Insight October 2024

OCT 2024

AUSTRALIA’S LEADING OPHTHALMIC MAGAZINE SINCE 1975 OCTOBER 2024

E N V I S TA I S N OW P R E LOA D E D

New 2023-24 report reinforces the importance of Australia in global business

A CANDID INTERVIEW WITH CHRIS BEER George & Matilda's CEO answers many burning questions about the group he founded

27

SPECSAVERS POSTS AU$1.7B LOCAL REVENUE

14

WWW.INSIGHTNEWS.COM.AU

03

Exceptional performance. Without compromise.

BACK TO BASICS WITH DRY EYE DISEASE Why some Australian optometrists have gone full circle with their approach

We’re Australia’s th 6 Best Workplace That’s right, you heard it first – Specsavers has been named Australia’s 6th Best Workplace

by Great Place to Work®, the global authority on workplace culture. For the second year in a row we’ve topped the list of Australia’s best workplaces due to our inclusive culture, great people and commitment to making a difference in the lives of our customers If you want to work for the best optometry / audiology / employer in the country talk to us today spectrum-anz.com/careers-at-specsavers/

OCT 2024

AUSTRALIA’S LEADING OPHTHALMIC MAGAZINE SINCE 1975

AUSTRALIA, CANADA STAND OUT FOR SPECSAVERS IN STRONG ANNUAL PERFORMANCE Specsavers’ Australian business has outstripped much of the rest of the world as the multinational optometry provider posted a strong financial performance in 2023-24.

The latest annual review shows Australia contributed £874.5 million (AU$1.69 billion) to the company’s global revenue of £4.01b (AU$7.74b) to February 2024, as the local business also hit new milestones with its lens glazing and audiology service.

The New Zealand business contributed £102.8m (AU$200.8m) in 2023-24, up from £92.9m (AU$181.5m) the previous year.

That Australian performance was 17.7% up on the £742.9m (AU$1.435b) it contributed in the previous year, and greater than the company’s 10.3% jump in global revenue, from £3.55b (AU$6.86b) during that period.

Australia’s result means it is

comfortably Specsavers’ second biggest market, behind only the UK, which generated £2.172b (AU$4.19b).

Specsavers’ growth in Canada was another stand-out. Its revenue grew 254%, from £17.6m (AU$33.9m) in 2022-23 to £62.3m (AU$120.3m), largely on the back of huge expansion in the North American nation. The company now has 110 stores there, after opening its first in 2021 – 63% of the 88 new stores opened around the world in 2023-24 were there.

The review acknowledged that the business was operating in a “tough economic environment” around the globe, with customers facing significant financial pressures.

It said Specsavers’ “relentless” focus on best-in-market pricing and promotions, combined with “world-leading expertise, ensures we can respond to the current climate

Specsavers spent AU$116 million on relocation, expansion or refit projects around the world. Image: Specsavers.

and really make a difference in our communities”.

It highlighted the launch of its new customer experience platform, InMoment, complemented by “industry-leading AI analysis”, helping it better understand customer sentiment, and the use of both email and SMS surveys to collect vital feedback and

enhance the customer journey.

Also, the company spent £60m (AU$116m) during the past year on 392 store relocation, expansion or refit projects around the world. This included upgrades and capacity reinvestments for 58% of stores across Australia and New Zealand.

Specsavers ANZ managing director Mr Paul Bott said while the economy continues to be challenging in Australia and New Zealand, the company took pride in being “a value champion”.

“Since the very beginning, Specsavers’ mission has always been to make eye and hearing care accessible and affordable to everyone, and it is something that is as true today as it was when we entered the market,” he said. continued page 8

QUESTIONS OVER PROPOSED HEALTH CHECKS FOR OLDER OPHTHALMOLOGISTS A failure of communication is likely behind a hike in complaints against older doctors, says Australian Society of Ophthalmologists (ASO) president Peter Sumich.

He was responding to news from the Medical Board of Australia (MBA) that it is considering introducing health checks for doctors over 70, including ophthalmologists, after the release of data showing the number of patient complaints jumps significantly as medical professionals get older.

The data shows they are 81% more likely to be the subject of a notification for any reason (not just impairment) than those under 70.

But Dr Sumich believes there are already plenty of good practices in

place to ensure that ophthalmologists are still able to do their duties well into their later years.

“I think we already have the framework with our CPD to do that, to assure the public that they’re safe,” he said.

“What we have with RANZCO is a practice visit component of our CPD where a colleague comes and visits for a day and spends time with the professional, and both write a report for the CPD. “I would suggest that should become more of a feature for people over 70, which takes care of their abilities and their cognitive abilities, and also how up to date they are. That’s far more valuable than a health check.”

According to the MBA, the rate of notifications about late-career doctors has almost doubled during the eight years to 2023, rising from 36.2 notifications per 1,000 practitioners aged 70 and older in 2015, to 69.5 complaints per 1,000 last year.

Notifications for doctors in the 70-74 year age bracket have risen more than 130% from 32 notifications for 1,000 doctors in 2015, to more than 74 per 1,000 in 2023. For medical practitioners aged 80 and over, notifications climbed by more than 180% per 1,000 doctors between 2015 and 2023. continued page 8

A new take on digital microscopy Bausch + Lomb has entered the field of ophthalmic microscopes in a big way – and a Brisbane hospital was Australia’s first to trial and install the fully digital surgical visualisation platform with some world-first features.

page 64

ZEISS at RANZCO 2024.

Join us at RANZCO 2024 Adelaide to get hands-on experience with our latest innovations and digital technologies set to advance your ophthalmic workflow - connecting devices, data and applications.

Insight Sessions Join us for our exclusive “Collaboration Zone” sessions on the ZEISS booth, where experts will share their experiences and insights on the latest ophthalmic solutions from ZEISS. Gain valuable knowledge and ask questions during our focused sessions. Scan the QR code for details on speakers, topics, and session times.

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

Managing Retinal Disease ZEISS Breakfast Session Start your Sunday off right with the ZEISS Hosted Breakfast Symposium, dedicated to the topic of advancing retinal disease management - from diagnosis to treatment of complex cases. Stay up-to-date in one of ophthalmology’s fastest-changing fields with our esteemed panel of experts.

Don’t miss this opportunity to gain valuable insights and knowledge on the latest advancements in retinal disease management.

ARTEVO 750 and ARTEVO 850 Hands-on Demo Book a hands-on experience with the latest ophthalmic microscope innovations from ZEISS, the ARTEVO 850 and ARTEVO 750. Learn how both of these solutions allow you to see more during retina, cataract, glaucoma and corneal surgeries.

Scan QR code for more info.

Scan QR code for invitation.

Book a demo!

IN THIS ISSUE OCTOBER 2024

EDITORIAL

FEATURES

16

69

It's classified A new platform has launched to make buying and selling of optometry practices easier across Australia.

Geographic atrophy Prof Robyn Guymer on the final hurdles towards an approved therapy and how local eyecare professionals can prepare.

DRY EYE DEDICATION

66

73

Triple threat Australian surgeons discuss upgrades to the iStent MIGS platform that's now TGA-approved.

City of Churches A glimpse into the key speakers and product launches slated for November's RANZCO Congress in Adelaide.

EVERY ISSUE 07 UPFRONT

90 MANAGEMENT

09 NEWS THIS MONTH

91 SOAPBOX

88 OPTICAL DISPENSING

93 CLASSIFIEDS/CALENDAR

89 ORTHOPTICS

94 PEOPLE ON THE MOVE

Since compiling the first Insight Dry Eye Directory in 2021, the ensuing four years have demonstrated the Australian ophthalmic sector is determined to continue moving the needle on a disease affecting so many, each in their own way.

It wasn’t long ago that sufferers struggled for validation of their complaints. But almost a decade since the pivotal TFOS DEWS II report – providing the bedrock of how we understand the disease today – dry eye management has become sexy and cool thanks to the invention of many products and gadgets.

That’s not to say it isn't hard work. In fact, dry eye patients can consume a lot of chair time. But done right, it can be an excellent practice builder.

Just ask the many independents listed in this year’s directory starting on page 42. Many see dry eye as their 'differentiating factor' and can attest to its value if patients’ disease is treated at the root and billed adequately. Even corporate providers are dipping their toes in the area now with light-based therapies.

Compared with the 2023 directory, it’s fascinating to see how many more practices are upping their game with a comprehensive dry eye service. The 91 practices listed is an 18% increase on 2023.

Many have incorporated dry eye into their existing workflows, but some have gone all-in on with a dedicated clinic.

Practices appear to be investing more in dry eye devices too. Forty-two practices reported having an intense pulsed light (IPL) machine, and an increasing number are using low level light therapy and one of the intriguing new technologies like radiofrequency.

These devices, among the almost 200 therapies listed and available in Australia, feature in the 2024 directory, with 20 more products than last year.

There’s also 17 dedicated diagnostic devices for readers to come to grips with.

Undoubtedly, it’s reassuring to have these tools at the optometrist’s disposal, but after talking to three independents this edition (page 27), sometimes it’s also about going beyond the next shiny instrument, and getting back to basics. That is: understanding the patient in the chair and painting a full picture of their contributing factors such as diet, as Ms Adele Jefferies, president of the Cornea & Contact Lens Society of New Zealand, covers in her CPD article (page 37).

Nevertheless, it's clear there are many clinical and commercial upsides to making dry eye a feature of your practice today. If you're not already doing so, there are plenty of collegial-minded practitioners willing to offer their time and expertise.

MYLES HUME Editor

INSIGHT October 2024

5

NEW RELEASE OUT NOW! View all of our collections and order online with ease at

www.eyesright.com.au

1800 637 654 INSIGHT MAGAZINE AD'S SEPT 2024.3.indd 28

@eyesrightoptical 28/08/2024 10:44:11 AM

44:11 AM

UPFRONT Just as Insight went to print, the FEDERAL GOVERNMENT has announced drugs for dry eye disease and glaucoma are among 300 medicines now available as 60-day prescriptions.

Sixty-day prescriptions were first introduced in September 2023. By 31 July 2024, more than 10 million prescriptions had been dispensed.

This latest announcement involves the third group of medicines to become available as 60-day prescriptions.

The government claims Australians have saved $525 million on the cost of

their medicines. IN OTHER NEWS, sexual harassment in the workplace is a new subject covered in this year’s Medical Training Survey (MTS), which is now open. The survey, now in its sixth year, is used to gain data that can improve medical training. More than half of Australia’s doctors in training, including ophthalmology trainees under RANZCO, do the MTS each year. In 2024, a new question separates out sexual harassment from other forms of harassment – which the MBA said would meet stakeholder requests for more detail to help health services, educators and training providers

Kirketon Road Centre, a free and confidential health service for marginalised people based in Sydney’s Kings Cross, is partnering with the Eyes of Hope not-for-profit to provide free eye checks and glasses. Through its new mobile eye clinic, Eyes of Hope is bringing eye health services to the homeless and vulnerable in NSW. It was founded by three friends working in the optometric, medical and ophthalmology fields.

WACKY

Beatles star John Lennon always claimed his contact lenses would not fall out if he was ‘stoned’ on cannabis, and Queensland University of Technology’s Professor Stephen Vincent has found he was probably right. The research, in Ophthalmic and Physiological Optics and co-authored by his optometrist wife Ms Roz Vincent, concluded this was “most likely a result of cannabis-induced upper eyelid ptosis, which would reduce the likelihood of lens ejection”.

Published by:

379 Docklands Drive, Docklands VIC 3008 T: 03 9690 8766 www.primecreative.com.au Chief Operating Officer

Publisher Sarah Baker sarah.baker@primecreative.com.au Editor Myles Hume myles.hume@primecreative.com.au Assitant Editor Rob Mitchell rob.mitchell@primecreative.com.au Commissioning Editor, Healthcare Education

Image: RossHelen/Shutterstock.com.

WONDERFUL

insightnews.com.au

Christine Clancy christine.clancy@primecreative.com.au

STAT

WEIRD

Mr Elon Musk has declared that his Blindsight cortical implant to restore sight may “ultimately exceed normal human vision”. But new research from the University of Washington suggests the billionaire entrepreneur’s own vision may have exceeded basic rules of human biology. Ms Ione Fine, lead author, said Musk’s projection for the latest Neuralink project was unrealistic, at best, and rested on the flawed premise that implanting millions of tiny electrodes into the visual cortex would result in high-resolution vision.

address and eliminate this behaviour.

FINALLY, the global ophthalmic sector is alarmed at the proliferation of unapproved eye drops that claim to change eye colour. The alert comes after the US FDA issued a warning letter to a company producing such products.

Testing found at least one eye drop breached regulations by consisting “in whole or in part of any filthy, putrid, or decomposed substance”. The American Optometric Association urged patients to work with doctors to access technologies that enhanced care, and "not be misled by questionable marketing claims that undermine it".

Jeff Megahan Business Development Manager Luke Ronca luke.ronca@primecreative.com.au Client Success Manager Salma Kennedy salma.kennedy@primecreative.com.au

Retinal risk Around half of people with late-stage disease age-related macular degeneration will have geographic atrophy (GA), with estimates suggesting five million people have GA worldwide. Page 69

Head of Design Blake Storey Art Director

WHAT'S ON

Bea Barthelson

Complete calendar page 93

THIS MONTH

NEXT MONTH

‘INDEPENDENT– TOGETHER’

RANZCO CONGRESS 2024

18 – 19 October

1 – 4 November

Eyecare Plus’ conference in Sydney will celebrate independent optometry coupled with a series of workshops, keynote speakers, a cocktail party, and gala dinner.

The college’s 55th annual congress heads to Adelaide, welcoming speakers from Nepal, Canada, US and some of Australia’s leading experts in their field.

eyecareplus.com.au/conference/

ranzco@thinkbusinessevents.com.au

Subscriptions T: 03 9690 8766 subscriptions@primecreative.com.au

The Publisher reserves the right to alter or omit any article or advertisement submitted and requires indemnity from the advertisers and contributors against damages or liabilities that arise from material published. © Copyright – No part of this publication can be reproduced, stored in a retrieval system or transmitted in any means electronic, mechanical, photocopying, recording or otherwise without the permission of the publisher.

INSIGHT October 2024

7

NEWS

continued from page 3

“In a tough economy, we see our role to deliver on that mission as more important than ever, ensuring Aussies and Kiwis can continue to prioritise their eye and hearing health, by providing quality care coupled with exceptional service and great value.”

Through its joint venture partnership model, Bott said in tough economies Specsavers was working hand-in-hand with store optometry, retail and audiology partners to ensure they are well set up to care for their local communities.

“Together, we invest a significant portion of growth back into the partnership so our stores look and feel the best they ever have, have the capacity to care for more customers, and can provide world-class clinical expertise and customer experiences for everyone who chooses Specsavers,” he said.

Looking ahead, Bott said Specsavers was keen to continue evolving its customer journey.

“Value isn’t just based on price, but respecting our customers’ time and increasing accessibility, and we are focused on offering that by blending digital, online and in-store experiences. Whether that’s remote eyecare so customers can access timely appointments in their area or trying on frames virtually to save time in store, we’re committed to ensuring customers can engage with us effortlessly into the future,” he said.

“One of the great things about an annual review is the opportunity to stop and reflect on what we’ve achieved over the past 12 months, and for me, across all the incredible

milestones, numbers and achievements, underpinning everything is our people. Both in our stores and our support office, our people are the heartbeat of Specsavers.”

Image:: Specsavers.

RECORD YEAR FOR ANZ AUDIOLOGY BUSINESS

Beyond the figures The review reported on a number of other highlights for Specsavers in Australia.

The company maintained its close relationships with universities across Australia and New Zealand (ANZ) to promote optometry and support its workforce. In 2023-24, 54% of final-year students from its eight affiliated optometry schools chose to work at Specsavers, which meant a record 247 graduate optometrists joined its two-year development program.

A major supply chain milestone was achieved for the company’s Australian factory, Melbourne Glazing Services, which processed its 60 millionth order in January 2024 for a Wonthaggi customer in Victoria.

After becoming fully operational in 2023, Century Optic, Specsavers’ newest prescription lenses lab and glazing facility in China, also added greater production capacity. The site now supplies two million surfaced lenses a year to Australia and New Zealand. Since opening, ongoing investments in surfacing lines, including faster and more accurate lens polishing machines, have increased overall capacity by 225% and anti-reflective coatings volume has grown by 185%.

Tele-optometry was a key focus during the past year as well, which helped improve access to eye health services in remote and hard-to-recruit areas. The service is

“VALUE ISN’T JUST BASED ON PRICE, BUT RESPECTING OUR CUSTOMERS’ TIME AND INCREASING ACCESSIBILITY.” PAUL BOTT, SPECSAVERS

now live in Sweden, Canada, the UK and the Netherlands, and is being piloted in Australia – where it’s referred to as remote eyecare.

The company continues to grow and expand its audiology offering too.

The annual review said audiology, available in the UK, Republic of Ireland, Netherlands, Australia and New Zealand, “enjoyed another successful year … dispensing almost three quarters of a million hearing aids globally”.

“We continued to grow our capacity and change the industry for the better by offering the best possible value in the provision of audiology outcomes.”

The fastest area of growth last year was ANZ, where customers gained access to “best-value hearing care” in almost 80% of Specsavers’ stores. That contributed to a record 30% volume increase on 2022/23.

The company celebrated highlights in its charitable work. It donated AU$1.6m to The Fred Hollows Foundation’s Indigenous Australia Program, which helped the foundation and its program partners conduct more than 13,500 eye tests, provide 2,183 pairs of glasses and support almost 3,000 eye surgeries, screenings and treatments for cataracts and diabetic retinopathy.

The funding also helped train 159 community health workers, deliver eye health education sessions to almost 600 school children, and establish an integrated optometry clinic within an Aboriginal medical service in rural Western Australia, the company said.

COMMUNICATION OFTEN AT THE ROOT OF COMPLAINTS – ASO continued from page 3

Those complaints covered a number of areas, including issues relating to clinical care (52% higher over the eight years), communication (141% higher), and pharmacological or medication (162% higher).

Health checks for older doctors is one of three options being considered. These are set out in the consultation regulation impact statement: 1. Keep the status quo and do nothing extra to ensure late career doctors are healthy and able to provide safe care.

2. Introduce an extensive and detailed

8

INSIGHT October 2024

‘fitness to practise’ assessment for all doctors aged 70 and older, to be conducted by specialist occupational physicians.

3. Introduce general health checks with a GP for late career doctors aged 70 and older, to support early detection of concerns with the opportunity for management before the public is at risk.

Dr Sumich questioned the value of a health or fitness check targeting those aged over 70, when medical professionals of all ages were struggling with physical and mental health issues.

“As a professional, it’s adherent to you to present yourself as healthy enough to do

Dr Peter Sumich, Australian Society of Ophthalmologists.

your job. So health-wise, I don’t think there needs to be any difference between a 70-year-old and a 50-year-old.”

He believed the rise in complaints came from societal and cultural changes, and the way some older doctors communicated, especially with younger patients.

The ASO would likely look to address that communication issue with older professionals in the future, “because we have workforce issues, and we can’t afford to lose people”.

Proposals for keeping late career doctors in safe practice are now open for public comment.

NEW POSITION STATEMENT ON MYOPIA MANAGEMENT Optometry Australia (OA) is encouraging a “significant shift” in clinical practice from merely correcting vision to using strategies that slow myopia progression.

That was one of the key recommendations outlined in its latest position statement on myopia management, which has highlighted the important role played by optometrists in addressing this global public health concern.

With the prevalence of myopia projected to affect half of the world’s population and 20 million Australians by 2050, the statement underscores the importance of evidence-based practices in mitigating and managing myopia.

“Myopia is associated with several severe ocular pathologies, including retinal detachment, maculopathy, glaucoma and cataracts,” said Mr Luke Arundel, OA’s chief clinical officer.

“Even low to moderate levels of myopia can significantly increase the risk of visual impairment later in life. The connection between myopia and these serious conditions emphasises the importance of proactive management and prevention strategies.”

Key points and recommendations for

optometrists include OA supporting a change in clinical practice from merely correcting vision to employing strategies that slow myopia progression.

“This approach includes educating patients on ways to mitigate the development of myopia and discussing evidence-based management options,” Arundel said.

“By focusing on slowing myopia progression, optometrists can help reduce the risk of sight-threatening complications of myopia.”

OA said it strongly encourages practitioners to provide regular comprehensive eye health and vision examinations to identify patients with myopia, at risk of myopia development, or with myopia-associated ocular pathology.

“These examinations should encompass the measurement of refractive error, and ocular biometry whenever feasible, and include dilated fundus examination where appropriate,” Arundel said. “A thorough examination ensures a detailed understanding of the patient’s eye health, allowing for the early detection and management of potential issues.”

In addition to comprehensive

The peak body supports a significant shift in clinical practice.

Image: Pixel-Shot/stock. adobe.com.

examinations, optometrists should also focus on assessing myopia risk and offering preventive counselling, OA said.

Arundel said this involved evaluating factors that may increase the likelihood of developing myopia and advising patients and their caregivers on strategies to delay myopia onset.

“Preventive counselling is crucial for mitigating the long-term impact of myopia,” he added.

Upon diagnosing myopia in children, OA said it was imperative optometrists offer treatment options grounded in the latest research.

“Treatments should aim to manage the progression of myopia effectively," Arundel said.

Regular follow-up appointments are essential to monitor myopia progression and adjust the treatment plan as necessary, ensuring optimal care and outcomes."

By integrating comprehensive eye health assessments with proactive myopia management strategies, Arundel said optometrists can contribute to reducing the burden of myopia on individuals and the broader community.

U LT R A S H I E L D P E R F O R M A N C E P RE M I U M M U LT I C O AT EXPERIENCE UNPRECEDENTED LENSE PROTECTION SCRATCH RESISTANCE AND LOW REFLECTION

S I N C E 19 3 9

18 0 0 8 6 4 8 8 6 to a . o r d e r s @ to k a i o p t . c o . jp W W W.TO K A I . C O M D I G I TA L LY M A D E I N JA PA N

NEWS

RAYNER UNVEILS ‘WORLD’S FIRST SPIRAL IOL’

IN BRIEF ICARE ACQUISITION

Cataract surgery product manufacturer Rayner has debuted the RayOne Galaxy and Galaxy Toric, described as the world’s first spiral intraocular lens (IOL) designed with artificial intelligence (AI).

Launched at the European Society of Cataract and Refractive Surgeons (ESCRS) Congress in Barcelona in September 2024, the RayOne Galaxy IOL comes to market 75 years after Rayner pioneered the first IOL with Sir Harold Ridley.

The company has partnered with leading ophthalmologist Dr João Lyra, from Brazil, to develop this full range of vision IOL. According to Rayner, a proprietary AI engine trained on patient outcomes has been used to create RayOne Galaxy’s spiral, which delivers a continuous full range of vision with minimised dysphotopsia, achieved through a non-diffractive optic with 0% light loss.

From the outset, RayOne Galaxy will be available in toric powers and comes fully preloaded across the entire power range in the same single-use injector system used across the RayOne family of lenses.

“We all read about the life changing potential of AI, but this is a real-world example of technology impacting the outcomes of patients,” Rayner CEO Mr Tim Clover said.

Ophthalmic product manufacturer Icare has acquired Dutch firm Thirona Retina B.V. and its artificial intelligence software. Icare, a subsidiary of Revenio Group, made a minority investment of €1.9 million (AU$3.1m) in Thirona Retina in 2023. It has now acquired the remaining shares for €4.8m (AU$7.8m). Thirona Retina’s RetCAD product uses AI to screen fundus images for diseases, including diabetic retinopathy, age-related macular degeneration, and glaucoma. RetCAD is already part of the iCare ILLUME retinal screening tool that has been “extremely well received by customers across Europe and the Asia-Pacific”, Revenio said. “Our iCare ILLUME screening solution helps detect increasingly common eye diseases and their severity. This acquisition strengthens our ability to further develop our AI-based ophthalmic solutions,” said Mr Jouni Toijala, Revenio Group CEO.

LIVING WITH KERATOCONUS New research from Sydney institutions published in Nature-Eye has revealed the effects of keratoconus on patients’ lives.

“The conversations I had with patients in this study highlighted to me that their condition goes far beyond just the chair in my clinic.

Patients described to me how they felt on dates, navigating their careers, and how their diagnosis affected their overall path in life,” lead author Mr Leo Fan said. Patients recounted how keratoconus affected their ability to drive, relationships, careers, enjoyment of life, and finances. Issues with access and cost of treatment were prominent concerns. “It’s important for surgeons to understand not just the technical aspects and outcomes of a procedure, but the wider benefits patient’s will have to their lives, it’s great to see the reassurance that surgery such as cross-linking provides to patients,” co-author Professor Stephanie Watson added.

10

INSIGHT October 2024

“RayOne Galaxy represents a next generation technology in intraocular lenses to enable patients to see without spectacles.

Launching the world’s first spiral optic lens on the 75th anniversary of the world’s first IOL feels poetic and I’m proud that Rayner is still at the forefront of technology, partnering with innovative surgeons from all over the world."

Clinical investigations with RayOne Galaxy began earlier in 2024 with eight surgeons, as well as key research labs in Europe and Brazil.

Mr Allon Barsam, consultant ophthalmic surgeon and director at OCL Vision in London, said the first patients received RayOne Galaxy at his clinic in July 2024 and their feedback so far “has been overwhelmingly positive”. Patients were reading without glasses and “thrilled with their quality of vision”.

