemma Ji, 

Katarina Marcijasz, Alice Jackson, George Stewart, Marna Claassen, Alicia Han, Andrew Kim, 

Menaga Manokaran 

Australian-Cambodian businessman Henry Ngai of 

ABC Tissue Products offered to give US$40 for every 

cataract operation carried out to 2018 to support the 

work of the clinic. 

Rose Charities Cambodia have a second clinic now, 

built and mostly funded by Dr Vra and his wife, and 

a Russian friend of theirs. This second clinic does see 

poor patients, but also targets the more affluent 

patients who pay private fees, which helps augment 

the costs of serving the poorer patients. 

Our 2016 trip 

Our trip last year started with a laugh. Dr 

Muhammad Khalid missed his connecting flight from 

Christchurch to Auckland, due to suffering a flat tyre 

driving from Timaru to Christchurch airport. Not to 

be deterred, flights were rejigged and he arrived in 

Phnom Penh just a day later. This trip did have some 

frustrations, however, as an allegedly not-altogetherhonest, 

lower-order bureaucrat forced Rose Charities 

to vacate the building it had used for nigh on 20 

years, and move all its equipment during the time 

we were there. This was quite a distraction for Dr 

Vra and his team. Muhammad, however, was able 

to spend some time teaching correct retinal lesion 

diagnosis techniques and demonstrating some of 

the finer points of vitreoretinal surgery. Since my first 

visit in 2005, we have noticed a significant increase 

in the presentation of diabetic retinopathy, resulting 

in the purchase of an Argon laser in 2013. Most of my 

time on this visit, however, was spent on fine tuning 

refraction techniques and planning future strategies 

for the clinics. We had one really busy Sunday, 

however, when five of us examined and screened 

290 villagers at an outreach clinic in the countryside. 

From this, 70 patients were identified and brought 

back to the clinic in Phnom Penh for cataract surgery 

and other forms of treatment, many in the Rose 

truck, funded by money raised in Whanganui. 

In summary, my Cambodian journey has been 

a challenging but rewarding and fascinating 

experience. ▀ 

* Mike Webber MNZM is a well-known, retired Kiwi optometrist 

who, over the past 45 years, has enjoyed being involved in 36 

overseas, voluntary eye care trips to Kenya, the Pacific and 

Cambodia to help provide eye care to those who can’t afford or 

access it. This was “probably” his last trip, he says. 

ODMA Fair ups the ante 

Facing competition for the first 

time from new rival, Silmo 

Sydney, the 2017 ODMA 

Fair organisers are promising “to 

deliver the very latest in fashion, 

innovation and technology.” 

New for the 2017 Australian 

industry-owned fair is ‘Design 

Junction’, a showcase of premium 

high-end international and 

Australian eyewear brands. “All 

the major equipment and lens 

companies are already confirmed and have been 

joined by frame and sunglass brands like Tom Ford, 

Jono Henessy, Face à Face, Lafont, and Salvatore 

Ferragamo to name a few,” said organisers in their 

latest press release. “A special feature of Frame 

MORE CLASSIFIEDS ON PAGE 28 

Dr Muhammad Khalid discussing the diagnosis of a retinal pathology 

with Drs Hang Vra and Natalia and a patient 

Fashion Week, ODMA2017 will be 

transformed with new features 

and many exciting attractions, 

promoting ODMA2017 as 

Australia’s key buying fair.” 

Details of speakers are also 

beginning to emerge for the 

ODMA17 Vision Summit, with 

Professor John Marshall, the Frost 

Professor of Ophthalmology from 

University College London, now 

confirmed as a keynote speaker. 

ODMA2017 will take place from 7-9 July 2017 

at the Sydney International Convention Centre in 

Darling Harbour. ▀ 

Read Chalkeyes take on ODMA2017 vs Silmo 

Sydney on p27. 

FULL TIME - DISPENSING OPTICIAN 

SPECSAVERS SYLVIA PARK 

We are looking for an experienced dispensing optician to join our three room practice at Specsavers 

Sylvia Park. This is a great opportunity to work in a central location in Auckland. Competitive Salary 

and bonus package based on experience. Great training opportunities available through Specsavers on 

management and leadership. Specsavers experience is not essential. Please email Ryan Mahmoud at 

dir.sylviapark.nz@specsavers.com or call 021 166 5899. 

Stars and their eyes: Dame Judi Dench 

In 2012, enigmatic star of stage and screen Judi Dench 

announced she had age-related macular degeneration. Her 

mother suffered with the same condition. 