ENTREPRENEUR’S CLUB LAUNCHES

NEXTSENSE CENTRE A new $75 million centre has opened at Macquarie University to remove barriers for people with vision and hearing loss nationwide.

The facility – developed by not-for-profit organisation NextSense – will support ongoing research, education, and treatment, to enhance people’s quality of life. NextSense CEO Mr Chris Rehn said it was a “nationally significant piece of social infrastructure” that will cement the leading role Australia already plays globally in hearing and vision service delivery and research. “We welcome the Australian Government’s significant financial support of $12.5 million to this project – it will change lives and create new opportunities for the way education and services are delivered to all people with sensory disability,” he said.

From the outset, RayOne Galaxy will be available in toric powers. Image: Rayner.

Eyecare Plus is hoping that gatherings like this will grow members’ businesses.

Image: Eyecare Plus.

Eyecare Plus is looking to drive entrepreneurial innovation and improvements within the network in a new initiative.

The network is introducing an Entrepreneur’s Club, an opportunity for motivated and ambitious members to launch and progress a project with the support of like-minded colleagues around the country.

“The Entrepreneur’s Club members will effectively become an expert advisory panel/peer support group for club members through the design and implementation of entrepreneurial projects,” said Ms Yvette

Safier, high performance manager.

“As a group, members will meet online to share ideas, refine strategies, and hold each other to account as they implement a practice improvement project.”

Monthly online meetings will be held from November 2024 until May 2025, with a small conference at Peppers Noosa Resort at the end of May, where each member will give a five- to 10-minute presentation of their initiative.

Expert advisors may join the group from time-to-time to further support the efforts.

“The Eyecare Plus Entrepreneurs Club will harness the greatest strength of the group by capturing the collective wisdom of its members and working with them to drive entrepreneurial innovation and improvements – that all members can learn from,” said Safier.

The club will produce new proven strategies and intellectual property that will be shared with all members via their staff magazine, meetings and conferences.

E N V I S TA I S N O W P R E L O A D E D

Exceptional performance. Without compromise.

Aberration-free optic1 | Glistening-free performance1,2 | Predictable outcomes1 For more information contact your Bausch + Lomb Territory Manager or Customer Service 1800 251 150

References: 1. enVista Directions for Use. 2. Data on File. Bausch+Lomb Inc. © 2024 Bausch & Lomb Incorporated. ®/TM denote trademarks of Bausch & Lomb Incorporated and its affiliates.

Bausch & Lomb (Australia) Pty Ltd. ABN 88 000 222 408. Level 2, 12 Help Street, Chatswood NSW 2067 Australia. (Ph 1800 251 150) New Zealand Distributor: Toomac Ophthalmic. 32D Poland Road, Glenfield 0627 Auckland New Zealand (Ph 0508 443 5347) EVA.0001.AU.24

COMPANY

ALCON REPORTS FIRST HALF 2024 GROWTH

SPECSAVERS MAKES THE GRADE AGAIN AS A TOP WORKPLACE Specsavers has been ranked sixth in Australia’s Best Workplaces List 2024 by Great Place To Work Australia. It’s the The Specsavers team second year the celebrates another year company has made as a top workplace.

Image: Specsavers. the top 10 after finishing eighth in 2023.

The Best Workplaces in Australia List 2024 highlights organisations committed to “fostering workplace equity, ensuring their employees feel safe, heard, challenged and value”.

In a media release, Specsavers said the “prestigious recognition” acknowledged its commitment to delivering “exceptional eye and hearing care to all Australians, but also highlights its ongoing dedication to fostering a positive, inclusive, and vibrant work environment where everyone can flourish and thrive”.

Specsavers has also been an accredited Great Place to Work organisation for the past five years.

Specsavers managing director Mr Paul Bott said: “While we take great pride in creating an environment where everyone feels empowered to be themselves and has the tools and support to grow and thrive in their career, this recognition is down to each and every one of our team members who make Specsavers one of the best places to work.

“Our people, both in our stores and our support office, are the heartbeat of our organisation, and this achievement is a reflection of the passion and dedication they bring to their work each day.”

Specsavers people director Ms Karen Clancy added: “Specsavers is, and has always been, a company built on great people – people who show up every day in our stores and across all of our support functions to ensure we are helping to change lives through better sight and hearing.

“With such a steadfast purpose, there’s something special about the culture it creates, a place where people feel welcome, valued and proud be part of the Specsavers family that is making a difference every day.”

12

INSIGHT October 2024

The company was pleased with the “solid second-quarter results”. Image: Konektus Photo/ Shutterstock.com.

Alcon’s intraocular lens (IOL) and contact lens products have delivered in the company’s latest financial results, as it reported nearly $5 billion (AU$7.4 b) in sales for the first half of 2024.

The Swiss-American multinational – best known for manufacturing IOLs, surgical equipment, contact lenses and eye drops – reported its financial results for the three- and six-month periods ending 30 June 2024.

Sales for the first half of 2024 were $4.9 billion (AU$7.2 b), an increase of 4% on a reported basis and 7% on a constant currency basis, compared to the first half of 2023.

For the second quarter (Q2) of 2024, revenue reached $2.5 billion (AU$3.7 b), up 3% on a reported basis and 6% on a constant currency basis.

“We are pleased with our solid second-quarter results, which were driven by robust demand for our innovative products, our balanced geographic footprint and strong execution by our team. These factors contributed to another quarter of sales and earnings growth and robust cash generation,” said Alcon CEO Mr David Endicott.

“As we look to the second half of the year, our focus will be on preparing for product launches that will position us well for our next phase of growth in 2025 and beyond.”

Breaking down the figures, net sales for Alcon’s Surgical business in the first six months of 2024 were $2.8 billion (AU$4.1 b).

This includes its IOL portfolio with premium products such as Vivity and PanOptix, as well as refractive laser systems and surgery consumables. It’s a 3% rose on the first half of 2023, and 6% on a constant currency basis.

For Q2 2024, Surgical net sales were $1.4 billion (AU$2.1 b), growing at a similar rate to the first half results.

Within the Surgical business, consumables were the strongest earner in Q2 with $736 million (AU$1.1 b).

But its implantables, including IOLs and the Hydrus Microstent, was the strongest growth-wise, rising 6% to $464 million (AU$683 m).

Meanwhile, growth in Alcon’s Vision Care business was spearheaded by its contact lens products.

For the first half of 2024, Vision Care net sales rose 6% to $2.2 billion (AU$3.2 m) on a reported basis and 8% on a constant currency basis.

“Contact lenses net sales were $636 million (AU$936 m) [in Q2], an increase of 7%, driven by product innovation, including our toric and multifocal modalities, and price increases,” the company said.

OPTIQUE LINE PURCHASES ASSETS OF MCCANN OPTICAL PARTS Victoria-based trans-Tasman optical eyewear frames supplier Optique Line has bought the plant, equipment, inventory, and various other assets from McCann Optical Parts.

“This strategic purchase ensures the seamless continuation of McCann’s well-regarded production of custom-printed spectacle cases, lens cleaners, tools, and other optical accessories," a statement said.

Optique Line director Mr John Nicola said the company was committed to a seamless transition.

The former McCann Optical Parts, now operating as part of Optique Line, will continue to run from the Carrum Downs warehouse in Melbourne, ensuring continuity of service with the same phone lines and ordering processes.

“Greg McCann and his team have provided exceptional expertise and service for many years, and we plan to continue their great work,” said Nicola.

Optique Line is "committed to a seamless transition". Image: Optique Line.

“This purchase is a perfect fit for us, enabling our account managers to offer a comprehensive, one-stop-shop service that includes both high-value eyewear and an extensive range of accessories.”

Mr Greg McCann, the former owner of McCann Optical Parts, said he was “confident that under Optique Line’s stewardship, McCann’s legacy of quality and service will not only be preserved but also enhanced, offering even greater value to our customers”.

Optos multimodality See the bigger picture with more images, information, efficiencies. optomap color rgb

optomap color rg

op m to

d Re

OC T

ap

-fr ee

o pt o m a p i c g

optomap Choroid al

op ue

op

bl

m to

ap

fa

to m

ap

optomap green af af

optomap is multimodality imaging technology, able to generate high-resolution 200° ultra-widefield (UWF™) images to visualise vitreoretinal, retinal and choroidal layers from pole to periphery.1

9* modalities including OCT make a practice…

multidimensional

multifunctional

multipurpose

Discover Multimodality

1. Stanga, 2023 *in press

www.optos.com

© 2024 Optos. All rights reserved.

BUSINESS

Image: George & Matilda.

Chris Beer, George & Matilda Eyecare CEO and founder.

Chris Beer unplugged

CHRIS BEER takes part in a rare interview and answers many of the burning questions about the group he founded, George & Matilda Eyecare. What’s his five-year plan for the business, and what’s yet to play out in the local optometry landscape?

I

t’s been a little over three years since Mr Chris Beer last sat down for an interview with Insight, and the timing couldn’t be more ideal as the independent optometry network he founded and directs today, George & Matilda Eyecare (G&M), goes through arguably the biggest change in its eight-year history.

It’s 14 days after the settlement of National Optical Care (NOC) and its 26 practices, the largest acquisition since G&M’s very first in 2016, the 12-practice Eyelines business in Tasmania. There’s a massive integration task ahead, especially when you consider there’s another eight practices – to be announced in due course – to introduce as part of G&M’s regular business.

“It’s effectively 35 practices that we’re onboarding; we’re integrating a business nearly 40% of our size in a six-month period – and often these things are a lot harder than people think,” he says.

“NOC has been in the market competing with us and has got many excellent practices, but when you peel back and look at their philosophies, what they do, why they do it, it’s very much in alignment with G&M. Each NOC practice is uniquely branded and they will remain that way; it’s about putting one and two together to make a bigger organisation, but one that gives us the ability to invest more back in our people, the business and communities we serve.”

In many ways, the NOC acquisition embodies G&M's intentions in the

14

INSIGHT October 2024

Australian optical landscape: partnering with well-oiled independents, not interfering with their clinical sovereignty, while adding value to the retail and dispensing side of the practice.

These platforms G&M has invested “ridiculous amounts of money” in power vital business functions such as product ordering, payroll, patient recalls and buying power, and are now being used to leverage another allied health stream, audiology.

There’s also ‘Tillie’ – a play on ‘Matilda’ of the company’s name – which is the name G&M has given its supply chain technology. “We can give visibility of every brand, every SKU (stock-keeping unit) to different customer segments, age groups and demographic. There’s also Salesforce that offers strong horsepower in terms of marketing, data analytics tools and so on.”

After a more than 20-year executive career at Luxottica and OPSM – 11 of those as the Asia Pacific CEO – it was this type of technology that Beer saw as the key advantage corporate groups had over independents. It’s expensive kit and largely out of reach for the everyday independent.

“Ultimately, we saw a gap in the marketplace where the independents could have been better supported,” he says.

For G&M, one of the hardest parts has been creating platforms that cater for the many varied needs of practices within the network.

Contrary to what some may think, Beer says there is no “cookie-cutter approach” to G&M’s model.

It’s just one of the many misconceptions and although he doesn’t tap into the rumour mill (he’s a self-confessed “recluse” these days) there’s another important thing to clear up: “Many people have asked, and I can say for certain, George & Matilda’s not for sale. We’re here for the long-haul, we’re about creating a legacy and a pillar in the optometry market.”

Looking across G&M’s more than 120 locations that service 140 communities (when counting outreach work), not one practice has the same supply chain or frames range.

“One of the strengths of George & Matilda is every single practice is different and unique, but that’s also one of our weaknesses,” Beer says.

“It takes more time, care and planning but it doesn’t matter how many variances there are, the technology is able to run every practice. If I was to take you to three different practices, you’d see the same infrastructure in place, but how they go to market is revolved around the personality of the owner and the practice manager – we try to customise that.

“With partners coming on board, they might have an eyewear brand that’s important to them that I’m not familiar with, but I can’t tell them if they are right or wrong. But in six months I can because our technology will tell us. And if it’s a brand that we haven’t been exposed to and it works in that demographic, we’ll take it and put it in other practices.”

It’s this flexibility that Beer says is probably the biggest shift since G&M’s more structured early days.

If anything, it’s a “fine-tuning” of the business model, but brings into focus the challenge of introducing a business of NOC’s size.

PRIMED FOR GROWTH Now the NOC deal is done, Beer says G&M and NOC will continue trading as separate businesses under parent IPIC Holdings. Mr Ant Hudson, who came on board from Audika for G&M’s audiology rollout (more on this soon), has been appointed to oversee the transition as NOC founder and managing director Mr Tomas Steenackers phases out.

Simple economics indicate that once NOC starts contributing to the balance sheet, G&M’s power to acquire more like-minded independents will increase.

Pre-COVID it was acquiring up to 20 practices a year, and the pipeline is primed to recommence at this level from 2025. The technology and systems in place make it a relatively low-cost exercise to bring practices on board – even big transactions like NOC or Mr Dale Rolfe’s nine-practice business in mid-northern New South Wales in 2022.

“You don’t need another CEO or CFO, for example, just a few extra licences and cloud space, but you get fractionalisation of cost and buying power benefits. With an organisation of our size and scale, I’ll be honest and confidently say we can buy any practice in the country and add value in terms of these economies of scale and buying power.”

But it’s not just about business. There is a deeper purpose for Beer. He’s the first to admit he was “pretty tough” and financially driven in the Luxottica days, but as he’s matured it’s become more about impacting the lives of G&M’s 600 employees, promoting from within and adding value to each practice.

“We could stop today, have a great life and pay back the bank, but I’m more interested in creating opportunities for those who’ll be running the business one day. I’m not planning on going anywhere, but my role will be different in the coming years. I’ll still be around on the board and assisting with M&A [mergers and acquisitions], but I’m 58 and the time will come when I don’t want to work seven days a week,” he says.

“The question is, how do you have a more meaningful impact on people?

You can do that and still achieve the financial outcomes, but you do it in a way that’s more rewarding and satisfying for everybody. It doesn’t mean there’s not an edge to what we do, but I believe if you’re in a position of leadership, for every person you lead, they’re responsible for 10 people, be it kids, partners, uncles, aunts and family. That’s 6,000 people for us, so we have a big responsibility to make sure we’re making the right decisions.”

‘BIGGEST THREAT IS OURSELVES’ In terms of G&M’s outlook, the audiology rollout is an exciting new component, taking it from an eyecare to a “sensory” business.

Beer says optometry and audiology are a snug fit, given eyesight is the most valued sense, followed by hearing. Serving near-identical patient demographics, G&M can leverage its optometry database to create a new service and revenue stream. And although there are some costs to retrofit and staff the practices for audiology, it benefits from the shared premises with optometry, as well as the utilities and back-end system costs.

After starting with its Leichhardt practice in Sydney in mid-2023, audiology is now a fixture at G&M’s Gosford practice on the NSW Central Coast, and Figtree, an inner western suburb of Wollongong.

“We’ve got a world-class audiology service and have run a whole bunch of experts through who have given us the tick, saying they haven’t seen this level of care anywhere. We’ve raised the standard and are happy to be

Image: George & Matilda.

Image: National Optical Care.

George & Matilda Eyecare for Antonello Palmisani Optometrist, in Leichhardt, NSW, was the network’s first practice to incorporate audiology.

Optiko Eyewear in Brisbane’s Queen Street Mall has joined G&M as part of the National Optical Care acquisition.

challenged on that by anyone,” Beer says.

“The three practices with audiology have different demographics, and now we’ve learned from that, the rollout plan is mapped out.”

The goal is to have audiology available across the entire network. In cases where a dedicated audiology space isn’t feasible, the practice will offer screening and refer patients to another G&M practice with full audiology services.

“There will be a hub and spoke model, which is common in the industry. It’ll take a couple of years, but audiology will be fully integrated throughout our G&M network, and NOC too,” he says.

As G&M matures, the challenge for the next three to five years is crystal clear.

Acknowledging some potential naivety, Beer believes there are few external forces that can now get in the way.

“I think our biggest risk is ourselves. If we do what we say, provide an amazing experience and execute well, we’re fine, and then other opportunities will present themselves. Everything is in our hands,” he says.

“Pre-COVID we were acquiring 15 to 20 practices a year. Next year, we’ll get back to that level. That, in addition to the audiology rollout and integrating NOC will keep us busy and laser-focused.

“I keep saying to my team, ‘I just want a boring life’ – and what that means is focusing on the things that matter and executing them well. You don’t want chaos or surprises, you just want to be really pragmatic about it.”

INSIGHT October 2024

15

Images: ProVision.

BUSINESS

A buying and selling hub for independents

M

ove over Domain. Step aside realestate.com.

There’s a new player in the business sale classifieds game, but with a twist: it’s a platform designed to plug a major gap in the independent Australian optical market.

The site, optometrypracticesales.com.au, is a bold initiative to make the buying and selling of practices around the country easier, encourage new people into the industry, ease the transition for those exiting, and support the retention of independent businesses in a competitive marketplace.

Launched in August 2024, it features listings for optometry practices around the country, but also information about partnership opportunities and resources to support the buyer and seller, to help all better understand the process.

People can also register their interest in certain areas and be notified of upcoming opportunities.

The site is the brainchild of business services manager Mark Corduff and his team at ProVision, which has worked with a number of partners to make it happen and ensure there’s plenty of appropriate expert advice available.

It is a natural extension of the work ProVision already does to support more than 440 independent optometry practices with everything from HR, recruitment and marketing to tailored business coaching and buying power.

That work has always included helping members with succession planning, the buying and selling of practices, as well as commercial leasing.

“I’ve been involved in business sales in the past,” says Corduff. “We had a buy-sell page that ranked as one of the most clicked pages on our site, so naturally we turned our minds to how we could improve it.”

He and others recognised the process could be better and more meaningful, not only for buyer and seller but also the industry.

“I always found it can be frustrating from both the buyer’s and seller’s point of view,” he says.

“Typically, you’ve got 100 words to play with in an ad, maybe one photo, if you’re lucky, and they’re generally pretty cryptic.”

Often there was not enough information and potential buyers would get in touch with him anyway, to see if he might be able to shed a little more light on a business they were interested in.

So Corduff and others, inspired by what they had seen on other

16

INSIGHT October 2024

commercial real estate and car sales sites, and a couple of similar ventures in the US, started to put the new optometry-dedicated website together.

ProVision’s senior web development and digital specialist team was invaluable in the process, particularly the tricky nuts and bolts of building a new platform.

But there were other challenges to overcome, including how to tailor all of this to the optometry industry.

“We’ve got plenty of experience in the buying and selling of practices, but what exactly do sellers need to put on the table, and what are buyers looking for? It’s not always completely transparent,” Corduff explains.

“We had to put our optometry hats on: How many consulting rooms are there? Are there any special interests? How is the lease length, even down to what is the profit and what is the asking price?”

Working with experts in other fields has helped too.

ProVision is careful to point out that it is not a real estate business, that it’s not getting involved in the buying or selling process; the new website is merely a shop window to help others understand what is out there so they can connect with other professionals if they need more technical or targeted advice.

“We’ve worked with a range of specific referral partners, in broking, in finance, for buyers, legal, so being able to link up with them and have that one-stop shop for when someone jumps in and says, ‘I’m ready to sell. Who do I turn to?’,” he says. “Being able to understand who to go to, where to go

“Our mission is to keep practices independent, no matter who they’re aligned with, and we just hope this makes things simpler for everyone.”

Mark Corduff ProVision

CARRERA 8885

ProVision has launched a new website to help the optometry industry to understand and navigate the commercial sale of practices.

looking at the option of ownership for that flexibility, freedom, and of course, the clinical care piece as well,” he says.

On the flip side there are practitioners keen to retire and move on, to give those younger colleagues a chance. Many want to sell to the right person.

“The majority will say, ‘I want to exit on my terms. I want the practice to remain independent’,” Corduff says.

“And then it becomes tricky, because they even narrow it down to, ‘I’m looking for a specific type of dispenser to take over the practice and continue the legacy, because my patients are important to me, so I’m happy to transition out and train someone up’.

“One of the big realisations we’ve had is this gap between the generation that have been doing it for some time and the younger generation looking to come in. And it was, how do we bridge that gap and connect?”

Corduff and his team believe the site will go some way towards achieving that.

But like the industry ProVision represents, it will need to constantly evolve as well. It is already planning upgrades to the website to make the process even easier for those keen to buy or sell a business.

“I think there’s some more information we can put in there for buyers that we’re working on at the moment, including the potential of a valuation calculator, because it’s usually the first question lots of people ask – how do I value the practice?

“So we’ll be collaborating with referral partners and other industry professionals to expand on the information that buyers and sellers would find valuable.”

Corduff and the team at ProVision are proud of what they have achieved, but they don’t see the likes of Domain and realestate.com getting too nervous and looking anxiously over their shoulders.

“We’re definitely going to stick to optometry.”

CARRERA 8885

and how to save time and get the best commercial outcome is the key idea of all this.”

Another important objective is support for independent optometry practices and maintaining retention in that segment of the industry.

Notably – and despite the rapid expansion of corporate-run practices during the past 15 years – independents are still the majority in the national optical market.

With that in mind, even non-ProVision-affiliated businesses can use the new service.

Corduff encourages all independent practitioners to access the site, which is free to use.

“Our mission is to keep practices independent, no matter who they’re aligned with, and we just hope this makes things simpler for everyone,” he says.

“We’ve got templates and tools to save them time and money and provide them advice.

"There are some great brokers there too, so when someone thinks, ‘look, I really don’t know where to start, I’m flat out, I want someone to take care of this for me’, that can be a really good option for them as well.”

He says the website has arrived at an ideal time, amid strong interest in the optometry industry.

“I’ve never seen as many interested buyers, and they’re primarily around CBD areas, so Melbourne and Sydney are in high demand, but we’re seeing some regional interest as well.

"They are looking at the benefits there of an improved lifestyle, lower cost of living, community, and more.”

He believes the site will appeal to professionals considering the next step and those at different stages of their careers.

“We’re seeing a lot coming out of uni, working for a few years, and then

#DRIVEYOURSTORY PAT CUMMINS

CONTACT LENSES

A

little help from a big friend

Two Australian optometrists in two very different markets share one important thing in common: the support of a global company that helps them succeed as independents.

18

INSIGHT October 2024

they say CooperVision’s size and extensive contact lens range can help independents gain a point or two of difference, level the playing field and maintain a profitable position in the market.

Both agree that a key advantage in dealing with the company is the ability to offer unique customised product offerings.

That makes it difficult for customers to go online in search of a cheaper version of the product, says Dr Casey.

“That’s a big one for us,” she says. “The patients are less able to try and buy the lenses online or from a competitor, because the lenses they’ve got in their hands are exclusively branded.”

Dr Posniak agrees.

“A huge amount of people have started using the internet, because they can undercut the price offered by the independent practices quite dramatically.

“It’s very annoying when patients come in and I fix them up with contact lenses, and then I’ve noticed that they haven’t bought lenses from me for a couple of years.”

Image: Glenn Zocher/Studio 2 You Photography.

W

hen you’re a small player in a competitive marketplace, sometimes it pays to have a big friend to lean on and bounce off.

For two independent Australian optometry practices, that’s exactly what they’ve got in their primary contact lens supplier, CooperVision.

That and a great deal more. Because sometimes, it’s the little things that are important as well.

Derek Posniak Optometrist and Central Coast Eyecare are two very different operations in two very different parts of New South Wales.

Dr Posniak is a sole operator in the leafy North Sydney suburb of Turramurra.

His practice is small, and the customers are largely older and retired.

Meanwhile, Dr Katy Casey and partner Dr Phil Crossfield own three practices as part of Central Coast Eyecare – in Gosford, Erina and Killarney Vale. That’s set to grow to four businesses in the next couple of months. They have eight optometrists and a collective database of about 40,000 patients.

Clientele range from children through to elderly customers.

In Gosford, the younger clients are more likely to favour contact lenses, while Posniak’s older customers lean more towards glasses.

Between the two businesses, there’s some key differences, but they also share two important similarities.

The first, and most challenging, is competition.

There’s plenty of that, says Dr Posniak. “It’s quite dramatic. There’s a lot of optometrists and the big companies in the big shops, they literally surround me. I’m the only one in my little area here.”

It’s a similar story in and around Gosford, says Dr Casey. Her practice may be a little bigger than Posniak’s but it still faces stiff competition from chain stores and online buying.

However, the two are thankful that they have another thing in common – the support of CooperVision, a global leader in the manufacture and distribution of soft contact lenses.

In a tough, competitive market with increasingly bigger corporate players,

Katy Casey and Phil Crossfield, Central Coast Eyecare.

The ability to use an exclusive brand is something not all companies can offer.

“Some of the other brands I use, very well-known brands, if you go on the internet, you can get them easily.”

That helps him to build brand equity, revenue and retain the loyalty of many of his patients.

But CooperVision’s support for smaller independents goes beyond a big shoulder to lean on.

There’s the strength of working with a global leader in soft contact lenses.

CooperVision has the widest range of soft contact lens prescription options, including expanded parameters for its toric lenses in recent times, the constant innovation of product and the ability to use those products to support other growing areas, such as myopia management.

That’s a key consideration for Dr Casey, with a varied clientele and a growing interest in myopia. CooperVision’s MiSight 1-day lens offers a key advantage in this patient cohort: it remains the only contact lens with US FDA approval for slowing the progression of childhood myopia, has a range covering 99.97% of prescriptions for both Asian and Caucasian children with myopia and less than 1D of astigmatism, and is backed by the longest-running soft contact lens study among children.