“I’m not going to make it something that’s going to stop me,” the 

82-year-old told People magazine in March 2015, but she admits 

she can no longer travel on the London Underground on her own 

and finds her favourite pastime of painting increasingly difficult. She 

overcomes her visual problems at work by having her scripts printed 

in a larger font, and has kept a sense of humour about it. 

“If six of us were coming in to read a sonnet they’d all have one 

piece of paper and I’d have two or three,” she told People. “They’d 

think, ‘why does she have a bigger part?’” ▀ 

Dame Judi Dench 


SILMO Sydney vs ODMA 

by 

Chalkeyes 

dancing, 

Every second year, many of us venture 

across the Tasman to attend the ODMA 

Fair, Australia’s largest optical exhibition. 

We weigh up the benefits, timing and costs of 

boarding the plane with order book in hand. The 

only questions being to go or not to go and how 

much do we spend? 

But in 2017 the Aussie tradeshow landscape 

is presenting us with a quandary; we now have 

two tradeshows to choose from – the ODMA Fair 

(7-9 July) and Silmo Sydney (9-11 March) – both 

held at the new International Convention Centre 

in Sydney. So the question many of us are now 

asking is which show do we attend? 

Since 1979, the ODMA Fair has been held 

every two years by the Optical Distributors & 

Manufacturers Association of Australia (ODMA). 

The members of ODMA are wholesale optical 

industry organisations whose wares include 

lenses, optical frames, sunglasses and equipment. 

ODMA’s mission is to “strengthen, support and 

grow the optical industry for the benefit of its 

members.” 

The new kid on the block is Silmo Sydney; 

though Silmo is far from new having run the large, 

internationally well-known Paris optical fair of the 

same name for 50 years this November. The 2016 

Paris show boasted 900 exhibitors and 34,000 

visitors over its four-day duration. Having reached 

capacity, Silmo’s owners have been looking 

overseas for expansion opportunities for some 

years. They launched Silmo Istanbul in 2015 and 

have now followed with Silmo Sydney. 

So with an oft-commented on shrinking 

Australian and New Zealand independent 

market, how have we come to the stage where 

it’s considered viable to hold two large optical 

tradeshows at the same place, in the same year? 

History provides some insight into how we arrived 

at this point. Silmo Sydney organiser, Expertise 

Events, managed the ODMA Fair in 2013 and 2015. 

Then after an allegedly somewhat acrimonious 

falling out, Expertise Events approached and 

partnered with Silmo to create Silmo Sydney and 

ODMA appointed rival events company, IEC Group, 

and, taa daa, we now have two large optical 

tradeshows in one year to mull over. 

So who’s exhibiting? 

Some of us attend tradeshows to purchase 

new season frames. Some of us attend to buy 

equipment. We also like to investigate industry 

innovation such as new technology and services. 

Examining exhibitor lists indicates the types of 

exhibitors we can 

expect to see at 

each show. These 

lists are evolving 

day-by-day, but 

it does provide 

some direction. 

On 2 January 

(so there’s still 

some time 

to go), Silmo 

Sydney listed 36 

exhibitors on its The last ODMA Fair 

website. Twothirds 

of these are frame or sunglass suppliers, so 

there’s relatively few equipment or lens suppliers, 

and around 40% have not exhibited at recent 

ODMA Fairs. 

In contrast, the 2017 ODMA Fair had 47 

exhibitors listed on its website. Frame or 

sunglass suppliers make up about 40%, with the 

remainder being the major equipment companies 

and several lens companies. The majority 

(approximately 90%) have participated in past 

ODMA Fairs. 

So at this stage, Silmo Sydney has more frame 

suppliers than ODMA, while the ODMA Fair has 

significantly more equipment and lens suppliers. 

Interestingly though, Silmo Sydney appears to 

have attracted far more ‘new’ exhibitors not seen 

at recent ODMA Fairs. 

We must feel some empathy for industry 

suppliers. Participating in a tradeshow is a costly 

business. While some companies may get away 

with only spending $10K on a small stand, others 

can spend up to $200K. Seriously! So it’s little 

wonder few suppliers’ budgets will extend to both 

the ODMA Fair and Silmo this year. Their marketing 

and exhibition budgets haven’t doubled, so they 

are faced with a similar quandary. 

What’s their focus? 