“CooperVision has also got the power range, the materials and the lens designs that we need for just about everyone," Dr Casey says.

"And they’ve also got a Biofinity XR design, which is like a custom disposable lens, for the people who have got the scripts that don’t fall in the normal ranges."

In 2024, the company also launched Biofinity Energys. It claims these are the only contact lenses to feature Digital Zone Optics lens design, which reduces stress on eye muscles during digital device use.

Dr Posniak, too, relies on CooperVision’s extensive range to serve his clients.

“I need the one-day lenses, also the fortnightly ones, but also their daily disposable and monthly lenses to correct astigmatism,” he says. “And they are in the multifocal lenses as well for this area. So I’ll use, basically, all their portfolio.”

That extensive range, and the support that goes with it, also help to build customer loyalty and retention.

“It’s very rare I will get a patient where I can’t use one of the lenses,” Dr Posniak adds.

Image: Michel Sekla/Derek Posniak Optometrist.

Image: CooperVision.

Contact lenses being manufactured by CooperVision.

Derek Posniak loves the exclusive branding he can use on his CooperVision contact lenses.

And it’s rare for Dr Posniak, Dr Casey and their practice colleagues to not be at the forefront of advances in contact lens materials, comfort and performance.

CooperVision aids with that as well, helping the pair understand the latest developments but also helping them recognise gaps in the marketplace and how to meet unmet needs, including groundbreaking work in slowing the progression of myopia in children.

The company’s website has plenty of information for practitioners about the latest advances in the industry, and this is followed up with webinars and regular visits by company reps to discuss new technology and equipment.

There’s even support for practitioners’ professional development via CooperVision’s on-demand education platform, CooperVision Academy and the regular educational in-person and live webinar events.

“Practitioners need to obtain a certain number of CPD hours per year,” says Casey, “so CooperVision offers an arrangement during the year with webinars or some face-to-face events to help with this.”

It’s one thing to be the big shoulder to lean on, but another thing that impresses Dr Casey about CooperVision is that despite its size, global reach and power, it also does the little things very well. It helps that the company has operations in Frenchs Forest, NSW, and Torrensville, SA, keeping customer service close to the market it services.

Beyond the branding, the range, the support for professional development, and even Central Coast Eyecare’s own marketing from time to time, the company does something she claims others don’t: it listens.

She raves about the company’s rep, the relationship they have established, and the reaction to feedback from customers and colleagues.

“CooperVision doesn’t pretend to listen, they genuinely want to hear what we say, and they try to give us solutions to compete in a world where we are the little fish.”

Dr Posniak agrees.

“It’s one of the most important things, that they support me . . . it’s a two-way relationship, it works beautifully.”

Casey goes even further.

“If I was speaking to someone who was opening up a practice for themselves for the first time, CooperVision would be my only recommendation for the lens company to chat with. That’s because they do actually listen and they care about the independents.”

INSIGHT October 2024

19

EQUIPMENT

Cutting edge in the countryside

20

INSIGHT October 2024

The PTS 2000 Automated Projection Perimeter.

that nothing is progressing with their condition.”

Young Eyes has always tried to position itself at forefront of advanced primary eyecare, despite the challenges of operating in a rural setting. The new visual field-testing machine has only strengthened this position, offering enhanced capabilities that benefit both patients and practitioners.

Hobson says this would not have been possible without the support from OptiMed who installed the device in the practice that’s four hours from Sydney and two hours from Canberra.

“We’ve had great after-sales service from the team at OptiMed,” she says.

“Given that we’re in a rural area, getting someone to come out for service can be tricky, but we haven’t had that problem with OptiMed. They’ve been very responsive, even providing us with extra training when we needed it.”

She recounted an instance where the practice had to perform a Superior-64 visual field test at the request of an ophthalmologist.

“We hadn’t done that particular test before, so we called OptiMed, and they walked us through setting it up. That kind of support is exactly what we need, especially when dealing with something new,” Hobson says.

As Young Eyes continues to adapt to the new technology, Hobson remains confident that it will lead to better outcomes for her patients.

“It’s been a learning curve, but the benefits far outweigh the challenges.

We’re able to offer our patients a higher level of care, and that’s what matters most,” she says.

For other optometrists considering a similar upgrade, Hobson says as with all new pieces of equipment, it’s important to trial it first.

“We tried it out, and it made the transition much easier,” she adds. “From all our staff that use it, it’s been very quick, easy and seamless to introduce into our practice.”

Janine Hobson, owner of Young Eyes in NSW.

Image: Young Eyes.

I

n the heart of Young in New South Wales, a bustling optometry practice is setting the standard for rural eyecare. Young Eyes – owned and operated by experienced optometrist Ms Janine Hobson – has been a fixture in the community for 21 years, providing essential eye health services to a region where specialist care is often hours away.

Recently, the practice has taken a significant leap forward by integrating cutting-edge visual field-testing technology, enhancing its ability to detect and manage glaucoma within a broader comprehensive eyecare framework.

Hobson’s dedication to her community is evident in her range of services. The practice has become a critical hub for patients requiring advanced diagnostics, so she says it is important to have the right tools and a comprehensive service offering beyond routine eye exams to meet these needs.

“Given that we don’t have an ophthalmologist within a couple of hours of us, we do quite a bit of specialty work,” she says.

Hobson recently complemented her already-impressive suite of diagnostics with a PTS 2000 Automated Projection Perimeter developed by Polish firm Optopol, the same manufacturer behind the popular REVO OCT. OptiMed imports and distributes the technology in Australia, with Hobson saying the intuitive software allows practitioners to seamlessly integrate OCT and visual field results, generating a quick and comprehensive structure-function report on a single page.

The introduction of the new visual field-testing device at Young Eyes was a carefully considered move, given that many specialists and staff were accustomed to the old machine.

“When our old visual field machine started to not function so well, we looked into alternatives. The integration with our OCT device was a big drawcard for us because it allows us to do structure and function analysis for both eyes together. That’s a significant advantage in diagnosing and monitoring conditions like glaucoma,” Hobson says.

However, the learning curve, according to Hobson, is justified by its standout features such as its ability to recheck points during the test if a patient misses them – a capability that was not available previously.

This is facilitated by the PTS 2000’s high resolution camera which precisely monitors patient compliance via a blink control feature. This has proven invaluable for Hobson, particularly during threshold tests where accuracy is paramount.

Moreover, the PTS 2000’s ability to perform specialised tests – such as those for ptosis –has been a significant upgrade.

“It has a superior test that lets us check for patients whose eyelids are interfering with their vision,” she says, adding that this is useful in a practice handling a high volume of neurological assessments.

For Hobson, the primary motivation behind the upgrade has always been the improved care she can offer patients.

“For us, especially being in a rural area, the ability to do these tests locally and manage patients’ care without them needing to travel is invaluable,” she says. “A lot of our patients are co-managed because it’s just too far for them to travel to see an ophthalmologist regularly. This machine helps us ensure

Image: OptiMed.

The integration of advanced technology such as the PTS 2000 Automated Projection Perimeter is just one of the ways optometrist JANINE HOBSON is ensuring her rural community receives the best possible care, close to home.

Thinking about buying or selling an optometry practice?

Independent optometry now has a dedicated platform that makes the process easier than ever.

OptometryPracticeSales.com.au is FREE to use and connects prospective buyers and sellers while highlighting criteria like lease terms, clinical scope and practice size.

Buyers can instantly browse partnership and full-sale options, while sellers have a streamlined exit that maintains the independence of the practice.

Connect today at OptometryPracticeSales.com.au or register for updates to never miss an opportunity.

PV_OPS_Insight_FP_Ad_OCT24.indd 1

6/9/2024 9:35 am

?

4 9:35 am

EQUIPMENT

A secondary retina l detachment.

Images: Gladstone Visio

n.

diagnosed by A retinal detachment st Peter Choc Queensland optometri a. ton Day os Opt his on

Seeing the unseen

Two seasoned rural optometrists say investing in an Optos ultra-widefield imaging device was one of the easiest and more successful decisions they’ve made, with only one regret: they should’ve bought it sooner.

Q

ueensland independent optometrist Mr Peter Choc from Gladstone Vision has spent most of his 43-year career practising in regions with often limited access to local ophthalmology services.

So, to look after his patients, he feels an added responsibility.

Equipped with sound observation skills, and the ability to refer to the right ophthalmologist, when necessary, he has carved out a niche focusing on exceptional patient care.

Beyond a slit lamp and OCT, he believed he didn’t need much more.

Ultra-widefield retinal imaging capabilities was far down on his device wish list. However, in 2022, he could no longer resist and eventually invested in an Optos Daytona.

Now, with the device embedded in his practice, Choc’s only disappointment was not investing earlier. He now considers an optomap scan, captured on Optos equipment, as the standard of care, and a routine part in patient consultations.

“The fact the optomap could take a single wide angle shot in one hit as well as its established and proven track record made the decision easy,” he says.

For Choc, the device was the missing link in his practice, as it bridged the gap between optometrist and ophthalmologist and expanded his pathology scope. And, as a high-volume practice, the optomap has relieved some of this workload.

“The optomap has created a more stress-free triage of emergency appointments. Being a busy long term independent practice, and with no full-time ophthalmologist in Gladstone, we are inundated with the medical side within our profession,” he says.

“They’re not always our own patients but we endeavour to see these patients. The obvious benefit of optomap has been in capturing images

that can be emailed direct to an ophthalmologist for referral or an opinion.

“Additionally, I had two optometry assistants who had worked with ophthalmologists and were familiar with the instrument.”

Beyond this, Choc says it is an asset to his demographic and the unique pathologies of the region.

“Queensland has a high rate of melanoma and people are genuinely surprised when it can be in the back of an eye. Being so close to the brain it needs prompt attention,” he says.

“All new patients are required to have an optomap. It is our focus to have all patients obtain a baseline ultra widefield scan, and with the inclusion of an OCT.” Choc quips that his most complex cases often appear in his practice on a Friday afternoon – after the eye doctors have finished work for the week.

“Although our books might be full, all we have to do is obtain an optomap of the patient – which is quick because you don’t have to spend any time dilating them – and then email the image to the retinal specialist for triaging,” he says.

“Something that normally would have taken an hour or so or more, can now be squeezed between patients with an optomap scan.”

And because of this, Choc says the device pays for itself.

He advises all his colleagues to consider an ultra widefield device in their workflow as both patients and practitioners alike are impressed.

He says although some optometrists may be on the fence about taking the leap, his only regret was not investing sooner.

Meanwhile, Choc’s patients welcome optomap scans as standard care. He says they understand its value, and they don’t bat an eye about the additional fee.

INSIGHT October 2024

23

EQUIPMENT

“Something that normally would have taken an hour or so or more, can now be squeezed between patients with an optomap scan.”

Peter Choc Gladstone Vision

Ross Cooper from Cooper Smith Optometrists in Goondiwindi, Queensland, says having an Optos sytem has helped with word-of-mouth referrals.

“The benefit too is that once patients have had an optomap and they’ve seen it – especially diabetic patients – they anticipate that that’s just part of their normal visit or consultation,” he says.

ANATOMICAL COMPLEXITIES Mr Ross Cooper from Cooper Smith Optometrists in Goondiwindi, Queensland, has enjoyed a career spanning decades. Having worked closely with ophthalmologists – particularly retinal specialists – he has been trained extensively in retinal pathology.

However, even with his expertise, the limitations of traditional ophthalmoscopy techniques have always been a challenge.

That’s where the Optos Daytona comes in. Cooper says for him the device offers an ultra-widefield view of the retina, providing a comprehensive image that traditional methods simply can’t match.

Unaware of the extent of the intricacies of the structures in the back of the eye, Cooper says his first use of the Daytona opened a whole

24

INSIGHT October 2024

new anatomical world.

“We had a patient with lattice degeneration and I knew there were a few pieces of lattice there. There were no holes, and I had no concerns, but to just get a lovely optomap and to appreciate the extent of the lattice was incredible,” Cooper says.

The ability to see the full extent of retinal pathology is not just a technical marvel; it’s a significant leap in patient care. Cooper explains that the device’s benefits extend beyond what he could have achieved with traditional tools.

“When you’re looking with a 90-diopter lens, you’re looking at these small sections, trying to piece them together – but you’re missing bits anyway. With the ultra-widefield image, you see the whole picture.”

Patients have been equally as impressed and, like Choc’s practice seven hours away in Gladstone, have had no objection paying extra for the optomap. In fact, word of mouth in the close-knit community has seen demand soar for an optomap since Cooper had the Daytona installed.

“Word goes around; we’re getting patients phoning up and asking to have an optomap when they book their appointment. This shows that patients are very happy to pay for the service,” Cooper says.

“The patients love it: I had a patient say it is worth paying slightly extra just to see what the back of their eye looks like.”

An added benefit is that Cooper is getting good views of children’s retinas – something he struggled with before.

“If you sit down with a 90-diopter lens or an indirect ophthalmoscope and you pour bright light into them, they just instantly look away. You’re only getting very rapid glimpses of the children’s eyes,” Cooper says.

“It’s fantastic: the youngest we’ve had on the Daytona was five years old, and we’ve got good, clear images of their retina. It’s a lovely little security blanket to have with children.”

And like Choc, Cooper says optomap scans can be sent to the nearest retinal specialist in Toowoomba with ease.

“We can just email an optomap through to him and, if there’s something there, he’ll let us know.”

Moreover, Cooper says that Optos’ ultra-widefield devices are within reach for all optometrists thanks to flexible purchasing options, making it possible for next-level imaging to become a standard fixture in any practice.

Looking forward, Cooper sees the potential for even greater integration of such technology into everyday practice.

He envisions a future where young retinal specialists, trained with access to these tools from the beginning of their careers, could provide invaluable guidance and continuing education to optometrists.

In the meantime, Cooper is content with the impact the Optos Daytona has had on his practice and his patients. As he continues to navigate the challenges of rural optometry, he does so with the confidence that he is offering the best possible care, thanks to the Daytona.

Plastic neutral†

Meet Michael Angelos George & Matilda Eyecare Professional Services Manager, B. Optom Michael Angelos was already a successful optometrist running his own practices in North Sydney then McMahons Point, when we approached him to join George & Matilda Eyecare in 2016.

“Timing is everything! When I met Chris Beer (CEO), I was really wanting more time to pursue my other passions. I liked Chris’ confidence … I had a good feeling about being part of his growth direction and being part of an Australian business”.

Fast forward to today, Michael has been appointed to Professional Services Manager, helping other optometrists develop their clinical and business skills. He remains a business partner and works part-time in practice to care for his loyal patients.

“What I love about my life now is that no two weeks are the same. I get to help people, from my younger colleagues to my loyal patients. It’s also comforting to know there’s support there if you need it.

Let’s Connect Contact Cassie Gersbach, General Manager of Partnerships at cassie.gersbach@georgeandmatilda.com.au SCAN TO LEARN MORE

REAL STORIES. REAL PEOPLE. REAL OUTCOMES

Image: gmstockstudio/stock.adobe.com.

DRY EYE

Back to the with dry eye

future

The sector has witnessed a stunning decade of research and development to treat dry eye disease, but even with this progress, Insight discovers some Australian optometrists have gone full circle with their approach to the disease.

N

“I hate to say it, but when somebody walks in and says they’ve got pain in their eyes, it’s almost automatic to say, ‘oh, it’s dry eye’, right?”

Image: Marilyn Stern.

ext year it will be a decade since the Tear Film and Ocular Surface Society (TFOS) launched Dry Eye Workshop II, a gathering of 150 global experts that represented a breakthrough in the world’s understanding and treatment of dry eye disease (DED).

That work brought a little-known condition into sharper focus for eyecare professionals and patients in Australia and around the world.

For many, DEWS II provided a vital roadmap, but almost 10 years on, a number of eyecare professionals in Australia are asking if the industry has perhaps veered off track in tackling the disease and whether it is really doing the best it can to help the sufferer in their journey.

Their thoughts, collected by Insight as part of a look into progress made on DED, appear to echo those of Dr Rolando Toyos, a world-renowned American DED expert who pioneered the use of intense pulsed light (IPL) in the treatment of the disease.

Dr Toyos, who visited Australia last year, acknowledged there are several tools eyecare professionals now have to tackle the condition.

Those include state-of-the-art diagnostic devices, as well as artificial tears, eye drops and lubricants, prescription eye drops (ciclosporin), hot/ cold compresses, eye lid scrubs, IPL machines, even radio technology equipment previously used in cosmetic healthcare.

These and other developments have helped many of the 700 million people around the world believed to be suffering from DED. Optometry Australia estimates that includes as much as 85% of this country’s population who have experienced it at some point, with almost one in five (18%) experiencing it frequently.

But during his Australia trip, Dr Toyos suggested that, despite the proliferation of products, the industry was still missing the bigger picture and underlying causes of DED. “There needs to be an unlearning phase,” he said at the time. “For the paradigm shift to happen, we need a new crop of doctors trained in a new way and the older doctors to dump what they have learned previously.”

Those thoughts were supported by the eyecare professionals Insight spoke to.

They represent different parts of Australia but also different approaches to DED diagnosis and eye health, from public to private, regional and metro.

Despite those differences, they shared a common theme: the future of DED diagnosis and treatment is not necessarily about the next technological advance.

In fact, it’s quite the opposite – it’s back to the future.

It’s about looking past the latest device or pharmaceutical drops to better understand the patient in front of the professional.

It’s about gaining a better understanding of that patient’s background,

Marilyn Stern Dry Eye WA

environmental factors, even diet, and how these many factors might influence their DED. It’s about something possibly even more precious to busy eyecare professionals: time. How to generate it and, possibly even more importantly, how to charge for it when issues with funding and bulk billing are so prevalent, and the nation is grappling with a cost-of-living crisis.

And it’s about taking more of a multi-factorial approach to not only diagnosis and treatment but also training for the next generation of optometrists and ophthalmologists.

Lastly, it’s about working with other medical colleagues, including GPs and dietitians, and maybe even embracing alternative therapies as part of ongoing treatments.

But the people we spoke to also agree on another important thing.

They believe that if an optometrist or ophthalmologist can take that time and open their minds to other pathways to better understand their patient, then DED represents an incredible opportunity for professionals to build long-term relationships with their patients, elevate their clinical practice, and drive commercial growth.

And that would be a sight for sore eyes – for the practice and the patient.

FORGET AI – IT’S ABOUT HUMAN INSIGHT Ms Marilyn Stern, a consulting optometrist at Dry Eye WA who is a dry eye specialist with a special interest in DED, has learnt a couple of things during her career.

Firstly, that she loves Perth, even though it was never meant to be her forever home.

And secondly, that parts of the industry are not getting it right on DED. On the former, the UNSW graduate moved to Perth in 1983 to start her career and then, when it came to considering a shift back to Sydney,

INSIGHT October 2024

27

DRY EYE

Image: Tom Donkin/Two Moons Consulting.

Marilyn Stern believes practitioners need to use their own intelligence and insights to build a more holistic image of their patient and their needs.

discovered the jobs there had dried up, she would have to take a 25% pay cut, and also pay a third more for rent.

Decision made.

On the latter, Stern is equally forthright.

Dry eye diagnosis is not up to scratch, she believes, with professionals too quick to rush to conclusions.

“I hate to say it, but when somebody walks in and says they’ve got pain in their eyes, it’s almost automatic to say, ‘oh, it’s dry eye’, right?”

Like many others, Stern was inspired by advances made in the wake of the TFOS workshop in 2015. It laid the foundation for how DED was managed, and her eyes were opened by the possibilities on display and the opportunities to focus on what was previously a little-understood eye issue.

“I was at a conference and went through the trade section and discovered suddenly that you could do more for dry eye than we had been taught,” she says. “I saw an IPL machine and found out a little bit more about that, and thought, well, this is really interesting.”

She uses some of that advanced technology and equipment to help her diagnose and treat DED in Western Australia.

“The most important equipment that I have is my keratograph. It performs tear film analysing, which is a huge thing for figuring out whether it’s dry eye or not – you can take photos, you can track everything each visit – what’s happening, what’s improving, what’s not improving.”

She also conducts osmolarity tests, to measure the concentration of osmotic solution in the tear fluid, which helps determine the severity of dry eye.

But even more important than the new techniques and technology is working to build a greater, more holistic picture of the patient’s health, their circumstances, and environmental factors that may be influencing the issues with their eyes.

Forget artificial intelligence, says Stern, practitioners need to use their own intelligence and insights to create that image.

“It’s important to find out their general health, history of any eye surgeries, anything else that’s done with their eyes,” she explains.

28

INSIGHT October 2024

“What are the environmental factors? Immune disease is huge, an important part of what’s causing dry eye health, gut health too. They all sort of cause a different form, it appears, of dry eye.”

Building that picture can take time in a busy practice, and time costs money.

But it is also an opportunity for private practitioners to carve out a profitable niche in a competitive industry with so many larger players.

Stern charges for the extra time she takes with her dry eye patients.

“Bulk billing is certainly good for pensioners and healthcare card holders, the ones who have serious problems, but otherwise, I believe that I am worth more than what Medicare tells me I am. So yes, I charge for it.”

She believes that extra time and aftercare work needed may not be as attractive to some of the bigger companies adopting a corporate model.

But for those who do take that time, the reward can be a better rapport with their patients.

“They do come back. Then they spread the word and that’s fabulous for getting new patients in amongst their family and friends,” Stern says.

It’s also about building a working relationship with other medical professionals. And keeping an open mind.

“Keep in touch with their GPs and let them know what’s going on. The patient may need to see an immunologist who can help get to the bottom of why this [dry eye symptoms] is happening.”

Stern recognises her views might be a little confronting for a sector constantly focused on the next big device or pharmaceutical advance.

“If you think that what I’m doing is ‘alternative medicine’, ‘alternative therapies’, well that takes a long time to be accepted in the medical and scientific communities.

“But I think more and more practitioners are going to catch on.”

REGIONS GREAT FOR BUILDING A GOOD RAPPORT One thing has Miss Jenny Kim very excited.

Radiofrequency technology. It has been used in the cosmetic health industry, to help improve skin tightness and texture. But Kim, an optometrist

Image: Daniel A’Vard/ACO.

“Dry eye is multifactorial, so unless we’re coming at it from multiple angles, looking at all factors potentially feeding into their symptoms, we’re not helping them.”

Varny Ganesalingam Australian College of Optometry

Optometrist Jenny Kim says word of mouth is a big motivator for potential customers in the regions.

Image: Howie Yin/G&M Mudgee.

at the George & Matilda practice in Mudgee, NSW, has read about its applications in eyecare.

And she wants one.

The thermal technology is designed to deliver targeted bipolar radiofrequency energy to small delicate ocular zones, directly on the upper and lower lid, to address DED caused by meibomian gland dysfunction.

Kim has seen it in action, in Sydney. She’d love to get her hands on one, but it remains out of the grasp of a small optometry practice serving a regional town so far from the metropolitan centre.

For now, at least.

Knowledge about DED is also something that appears to diminish the further a person heads inland from Sydney.

Kim’s clientele is largely older and retired. As a dry eye sufferer herself, she’s passionate about the subject and has seen plenty of symptoms in her clinic that could add up to DED. But many patients are happy to put this down to older age, and a burden that must be endured.

“I’ve noticed patients in the regional areas tend to just learn to live with it,” she says. “So then every time I delve into questions about how their eyes feel, that’s when they confess, ‘oh yeah, my eyes have been itchy, but, you know, it’s okay, I just live with it all’, or ‘my eyes have been watery, I just wipe it away’.”

For those who do want help, Kim can offer preservative-free, lubricating eye drops/ointment and eye masks, as well as lid wipes or foam lid cleansers to treat blepharitis.

“Some patients are happy with that.”

Patients with more severe ailments, including Sjogren’s syndrome, might need to be prescribed with cyclosporine drops.

But for those needing access to more sophisticated equipment, treatment might mean a bit of a trip.

“There’s an IPL machine in Dubbo, which will be an hour and a half drive out,” she says, noting that her practice is hoping to get its own machine soon.

However, what the regional practice might lack in state-of-the-art DED technology, it makes up for in another important asset: time.

“The advantage of being out here in a rural region is building that rapport with patients and spending a lot of time gaining an understanding of their dry eye problem, and explaining the mechanism of their type of dry eye symptoms to help them comprehend why they are using a certain eye drop or requiring certain treatment.

“Patients appreciate this explanation and I’ve noticed it improves compliance too.

“So before you even start those treatments – diagnosing, asking the right questions and getting the right information is very important.”

For Kim, being a regional optometrist, she needs to be more flexible in finding solutions for dye eye sufferers.

“There’s only so much we can help relieve their dry eye symptoms with at-home treatments, because those products only provide short term relief instead of fixing the core problem,” she says.

“IPL and radiofrequency, they can help treat the core problem, but so can nutrition and diet, and understanding their medical history and any co-existing systemic conditions, which will help you guide the treatment process needed.”

That can bring rewards for even small regional practices.

“Word of mouth is really big in this sort of community. I had a patient who came back saying, ‘Oh, my friend used those drops and I feel like those drops will help me as well. Can you see if I have dry eyes?’”

Kim is optimistic about the future of DED diagnosis and treatment.

“Science is always evolving, and there’s always newer studies coming out as well. Even with radiofrequency technology – who would have thought that something for improving skin texture would be available for dry eye treatment as well?”

OPTOMETRISTS READY TO TAKE OWNERSHIP OF DED Ms Varny Ganesalingam is busy. She’s frantically typing up notes on a previous patient, looking around to see where the next interruption might come from, all while being interviewed by Insight.