With more frame suppliers and the Silmo brand 

association, it appears Silmo Sydney is positioning 

itself more as a fashion show with the brand 

statement, “where fashion meets function”. It 

is also shaping up to have a strong retail focus 

through its partnership with the National Retail 

Association, which should (if done well) provide 

valuable retailing and merchandising ideas for 

practices. Plus, it’s looking a little more “rock’n’roll” 

than ODMA with its relatively heavily marketed 

Saturday night event, Silmo Sydney’s Mega Rox 

Party, which is being touted as an evening of 

drinking 

and dining, 

without the 

normal awards or 

speeches! 

Looking at 

ODMA’s exhibitor 

list, it appears 

to have more 

of a focus on 

equipment and 

lenses, which is 

in keeping with 

its membership, 

though frame and sunglass suppliers still make 

up about 40% of the Fair’s current floor space, but 

there is a lot longer to go to July. Tradition lends 

itself to the assumption that the ODMA Fair is 

not focusing on being a ‘fashion’ show, but then, 

it is making moves to try to change this (how 

much of this change results from Silmo Sydney’s 

appearance can only be guessed at) with a new 

area called ‘The Design Junction’ to showcase 

exhibitors’ premium frame brands. This is being 

promoted as part of Australia’s inaugural Frame 

Fashion Week (July 1-10), details of which are still 

unclear, though it appears the audience is only 

trade, not consumers. While the usual ODMA gala 

dinner, with speeches and awards, appears (at this 

early stage at least) to have been dropped?! 

Is there an educational element? 

Optometry Australia is the optometrist association 

in Australia. Each of the state branches typically 

run CPD education events each year. The largest 

is New South Wales’ Super Sunday event, which 

this year has partnered with Silmo Sydney. Two 

conference streams, including 18 educational 

sessions, representing 53 Australian CPD points 

will be available to delegates. At the time of going 

to press, however, no application had been made 

for CPD points for Kiwis. Few details are presently 

available, but it looks like the topics will be 

business and retail-related. 

The ODMA Fair included a conference programme 

for the first time in 2013 with 30 CPD points on 

offer in 2015 and four CD and five general credits 

available to New Zealand delegates. ODMA is 

including a conference this year, though again little 

detail is available and no New Zealand CPD points 

as yet applied for, though I suspect they will be 

available if they adopt the 2015 model. There will 

also be masterclass sessions which typically focus 

on dispensing and business topics. 

The overall feel? 

For some of us, the place, ambience and 

atmosphere of an event is also a factor for 

consideration. Not a deciding factor, but certainly a 

consideration given the time and financial costs of 

attending a show. Given they are both in Sydney, at 

the same conference venue, place isn’t much of a 

consideration this time (though one is being held in 

summer and one in winter). 

But in my humble opinion, and this is only one 

industry participant’s view, ODMA has grown a 

little tired. Nothing surprising happens. Granted, 

it is much smaller than the big international fairs, 

but it doesn’t even come close to the energy and 

excitement of Mido in Milan or Silmo in Paris. 

Hopefully Silmo Sydney will emulate some of the 

Silmo Paris magic (the 2016 event captured well in 

the pages of our own NZ Optics last year). At this 

stage, Expertise Events certainly appears to have 

more control over the Silmo Sydney event than 

ODMA’s event organiser IEC, which should result in 

a more dynamic and enjoyable experience. 

Decisions, decisions? 

Identifying your main objective for attending a 

show should solve some of your ODMA Fair versus 

Silmo Sydney quandary. 

For example, if you’re into frames with all the 

new frame exhibitors and focus on fashion at Silmo 

Sydney that would probably be the best choice. 

Whereas if it’s a new OCT you’re after, or any other 

bigger pieces of technology, the ODMA Fair is a clear 

winner with most of the major equipment suppliers 

signed up, giving you a great platform to compare 

brands in one place. Education is tricky as neither 

has applied for NZ CPD points yet and we aren’t 

short of educational events in either market. And 

finally, there’s the ambience thing, which is also 

difficult to gauge as this is Silmo Sydney’s inaugural 

event. But in this individual’s mind at least, the 

newcomer looks like it’s shaping up to be something 

new and fun, and it is being held in Sydney’s 

summer months. So I have chosen Silmo Sydney. If I 

lament my decision, I can at least do so in the balmy 

harbourside weather with wine in hand. 

Cheers! ▀ 

The views expressed by Chalkeyes are his, or 

hers, alone and not necessarily the views of NZ 

Optics. If you wish to comment on Chalkeyes’ 

views, please email a brief letter to the editor 

at info@nzoptics.co.nz for consideration. 