That’s the life of the staff optometrist and lead DED clinician at the Australian College of Optometry’s busy Carlton clinic in Melbourne. She’s one of about 20 optometrists working across a number of specialties.

The focus on dry eye at the clinic started as a trial in 2021 and then moved to bi-weekly sessions in 2022.

Patients are largely Medicare and pension-card holders, and the disadvantaged living in Victoria’s vast catchment without access to private services.

That can mean an issue with their eyes is often not their only burden.

“You’ve got patients with co-morbidities, often with a lot on their plate; they have poor health literacy and mental health issues.”

Like many others, Ganesalingam was inspired by the work on DEWS II, and in particular that of fellow New Zealander, Professor Jennifer Craig, who played a prominent role during the workshop.

INSIGHT October 2024

29

DRY EYE

Image: Johnstocker/stock.adobe.com.

Optometrist Varny Gainesalingam would like to see more colleagues allowed to prescribe medicines.

Image: Daniel A’Vard/ACO.

Varny Gaesalingam (right) is excited by the idea that dry eye could be an optometry area of interest.

“She was kind of my guru, and I ended up doing my master’s thesis under her, looking at ocular surface inflammation in the context of dry eye.”

How to put dry eye into the right context has been an ongoing piece of work for the clinic.

“When I first started, we were checking for glaucoma or diabetic retinopathy first, so dry eye was a bit of a low priority – ‘you’ve got a bit of dry eye here, have some drops and we’ll see you in six months’ time’.”

Also, diagnosing, treating and explaining DED properly took up time in a busy public health centre used by patients with complex needs. Charging for that extra time can be a challenge as well, with Medicare and bulk billing struggling to reflect the true cost of time and energy expended.

But she says the “mentality is changing” and there is a recognition now that DED does have serious impacts on quality of vision and life, and that more time spent understanding patients is important.

Another issue is a lack of top-line equipment. Ganesalingam and her

30

team have access to an OCULUS Keratograph 5M machine for diagnosis, and a Lipiflow Thermal Pulsation device to treat meibomian gland dysfunction. But patients needing IPL treatments are told they may need to go elsewhere, although there may be funding for this in the near future – “it’s a work in progress”.

Despite all of these challenges, she believes optometrists, in particular, could take ownership for the diagnosis and treatment of DED. “General ophthalmology seems to not be too interested in managing these patients, because it’s not something that can be surgically remedied,” she says.

Realising that opportunity needs commitment, investment in “a few pieces of kit” and understanding that it’s not just about sending the patients off with a few eye drops.

“Dry eye is multifactorial, so unless we’re coming at it from multiple angles, looking at all factors potentially feeding into their symptoms, we’re not helping them.”

Again, that’s about taking the time and asking the right questions.

It’s also about collaboration with other professionals.

“Lots of patients at our clinic have underlying conditions that provoke their dry eye, whether it’s the condition itself or the medications that they’re taking for it; you have to be in consultation with their specialists for a more holistic approach.

“It’s got to be a collaborative effort if we’re doing that kind of patient-centric care, which I think is the ideal scenario.”

That will need a change in training and also allowing optometrists to issue oral prescriptions.

“There’s two oral medications that are largely used in the dry eye space – Azithromycin and Doxycycline – both of which have been around for a long time and are unlikely to cause any major issues, especially at the sub-antimicrobial dosages prescribed in the context of dry eye, but of course the training is required for a safe roll-out of any increase in scope of practice.

“New Zealand have done it safely so I think Australia could too.”

So myriad challenges remain. But like the others interviewed by Insight, she believes that tackling DED and improving patients’ quality of life remains a great opportunity for her industry.

“I’m excited by the idea that dry eye could be an optometry area of interest.”

INSIGHT October 2024

ALC2146

GIVE YOUR PATIENTS A CONTACT LENS WITH

INCREDIBLE C MFORT ALL MONTH LONG

1-3

FIT YOUR PATIENTS WITH TOTAL30™ MONTHLY REPLACEMENT LENSES ALWAYS READ THE LABEL AND FOLLOW THE DIRECTIONS FOR USE. References: 1. Alcon data on file, 2021. [Summary of the CLY935-C013 study p4, available from phone 1800 224 153 (AU), 0800 939 999 (NZ)] [REF-11403].

2. Alcon data on file, 2021. CLV201-C001, p.4; [REF-15339]. 3. Alcon data on file, 2021. CLV201-M102, p.8,9; [REF-15340]. © 2024 Alcon Laboratories Pty Ltd. AUS: 1800 224 153; Auckland NZ: 0800 101 106. ALC2146d 07/24 ANZ-T30-VCL-2400006

ALC2146 Total30_Insight_FP Ad_v1.indd 1

3/07/2024 2:12:03 PM

DRY EYE

battle against

A key weapon in dry eye disease

Two Queensland optometrists have an older client base and a fair bit of dry eye on their plate.

To help with diagnosis and management, there’s one instrument they depend on.

Image: Heron Eyecare.

32

INSIGHT October 2024

“If you want to be definitive, if you want to show your patients that you know what you’re doing and that you’re on the right track – or not, then this is the piece of kit you need.”

Adam Barron Heron Eyecare

The Idra diagnostic device enables a quick but detailed structural assessment of tear composition.

Image: BOC Instruments.

“F

or anyone wanting to be involved in the dry eye space, if they’re not using objective parameters to measure or perform an initial assessment, and they’re not quantifying metrics, they’re just guessing.”

Those are fighting words from Queensland optometrists Dr Hugh Bradshaw and Dr Adam Barron.

And they are just as forthright about the vital piece of equipment they take into that battle with dry eye. The device they trust to diagnose the disease and confirm they are on track with its management is their Idra tear film analyser, from Italian manufacturer SBM Sistemi.

Dry eye is an important focus in their Toowoomba practice, Heron Eyecare.

Dr Bradshaw joined the business in 2009 and then took over a little later on when founders Henry and Miriam Heron left. Dr Barron joined in 2017 and is now a partner.

Many of their patients are older, and Toowoomba is known as the ‘Garden City’, meaning plants, pollen and plenty of allergies to exacerbate any eye issues, making dry eye a key focus.

Because of that, Dr Bradshaw is on the board of the Dry Eye Society and joint chair of its Education Committee.

The disease has become a strong pillar of growth in his practice, clinically and commercially.

“Patients that are struggling with dry eye are often referred to us because we have got either the equipment or the expertise to manage it better,” he says.

“We have improved our retention, but also our referrals, both from ophthalmology and from local optometry as well.”

That equipment includes intense pulsed light (IPL) technology and the Rexon-Eye, which uses high-frequency electric fields to regenerate cells.

But devices to aid treatment and management are nothing without other equipment to first diagnose what is wrong and then objectively track treatment and management.

And for that, Dr Bradshaw and Dr Barron swear by their Idra device.

The machine, distributed in Australia by BOC Instruments, enables a quick but detailed structural assessment of tear composition, an important part of diagnosing dry eye and its severity.

“The tear film has got three layers – oil, water, gel. If you’ve got the right amount and the right ratios, you’ve got good tear film,” says Dr Barron.

“Idra analyses meibomian glands and tear film content,” he says.

“Using interferometry it can analyse the stability of your tears, your blink rate. It analyses the oil layer, so you know the amounts and strength of that layer. It quantifies the aqueous tear layer by the tear meniscus height, which is an indirect barometer for the aqueous layer across the ocular surface. And it also measures the stability of the tear film and blinking efficiency.

“So we get a quantitative metric for all of those parameters, and from there that helps us with advice, management and progression analysis in terms of actually how someone feels at any given point in time.”

That gives the practice, and the patient, a definitive, objective analysis of not only the severity of their dry eye but also the efficacy of its treatment and management.

Dr Bradshaw says other machines can provide part of that picture, but the SBM Sistemi Idra distributed by BOC Instruments “gives you all of this data in a very short space of time, in a quick snapshot, and then collates the data concisely so that we can measure it against what’s considered normal and what’s not”.

The device can also help some patients stay the course on treatment, when they appear frustrated by a lack of perceived progress.

“It’s an unequivocal diagnostic tool,” Dr Barron says.

“Often through the course of treatment there’s a disconnect between physiological and symptomatic improvement, which can be a source of frustration and concern for patients,” he says.

“When patients can see objective quantitative data showing an improvement to physiological signs, their fear and frustration turns to confidence and we all know we’re heading in the right direction and all we need to do is be more patient.”

The machine is also invaluable for helping professionals understand when treatment is not working.

“Based on our professional judgment we can implement a management plan, but when that doesn’t work, for whatever reason, you then need to be able to reassess why, and this is where it can help.”

Both agree the Idra is an essential part of the toolkit for any professional looking to focus on dry eye in their practice.

“If you want to be definitive, if you want to show your patients that you know what you’re doing and that you’re on the right track – or not, then this is the piece of kit you need.”

We’re one of the best!

It’s official, Specsavers has been named one of the Best Workplaces in Australia for the second year in a row by Great Place to Work®, the global authority on workplace culture. What makes us the best? It’s our commitment to our people making sure we are a place where everyone feels welcomed, valued and proud to belong. Where our people can come to work and make a difference every day.

Find out more about what makes us one of the best at spectrum-anz.com/careers-at-specsavers/

DRY EYE

T he Power

of low light level therapy Sydney ophthalmologist DR NISHA SACHDEV dissects low light level therapy, a new tool generating what she describes as remarkable, non-invasive results in patients with ocular surface and eyelid issues.

O

ne of the most cutting-edge developments in ophthalmic device technology of late is photobiomodulation therapy (PBMT), more commonly referred to as low light level therapy (LLLT). This has been recently adapted for ophthalmological use, having been applied in other fields such as dermatology and pain management thanks to its versatility, non-invasive nature and impressive results.

LLLT is gaining widespread recognition as a powerful tool for addressing various ocular surface diseases. This therapy works by harnessing the power of specific light wavelengths to promote cellular repair and regeneration.

The foundation of LLLT lies in photobiomodulation – a process where light photons are absorbed by cellular components, primarily cytochrome c oxidase within the mitochondria. It boosts the production of adenosine triphosphate (ATP), the cell’s primary energy source. ATP plays a critical role in cellular repair and regeneration, revitalising damaged tissue, enhancing metabolic activity, and improving overall cellular function.

The beauty of LLLT is that it works in a non-invasive, atraumatic and painless manner. Unlike other treatments that may involve surgery, discomfort or downtime, PBMT is completely non-destructive. It delivers energy to cells in a controlled way, triggering beneficial biological responses without causing thermal damage or injury to the tissues.

LLLT has proven extremely effective for various ocular surface diseases.

Some of its primary uses include dry eye disease (DED), allergic eye disease, anterior and posterior blepharitis, meibomian gland dysfunction (MGD), meibomian cysts, pre- and post-cataract and refractive surgery, and lower eyelid oedema.

A key advantage is addressing these conditions without the need for surgical intervention. For instance, meibomian cysts or chalazia can now be treated effectively using LLLT, providing a new non-invasive option. Additionally, certain wavelengths in LLLT can reduce scar formation and minimise tissue oedema, particularly removing bags under the eyelids. This is valuable in reducing post-operative oedema and scar tissue formation following eyelid surgery.

The effectiveness lies in its targeted mechanisms of action. Depending on the wavelength used, PBMT can trigger various beneficial effects within the eye.

Here are the three main types adopted in ophthalmology: 1. Red light therapy: Red light can penetrate the skin of the eyelids and reach the subcutaneous fat layers, where it targets the meibomian glands.

36

INSIGHT October 2024

Images: Nisha Sachdev.

Red low level light therapy with the Eye-Light system.

By increasing ATP production in these cells, red light helps to reduce inflammation, liquefy meibum and improve blood circulation within the glands. This makes red light therapy particularly effective in DED, MGD, posterior blepharitis and chalazia.

2. B lue light therapy: This, on the other hand, penetrates more superficially, targeting the epidermal-dermal junction. It is particularly effective for anterior blepharitis and bacterial infections like Demodex. Blue light is absorbed by porphyrins within bacteria, ultimately leading to the destruction of the bacterial cell wall, hence a bacteriostatic effect.

3. Y ellow light therapy: Yellow light penetrates the dermis, where it increases ATP production and promotes the release of nitric oxide, which plays a crucial role in tissue repair and neurotransmission. Additionally, this helps to reduce inflammation and erythema while increasing skin elasticity and reducing oedema through the lymphatic system.

CLINICAL RESULTS AND REAL-WORLD APPLICATIONS The clinical outcomes of LLLT are impressive. I now have more than 12 months’ experience with 322 treatments to 97 patients. The outcomes have been outstanding for several systemic and ocular conditions, in particular ocular surface diseases, eyelid cysts and autoimmune disorders.

Case 1: A 58-year-old woman with chronic DED from Sjögren’s syndrome and scleroderma using multiple combinations of topical steroids, cyclosporin and lubricants over the years. After three sessions of red light LLLT, her symptoms improved dramatically, inflammation subsided, and tear film quality improved. She enjoyed lasting relief with quality-of-life improvement and no drops.

Case 2: A 33-year-old man with multiple cysts on his eyelids and severe eyelid erythema with known eczema and an autoimmune disease (figure 1). After three sessions of red LLLT five days apart, followed by three sessions of blue LLLT, he experienced complete resolution of all eyelid cysts. They disappeared without the need for surgical correction.

Case 3: A 9-year-old girl with a chalazion. Three sessions of red LLLT resulted in complete resolution of her cyst, without surgical intervention.

As shown, LLLT is helping to reshape how we approach ocular surface diseases. This form of photobiomodulation therapy is not only safe, non-invasive, and painless, but offers patients an office-based treatment option that can deliver long-lasting results without the risks or downtime associated with more invasive procedures.

Whether used as a primary treatment or as an adjunct with IPL, LLLT is opening new possibilities in the management of various eye conditions like DED, blepharitis, and meibomian cysts, and providing new hope for patients.

Figure 1 – TOP: Right and left eyes on initial presentation of 33-year-old man with multiple cysts on his eyelids. BOTTOM: Right and left eyes following red and blue LLLT therapy.

CPD - DRY EYE

Nutrition and dry: evidence-based strategies and supplements Given the multifactorial nature of dry eye disease, diet, lifestyle changes and nutritional supplements should be considered alongside other approaches. But which ones? ADELE JEFFERIES provides an overview of the latest studies and shows that, as research evolves, nutritional strategies could become an integral part of holistic management.

ABOUT THE AUTHOR:

Adele Jefferies MSc(Hons) BOptom(Hons) CertOcPharm(Therap) Optometrist & National Clinical Manager Matthews Eyecare Eyewear Ltd President - Cornea & Contact Lens Society of New Zealand

CLINICAL CPD HOURS

D

ry eye disease (DED) is a complex, multifactorial condition that can profoundly affect our patients’ quality-of-life. While topical treatments remain the cornerstone of DED management, the role of lifestyle factors, including diet and nutrition, is becoming increasingly understood. Patients may also read many ‘facts’ online, so understanding the current evidence can assist in their clinical care. Nutritional approaches offer a complementary strategy that enhances overall health and helps target some of the underlying mechanisms of DED, including inflammation.

THE ROLE OF HYDRATION Adequate hydration is fundamental to maintaining the body’s overall health, and dehydration is common in the elderly. While good hydration feels like a logical consideration for DED, the evidence is not definitive – while dehydration has been linked to increased tear osmolarity,1 other population-based research has reported no link between higher water intake and the risk of DED.2 The ‘Tear Film & Ocular Society’s (TFOS) Lifestyle Report’ concluded that “increased water intake has not been directly tied to improved dry eye or ocular surface outcomes” and that future longitudinal studies are needed.3 Nevertheless, due to the general health benefits of good hydration, it is still something I actively recommend to patients.

A SIMPLE DIETARY APPROACH When it comes to nutrition, there is a principle idea that ‘whole food’ is more beneficial than the individual parts, so recommending an overall dietary approach may have advantages over recommending supplements.

While there are a lot of diet trends, the only diet with evidence for improvement for DED is the Mediterranean diet.3 This diet is more a way of eating than a prescriptive diet; it’s based on the traditional eating patterns in countries near the Mediterranean Sea, including Greece, Spain, Italy, North Africa and the Middle East.

The Mediterranean diet focuses on minimallyprocessed foods; it’s high in monounsaturated, polyunsaturated, and Omega-3 fatty acids; and it is low in saturated fats, added sugars and sodium. Olive oil is the primary fat source; it is high in plant-based foods; it features a moderate-to-high seafood intake, moderate dairy consumption; low-to-moderate consumption of wine, and limited intake of red meat, sweets and white flour.

The Mediterranean diet has been shown to have antioxidant and anti-inflammatory properties, improve gut health and be beneficial in several health conditions, including cardiovascular disease, Alzheimer’s, psoriasis and depression.3 It has also been shown to be associated with a lower likelihood of developing Sjögren’s Syndrome.4 Image: Tatjana Baibakova/Shutterstock.com.

This activity meets the OBA registration standards for CPD

LEARNING OBJECTIVES: At the completion of this article, the reader should be able to improve their management of dry eye disease (DED), including …

• Recognise the benefits of the Mediterranen diet and Omega-3 fatty acids in reducing DED symptoms and inflammation.

• Explore the significance of testing and supplementing Omega-3, Vitamin D, and Vitamin B12 levels, particularly in patients with Sjögren’s Syndrome.

• Assess the emerging role of nutraceuticals like curcumin and astaxanthin in the holistic management of DED.

Recommending a Mediterranean diet can be beneficial in cases of dry eye disease.

INSIGHT October 2024

37

CPD - DRY EYE

Image: Photoongraphy/Shutterstock.com.

Animal studies suggest curcumin may enhance tear volume, improve TBUT, and reduce inflammatory markers in tears.

A small 2020 study examined the impact of the Mediterranean diet supplemented with extra virgin olive oil and nuts (standard intervention) and a hypocaloric Mediterranean diet combined with an intensive lifestyle program with physical activity and weight loss (intensive intervention). The authors found that in both patient groups, the ocular surface disease index (OSDI), tear breakup time (TBUT), Schirmer score, and Oxford staining scores improved after six months, but more significant improvements were seen in TBUT, Schirmer and staining scores in the intensive intervention group.5

THE PUZZLE PIECES Our diets are made up of macro- and micronutrients, and there is growing research on how these individual components and their supplementation may impact our patients’ ocular surface health.

Fatty Acids One of the most-studied nutritional interventions for DED is omega fatty acids, primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). While some study results are conflicting, and there is still more to be known, Omega-3 in the diet or via supplementation has been shown in various studies to improve many aspects of DED. Omega-3 The 2019 Cochrane review summarised 34 randomised control trials, and the consensus was that signs of DED improved with oral supplementation of Omega-3, and symptoms improved when Omega-3 was combined with other dry eye treatments, such as lubricants and warm compresses.6 A 2019 meta-analysis examined 17 clinical trials and found significant improvements in signs and symptoms, particularly in populations with lower intake of fish in their diets.7 Unfortunately, there is no current consensus on treatment guidelines, including the composition, dose and treatment duration.

Omega-6 As the ratio of Omega-6 to Omega-3 is important, patients can consider reducing sources of inflammatory Omega-6 in their diet or including

38

INSIGHT October 2024

more Omega-3-rich foods in their diet, such as fatty fish (salmon, mackerel, tuna and sardines), as well as flaxseed, chia seeds and walnuts. They could also consider getting their blood levels of Omega-3 tested.

Based on the research, if patients are interested in trialling supplementation as part of their management strategy, I recommend they trial a re-esterified/ triglyceride formula with between 1500-3000mg EPA/DHA per day for three months. I then review their signs and symptoms to confirm the benefit for that individual patient. Due to the additional benefits discussed later in this article, there may be added therapeutic benefits if the Omega-3 supplement contains GLA and/or Vitamin D. Notes on dietary supplements When supplementing, you want to advise patients that they may cause gastrointestinal side effect,3 and while there is the theoretical potential for Omega-3 supplements to cause an increased risk of increased bleeding, it is typically only a concern in doses over 3000mg, in elderly patients on blood thinning medications and in those with haemophilia.3,7 If the patient is vegan or vegetarian, they could consider flaxseed oil, which contains the short-chain Omega-3 Alpha-linoleic Acid (ALA), but as ALA converts to DHA/EPA in the body, a higher dose is needed, with 6g/day being shown to improve symptoms, TBUT and meibum score.3 In addition to Omega-3 fatty acids, Gamma Linolenic Acid (GLA) – found in sources like borage oil and black currant seed oil – has shown significant anti-inflammatory activity. GLA works by inhibiting the conversion of Omega-6 fatty acids into pro-inflammatory compounds. Clinical studies have demonstrated that a daily intake of 15mg of GLA can improve symptoms, reduce ocular surface staining, and decrease inflammation.8 Micronutrients Micronutrients are the vitamins and minerals in food that affect many bodily functions. There are 13 essential vitamins and 16 essential minerals for human health. The major vitamins associated with ocular surface disease are currently thought to be vitamins A, B12, C and D.3

Vitamin A Vitamin A, essential for cell differentiation, development and function, is the most frequent form of malnutrition contributing to ocular disease in the developing world.3 It is a fat-soluble vitamin found in many foods, including liver, butter, cheese, eggs, fish, sweet potato, carrot, broccoli, sweet red pepper, spinach and lettuce. In developed populations like Australia and New Zealand, poor intake is uncommon.

Vitamin A is beneficial to the ocular surface, having antioxidant properties, reducing corneal epithelial apoptosis, increasing conjunctival mucin expression, promoting corneal and conjunctival wound healing and preventing goblet cell loss.3 Still, investigations on the impact of oral intake of vitamin A are limited. In 1982, a small study of patients with severe deficiency benefited from oral vitamin A with improved goblet cell numbers and density and improved corneal epithelisation;9 a 2019 study found that in those without a vitamin A deficiency, oral supplementation improved quality (tear ferning), but not quantity of tears.10 B vitamins B vitamins are found in various foods, including whole grains, meat, eggs and dairy products, legumes, s​ eeds and nuts and dark green vegetables.

Deficiencies in the water-soluble B vitamins (thiamine (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folate (B9) and cobalamin (B12)) are also uncommon, but do increase with age.3 B12 deficiency appears to have the most significant role in DED – it’s been associated with an increased risk of DED3 and neuropathic pain.11,12 Additionally, 10-25% of patients with Sjögren’s Syndrome have also been found to have a vitamin B12 deficiency.11 The benefit of supplementation has also been demonstrated – three months of vitamin B12 supplements in patients with both a vitamin B12 deficiency and neuropathic ocular pain, was shown to nearly halve their OSDI score and to increase tear secretion.12 Vitamin C Vitamin C has antioxidant, anti-inflammatory and immunomodulatory functions. It is present on the ocular surface; as it’s found in fruit and vegetables, deficiencies are very uncommon.3 Vitamin D Vitamin D’s role in dry eye disease is becoming widely recognised. This fat-soluble essential vitamin has antioxidant, anti-inflammatory and immuneregulatory effects.13 Deficiencies can be common.

Vitamin D deficiency has been linked to increased tear film instability,14 lower tear secretion,13,14 lower Schirmer’s Test,13,14 hyperosmolarity13,14 and increased symptoms.11 Supplementation has also been shown to improve these signs and symptoms of dry eye in those with a deficiency.3,15

OUR VICES Coffee I, and many others, are partial to beginning our days with a cup or two of coffee. While the health benefits of coffee may be debated, the prevalence of DED has been found to decrease as coffee consumption increased from less than one cup per day to up to three cups per day,16 and the study authors concluded that there was no significant relationship between the frequency of coffee consumption and DED.16 In other research, higher caffeine intake is associated with a reduced risk of dry eye disease.17 Alcohol The role of alcohol on dry eye is mixed. Alcohol has been found to be secreted into the tears,18 to increase tear film osmolarity,18 to shorten tear film break-up time18 and to increase the risk of DED symptoms.19 Further, a 2016 meta-analysis concluded there was a borderline significant positive association between dry eye and alcohol use, but that there was no clear increased risk of dry eye in heavy drinkers.18 The authors postulated that there may be a protective effect of neuropathy on dry eye symptoms in heavy drinkers.18 In 2021, our knowledge was further refined with insights including that alcohol intake significantly increased the risk of symptomatic dry eye in females, but not males.19 It also confirmed that older patients and heavier drinkers were likely to have alcohol-induced peripheral neuropathy, leading to decreased corneal sensitivity and, therefore, fewer symptoms.19

EMERGING NUTRACEUTICALS Curcumin Curcumin, the primary curcuminoid found in turmeric, is a yellow polyphenol with well-documented anti-inflammatory and antioxidant properties.3,20 Research, including several in vitro and animal studies, has demonstrated the beneficial effects of topical curcumin in preventing corneal neovascularisation, promoting corneal wound healing, and inhibiting the pathological mechanisms associated with allergic conjunctivitis, pterygium and corneal endothelial dysfunction.3,20 Although further research is necessary to understand the potential benefits of dietary curcumin for DED, animal studies suggest that oral curcumin may enhance tear volume, improve TBUT, and reduce inflammatory markers in tears.20 Notably, a recent double-masked randomised controlled trial found that an eight-week regimen of a supplement containing curcumin, lutein, zeaxanthin and vitamin D3 significantly improved ocular symptoms, Schirmer scores, TBUT and corneal staining scores, indicating a promising role for curcumin in managing dry eye.21​ Honey Honey has been shown to have antibacterial, antifungal, antiviral, anti-inflammatory and

antioxidant properties. Several randomised clinical trials have investigated the effect of topically applied Manuka honey (Leptospermum spp.) and its benefits on improving tear film evaporation, meibomian gland dysfunction and blepharitis.3 The effect of oral intake of honey on ocular surface disease has not been comprehensively studied.

One double-masked randomised controlled trial investigated the effect of oral royal jelly, finding improvements in tear break-up time and Schirmer scores, but no improvement in symptoms.3 Astaxanthin Astaxanthin, a red-pigmented marine carotenoid found in organisms like algae and shrimp, is part of the xanthophyll family, closely related to lutein and zeaxanthin.

Known for its potent antioxidant and anti-inflammatory properties, astaxanthin has shown potential in managing DED by reducing oxidative stress on the ocular surface and lowering the levels of pro-inflammatory cytokines and reactive oxygen species in tears. Studies suggest that astaxanthin can improve tear production and stability, thereby alleviating symptoms of dry eye.22 Probiotics There have also been correlations between gut dysbiosis and dry eye severity,23,24 and dry eye patients have been found to have reduced gut microbiota diversity compared to controls.23 In 20 patients with DED, 30-day supplementation of B. lactis and B. bifido significantly increased tear secretion and tear break-up compared to placebo,25 and the combination of IRT-5 probiotics (Lactobacillus casei, Lactobacillus acidophilus, Lactobacillus reuteri, Bifidobacterium bifidum, and Streptococcus thermophilus) has been shown to reduce ocular staining and improve tear secretion.26 An Australian, double-masked randomised clinical trial examined the impact of oral probiotics and prebiotics in managing DED over a four months and found an improvement in symptoms.27

FINAL THOUGHTS DED requires a multifaceted treatment approach, and attention to nutrition and lifestyle factors offers a valuable opportunity to improve patient outcomes.

Recommending a Mediterranean diet, a good intake of Omega-3 and antioxidants, maintenance of good gut health and adequate hydration can be an effective adjunct to conventional treatments.

Additionally, eyecare providers could consider referral to the patient’s general practitioner or a dietician to test Omega-3, Vitamin D and Vitamin B12 levels, particularly in Sjögren’s Syndrome patients.

Ultimately, as research in this area continues to evolve, nutritional strategies may become increasingly integrated into the standard care for DED to offer a holistic approach to managing this common and often debilitating condition.

REFERENCES 1. Walsh NP, Fortes MB, Raymond-Barker P, Bishop C, Owen J, Tye E, et al. Is whole-body hydration an important consideration in dry eye? Invest Ophthalmol Vis Sci. 2012; 53 (10): 6622-7.

2. Nguyen L, Magno MS, Utheim TP, Jansonius NM, Hammond CJ, Vehof J. The relationship between habitual water intake and dry eye disease. Acta Ophthalmol. 2023; 101 (1): 65-73.

3. Markoulli M, Ahmad S, Arcot J, Arita R, Benitez-Del-Castillo J, Caffery B, et al. TFOS Lifestyle: Impact of nutrition on the ocular surface. Ocul Surf. 2023; 29: 226-71.

4. Machowicz A, Hall I, de Pablo P, Rauz S, Richards A, Higham J, et al. Mediterranean diet and risk of Sjogren’s syndrome. Clin Exp Rheumatol. 2020; 38 Suppl 126 (4): 216-21.

5. Molina-Leyva I, Molina-Leyva A, Riquelme-Gallego B, Cano-Ibanez N, Garcia-Molina L, Bueno-Cavanillas A. Effectiveness of Mediterranean Diet Implementation in Dry Eye Parameters: A Study of PREDIMED-PLUS Trial. Nutrients. 2020; 12 (5).

6. Downie LE, Ng SM, Lindsley KB, Akpek EK. Omega-3 and omega-6 polyunsaturated fatty acids for dry eye disease.

Cochrane Database Syst Rev. 2019; 12 (12): CD011016.

7. Giannaccare G, Pellegrini M, Sebastiani S, Bernabei F, Roda M, Taroni L, et al. Efficacy of Omega-3 Fatty Acid Supplementation for Treatment of Dry Eye Disease: A Meta-Analysis of Randomised Clinical Trials. Cornea. 2019; 38 (5): 565-73.

8. Barabino S, Horwath-Winter J, Messmer EM, Rolando M, Aragona P, Kinoshita S. The role of systemic and topical fatty acids for dry eye treatment. Prog Retin Eye Res. 2017; 61: 23-34.

9. Sommer A, Green WR. Goblet cell response to vitamin A treatment for corneal xerophthalmia. Am J Ophthalmol. 1982; 94 (2): 213-5.

10. Alanazi SA, El-Hiti GA, Al-Baloud AA, Alfarhan MI, Al-Shahrani A, Albakri AA, et al. Effects of short-term oral vitamin A supplementation on the ocular tear film in patients with dry eye.

Clin Ophthalmol. 2019; 13: 599-604.

11. Fogagnolo P, De Cilla S, Alkabes M, Sabella P, Rossetti L. A Review of Topical and Systemic Vitamin Supplementation in Ocular Surface Diseases. Nutrients. 2021; 13 (6).

12. Ozen S, Ozer MA, Akdemir MO. Vitamin B12 deficiency evaluation and treatment in severe dry eye disease with neuropathic ocular pain. Graefes Arch Clin Exp Ophthalmol. 2017; 255 (6): 1173-7.

13. R olando M, Barabino S. Dry Eye Disease: What Is the Role of Vitamin D? Int J Mol Sci. 2023; 24 (2).

14. Y ildirim P, Garip Y, Karci AA, Guler T. Dry eye in vitamin D deficiency: more than an incidental association. Int J Rheum Dis. 2016; 19 (1): 49-54.

15. N ajjaran M, Zarei-Ghanavati S, Arjmand Askari E, Eslampoor A, Ziaei M. Effect of oral vitamin D supplementation on dry eye disease patients with vitamin D deficiency. Clin Exp Optom. 2022: 1-6.

16. J eong KJ, Choi JG, Park EJ, Kim HE, Yoo SM, Park SG. Relationship between Dry Eye Syndrome and Frequency of Coffee Consumption in Korean Adults: Korea National Health and Nutrition Examination Survey V, 2010-2012. Korean J Fam Med. 2018; 39 (5): 290-4.

17. Magno MS, Utheim TP, Morthen MK, Snieder H, Jansonius NM, Hammond CJ, et al. The Relationship Between Caffeine Intake and Dry Eye Disease. Cornea. 2023; 42 (2): 186-93.

18. You YS, Qu NB, Yu XN. Alcohol consumption and dry eye syndrome: a Meta-analysis. Int J Ophthalmol. 2016; 9 (10): 1487-92.

19. M agno MS, Daniel T, Morthen MK, Snieder H, Jansonius N, Utheim TP, et al. The relationship between alcohol consumption and dry eye. Ocul Surf. 2021; 21: 87-95.

20. Liu XF, Hao JL, Xie T, Mukhtar NJ, Zhang W, Malik TH, et al.

Curcumin, A Potential Therapeutic Candidate for Anterior Segment Eye Diseases: A Review. Front Pharmacol. 2017; 8: 66.

21. G ioia N, Gerson J, Ryan R, Barbour K, Poteet J, Jennings B, et al. A novel multi-ingredient supplement significantly improves ocular symptom severity and tear production in patients with dry eye disease: results from a randomised, placebo-controlled clinical trial. Frontiers in Ophthalmology. 2024; 4.

22. Tian L, Wen Y, Li S, Zhang P, Wang Y, Wang J, et al. Benefits and Safety of Astaxanthin in the Treatment of Mild-To-Moderate Dry Eye Disease. Front Nutr. 2021; 8: 796951.

23. B aqai AF, Fishman H. Dry Eye Disease Associated with Lower Gut Microbiome Diversity. Investigative Ophthalmology & Visual Science. 2019; 60 (9): 2760.

24. de Paiva CS, Jones DB, Stern ME, Bian F, Moore QL, Corbiere S, et al. Altered Mucosal Microbiome Diversity and Disease Severity in Sjogren Syndrome. Sci Rep. 2016; 6: 23561.

25. C hisari G, Chisari EM, Francaviglia A, Chisari CG. The mixture of bifidobacterium associated with fructo-oligosaccharides reduces the damage of the ocular surface. Clin Ter. 2017; 168 (3): e181-e5.

26. M oon J, Ryu JS, Kim JY, Im SH, Kim MK. Effect of IRT5 probiotics on dry eye in the experimental dry eye mouse model. PLoS One. 2020; 15 (12): e0243176.

27. Tavakoli A, Markoulli M, Papas E, Flanagan J. The Impact of Probiotics and Prebiotics on Dry Eye Disease Signs and Symptoms. J Clin Med. 2022; 11 (16).

NOTE: Insight readers can scan the QR code or visit insightnews.com.au/cpd/ to access a link to this article to include in their own CPD log book.

INSIGHT October 2024

39

Viscotears

®

Viscotears® Gel PF improves the moistening of the ocular surface in the presence of dry eye sensations, burning or tiredness of the eyes, caused for instance: • by watching television for a long time • extensive computer work • dry air from air-conditioning or heating Preservative free Moistening and wetting effect1

Viscotears® Eye Gel provides soothing relief for sore, gritty dry eyes.

Its long lasting gel formulation is suited for those who: • need extra protection • added nighttime support, or • prefer a heavier gel 6H

Maintains the tear film stability for a period of up to 6 hours2 Viscous gel for nighttime protection

VISCOTEARS® GEL PF 30 × 0.6g Single dose units • Preservative-free • PBS Listed

VISCOTEARS® EYE GEL 10g Tube • Soothing, long lasting relief for sore, gritty dry eyes • PBS Listed

For more information, contact your Bausch + Lomb Territory Manager or Bausch + Lomb Customer Service 1800 251 150

Material was prepared in February 2023 References: 1. Viscotears Gel PF IFU. 2. Viscotears Single Dose Unit 2.0mg/g Eye Gel, EMC, 5.1 pharmacodynamic properties https://www.medicines.org.uk/emc/product/2311/smpc - Accessed Feb 2023 © 2023 Bausch & Lomb Incorporated. ®/TM are trademarks of Bausch & Lomb Incorporated or its affiliates. Bausch & Lomb (Australia) Pty Ltd. ABN 88 000 222 408. Level 2, 12 Help Street, Chatswood NSW 2067 Australia. (Ph 1800 251 150) Vis.0001.AU.23

Dry Eyes?

Restore the tear film with every

blink® Intensive Tears Long lasting relief from the feeling of dry, tired eyes.

An advanced lubricating eye drop specially formulated to provide protection and comfort for the eyes that are dry, irritated or uncomfortable.

• With hyaluronic acid • May be used with contact lenses

blink® Intensive Tears PLUS A thicker, more viscous advanced lubricating eye drop formulation that adapts to your dry eye needs and provides long lasting relief.

• Specially formulated for enhanced ocular comfort • Recommended for both day and night use • With hyaluronic acid • For Moderate to Severe Dry Eye

For more information contact your Bausch + Lomb Territory Manager or Bausch + Lomb Customer service 1800 251 150

Material was prepared in August 2024 © 2024 Bausch & Lomb Incorporated. ®/TM are trademarks of Bausch & Lomb Incorporated or its affiliates. Bausch & Lomb (Australia) Pty Ltd. ABN 88 000 222 408. Level 2, 12 Help Street, Chatswood NSW 2067 Australia. (Ph 1800 251 150) BTLD.0009.AU.24

INSIGHT

Dry Eye

DIRECTORY

Australia’s most comprehensive resource for dry eye disease has returned in 2024, featuring an up-to-date list of therapies and diagnostics from Australian suppliers, as well as a directory of clinics with a special interest in managing the disease.

Disclaimer: The Insight Dry Eye Directory is compiled of opt-in participants. If you missed out or need to update your details for next year’s directory, please email myles.hume@primecreative.com.au.

GOOD OPTICAL SERVICES_CT-127291 SHOWCASE SPONSORSHIP BANNER IN1022.pdf

1

22/8/2024

10:28 am

e: orders@goodoptical.com.au p: +61 3 9645 1066 / f: +61 3 9681 7976 www.goodopticalservices.com.au

Dry Eye DIRECTORY

CLINICS NEW SOUTH WALES

Hansen Optometrists

Nova Optical Newcastle

Charlestown Eyecare

Jake Hansen P (02) 6362 2222 W hansenoptom.com.au/

Michael Wilkins P (02) 4942 1515 W novaoptical.com.au

In-depth dry eye testing. IPL, BlephEx, in-office meibomian gland expression, punctal plugs, therapeutically-endorsed.

Dry eye analysis (DEA by Moptim), dry eye treatment using Eye-Light incorporating IPL and LLLM therapies.

HineSight

OPSM Warringah Mall

1/147 Pacific Hwy Charlestown 2290

Paul Dougherty P (02) 4943 0744 W charlestowneyecare.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

City West Eye Specialists 212 Elswick St Leichhardt 2023

Ophthalmologist P (02) 9569 5722 W cotywesteyespecialists.com.au First ophthalmic practice to offer low light level therapy for anterior and posterior blepharitis. A comprehensive dry eye assessment performed to exclude any other ocular conditions.

David Hendry EyeQ Optometrists 1A Turner Rd Berowra Heights 2082

David Hendry P (02) 9456 1545 W eyeq.com.au Meibography, Medmont meridia, heat packs, Omega-3 supplements, Optimel, punctal plugs, Blephasteam, and a wide range of lubricants.

Expert Eyecare

Shop 3, The Pottery, 11 Mashman Ave Kingsgrove 2208

Elias Harb P (02) 8014 8933 W eyecareplus.com.au/kingsgrove Ocular Surface Analyser (NIBUT, tear meniscus measurement, lipid layer thickness measurement, and meibography), anterior photography, Blephasteam, IPL treatment, low level light therapy, Lacritec, Ocusoft Platinum, Hypochlor, Blephadex, Optimel, lubricant eye drops, and dry eye kits.

Eyecare Plus Chullora

Chullora Market place 26/355 Waterloo Rd Chullora 2190

Soojin Nam & Ali Khallife P (02) 9642 7799 W eyecarekids.com.au Blephasteam, LLT masks, IPL therapy, meibomian gland expression, prescribing a range of eye drops and therapies.

Eyecare Plus Merrylands

3 Memorial Ave Merrylands 2160

Thu Le & Thao Le P (02) 9637 5047 W eyecareplus.com.au/Merrylands/ Comprehensive dry eye assessment with OCULUS Keratograph 5M and all treatments including Blephasteam and IPL.

170 Summer St Orange 2800

61-101 Phillip St Sydney 2000

Narelle Hine P (02) 9235 3044 W hinesight.net.au Assessment of tear film quality and volume and meibomian gland function, desiccation and cell changes to the corneal and conjunctival surface – all prior to diagnosing aetiology and severity of dry eye case. Prescribe commensurate treatment level which is usually a combination of meibomian gland therapy, lubricants and Lacritec Omega-3 supplements.

Marsden Eye Specialists

152 Marsden St Parramatta 2150

Danielle Valencia & Steven Ngo P (02) 9893 9518 W marsdeneye.com.au Ophthalmology clinic with specialised dry eye assessment and treatment service. Includes comprehensive tailored approach with Keratograph and Tear Lab diagnostics. Eyelid heat, massage, debridement, expression and cleansing treatments are available.

Maximeyes

1/7A Wentworth St Manly 2095

Max Humphreys P (02) 9977 2554 W maximeyes.com.au Appropriate treatments for a wide range of dry eye problems and specialised equipment such as Medmont meridia dry eye analyser and Tomey equipment. We can document progress using high definition photos and video images.

Medioptics Greg Luke Optometrist

SP017 Toormina Gardens, 5 Toormina Rd Toormina 2452

Rory Dowdall P (02) 6658 9114 W medioptics.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Metrospecs

34 Victoria Rd Marrickville 2204

Leslie Pieratos P (02) 9550 5363 W metrospecs.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

28 Smart St Charlestown 2290

Shop 2340, Westfield Warringah Mall, 145 Old Pittwater Rd Brookvale 2100

Claudia Jiang P (02) 9905 2666 W opsm.com.au Light modulation low-level light therapy (LM LLLT) is a unique, light-based photobiomodulation technology. LM LLLT treats deeper into the cellular level to treat dry eye disease and meibomian gland dysfunction.

Paul Harvey Optometry

Shop 3 395-401 Peel St Tamworth 2340

Paul Harvey P (02)6766 5944 W harveyoptometry.com.au We manage dry eye from mild to severe with the latest training and state-of-the-art equipment.

Perfect Vision

Strand Arcade, Level 4 Suite 403, 412 George St Sydney 2000

David Rollo P (02) 9251 2020 W perfectvisionoptical.com/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Shire Optometrists

85 Gymea Bay Rd Gymea 2227

Stephen Langshaw P (02) 9526 2155 W shireoptometrists.com.au Radiofrequency, IPL, masks, microneedling and lubricants.

Westmead Eyes Optometrists T204, Westmead Hospital, Darcy Rd Westmead 2145

Dr Kevin Trac P (02) 9635 8464 W westmewdeyes.com.au Treatments include in-office IPL, Blephasteam, meibomian gland expression, meibomian gland debridement, scleral lenses, punctal plugs, low level light (red light) therapy.

Whitehouse Optometrists

3rd Floor, 70 Castlereagh St Sydney 2000

Geoff Matthews P (02) 9233 4944 W whitehouseoptometrists.com.au/

... not a dry eye in sight

CLINICS Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Whitehouse Optometrists

Ground Floor, North Shore Medical Centre, 66 Pacific Hwy St Leonards 2065

Geoff Matthews P (02) 9460 9766 W whitehouseoptometrists.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

IPL, meibography, interferometry, microblepharoexfoliation, eyelid debridement scaling, meibomian gland expression and therapeutics.

Dry Eye Relief Clinic

1/36 Station St Sandringham 3191

Andrew Reveley P (02) 4227 3330 W wiseeyes.com.au Blephasteam, Blephadex expressions, IRPL and meibography.

VICTORIA Ascot Vale Eyecare

2/327 Mount Alexander Rd Ascot Vale 3032

Robert Nawrocki & Simone Hibbert P (03) 9967 7222 W ascotvaleeyecare.com.au/ Digital slit lamp to record images, meibography, topography, meibomian gland expression, access to a variety of eye drops.

Bundoora Eyecare Plus Bundoora

Shop 5 University Town Centre 224 Plenty Rd Bundoora 3082

Diane Vue P (03) 9467 7580 W eyecareplus.com.au/bundoora IPL, Blephasteam, meibomian gland expression, extensive range of eye drops and lids cleansers, dry eye assessment including OSDI, meibography, tear meniscus height and NITBUT.

Advanced diagnostics and cutting-edge treatments and committed to restoring your eye health and enhancing your quality-of-life. Step into our clinic and embark on a journey towards lasting relief and rejuvenated vision.

Eyescan

Evergreen Optical Carnegie

Eyecare Plus Bundoora

Graham Hill Eyecare

Shop 5 University Town Centre 224 Plenty Rd Bundoora 3082

Diane Vue P (03) 9467 7580 W eyecareplus.com.au/bundoora

98 Maude St Shepparton 3630

Mark DePaola P (03) 5821 2811 W hilleyecare.com

IPL, Blephasteam, meibomian gland expression, extensive range of eye drops and lids cleansers, dry eye assessment including OSDI, meibography, tear meniscus height and NITBUT.

Dry eye diagnostics such as OCULUS K5 meibography, IPL, therapeutic prescriptions, supply of dry eye products such as OTC drops, gels, Manuka, dry eye forte tablets, heat compresses etc.

Eyecare Plus Mill Park

Harris Blake & Parsons Optometrists

512 Plenty Rd Mill Park 3082

Shatlotta Cote P (03) 9436 9644 W eyecareplus.com.au/millpark IPL, Blephasteam, meibomian gland expression, meibomian imaging, various eye lubricants and lid clensers such as Optimel and Demodex Oust.

Eyecare Plus Optometrists Cheltenham Suite D 149-151 Centre Dandenong Rd Cheltenham 3192

Nick Hockley P (03) 5227 8280 W deakin.edu.au/faculty-of-health/facilities/

deakin-collaborative-eye-care-clinic

Assessment, diagnosis with Medmont topographer and meibomagrapher and slit lamp, and management with therapeutic medication, including eye drops and eyelid hygiene solutions and eye masks, Blephasteam and Eye-Light IPL and low level light modulation therapy.

Comprehensive dry eye diagnostics and management including IPL, punctal plugs and amniotic membranes.

Eyecare Plus Springvale

Deakin Collaborative Eye Care Clinic

Denise Lee P (03) 9558 4499 W EyecareplusSpringvale.com.au

37a Buckingham Ave Springvale 3171

Large range of treatment options: Lipiflow, Rexon-Eye, Alissa Maillet IPL, low level light therapy, Blephasteam, meibomian gland P (03) 5227 8280 expression, dry eye 1analysis (meibography), range GOOD OPTICAL SERVICES_CT-127291 SHOWCASE SPONSORSHIP BANNER IN1022.pdf 22/8/2024 10:28 am of topical W www.deakin.edu.au/medicine/facilities/ medications and warm compresses.

deakin-collaborative-eye-care-clinic

Dr Natalie Savin, Dr Luke Yong & Dr Harry Unger (ophthalmologist) P (03) 9826 0740 W eyescan.com.au/

Full scope clinical optometry including emergency care, dry eye management and myopia management.

Deakin Collaborative Eye Care Clinic

Level 3, Building DD, Nichols Drive North Waurn Ponds 3216

467 Toorak Rd Toorak 3142

Comprehensive dry eye assessments. With advanced diagnostic tools and a team of skilled optometrists, we assess tear production and tailor personalised treatments for those suffering from dry eyes, aiming to alleviate discomfort and enhance overall eye health.

Flora Luk P (03) 9583 3596 W eyecareplus.com.au/cheltenham/

Deakin University 75 Pigdons Rd Waurn Ponds 3216

Dr Valery Daviotis P (03) 9569 9609 W eyedentityoptometrists.com.au Comprehensive diagnostic equipment with MYAH, BlephEX treatment, meibomian gland expression, Eye-light low level light therapy and IPL.

Khang Ta P (03) 9571 3233 W evergreenoptical.com.au

2-4 Kenny St Wollongong 2500

80a Koornang Rd Carnegie 3163

Helen Higgins P 1800 379 393 W dryeyereliefclinic.com.au

Shop 2/2-20 Koornang Rd Carnegie 3163

Wise Eyes Optical

Eyedentity Carnegie

Eastland Shopping Centre, 175 Maroondah Hwy Ringwood 3134

Stephanie Gouldthorpe P (03) 9870 5478 W harrisblakeparsons.com.au Comprehensive dry eye assessment and treatments include Zest eyelid cleaning, IPL and low level light therapy. Dry eye forte supplements and large variety of ocular lubricants.

Mildura Optical

89 Langtree Ave Mildura 3500

Emily Chatterton P (03) 5023 2419 W milduraoptical.com.au/ Dry eye assessment and products, including heat masks, lubricants, TTO foaming cleanser/wipes and IPL treatment.

Rashelle Cohen Optometry 263 Glen Eira Rd Caulfield N 3161

Rashelle Cohen P (03) 9528 1910 W cfmp.com.au/rashelle-cohen-optometry/ Diagnosis and treatment of dry eyes : quantitative assessment using the OCULUS K5. Treatment options and advice: Blephasteam, meibomian gland expression, Nulid treatment.

A range of products including lubricants, Optimel, Lacritec Omega-3 supplements and more.

e: orders@goodoptical.com.au p: +61 3 9645 1066 / f: +61 3 9681 7976 www.goodopticalservices.com.au

Dry Eye DIRECTORY The Eye Collective

165 Lonsdale St Dandenong 3175

Adrian Vecchio P (03) 9792 3077 W eyecollective.com.au/ OCULUS K5 assessment, IPL, Blephex treatments, therapeutic management.

QUEENSLAND Aphrodite Livanes Eyecare Plus Alexandra Hills 71 Cambridge Dr Alexandra Hills 4161

Aphrodite Livanes P (07) 3824 1878 W livanes.com.au A dry eye assessment with treatments including a range of eye drops, ointments, cleansing foams and wipes, and eyeseals.

Blephasteam, Blephex, and IPL treatments are performed in practice for the stimulation and improvement of symptoms.

Bay Optics

67 Main St Megan Millard 4655

Hervey Bay P (07) 4197 1475 W bayoptics.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Best Practice Eyecare

35 Bulcock St Caloundra 4551

Dr Michael Karpa P (07) 5492 2822 W bestpracticeeyecare.com.au/ Comprehensive assessment by ophthalmologist if indicated.

BlephEx and IPL. Complimetary Tea Tree foam and heat mask.

Lifestyle education and ongoing support.

Christopher McMahon Quality Eyecare – Runway Bay Shop 62 Runaway Bay Centre Runaway Bay 4215

Tom Brimelow P (07) 5591 1700 W qualityeyecare.com.au/

recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Clarity Optometrists

134 Oxford St Bulimba 4171

Sarah Mckinstrey P (07) 3899 4044 W clarityoptom.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Dickens and Herd Optometrists

H2 Vision Centres

Shop 7/11 Chancellor Village Blvd Sippy Downs 4556

Dr Tracy Hills P (07) 5353 5080 W h2visioncentres.com.au A personalised dry eye assessment, debridement, expression and IRPL treatment.