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27

OUR EXPANSION… 

YOUR CAREER GROWTH 

A MUTUAL OPPORTUNITY 

As the Specsavers network of 370 Australian and New Zealand stores 

continues to experience significant growth, opportunities abound in 

many locations across both countries for career focussed optometry 

and dispensing professionals. 

OPPORTUNITIES NOW AVAILABLE… 

Last financial year Specsavers New Zealand grew 

significantly and already this year we are seeing further 

growth – which presents ongoing opportunities for 

optometrists in the following locations: 

NORTH ISLAND 

• Chartwell 

• Henderson 

• Lower Hutt 

• Masterton 

• Mt Maunganui 

• Palmerston North 

• Paraparaumu 

• Wellington CBD 

South 

• Whakatane 

SOUTH ISLAND 

• Dunedin 

• Invercargill 

• Shirley 

We are currently also seeking experienced dispensers in a 

number of our New Zealand stores. 

To find out more, contact Chanelle Coates on 

0800 717 350 or chanelle.coates@specsavers.com – 

or visit spectrum-blog.com to review all your options 

and currently available locations. 

PRACTICE FOR SALE TAURANGA 

Want to work and live in a holiday paradise? 2017 is a great year to 

pursue your dream. The practice is well situated with very high 

traffic. Turnover is increasing annually with excellent potential in 

the fast growing Tauranga. Single testing room fitted with state-ofthe-art 

equipment. From BIO to topographer to retinal camera 

simply walk in and work! Tauranga, ‘NZ’s mini Gold Coast’ is a 

coastal resort town, which enjoys great weather all year round. 

Only walking distance to beautiful beaches and mountains; you 

can surf, swim, play golf, shop and dine. Reasonably priced with 

genuine reasons for selling. Confidentiality assured. 

Please email mtmaunganui@hotmail.com 

PRACTICE FOR SALE AUCKLAND CBD 

Live the dream and own your own practice in the heart of Auckland 

City. Be your own boss and practice independent optometry. Great 

loyal customer base that appreciate personal and professional 

eyecare as well as offering contemporary eyewear. The store is 

attractive with current quality stock, versatile display units and a 

modern, well optimised website. Don’t miss out on this great 

opportunity as a business like this rarely comes up for sale. 

Contact: Tony Davenport 027 555 5938 

Email: tonyd@clythbiz.co.nz 

CLYTH MACLEOD LIMITED 

Licensed Agent REAA 2008 

MORE CLASSIFIEDS ON PAGE 26 

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CHOOSE YOUR 

AUSSIE ADVENTURE 

WE SEE YOUR 

FUTURE WITH US 

At OPSM, we are passionate about opening eyes to 

the unseen. Our advanced technology enables us to look 

deeper to ensure we give the best care to every customer. 

At OPSM, we are passionate about opening eyes to 

the unseen. Our advanced technology enables us to look 

deeper to ensure we give the best care to every customer. 

OPTOMETRISTS 

QUEENSLAND AND NORTHERN TERRITORY 

WITH ATTRACTIVE SALARY PACKAGES 

We are looking for Optometrists who share our passion 

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world. Whether you like the city, the surf or the outback, 

we’ve got the role for you with our teams in: 

• Bundaberg 

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JOIN OUR TEAM 

You can look to take on a fixed period role or even 

consider a more permanent move - who knows, you might 

fall in love with the place. Depending on the location, 

salary packages up to 175K including superannuation, 

accommodation, annual return flights to visit family and 

friends and relocation support for the right candidate. 

Start your journey with us today! Graduates or recent 

graduates are very welcome to apply. 

CONTACT: 

Brendan Philp 

brendan.philp@luxottica.com.au or call +61 418 845 197 

Kim Shepherd 

kim.shepherd@opsm.com.au or call +61 408 763 575 

OPSM.COM.AU/CAREERS 

OPTOMETRISTS 

NORTH & SOUTH ISLAND, NEW ZEALAND 

Our New Zealand business is looking for passionate 

Optometrists to join the team. 

• Whangarei – full time 

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When you join OPSM, you work within a team who 

are committed to providing the best possible eyecare 

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with world class technology including our exclusive 

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will have many opportunities for continuing professional 

development and can enjoy career flexibility through 

our extensive store network. You can also make a 

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participating in our OneSight outreach program. 

JOIN OUR TEAM 

Start your journey with us today! Recent graduates are 

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CONTACT: 

Hirdesh Nair 

hirdesh.nair@opsm.co.nz or call +64 21 523 282 

Robbie Singh 

robbie.singh@luxottica.com.au or call +64 21 750 847 

OPSM.CO.NZ/CAREERS 

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