Insight Eye Surgery

Suite 203 Westside Private Hospital, 32 Morrow St Taringa 4068

Ophthalmologist P (07) 3154 1515 W insighteyesurgery.com.au

Chermside Health Hub, Ground Floor, 621 Gympie Rd Chermside 4032

Comprehensive evaluation, IPL, Blephex, Blephasteam and topical therapy.

Kerrin Duong P (07) 3359 3423 W dickensandherd.com.au/

Insight Optometrists

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Envision Optical

4B/7 Classic Way Burleigh Waters 4220

Andrew Bowden P (07) 5593 7844 W envisionoptical.com.au Comprehensive diagnosis, IPL, Lipiflow therapy, therapeutics and scleral lenses.

37 Station Rd Indooroopilly 4068

Noreen Khan P (07) 3878 2655 W insightoptom.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues. In severe cases, procedures like intense pulsed light therapy may be considered to regulate tear flow or reduce inflammation.

iSight Specialists Townsville 13-15 Martinez Ave West End 4810

Eyecare Eyewear

Dr William Talbot P (07) 4775 1633 W isighttownsville.com.au/

Tom Roger P (07) 4669 7072 W ecew.com.au

Our specialist dry eye clinic offers a comprehensive assessment to ensure you receive an individualised treatment plan which includes IPL, punctal plugs, artificial tears and prescription medications.

Optilight IPL, Medmont meridia assessment, Blephasteam and Nulid eyelid cleaning.

OPSM Pacific Fair

87 Cunningham St Dalby 4405

Eyecare Plus Mermaid Beach

Shop 3A, 2431 Gold Coast Hwy Mermaid Beach 4218

Jackson Yip P (07) 5526 1400 W eyecareplusmermaidbeach.com.au

Shop 1546, Pacific Fair Shopping Centre, Hooker Blvd Broadbeach 4218

Sayo Kokubun P (07) 5570 6204 W opsm.com.au

Envision IPL and radiofrequency, low level light therapy, Rexon-Eye, BlephEx, Blephasteam and home dry eye treatments.

Light modulation low-level light therapy (LM LLLT) is a unique, light-based photobiomodulation technology. LM LLLT treats deeper into the cellular level to treat dry eye disease and meibomian gland dysfunction.

Eyes on Edward

Neilson Eyecare

57 Edward St Brisbane 4000

128 Russell St (Cnr Cecil St Toowoomba 4350

Christopher McMahon Quality Eyecare – Australia Fair

David Bradley P (07) 3221 3221 W www.eyesonedward.com.au/

David Neilson P (07) 4638 2377 W neilsoneyecare.com.au/

Shane White

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues. In severe cases, procedures like IPL therapy may be considered to regulate tear flow or reduce inflammation.

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Shop 1031 Australia Fair Shopping Centre Southport 4215 (07) 5591 1700 qualityeyecare.com.au/ Warm compresses and eyelid massage are commonly

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues. In severe cases, procedures like intense pulsed light therapy may be considered to regulate tear flow or reduce inflammation.

... not a dry eye in sight

CLINICS Optiko

recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

19 James St Fortitude Valley 4006

Sarah Gulliemain P (07) 3257 7281 W www.optiko.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues. In severe cases, procedures like intense pulsed light therapy may be considered to regulate tear flow or reduce inflammation.

Optiko

215 Queen Street (Queen St Mall) Brisbane 4000

Sarah Gulliemain P (07) 3012 8883 W www.optiko.com.au/

Andew Angeli P (07) 3844 1556 W visionoptics.com.au/

John Merrin P (07) 4659 9599 W smnoptometrists.com.au

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues. In severe cases, procedures like intense pulsed light therapy may be considered to regulate tear flow or reduce inflammation.

The Range Shopping Centre, 11 James St Toowoomba 4350

Equipment for assessment of dry eye includes the OCULUS K5 examination for full assessment. We offer therapeutic treatments as well as Blephasteam and IPL.

The Eye Health Centre

Jason Holland P (07) 3831 8606 W theeyehealthcentre.com.au Advanced dry eye diagnosis and treatment. Technology used includes OCULUS Keratograph 5M, BlephEX, NuLids, punctal plugs, OptiLight IPL, Rexon-Eye, MeiboMask LLLT, lacrimal lavage, meibomian gland expression, eyelid debridement.

The Eye Health Centre

Optikus Optometrists

3/1 Chancellor Village Blvd Sippy Downs 4556

Zahn Kidson P (07) 5456 4300 W optikus.com.au Dry eye assessment, Rexon-Eye QMR, Blephasteam, Bleph-Ex eyelid treatment, meibomian gland expression, ocular lubricants, heat packs, punctal plugs and therapeutic dry eye treatment.

Options Eyecare

44 South Station Rd Booval 4304

Phuc Q. Ngo P (07) 3282 4396 W theeyehealthcentre.com.au IPL, Blephsteam, BlepEx, LLLT, punctal plugs, pharmaceutical products and nutrition.

The Eye Health Centre 93 Clara St Wynnum 4178

Bregan Soh P (07) 3026 2600 W theeyehealthcentre.com.au

14/18 Thomas St Noosaville 4566

Louise Kowalski P (07) 5473 0008 W optionseyecare.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues. In severe cases, procedures like intense pulsed light therapy may be considered to regulate tear flow or reduce inflammation.

RA Optometrists

Comprehensive dry eye service including blephasteam, IPL, punctal plugs, lacrimal lavage, lid debridement, meibomian gland expression, steroid and immunomodulatory eye drops.

Vedelago Optometrists

Shop 5/24-28 Browns Plains Rd Browns Plains 4118

Sheila Tsang P (07) 3800 5013 W vedelagooptometrists.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

345 Gympie Rd Strathpine 4500

Dom Kelly P (07) 3205 1593 W raoptometrists.com.au

95 Vulture St West End 4101

Somerville and Merrin Optometrists

Level 11, 87 Wickham Tce Brisbane 4000

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues. In severe cases, procedures like intense pulsed light therapy may be considered to regulate tear flow or reduce inflammation.

Vision Optics

Visual Eyes Optometry

L1 Shop 319 Sunshine Plaza, 154-164 Horton Pde Maroochydore 4558

Matt Kowalsk P (07) 5479 6444 W visualeyesoptometry.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

SOUTH AUSTRALIA Alleve Eye Clinic 49a Stephen Tce St Peters 5069

Jennifer Rayner P (08) 7225 9798 W alleveeyeclinic.com.au Dedicated dry eye clinic offering full range of treatments including IPL, cold laser therapy, amniotic membranes, topical steroid/ciclosporin, oral tetracyclines, punctal plugs, Optimel therapy, Blephasteam, blephartis management and more.

Campbelltown Eye Care

608D Lower North East Rd Campbelltown 5074

Dr Nadia Al Daghestani P (08) 8336 7788 W campbelltowneyecare.com.au Dry eye workup, lubricants, steroids and ciclosporin.

Eyes & Vision

431 Portrush Rd Toorak Gardens 5065

Naima Bammann P (08) 8338 5311 W eyesandvision.com.au Evaluation, Blephasteam and supplements.

Dry eye treatments range from IPL, Blephastem, nutrition advice, lid hygiene and in-office therapies.

VISION Michael Hare Optometrists

Eyes and Vision Colonnades

17A Nerang St Southport 4215

Shop 75 54 Beach Rd Noarlunga Centre 5168

Rosser Optometry

Jonathan McCorriston P (07) 5532 9566 W visionmichaelhare.com.au

Dr Jeff Singh P (08) 8384 6211 W eyesandvision.com.au

6 New St Nerang 4611

Bregan Soh Meibography, tear film assessment, Schirmer and phenyl P (07) 5578 4611 thread testing, Blephasteam, meibomian10:28 gland expression, GOOD W OPTICAL SERVICES_CT-127291 SHOWCASE SPONSORSHIP BANNER IN1022.pdf 1 22/8/2024 am rosseroptometry.com.au/ IPL, and low level light therapy.

Warm compresses and eyelid massage are commonly

Dry eye assessment, including imaging for lipid layer assessment, Schirmer's test, punctal plugs, ciclosporin drops, tear and nutritional supplements and IPL therapy.

e: orders@goodoptical.com.au p: +61 3 9645 1066 / f: +61 3 9681 7976 www.goodopticalservices.com.au

Dry Eye DIRECTORY Philip Milford Optometrist

For Eyes Optometrist

Evans and McMahon Optometrists - City

Philip Milford P (08) 8364 3011 W PhilipMilfordOptom.com.au

Adrian Rossiter P (08) 9335 3433 W foreyes.com.au

Katherine Gouliaev P (02) 6257 1103 W evansmcmahon.com.au/

158 The Parade Norwood 5067

Comprehensive dry eye assessment and treatments including Lumenis IPL and Lipiflow Thermal Pulsation System.

WESTERN AUSTRALIA Abernethy Owens Optometrists 2/39 Adelaide Street Fremantle 6160

Optometrist on duty P (08) 9335 5866 W abernethyowens.com.au/eyecare/Dry-Eye-Clinic LipiFlow and E-Eye IPL, and the ability to test tear osmolarity and meibomography.

Dry Eye WA

Suite 18, 135 Riseley St Booragoon 6154

Marilyn Stern P (08) 6468 5296 W dryeyewa.com.au Examination of the eyelids and cornea using Antares meibography tear meniscus, Schirmer's tear, I-pen, treatments with eyelid scrubs with BlephEx, IPL, Rexon-Eye QMR, low level light therapy, red light therapy and meibomian gland expression.

Ernie Hawes Optometrist

2/52 Davidson Tce Joondalup 6027

Dr Ernie Hawes P (08) 9300 0409 W erniehawes.com.au Tear film break-up analysis, meibomography and lid massage.

Eye Health Centre of Western Australia (UWA Optometry) 39 Fairway Crawley 6009

Stuart Aamodt P (08) 6488 7429 W ehcwa.com.au Therapeutic management, IPL, meibomian gland expression and blepharitis treatment.

Eyecare Plus Glen Forrest

U4 5 Hardey Rd Glen Forrest 6071

Dr Kristin Larson P (08) 9298 9992 W eyecareplus.com.au/glenforrest IPL, Rexon-Eye, Bleph-Ex, drops and accessories for sale.

Ezekiel Eyes

158 High St Fremantle 6160

29-33 Northbourne Ave Canberra 2601

Tear film stability, ocular imaging, osmolarity and meibography.

Artificial tears, punctal plugs, warm compresses, eyelash and eyelid scrubs, dietary supplements such as Omega-3, meibomian gland expression, IPL targeting inflammation.

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

OPSM Subiaco

Evans and McMahon Optometrists Tuggeranong

30 Rokeby Rd Subiaco 6008

Sean Ryan P (08) 9388 1706 W opsm.com.au Light modulation low-level light therapy (LM LLLT) is a unique, light-based photobiomodulation technology. LM LLLT treats deeper into the cellular level to treat dry eye disease and meibomian gland dysfunction.

Optomize Optometrists

Tuggeranong Square, Anketell & Reeds Sts Canberra 2901

Katherine Gouliaev P (02) 6293 1171 W evansmcmahon.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Shop 14, Meadow Springs Shopping Centre, 25 Meadow Springs Dr Meadow Springs 6210

TASMANIA

P (08) 9581 9955 W optomize.com.au

Martin's Eyecare

Blephasteam.

W A Opticians Associates 3/101 Royal St East Perth 6004

Anna Lim P (08) 9221 0577 W waopticians.com.au Complete dry eye examination and analysis. Provide evidence-based advice on management and treatment of various types of dry eyes. Technologies include the Antares meibography, tear film break up time analysis, IPL and Blephasteam.

ACT Andrew Watkins Optometrists

Shop 1/359 Main Rd Glenorchy 7010

Martin Robinson P (03) 6272 8423 W martinseyecare.com.au Sixty-minute dry eye initial investigation, OCULUS Keratograph K5, Lumenis IPL, lacrimal lavage, ZEST, Zocular, Blephex, Blephasteam and meibomian gland expression.

Vivid Optical

47 York St Launceston 7250

William Howe P (03) 6334 1566 W vividoptical.com.au/ Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Shop CG 5 Ground floor Canberra Centre, City Walk Canberra 2606

Devonport Eyecare

Andrew Watkins P (02) 6247 7705 W andrewwatkins.com.au/

Steven Davis P (03) 6424 3088 W devonporteyecare.com.au/

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

27 Stewart St Devonport 7310

Warm compresses and eyelid massage are commonly recommended to unclog oil glands. Artificial tears provide temporary lubrication, while prescription eye drops might address inflammation or tear production issues.

Capital Eye

Suite 3B 3 Sydney Ave Barton 2600

69 Hampden Rd Nedlands 6009

Damon Ezekiel P (08) 9386 3620 W ezekieleyes.com IPL, Blephasteam, meibography, tear film analysis.

Dr Jack Guan P (02) 6273 7458 W capitaleye.com.au/ Blephasteam, IPL, OCULUS Keratograph 5M and JENVIS assessment.

... not a dry eye in sight

CLINICS

Dry eye clinic locations With dry eye disease prevelence increasing – and a way that Australian eyecare professionals can incorporate another clinical stream into their business – Insight has compiled a map of practices offering this important service to patients across the nation.

New South Wales 1. Charlestown Eyecare 2. City West Eye Specialists 3. David Hendry EyeQ Optometrists 4. Expert Eyecare 5. Eyecare Plus Chullora 6. Eyecare Plus Merrylands 7. Hansen Optometrists 8. HineSight 9. Marsden Eye Specialists 10. Maximeyes 11. Medioptics Greg Luke Optometrist 12. Metrospecs 13. Nova Optical Newcastle 14. OPSM Warringah Mall 15. Paul Harvey Optometry 16. Perfect Vision 17. Shire Optometrists 18. Westmead Eyes Optometrists 19. Whitehouse Optometrists 20. Whitehouse Optometrists 21. Wise Eyes Optical Victoria 22. Ascot Vale Eyecare 23. Bundoora Eyecare Plus Bundoora 24. Deakin Collaborative Eye Care Clinic 25. Deakin Collaborative Eye Care Clinic 26. Dry Eye Relief Clinic 27. Evergreen Optical Carnegie 28. Eyecare Plus Bundoora 29. Eyecare Plus Mill Park 30. Eyecare Plus Optometrists Cheltenham 31. Eyecare Plus Springvale 32. Eyedentity Carnegie

33. Eyescan 34. Graham Hill Eyecare 35. Harris Blake & Parsons Optometrists 36. Mildura Optical 37. Rashelle Cohen Optometry 38. The Eye Collective Queensland 39. Aphrodite Livanes Eyecare Plus Alexandra Hills 40. Bay Optics 41. Best Practice Eyecare 42. Christopher McMahon Quality Eyecare – Runway Bay 43. Christopher McMahon Quality Eyecare – Australia Fair 44. Clarity Optometrists 45. Dickens and Herd Optometrists 46. Envision Optical 47. Eyecare Eyewear 48. Eyecare Plus Mermaid Beach 49. Eyes on Edward 50. H2 Vision Centres 51. Insight Eye Surgery 52. Insight Optometrists 53. iSight Specialists Townsville 54. OPSM Pacific Fair 55. Neilson Eyecare 56. Optiko 57. Optiko 58. Optikus Optometrists 59. Options Eyecare 60. RA Optometrists 61. Rosser Optometry 62. Somerville and Merrin Optometrists 63. The Eye Health Centre 64. The Eye Health Centre 65. The Eye Health Centre

GOOD OPTICAL SERVICES_CT-127291 SHOWCASE SPONSORSHIP BANNER IN1022.pdf

1

22/8/2024

66. Vedelago Optometrists 67. VISION Michael Hare Optometrists 68. Vision Optics 69. Visual Eyes Optometry South Australia 70. Alleve Eye Clinic 71. Campbelltown Eye Care 72. Eyes & Vision 73. Eyes and Vision Colonnades 74. Philip Milford Optometrist Western Australia 75. Abernethy Owens Optometrists 76. Dry Eye WA 77. Ernie Hawes Optometrist 78. Eye Health Centre of Western Australia (UWA Optometry) 79. Eyecare Plus Glen Forrest 80. Ezekiel Eyes 81. For Eyes Optometrist 82. OPSM Subiaco 83. Optomize Optometrists 84. W A Opticians Associates Australian Capital Territory 85. Andrew Watkins Optometrists 86. Capital Eye 87. Evans and McMahon Optometrists - City 88. Evans and McMahon Optometrists -Tuggeranong Tasmania 89. Martin's Eyecare 90. Vivid Optical 91. Devonport Eyecare

10:28 am

e: orders@goodoptical.com.au p: +61 3 9645 1066 / f: +61 3 9681 7976 www.goodopticalservices.com.au

Dry Eye DIRECTORY Darwin

53

69 5845 5940 60 56 50 Brisbane 47 44 41 62 55 576349 65 46 51 6643 5442 64 52 686148 39 67

11 15

77

Perth

79 80 8284 78 81 7576 83

Adelaide

70 71 74 72 73

14

13 18 7 9 6 1 3 5 20 8 10 2 4 1916 12 17 21 85 86 88 87

36

Sydney

Canberra

28 3235 22 23 3829 34 24 33 37 31 25 2630 27

Melbourne 91

90 89

Hobart

... not a dry eye in sight

All-in-one treatment for all types of dry eye# #Targets all layers of the tear film, suitable for evaporative, aqueous deficient & mixed dry eye

LONG-LASTING RELIEF1,2 1 drop up to 4 times per day

CAN BE USED WITH CONTACT LENSES WITHOUT THE NEED TO REMOVE THEM¶3 ¶Based on a study of 60 different types of contact lenses, including hydrogel silicone-hydrogel, and rigid gas permeable lenses.

SUITABLE FOR PRE- & POST-OP DRY EYE2,4,5

FORMULATION MATTERS. THINK POSITIVE.

PBS Information: Cationorm® Multi Dose (10mL) Authority required (STREAMLINED) 6172.

Referto PBS Schedule forfullauthority information. Cationorm®(30x0.4mL) is not listed on the PBS.

References: 1. Lallemand f, et al. J Drug Deliv 2012:604204 2. Cationorm Package Information 3. Chang D, et al. Cationorm for treatment of ocular discomfort associated with ocular dryness in contact lens wearers. [Poster] Presented at the International Cornea & Contact Lens Congress (ICCLC), 15-17 October 2022, Sydney, Australia. [Data on File]. Financial Sponsor: Santen S.A.S. 4. Memona, 5 et al. Pak J Heal Sci 2022; 3(4):32-36 5. Jaworski D, et al. Euro J Ophthal 2023; 33(6):2178-2184 6. IQVIA™, National Sales Audit, Retail Pharmacy Channel, 501K9 - Dry Eye Products Other, Ciclosporin Eye Drop, Total Unit Sales, Moving Annual Total (MAT) May 2023 - April 2024 (excludes extemporaneous preparations).

7. LeonardiA, et al. Eru J Ophthalmol 2016;26(4):287-296 8 Baudouin C, et al. Eur J Ophthalmol 2017;27(6):678-685 9. Pisella PJ, et al. Clin Ophthalmol 2018; 12:289-299 10. Geerling G, et al. OphthalmolTher 2022;11: 1101-1117.11. Ikervis® Product Information 12. Data on File

When you need more than artificial tears* *For the treatment of severe keratisis in adults with dry eye disease which has not improved despite treatment with tear substitutes

#1 PRESCRIBED TOPICAL CICLOSPORIN IN AUSTRALIA6

SYMPTOM IMPROVEMENT OBSERVED FROM 1 MONTH^7-11 ^Improvement in OSDI vs baseline (-10.1 at month 1,p=0.003)6,11

ONCE DAILY DOSING12

SEE THE DIFFERENCE A CATIONIC EMULSION CAN MAKE.

PBS Information: Authority Required. Refer to PBS Schedule for full information.

Before prescribing, please reviewthe Approved Product Information available at www.seqirus.com.au/products This medicinal product is subject to additional monitoring in Australia. This willallow quick identification of new safety information.

Healthcare professionals are asked to report any suspected adverse events at www.tga.gov.au/reporting-problems.

Segirus (Australia) Pty Ltd Melbourne, Victoria | Ph: 1800 642 865. Segirus is a trademark of Segirus UK Limited or its affiliates. Cationorm® and Ikervis® are registered trademark of Santen S.A.S. and distributed by Segirus (Australia) Pty Ltd under license from Santen Pharmaceutical Asia Pte Ltd. Date of Preparation: June 2024. AU-Cati-24-0050.

THERAPIES

EYE DROPS/PHARMACEUTICALS

ABBVIE Celluvisc Eye Drops Ircal Eye Ointment Liquifilm Tears Eye Drops Optive Advanced Lubricant Eye Drops Optive Advanced Preservative-Free Lubricant Eye Drops Optive Fusion Lubricant Eye Drops Optive Fusion Preservative-Free Lubricant Eye Drops Optive Gel Drops Lubricant Eye Drops Optive Lubricant Eye Drops Optive Sensitive Eye Drops PVA Tears Eye Drops Refresh Liquigel Refresh Night Time AFT PHARMACEUTICALS Hylo Forte 10mL Hylo-Fresh Nova Tears 3mL Nova Tears Omega-3 3mL VitaPos Ointment 5gm ALCON Poly Visc (3.5g) Poly Visc Twin Pack (2 x 3.5g) Polytears (15mL) Systane Balance Lubricant Eye Drops (10mL) Systane Complete Lubricant Eye Drops (10mL) Systane Complete Preservative-Free Lubricant Eye Drops (10mL) Systane Eye Wash Rinse Solution *(120mL)

Systane Gel Lubricant Eye Drops (10mL) Systane Hydration UD Lubricant Eye Drops (30 x 0.7mL) Systane Lid Wipes Cleansing Wipes (30 pack) Systane Original Lubricant Eye Drops (15mL) Systane Original UD Lubricant Eye Drops (28 x 0.8mL) Systane Ultra Preservative-Free Lubricant Eye Drops (10mL) Systane Ultra UD Lubricant Eye Drops (25 x 0.5mL) Tears Naturale Artificial Tears (15mL) Systane Hydration Preservative-Free Lubricant Eye Drops (10mL) BAUSCH + LOMB Viscotears Eye Gel Viscotears Eye Gel PF Blink Intensive Gel Tears Eye Drops 10mL Blink Intensive Tears Protective Eye Drops 0.4mLx20 Blink Intensive Tears Protective Eye Drops 15mL CARE PHARMACEUTICALS Murine Dry Eyes Murine Relief Murine Eye Mist CSL SEQIRUS Cationorm Multi Dose 10mL Cationorm Single Unit Ampoules x 30 Ikervis (1mg/mL ciclosporin) Single Unit Ampoules x30 DESIGNS FOR VISION Optimel Manuka + Antibacterial Drops Optimel Manuka + Forte Gel Optimel Manuka+ Eyelid Cream GOOD OPTICAL SERVICES Hylo Forte 10mL Hylo-Fresh Nova Tears 3mL GOOD OPTICAL SERVICES_CT-127291 Nova Tears Omega-3 3mLSHOWCASE SPONSORSHIP BANNER IN1022.pdf

AbbVie AbbVie AbbVie AbbVie AbbVie AbbVie AbbVie AbbVie AbbVie AbbVie AbbVie AbbVie AbbVie AFT Pharmaceuticals/Good Optical Services AFT Pharmaceuticals/Good Optical Services AFT Pharmaceuticals/Good Optical Services AFT Pharmaceuticals/Good Optical Services AFT Pharmaceuticals/Good Optical Services Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Alcon Laboratories (Australia) Pty Ltd Bausch + Lomb Australia Bausch + Lomb Australia Bausch + Lomb Australia Bausch + Lomb Australia Bausch + Lomb Australia Care Pharmaceuticals Care Pharmaceuticals Care Pharmaceuticals

1

• • • • • • • • • • • • •

•

Severe

Moderate

NAME

Mild

Company

GRADE OF DRY EYE

• • • • • • • • • • • • •

• •

• • • • •

•

• •

• •

• • • •

• •

• • • • •

• •

• • • •

• • •

•

• •

• •

•

• • •

•

• • •

CSL Seqirus CSL Seqirus CSL Seqirus

• •

• •

• •

Designs For Vision/Melcare Designs For Vision/Melcare Designs For Vision/Melcare

•

• • •

• •

Good Optical Services/AFT Pharmaceuticals Good Optical Services/AFT Pharmaceuticals Good Optical Services/AFT Pharmaceuticals 22/8/2024 am Good Optical10:28 Services/AFT Pharmaceuticals

e: orders@goodoptical.com.au p: +61 3 9645 1066 / f: +61 3 9681 7976 www.goodopticalservices.com.au

•

•

• • • •

•

•

Dry Eye DIRECTORY

• • •

•

• •

• • •

• •

• • • • •

• • •

• • •

• •

• • • • • •

•

•

•

•

•

Contact

PBS-listed

Over the counter • • • • • • • • • • • • •

•

• • • • • • • •

• •

Prescription

• • • •

•

Contact lens friendly

Preservativefree

PARTICULARS

Eye lid

Antiinflammatory

Evaporative/ Meibomian gland dysfunction

Tear insufficiency/ Aqeuous deficiency

TREATMENT TYPE

• • •

• • • •

• • • • •

• • •

• • • • • •

• • •

•

•

• • • • • • •

• • •

• • • •

•

• •

• • • • •

•

•

•

•

• • •

• • •

• •

• •

•

• • • • •

• • • •

•

• • • • •

• •

• • • • • • •

• • • •

• • •

• • •

•

• • • •

•

• •

• • •

• •

• • • •

orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com visioncareorders.anz@Alcon.com ausorders@bausch.com ausorders@bausch.com ausorders@bausch.com ausorders@bausch.com ausorders@bausch.com sales@carepharma.com.au sales@carepharma.com.au sales@carepharma.com.au

•

• • • •

australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com australiaenquiries@allergan.com

aunz.medicalinformation@seqirus.com aunz.medicalinformation@seqirus.com aunz.medicalinformation@seqirus.com info@dfv.com.au info@dfv.com.au info@dfv.com.au

• • •

orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au

... not a dry eye in sight

THERAPIES

EYE DROPS/PHARMACEUTICALS

VitaPos Ointment 5gm Alcon (including Systane Range) Allergan (including Optive Range) Cationorm 10mL Cationorm UD 30x0.4mL Bausch + Lomb (Blink range) Tears Again (Liposomal Eye Spray) Hypochlore Spray 50ml Optimel Manuka + Forte Gel Optimel Manuka + Antibacterial Drops Optimel Manuka Cream + Jojoba Oil Hypochlorous Eyelid Spray JUBELEE EYECARE SUPPLIES Optimel Manuka+ Dry Eye drops Optimel Manuka+ Eyelid Cream Optimel Manuka+ Forte Eye Gel OPHTHALMOPRO Manuka+ Dry Eye Drops Manuka+ Forte Eye Gel Manuka+ Eyelid Cream Dry Eye Complete (supplement) OPTIMED BlephaDex Liquid (NICNAS-registered) Bruder Hygenic Eyelid solution spray (HA 0.02%) Glass bottle (NICNAS-registered) Xalin eye Gel Xalin Fresh single dose eye drop Xalin Hydrate eye drop Xalin Night Gel SUN PHARMA Cequa

• • •

•

1

Severe • • • • • • • • • • • •

• • • • • •

• • • •

Jubelee Eyecare Supplies/Optimel Jubelee Eyecare Supplies/Optimel Jubelee Eyecare Supplies/Optimel

• •

• • •

• • •

OphthalmoPro/Optimel OphthalmoPro/Optimel OphthalmoPro/Optimel OphthalmoPro/Ocusci

•

• •

•

•

•

OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed

•

•

•

• • •

• • • •

•

•

•

Sun Pharma ANZ

DEVICES/EQUIPMENT

BOC INSTRUMENTS SBM Activa DEVICE TECHNOLOGIES Debridement equipment, spuds etc Epilation forceps Gland expression Forceps Disposable Dry Eye instrument kits Punctal Plugs - Permanent occlusion Punctal Plugs - Temporary occlusion DESIGNS FOR VISION Oasis Punctal Plugs Mastrota Meibonian Gland Paddle Mastrota Forcep Golf Club Spud Francis Foreign Body Spud Ellis Foreign Body Spub LUMIBIRD MEDICAL C.STIM - I.P.L. (Intense Pulsed Light) System GOOD OPTICAL SERVICES Nulids Pro MDG Machine - In Practice Nulids MDG Machine Patient Ocusoft Compliance Kit 50ml + 100 Pads Ocusoft Hypochlor Gel 59mL Ocusoft Hypochlor Spray 59mL Ocusoft Lid Scrub Bottle 50mL Ocusoft Oust Demodex Foam 50mL Ocusoft Oust Demodex Sachets 30s GOOD OPTICAL SERVICES_CT-127291 SHOWCASE SPONSORSHIP BANNER IN1022.pdf

Good Optical Services/AFT Pharmaceuticals Good Optical Services/Alcon Good Optical Services/Allergan Good Optical Services/Seqirus (Aust) P/L Good Optical Services/Seqirus (Aust) P/L Good Optical Services/Johnson & Johnson Good Optical Services/Bio Revive Good Optical Services/Ocusoft Good Optical Services/Melcare Good Optical Services/Melcare Good Optical Services/Melcare Good Optical Services/The Body Doctor

Moderate

NAME

Mild

Company

GRADE OF DRY EYE

•

BOC Instruments

•

•

•

Device Technologies/Katena Device Technologies/Katena Device Technologies/Katena Device Technologies/OLIE Device Technologies/Eagle Vision & Sharpoint Device Technologies/ Eagle Vision & Sharpoint

• • •

• • •

• • •

• •

• •

• •

Designs For Vision/Oasis Designs For Vision/PRICON Designs For Vision/PRICON Designs For Vision/PRICON Designs For Vision/Albert Heiss Designs For Vision/Albert Heiss

•

• • •

• • • • • •

• • • • • •

Lumibird Medical

•

•

•

Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA 22/8/2024 10:28 am

e: orders@goodoptical.com.au p: +61 3 9645 1066 / f: +61 3 9681 7976 www.goodopticalservices.com.au

• • • •

•

•

• • • •

Dry Eye DIRECTORY

• • • • • •

• • • • •

•

• •

• •

• • • • •

• • • • • •

•

•

• • •

•

• • •

•

•

•

•

• • • •

• • • • • • • • • • • •

• •

• •

• •

•

Contact

PBS-listed

Over the counter

Prescription

Contact lens friendly

Preservativefree •

• • •

PARTICULARS

Eye lid

Antiinflammatory

Evaporative/ Meibomian gland dysfunction

Tear insufficiency/ Aqeuous deficiency

TREATMENT TYPE

•

• • •

• • •

manager@jubelee.com manager@jubelee.com manager@jubelee.com

•

orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au

• • • • • •

sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au

• • • • • • • •

• • • •

•

•

•

•

•

• • • • •

• •

•

•

•

•

•

• •

• • •

customers@device.com.au customers@device.com.au customers@device.com.au

• •

customers@device.com.au customers@device.com.au

• • • • • • •

Cequa.Samples@sunpharma.com

sales@bocinstruments.com.au

• • •

•

orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au

• • • • • •

• • • • • • • • •

• • • • •

info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au

• • • • • •

salesadmin@ellex.com • • • • • • •

orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au

... not a dry eye in sight

THERAPIES

DEVICES/EQUIPMENT

Ocusoft Platinum Plus 50mL Ocusoft Plus Bottle 50mL Ocusoft Plus Sachets 30s Ocusoft Sachets 30s Ocusoft Swab Stix (In Practice Oust & Plus) Box 12 Zocular Zest Kit Zocular Gel (syringe) Zocular Eyelid Wipes INMODE Envision OPHTHALMOPRO Flexx MGE Broad 8mm tips - Titanium Flexx MGE Precision 3mm tips Flexx MGE Roller - Titanium Flexx Spud Debridement MGrx - Dry Eye Treatment System Eye-Light IPL with LLLT MeiboMask LLLT My-Mask OPTIMED Bleph-Ex Blephadex Applicator (in office use only, NICNAS-registered) Bruder - Collins expressor Forceps Bruder - Karpecki punctal plug forceps Bruder - Livengood gland expressor paddle Bruder - Longnose expressor Bruder epilation forceps Bruder Karpecki Debrider Bruder Karpecki-Lindstrom Gold Line OSD Instrument Set (contains six instruments) Bruder recatangular expressor Bruder roller expressor Thermaye Plus IPL SPECTRUM SURGICAL Painless Plug (Punctum Plug)

WIPE/MASK

AFT PHARMACEUTICALS Opti-Soothe Preservative-free Eyelid Wipes Opti-Soothe Moist Heat Mask Reusable mask DESIGNS FOR VISION Eye Eco D.E.R.M. Mask Eye-Eco EyeCloud Eye Eco Tranquileyes Advanced XL Kit (moist heat therapy) Eye-Eco Eye Seals/Seals 4.0 Eye-Eco Quartz Eye-Eco Onyx I-LID'N'LASH Cleansing Wipes I-LID'N'LASH PLUS Antiseptic Cleansing Wipes Avenova Eye Eco Tea Tree Foaming Facial Cleanser Eye Eco Advanced Tea Tree Foaming Facial Cleanser GOOD OPTICAL SERVICES Opti-Soothe Preservative-free Eyelid Wipes Optisoothe Tea Tree Eyelid Wipes 20s Opti-Soothe Moist Heat Mask Reusable mask Bio Revive Travel Mask (disposable packs of 10) Tear Restore Mask + 2 gel inserts The Eye Doctor Allergy Mask The Eye Doctor Antibacterial Stye Relief Compress (single eye patch) The Eye Doctor Lid Wipes Sachets 20s SPONSORSHIP BANNER IN1022.pdf GOOD OPTICAL SERVICES_CT-127291 SHOWCASE

1

Severe

Moderate

NAME

Mild

Company

GRADE OF DRY EYE

•

•

• • • • • • • •

InMode

•

•

•

OphthalmoPro/Ocusci OphthalmoPro/Ocusci OphthalmoPro/Ocusci OphthalmoPro/Ocusci OphthalmoPro/Ocusci OpthalmoPro/Espansione OpthalmoPro/Espansione OpthalmoPro/Espansione

• • • • • • • •

• • •

• • •

OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed

• • • • • • •

•

•

• • • • • • • • • •

• • • • • • • • • •

Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/OCuSOFT USA Good Optical Services/Zocular USA Good Optical Services/Zocular USA Good Optical Services/Zocular USA

• • • • •

• • •

• • • • •

Spectrum Surgical

•

•

•

AFT Pharmaceuticals / Good Optical Services AFT Pharmaceuticals/Good Optical Services

• •

• •

• •

Designs For Vision/Eye Eco Designs For Vision/Eye Eco Designs For Vision/Eye Eco Designs For Vision/Eye Eco Designs For Vision/Eye Eco Designs For Vision/Eye Eco Designs For Vision/I-MED Pharma Designs For Vision/I-MED Pharma Designs For Vision/Avenova Designs For Vision/Eye Eco Designs For Vision/Eye Eco

• • • • • • •

• • • • • • • • • • •

• • • • • •

• • • • • • • •

• • •

Good Optical Services/AFT Pharmaceuticals Good Optical Services/AFT Pharmaceuticals Good Optical Services/AFT Pharmaceuticals Good Optical Services/Bio Revive Good Optical Services /Tear Restore USA Good Optical Services /The Body Doctor UK Good Optical Services /The Body Doctor UK Good Optical Services /The Body Doctor UK 22/8/2024 10:28 am

e: orders@goodoptical.com.au p: +61 3 9645 1066 / f: +61 3 9681 7976 www.goodopticalservices.com.au

• •

• • • • • • •

• • •

• •

Dry Eye DIRECTORY

• • •

• • • • •

• • • • •

•

•

• • • • • •

• • • •

• • • •

• • •

•

•

•

•

•

• •

• • • • • • • •

• • • • • • • • • •

• • • • •

Contact

PBS-listed

Over the counter

•

•

• • •

Prescription

• •

•

• • • • • • • •

•

Contact lens friendly

Preservativefree

PARTICULARS

Eye lid

Antiinflammatory

Evaporative/ Meibomian gland dysfunction

Tear insufficiency/ Aqeuous deficiency

TREATMENT TYPE

orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au orders@goodoptical services.com.au INFO@INMODE.COM.AU

• • • •

orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au

•

• • • • •

•

•

•

•

•

• •

• •

• •

orders@goodopticalservices.com.au orders@goodopticalservices.com.au

• • •

• • •

• • • • • •

• • • • • • • • • • •

info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au

•

orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au

• • • • • • • •

• • •

• •

• • • • •

• • • • •

• • • • • •

•

• • •

• • • • •

sales@spectrumsurgical.com.au

• • • • • •

... not a dry eye in sight

THERAPIES/DIAGNOSTICS

WIPE/MASK

Severe

Moderate

NAME

Mild

Company

GRADE OF DRY EYE

The Eye Doctor Liquid Lid Cleanser (Argon & Coconut Oil/Micellar Water) The Eye Doctor Sterileyes Antibacterial Click'N'Go Travel Mask The Eye Doctor Sterileyes Antibacterial Hot/Cold Eye Compress

Good Optical Services /The Body Doctor UK Good Optical Services /The Body Doctor UK Good Optical Services /The Body Doctor UK

• •

• • •

• •

The Eye Doctor Tea Tree Lid Wipes 20s The Eye Doctor Antibacterial Essential Mask The Eye Doctor Junior Eye Compress OPHTHALMOPRO Dry Eye Compress with HydroBlock USB Powered Dry Eye Compress with HydroBlock Tear Restore Wipes Tear Restore Wipes with Manuka Honey OPTIMED BlephaDex Wipe (regular and PRO, NICNAS-registered) BlephaDex Wipe (regular and PRO, NICNAS-registered) Bruder Eye compress Bruder Eye compress Bruder Eye wipe (NICNAS-registered) Bruder Eye wipe (NICNAS-registered) Bruder Eyeleave Eye compress Bruder Eyeleave Eye compress EyeGiene compress (NICNAS-registered) EyeGiene compress (NICNAS-registered) OptiMed USB Eye warmer (NICNAS-registered) OptiMed USB Eye warmer (NICNAS-registered)

Good Optical Services /The Body Doctor UK Good Optical Services /The Body Doctor UK Good Optical Services /The Body Doctor UK

• • •

•

•

OphthalmoPro/Ocusci OphthalmoPro/Ocusci OphthalmoPro/Tear Restore OphthalmoPro/Tear Restore

• • • •

• • • •

• • • •

• • •

• • •

• • •

• • •

• • •

• • •

•

•

•

•

•

•

OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed OptiMed

DIAGNOSTICS/ASSESSMENT

BOC INSTRUMENTS SBM DSLC200 & DEM100/DEM100 PLUS BOC Instruments SBM IDRA Basic & Full BOC Instruments SBM OS1000 BOC Instruments DEVICE TECHNOLOGIES Topcon CA-800 - corneal topography, basic lens fit, dry eye suite Device Technologies/Topcon Topcon MYAH - Axial lenth, corneal topography, basic lens fit, dry eye suite Device Technologies/Topcon Topcon SL-D701 slitlamp w/ DC4 camera for gland imaging Device Technologies/Topcon DESIGNS FOR VISION OCULUS Keratograph 5M Designs For Vision/OCULUS Optikgerate GmbH Tear Touch Blue Designs For Vision/Madhu Instruments Fluoro Touch Designs For Vision/Madhu Instruments LUMIBIRD MEDICAL C.DIAG Lumibird Medical MEDMONT medmont meridia Professional Medmont OPTHALMOPRO Me-Check OpthalmoPro/Espansione Dry Eye Analyser OphthalmoPro/Moptim OPTIMED Huvitz HTR-1A OptiMed Huvitz HRK-9000A OptiMed Rexxam RET-700 Dry Eye Option OptiMed ZEISS ATLAS 500 ZEISS 1 GOOD OPTICAL SERVICES_CT-127291 SHOWCASE SPONSORSHIP BANNER IN1022.pdf 22/8/2024 10:28 am

Blinking rate/quality

Tear meniscus height

Lipid layer thickness

Meimbography

Corneal Topography

NAME

Company

DIAGNOTIC CAPABILITY

•

• • •

• • •

• • •

• • •

• • •

• • •

• • •

• • •

• • •

•

•

•

•

•

•

•

•

•

•

•

•

• •

•

• •

•

•

•

• • • •

e: orders@goodoptical.com.au p: +61 3 9645 1066 / f: +61 3 9681 7976 www.goodopticalservices.com.au

Dry Eye DIRECTORY Contact

PBS-listed

Over the counter

Prescription

Contact lens friendly

Eye lid

Preservativefree

PARTICULARS

Antiinflammatory

Evaporative/ Meibomian gland dysfunction

Tear insufficiency/ Aqeuous deficiency

TREATMENT TYPE

•

•

•

• • •

•

•

•

• •

• •

• •

•

• • • •

• •

• •

• • •

• • •

• • •

• •

• • •

• • •

orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@goodopticalservices.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au orders@ophthalmopro.com.au

• •

• •

• • • • • • • •

• • • •

•

•

•

•

•

•

sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au

• • •

• • •

• • •

• • •

• • • •

• • •

• • • •

• • •

• • •

•

•

•

•

• • •

•

•

•

•

•

•

• •

•

• • • •

•

• • • •

•

Contact

Blepharitis examination

Nocturnal lagopthalmos

Measuring/ tracking symptoms

Meibomian Gland performance/ functionality/ expression tool

Ocular surface staining

Tear osmolarity

Schirmer test

Interferometry

Bulbar redness

Tear break up time

DIAGNOTIC CAPABILITY

•

sales@bocinstruments.com.au sales@bocinstruments.com.au sales@bocinstruments.com.au customers@device.com.au customers@device.com.au customers@device.com.au info@dfv.com.au info@dfv.com.au info@dfv.com.au salesadmin@ellex.com

• •

info@medmont.com orders@ophthalmopro.com.au orders@ophthalmopro.com.au

• • •

• •

sales@optimed.com.au sales@optimed.com.au sales@optimed.com.au

•

•

info.au@zeiss.com

... not a dry eye in sight

GEOGR APHIC

ATRO PHY

WE CAN T ’ AND WAIT

Functional vision continues to decline as lesions grow, even when visual acuity remains unchanged.1-5 At Apellis, our goal is to bring to market a treatment for geographic atrophy (GA).

To learn more about GA and its impact, scan here

Vision impairment due to geographic atrophy may vary.

References: 1. Boyer DS, et al. Retina. 2017;37(5):819-835.

2. Sunness JS, et al. Ophthalmology. 1997;104(10):1677-1691.

3. Sunness JS, et al. Ophthalmology. 1996;103(9):1458-1466.

4. Sunness JS, et al. Am J Ophthalmol. 2005;140(6):1085-1093.

5. Sunness JS, et al. Ophthalmology. 2007;114(2):271-277.

Apellis Australia Pty Ltd, L3, 141 Camberwell Rd. Hawthorn East, VIC, 3123, ABN 87 600 316 612 April 2024 | AU-GA-2400033

SEE

CPD

ABOUT THE AUTHOR:

Dr Shanel Sharma

BSc (Med), MBBS, FRANZCO, GAICD, MBA (Exec) Excellence Eye & Laser Surgeons, Bondi Junction & Miranda Paediatric, strabismus and cataract surgery www.eyeandlaser.com.au

Dr Daya Sharma

BSc (Med) Hons I, MBBS, MSc (Research), FRANZCO, GAICD, MBA (Exec) Eye & Laser Surgeons, Bondi Junction & Miranda Corneal, cataract and refractive Surgeon www.eyeandlaser.com.au

Dr Loreto (Loren) Rose

BSc (Hons) MBBS (Hons) FRANZCO PhD paediatric and general ophthalmic Surgeon Clinical Senior Lecturer, Macquarie Medical School Adjunct Associate Professor, University of Canberra Founding member of Myopia Australia (www.myopiaaustralia.com.au)

Combining myopia treatment with UV protection As eyecare professionals increasingly recommend outdoor activities to curb the myopia epidemic, another concern arises: ultraviolet radiation-related eye disease. But how does one balance their approach, while integrating 0.01% atropine as an early intervention and ensuring proper guidance to prevent UV-induced eye conditions.

M

yopia is a worldwide epidemic, a fact that has justifiably garnered increasing attention and research around the world. The prevalence of myopia is expected to reach 52% by 2050.1 Complications secondary to myopia can lead to loss of vision and are expected to become the leading cause of permanent blindness in adults. These include retinal detachments, neovascular membranes secondary to myopic macular degeneration, glaucoma and presenile cataracts.2 The risk of these complications are significantly higher in patients with axial myopia; and it’s predicted that one billion people will have myopia with axial lengths greater than 26 mm by 2050.1 Systematic reviews and meta-analyses have established that increased time spent outdoors in high lux light in childhood is associated with lower incidence of myopia development and progression.

It is now widely advised that children spend 14-17 hours outdoors per week to limit their progression to myopia.3

THE SILENT OCULAR EPIDEMIC

CLINICAL CPD HOURS This activity meets the OBA registration standards for CPD

LEARNING OBJECTIVES:

However, myopia is not the only epidemic eyecare professionals have to contend with. Ultraviolet radiation (UVR)-associated eye disease has proven to be the silent ocular epidemic. It’s well understood that sunburns to the skin cause damage in childhood and can lead to the development of skin cancers in adulthood. It’s now becoming apparent in the literature that this is likely to be the same for the eyes. For example, in 2007, a study of Sydney school children showed that UV damage to the eyes

was present in 29% of 9-11 year olds and 81% of 12-15 year olds.17 (Interestingly, the children who were screened under the age of nine did not have any signs of UV damage on the anterior ocular surface.

However, it is speculated that the technology is not sophisticated enough to detect low grade damage at this age).17 UVR-related eye diseases include periocular skin cancers, pterygium, pinguecula, ocular surface tumours, cataracts and age-related macular degeneration (AMD), which typically presents in adulthood.4 These conditions have significant impact on patients’ long term visual health. The Beamer Dam, Rotterdam, and Blue Mountains Eye Studies and the Melbourne Vision Impairment Project have all shown that areas with higher incidences of skin cancers and UV-related diseases have lower levels of myopia.5 When treating children with myopia, it is important to simultaneously consider the impact of UVR. With this in mind, we reviewed the evidence for outdoor light exposure with high lux light to reduce myopia progression and simultaneously assess the evidence regarding UV-related eye diseases and the need to advocate for UVR protection for children to simultaneously reduce UV related eye diseases later in life.6 We feel that it is imperative that all eye health care professionals understand that both myopia and UV-related eye diseases can result in impaired vision later in life. We don’t want to inadvertently give advice that results in increasing the patient’s risk of developing different, yet potentially blinding, ocular complications.

• Recognise the association between outdoor high lux light exposure in childhood and reduced myopia progression.

• Review some of the evidence linking outdoor activity and UV exposure to both myopia management and UV-related eye conditions.

• Examine the inverse relationship between myopia and the prevalence of UVR-related eye conditions such as pterygium.

• Understand how 0.01% atropine can be integrated into holistic myopia treatment protocols alongside outdoor activity recommendations.

Image: Beamers.

At the completion of this article, the reader should be able to improve their myopia management approach, including...

It’s now widely advised that children spend 14-17 hours outdoors per week to limit their progression to myopia.3

INSIGHT October 2024

61

Image: Evgeniia Zakharishcheva/Shutterstock.com.

CPD

If prescribing atropine, there is potential for glare, which may impact on the child’s readiness to spend time outside.

Evidence for the protective effect of high lux light High-intensity outdoor light has been demonstrated to protect against and slow the progression of myopia in epidemiological studies and animal studies. The seminal chick studies7 exposed deprivation-induced myopic chicks to UV-free light of varying intensities measured in lux. They demonstrated that high lux UV-free light retarded myopia progression in these chicks. Additionally, fewer chicks developed myopia when exposed to high lux UV-free light. Furthermore, other animal studies including on rhesus monkeys8 and tree shrews9 showed that high intensity UV-free lighting systems inhibited scleral growth rates.

Epidemiological studies showed a similar relationship between the amount of time spent outdoors by children and the rates of developing

myopia. Rose et al compared the rates of myopia in children of Chinese ethnicity living in Sydney to those living in Singapore. In Sydney, 3.3% of children developed myopia, (who spent 13.5 outdoor hours per week) compared to 29.1% of the Chinese ethnicity children living in Singapore (who spent 3.05 outdoor hours per week).5 Further supporting the importance of the brightness of outdoor light is evident by the seasonal differences noted in the higher rate of myopia progression in winter months compared to summer months. This has been demonstrated in several studies in a number of different ethnic groups including Chinese, Czech and Norwegian Children.11-13 Intervention in the form of increased outdoor time has been shown to reduce the incidence of myopia. In Chinese children in China, the incidence

CLINICAL RECOMMENDATIONS FOR MYOPIA TREATMENT Dr Loreto (Loren) Rose BSc (HONS) MBBS (HONS) FRANZCO PhD It’s important to assess risk factors to the development and potential fast progression of axial myopia.

Initially, the review should include a discussion of lifestyle and the contribution of not enough outdoor UV free natural light exposure and the general reduction of recreational near work to reduce the rate of progression into myopia and potentially delay its onset as well as the progression once myopia has occurred. The education should include the importance of UV protection for the eyes and skin.

Once myopia has been diagnosed, the intervention treatment plan should be systematic to the benefits and potential side effects of treatment to the child. The best and most accurate method to detect fast progression is the measurement and monitoring of axial length elongation.

There is a low threshold to use peripheral defocus lenses as they treat the myopic correction with evidence of reducing elongation by approximately 50%.21,22 My recommendation if the axial growth is 0.1 mm or greater (0.25 D) over a six-month period is to consider commencing atropine 0.01 % supported by the evidence of significant effect in the WA-ATOM study.23 Counselling should include the potential side effects such as near blur, glare and rebound. The most recent publication of the WA-ATOM washout data demonstrated that even with this low dose rebound could negate the positive effect of atropine 0.01% within one year of washout.24,25 Titration of atropine dose concentration can then be increased based on treatment effect and side effect profile. The LAMP studies highlighted the benefits of the dose of atropine 0.05% in retarding progression, especially in the young Asian population.26,27 The higher the concentration of atropine, the greater the potential for rebound. Additionally, there is more potential for glare, which may impact on the child’s readiness to spend time outside. This will require further discussion to ensure outdoor time is a priority to be conducted comfortably and safely from UV potential damage.

For managing rapidly progressing axial myopia, initiating treatment with 0.01% atropine is the first choice. This recommendation is supported by evidence from the WA-ATOM study, demonstrating significant effectiveness in slowing myopia progression. The low concentration of atropine minimises the risk of severe side effects, making it a suitable starting point. Monitoring and adjusting the dosage based on treatment response and tolerance ensures optimal patient outcomes.

62

of myopia was reduced by increasing outdoor time by 40 minutes a day. Furthermore, less than 40 minutes of outdoor activity daily was associated with rapid axial length progression. Meta-analysis of the dose-response relationship between outdoor light exposure and myopia by Ho et al, found that more than 120 minutes of daily outdoor exposure decreased myopia incidence by 50%, decreased axial elongation by 24.9% and reduced spherical equivalent refraction by 32.9% in Asian children aged four to 14 years.14 Similarly, the National program of Tian-Tian in Taiwan, where schools were encouraged to incorporate 120 minutes of outdoor daily activity into the school day was instituted in 2010. As a result, a reduction in the number of children progressing to myopia was seen.15

THE PROBLEM So, the benefit of exposing children to the high lux outdoor light in reducing the incidence and rate of progression of myopia developing is clear.

However, it isn’t possible to spend time outdoors exposed to the benefits of high lux light without being simultaneously exposed to UV radiation – the invisible portion of light spectrum which has been known to be damaging to the eyes and skin.

We know that UV radiation causes sunburns and damage to the skin during childhood. We also know that the long-term complications of this cumulative UV skin damage result in wrinkles, actinic keratosis and both melanoma and non-melanoma skin cancers. Five to 10% of all skin cancers occur in the periocular skin, which includes basal and squamous cell carcinomas and melanomas.16 Ooi et al showed that 33% of children aged 12-15 years of age had a pinguecula on clinical examination.17 Pingueculae are known to progress to pterygium with cumulative UVR exposure.

The prevalence of pterygium has been shown to increase linearly with age.8 Mackey et al 18 showed that patients with pterygium had a 24% increased risk of melanoma, as the presence of pterygium, an indication of the cumulative UVR the persons skin was likely to have been exposed to. It’s clear that UV exposure in childhood causes damages both eyes and skin.

UV AND MACULAR DEGENERATION It has long been recognised that UVR plays a significant role in the pathogenesis of pinguecula, pterygia, ocular surface neoplasia, periorbital skin cancers and cataract. However, the question of UVR in the pathogenesis of macular degeneration is less clear.

Proving or disproving the link between childhood UV exposure and the late adulthood development of macular degeneration is difficult. There is a long lag time between the development of macular degeneration and childhood the childhood outdoor behaviour that may have precipitated it.

INSIGHT October 2024

RR1947

Table 1. Axial length versus prevalence of pterygium Axial length

Axial length

Axial length

Study: Zhang et al.28

AL≤23 mm

23<AL≤26 mm

AL>26 mm

Prevalence of pterygium (%)

51.4

46.8

1.8

INVERSE RELATIONSHIP BETWEEN PTERYGIUM AND MYOPIA To explore the link in adult macular degeneration and childhood outdoor behaviour in our recently-published paper,4 we used the axial length and degree of myopia as an indication of low childhood UVR exposure, and pterygium and pinguecula as a marker for significant childhood UV exposure, particularly as there is a dose-response curve for outdoor exposure and pterygium growth.

This assumption was validated when it was found that the presence of pterygium was associated with reduced axial length measurements. Only 1.8% of patients with axial lengths of greater than 26 mm have pterygia–compared to 51.4% of pterygia patients with axial lengths less than 23 mm in the same population group.4

GLOBAL CORROBORATIVE STATISTICS This inverse relationship was also seen in Shanghai where 22.9% myopia rates are associated with a high prevalence of pinguecula at 75.6%. Similarly, the 70.6% rate of myopia in South Korea was

inversely correlated with the 3.8% rate of pterygia.

This has also been seen in the Blue Mountains Eye Study, where the 69.5% rate of pinguecula correlated with the 15% rate of myopia.17-20 As a final point, a systematic review and meta-analysis of 14 studies comprising over 5,800 eligible patients found that hyperopia was a risk factor for developing early macular degeneration and myopia conferred a degree of protection which increased for every additional dioptre of myopia, or millimetre increase in axial length the person had.11

SUMMARY Having collected and analysed this information, we can see that advocating for outdoor time as part of our myopia management protocols is important.

However, the data shows it must be done with due care and appropriate guidance to minimise the risks of both myopia complications and UV-related eye diseases.

To best advise our patients, eyecare professionals need to have a clear understanding not only about treating and preventing myopia, but also

understanding how UVR reaches the eye. They need an understanding of the damage UVR causes to the eye and the environmental factors associated with an increased risk of developing UVR related eye diseases.

Having gained these insights, we can advance our approach, refine our strategies, and help define holistic myopia treatment. In a future issue of Insight magazine, the authors will explore the evidence for combining frame and lens designs in sunglasses to maximise eye and periorbital protection.

Disclosure: As a result of their research in this area and a desire to protect their children and the community, Daya Sharma, Shanel Sharma, and Alina Zeldovich founded Beamers, which produces and sells protective sunglasses.

NOTE: References are available in the online version of this article or upon request.

NOTE: Insight readers can scan the QR code or visit insightnews.com.au/cpd/ to access a link to this article to include in their own CPD log book.

PBS Information: Xalatan (latanoprost 0.005% eye drops, 2.5 mL) is listed on the PBS as antiglaucoma preparations and miotics.

Before prescribing please review Product Information available via www.aspenpharma.com.au/products or call 1300 659 646.

Minimum Product Information: XALATAN® (Latanoprost 50 µg/mL) Eye Drops. Indication: Reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension.

Contraindications: Hypersensitivity to ingredients. Precautions: Change in eye colour due to increased iris pigmentation; heterochromia; eyelid skin darkening; reversible eyelash and vellus hair changes; macular oedema often associated with aphakia / pseudoaphakia; other types of glaucoma; contact lenses; severe or brittle asthma; herpetic keratitis; driving or using machines – transient blurry vision; elderly: no data; children: do not use, no data; lactation- metabolites present in breast milk, risk / benefit. Pregnancy: Category (B3) Interactions: other prostaglandins, thiomersal. See PI for details. Adverse Effects: Eye Disorders: blurred vision, burning, conjunctivitis, excessive tearing, eye pain, foreign body sensation, hyperaemia, iris hyperpigmentation, itching, punctate epithelial erosions, grittiness, stinging, eyelash and vellus hair changes, punctate keratitis, blepharitis, eyelid oedema, localised skin reaction on eyelids; Systemic: bronchitis, upper respiratory tract infection, eczema, rash, urinary tract disorder, abnormal liver function, myalgia, arthralgia, dizziness, headache, rash, chest pain, asthma, dyspnoea . See PI for details and other AEs. Dosage and Administration: One eye drop in the affected eye(s) once daily. Other eye drops should be administered at least 5 minutes apart.

A first choice for glaucoma management1

✔

If clinically necessary for the treatment of your patient, prescribe by brand and disallow brand substitution2

RR1947 Xalatan ½ Page Ad.indd 1

References: 1. Clinical Practice Guide for the Diagnosis and Management of Open Angle Glaucoma.

Optometry Australia 2020 2. Australian Commission on Safety and Quality in Healthcare Active Ingredient Prescribing Guide - list of medicines for brand consideration December 2022 Aspen Australia includes Aspen Pharmacare Australia Pty Ltd (ABN 51 096 236 985) and Aspen Pharma Pty Ltd (ABN 88 004 118 594). All sales and marketing requests to: Aspen Pharmacare Pty Ltd, 34-36 Chandos Street, St Leonards NSW 2065. Tel: +61 2 8436 8300 Email: aspen@aspenpharmacare.com.au Web: www.aspenpharma.com.au Trademarks are owned by or licensed to the Aspen group of companies. © 2023 Aspen group of companies or its licensor. All rights reserved. Prepared: July 2023 AU-LAT-072023-07653

25/7/23 3:16 pm

Image: Mater Private Hospital Redland.

SURGERY

Dr Sunil Warrier was the first in Australia to access the SeeLuma microscope.

A new take

on digital microscopy Bausch + Lomb has entered the field of ophthalmic microscopes in a big way – and a Brisbane hospital was Australia’s first to trial and install the fully digital surgical visualisation platform with some world-first features.

O

Image: Bausch + Lomb.

phthalmology can be a demanding job. A demanding workload and demanding patients can take a toll. Throw a musculoskeletal injury into the equation and the mental load can become that much greater.

Increasingly, the sector is shining the spotlight on the physical stresses of the job. In fact, a 2023 study of 514 eyecare professionals published in Cureus found 66.7% suffer from musculoskeletal pain.1 For ophthalmologists, it’s reported that more than half experience at least one type of pain, either in the lower back (39%) or neck (32.6%).1,2 Several factors are thought to contribute to this, such as working in the same posture for long periods, awkward posture, and bending the back.1,3 Studies have also noted the prevalence of lower back pain was high among ophthalmologists and healthcare professionals due to sitting for long periods that ultimately increases the chance of lower back pain by 1.5 times.1,4,5,6 Digital microscopy and heads-up displays have been heralded as a solution to this ergonomics problem, allowing surgeons to sit straight without straining the neck and back. But this is only part of the picture, with the next wave of microscopes also offering new levels of visualisation, intuitive interfaces, smoother workflows and an immersive educational experience.

Equipped with decades of experience in optical innovation, Bausch + Lomb (B+L) –in collaboration with digital microscopy pioneer Munich Surgical Imaging (MSI) that’s a wholly owned subsidiary of Heidelberg Engineering – had these issues in mind when developing its first-ever ophthalmic microscope.

Launched in Europe and the US in April 2023 and now available in Australia, the SeeLuma is the company’s new fully digital surgical visualisation platform with a major advance being the world’s first digital binoculars.

64

INSIGHT October 2024

It means the surgeon can choose between operating on a heads-up surgical monitor or can look through the binoculars that remain in the same position even when tilting the microscope head – such as during glaucoma surgery.

“In reality, other digital microscopes force you to operate while looking sideways at the monitor to perform surgery. These shortcomings mean that over half of ophthalmic surgeons report job-related neck or back pain with 15% finding that this limits their work7,” the company says.

“SeeLuma addresses this challenge with its C-shaped suspension arm

SeeLuma features a C-shaped suspension arm that enables surgeons to view the monitor straight ahead of them.

“Visualisation and depth of field were amazing, not just for cataract but also glaucoma surgery. This is more than just a trial; it’s a leap forward in our shared vision for the future of eyecare.”

Dr Sunil Warrier Mater Private Hospital Redland which enables surgeons to view the 3D 55-inch and 31-inch 4K monitors straight ahead of them. The fully digital binoculars can be positioned freely, allowing you to take an ergonomic posture and work with greater ease.”

B+L’s first installation of SeeLuma in Australia was at the Mater Private Hospital Redland in Brisbane where Dr Sunil Warrier and his team trialled the system. The hospital then purchased the microscope in 2024.

“Visualisation and depth of field were amazing, not just for cataract but also glaucoma surgery,” he says, noting that better visualisation leads to neater, cleaner surgery and therefore improved recovery and outcomes.

“This is more than just a trial; it’s a leap forward in our shared vision for the future of eyecare.”

The SeeLuma’s premium image quality, according to B+L, is brought about by its colour reproduction, contrast, and resolution, along with a 9x depth of field enhancer, that can enable surgeons to confidently tackle complicated surgical cases, with cinematographic-quality visualisation.

In addition, it comes with two separate 3D 4K monitors: the main 55-inch display, and a stand-mounted 31-inch display.

Whether controlled by nurses on the e-rack or by the operating surgeon using the footswitch, SeeLuma also provides a fully integrated system that enables control of system parameters, helping to optimise workflow.

B+L says an example of this is the ability to work “harmoniously” with the OCULUS BIOM 5c binocular indirect ophthalmoscope for fundus viewing.

In this case, it can automatically adapt parameters such as zoom, focus speed, white balance, image inversion, and footswitch layouts, allowing the user to continue surgery without interruptions.

Professor Marco Mura, chair of the Department of Ophthalmology at University of Ferrara in Italy, performs many complicated surgeries requiring precision and optimal visualisation. With SeeLuma, he can see some retinal structures and pathology in greater detail than other microscopes he has used.

“What I like about the SeeLuma is the huge depth of field it offers. You are able to basically see the periphery of the retina and the posterior pole in the same image without the need to refocus,” he says.

“Another advantage is the possibility of a digitally manipulated image.

For example, a recent case was a quite complex peeling of the epiretinal membrane, and the structure was very transparent. It was not colouring very well. With the SeeLuma, you can apply a filter which enhances the blue colour to be able to remove the membrane in a safe way.”

For Dr Alain Saad, ophthalmologist at Rothschild Foundation Hospital in Paris, the SeeLuma’s image quality has been a standout.

“I was a little reluctant [to try it], because I’ve tried other systems and whenever you have something new, you always wonder if it’s as good as what we already have. It was not only as good, it was a little superior,” he says.

Dr Saad also lauded the system’s usability, with an impressive number of parameters controllable on the foot pedal.

“You can also project many things to your assistant, fellow or resident who will be able to see that and reproduce the movement, so it has very

The system comes equipped with two 3D 4K monitors: the main 55-inch display (pictured), and an integrated 31-inch display.

high capability in teaching. What’s interesting is the frequency of the acquisition is very high, so it follows exactly the movement and the quality of the image is great.”

According to B+L, surgery can be recorded in 2D or 3D formats prior to being exported. This recording functionality, and the heads-up display configuration, make SeeLuma ideal for teaching situations, as Dr Saad has suggested.

“Surgeons can connect multiple wireless displays simultaneously, allowing trainees and stakeholders to follow and anticipate surgical steps as they occur, in-person and remotely,” B+L says.

“Offering real-time support via a touch screen interface, the Assist Mode feature allows users to make annotations or notes on the surgical image, enabling cutting-edge collaboration during live surgery.”

REFERENCES: 1. A l Taisan A, Al Qurainees AE, Al Sowayigh OM, Al Owayfir MA. Musculoskeletal Pain Among Eye Care Professionals. Cureus. 2023 May 23;15(5):e39403. doi: 10.7759/cureus.39403.

PMID: 37362510; PMCID: PMC10287028.

2. S ymptoms of musculoskeletal disorders in ophthalmologists. Dhimitri KC, McGwin G Jr, McNeal SF, et al. Am J Ophthalmol. 2005;139:179–181.

3. A survey study of musculoskeletal disorders among eye care physicians compared with family medicine physicians. Kitzmann AS, Fethke NB, Baratz KH, Zimmerman MB, Hackbarth DJ, Gehrs KM. https://pubmed.ncbi.nlm.nih.gov/21925736/ Ophthalmology. 2012;119:213–220.

4. P revalence and associated factors of low back pain among physicians working at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia. Al-Ruwaili B, Khalil T. https://pubmed. ncbi.nlm.nih.gov/31844441/ Open Access Maced J Med Sci. 2019;7:2807–2813. [PMC free article] [PubMed] [Google Scholar] 5. P revalence of and risk factors for low back pain among healthcare workers in Denizli. Şimşek Ş, Yağcı N, Şenol H. https://pubmed.ncbi.nlm.nih.gov/28895982/ Agri. 2017;29:71–78. [PubM ed] [Google Scholar] 6. S elf-reported musculoskeletal disorders and quality of life in supermarket cashiers. Algarni FS, Alkhaldi HA, Zafar H, Kachanathu SJ, Al-Shenqiti AM, Altowaijri AM. https://pubmed. ncbi.nlm.nih.gov/33322079/ Int J Environ Res Public Health. 2020;17:9256. [PMC free article] [PubMed] [Google Scholar] 7. B etsch D, Gjerde H, Lewis D, Tresidder R, Gupta RR. Ergonomics in the operating room: it doesn’t hurt to think about it, but it may hurt not to! Can J Ophthalmol. 2020 Jun;55(3 Suppl 1):17-21. doi: 10.1016/j.jcjo.2020.04.004. Epub 2020 May 21. PMID: 32448408.

INSIGHT October 2024

65

GLAUCOMA

power of three Image: Glaukos.

The

Glaukos has made significant modifications to its iStent platform that Australian surgeons, with early access to the MIGS technology, say is improving the surgical experience with the potential for better patient outcomes.

F

or Dr Colin Clement there is much to like about the new iStent infinite.

After receiving TGA approval in Australia earlier in 2024, headlines for the latest minimally invasive glaucoma surgery (MIGS) device from Glaukos have emphasised the new three-stent approach – upgraded from two – and the unlimited number of delivery attempts – upgraded from four.

He agrees these mark a significant step-change from older generation iStents, but his standout feature is the new levels of visualisation during surgery, an important factor considering he’s implanting the world’s smallest known medical device at 0.36 x 0.36 mm.

What Dr Clement is referring to is a clever design tweak incorporating ‘viewing windows’ on the insertion tube, so surgeons can visualise stent positioning. Essentially each modification that’s culminated in the iStent infinite has involved the injector handpiece.

“Visibility of the trocar – the small needle used to place the stents into the target tissue – has been one of the biggest improvements for me,” says the Sydney-based cataract and glaucoma subspecialist.

“The stents slide along this component into the point of insertion. With the previous injector, sometimes it was difficult to accurately see where that’s positioned in the eye. Now, it’s clear as day, which is vital when you consider that 90% of a successful implantation comes down to visibility.”

Glaukos helped create the MIGS category in the early 2010s with its first generation iStent, and Dr Clement has been an early adopter at each step.

The stents are implanted in the Schlemm’s canal, the eye’s primary drainage channel, and work to lower intraocular pressure (IOP) by restoring the natural, physiological outflow of aqueous humor. It has proven to be an ideal intermediate therapy where other options, such as eye drops, have failed for glaucoma patients also wanting to avoid more invasive options like tube shunts and trabeculectomy.

Dr Clement remembers the 2016 second generation iStent inject being a major step forward. At a third of the size of the original device, it also created a new standard of care using two stents in a pre-loaded injector. Glaukos then developed the iStent inject W with a wider flange at its base to optimise stent visualisation and prevent over-implantation, while also making modifications to the handpiece to offer more consistent injection speeds.

But with the new iStent infinite, he says Glaukos has made the surgical experience even simpler, with the added potential of greater IOP

66

INSIGHT October 2024

ABOVE: The new iStent infinite comprises three stents along with major upgrades to the injector system to improve the surgical experience.

reductions in some cases. This is because the iStent infinite comes with an extra heparin-coated titanium stent, with all three stents preloaded into the newly designed auto-injection system.

According to the company, this allows the surgeon to inject stents across a span of up to approximately six clock hours around Schlemm’s canal, with the intention to reduce IOP in adult patients with primary open-angle glaucoma (POAG) currently treated with ocular hypotensive medication.

“This increases your chances of getting the stent in the location you need and hitting the pressure reduction and medication reduction you’re targeting,” Dr Clement says.

“We’ve been conducting an Australian multi-site clinical trial for the past two years looking at the outcomes of three stents in eyes combined with cataract surgery and standalone. Those with cataract surgery are getting similar outcomes to those with two stents implanted, but those who had standalone with three stents seem to be doing better than those with two stents.”

Dr Clement plans to publish that data in 2025/26, but in the US a 12-month pivotal trial for iStent infinite (standalone) was conducted in patients with open-angle glaucoma with failed prior surgical intervention.1 Notably, those enrolled had a significantly higher preoperative treatment burden with more severe glaucoma compared with other trabecular bypass MIGS pivotal trials,1,2,3 Glaukos says.

Despite this tough-to-treat population, the iStent infinite “delivered exceptional results”, demonstrating sustained efficacy throughout the course of the study.1 It found 73.5% of patients had ≥20% reduction in IOP, and 47.3% had a ≥30% reduction. And 91.7% of study participants in the failed prior surgery group reduced or maintained medication burden at 12 months.1 There was also a 16.9 mmHg mean diurnal IOP in patients who did not have an IOP-related secondary surgical intervention (SSI, n=57), corresponding to a mean reduction of 6.5 mmHg (27.7%).4 In other major upgrades to the iStent infinite, Glaukos has incorporated a stent delivery button designed for smooth stent deployment with an unlimited number of delivery attempts. This is a significant advance over the previous injector that only allowed four.

With around 20% of his cases previously involving an under- or over-implantation, Dr Clement says having unlimited delivery attempts improves surgical accuracy and efficiency. It’s also a cost-saver, avoiding the need to discard the system once reaching the four-attempt limit.

“If you under-implant the iStent infinite, it’s not a big deal to reload the stent and have another attempt until you get it positioned correctly,” he says.

“Other changes to greatly improve the surgical experience include a slight angulation on the handpiece, making the angular approach better and allowing you to access a wider area of tissue without causing significant distortion to the eye.”

Glaukos says this eight-degree angled insertion tube is designed to minimise incision interference and provide greater access to deliver stents widely.

“There’s also a new auto-retracting introducer tip that removes a manual step we had to do with previous generations,” Dr Clement adds.

Dr Lourens van Zyl with Glaukos senior regional business manager for WA Rick Sargeant before implanting the first iStent Infinite in WA.

EQUAL ACCESS

Image: Dr Colin Clement.

Glaukos’ iStent technology has approved indications for use in combination with cataract surgery or as a standalone procedure and is reimbursed by private health funds for those who are privately insured. Many public and teaching hospitals around the country have also approved the use of the

“Visibility of the trocar – the small needle used to place the stents into the target tissue – has been one of the biggest improvements for me.”

Dr Colin Clement Sydney ophthalmologist

Image: Crystal Eye & Laser Centre

THE RESURGENCE OF GLAUCOMA For Western Australia’s Dr Lourens van Zyl, the MIGS category – spearheaded by the iStent and Hydrus microstent and the elegance of these surgeries – hasn’t only made glaucoma a more attractive subspeciality but has opened surgical glaucoma management to general ophthalmologists.

Although the Perth-based ophthalmologist has completed a glaucoma fellowship, today at Crystal Eye & Laser Centre he divides his time between refractive laser surgery and general ophthalmology that includes some glaucoma work.

“The beauty of stent-based MIGS is that ophthalmologists that aren’t fully dedicated to glaucoma can now do glaucoma surgeries as routine, and you don’t have to necessarily send patients to a glaucoma subspecialist and create a double referral,” he says.

“It’s making glaucoma management, or surgical glaucoma management, so much more accessible, and with the iStent infinite, Glaukos has improved on the original design significantly. It’s made this surgery so much easier.”

Dr van Zyl was WA’s first to implant the iStent infinite and, like Dr Clement, was impressed with the new-found visibility mid-surgery.

“In the first case performing the iStent infinite, the patient’s Schlemm’s canal and angle was difficult to see, but I was able to visualise the tip much better and use the landmarks and, even though this was my first case, I managed to implanted it perfectly,” he says.

“We have to wait for the outcomes, but with the ease-of-use, I think this is probably going to be the more standard MIGS to use.”

technology and have made MIGS available in the public sector.

For the iStent infinite, Glaukos has secured reimbursement and it’s covered by private health insurance.

Dr Clement says it’s vital to offer a proven option for patients who either don’t have cataracts or who have previously had cataract surgery, but more work is required to better identify patients who would benefit from standalone MIGS. “Having said that, I have had some patients that have had incredible results with a standalone iStent,” he says.

“MIGS is not a first-line treatment at the moment, and the reimbursement codes state that clearly. Certainly, in any patient with treated glaucoma that requires a cataract operation, I will always consider MIGS in combination.

For standalone, that group is mixed; the indications are: intolerant of their current treatments, trying to avoid filtration surgery or previous failed other interventions, and there’s a range of severity from mild to severe glaucoma.”

For Dr van Zyl, greater use of MIGS and selective laser trabeculoplasty (SLT) have decimated his trabeculectomy rate and helped his patients avoid invasive surgeries. But being able to fix a patient’s vision with cataract surgery while easing their medication burden with MIGS in the same surgical sitting is a “double whammy” that’s a fantastic practice builder.

“It’s massive because we have an option for patients who are pseudophakic, on one eye drop, or with some high pressure but no signs of glaucoma. Surgery has its risks, but the surgery itself is so straightforward and safe because you’re hardly taking any tissue out,” he says.

In fact, iStent infinite occupies 3% of the Schlemm’s canal, leaving 97% untouched.

“It’s something extra we can offer patients, especially those unhappy with using drops – it significantly reduces disease morbidity,” he says.

“I’m selective with who this is offered to, I have probably gotten 60-70% of patients off eye drops with standalone MIGS.” NOTE: References are available in the online version of this article or upon request.

INSIGHT October 2024

67

Leader in hand-held Fundus Imaging Expanded 50 degree field of view Sleek modern design

Optomed Aurora IQ

Versatile and compact Clear Fundus & Anterior Eye imaging High resolution quality display screen Autofocus and AutoExposure Integrated image quality analysis 9 Internal fixation points for Peripheral imaging WLAN or USB connectivity

Nidek AL-Scan M

Non-contact Optical Biometer

For Myopia management – predict and monitor the progression of myopia.

Simple operation with 3D Auto tracking and Auto shot.

Myopia risk evaluation can be monitored and assessed against typical AL growth rates.

The MV-1 software presents trend reports influenced by treatment and patient behaviour.

The N Stand ew a V isua r d in l Fie Tes t in ld g

VF2000 Neo -

Portable Visual Field Analyzer Virtual Reality Visual Field device incorporates complete Visual Field analysis.

Detailed progression analysis and the most versatile & efficient vision screening technology.

Latest technology provides the same reliability and reports as the “gold standard”.

Supplied complete with a Tablet PC BlueTooth interface with the VF2000 NEO. Compact/Space-saving/Portable - can be used anywhere, no need for a darkened room.

Features include: Active eye tracking – enhances reliability.

Full and Fast Thresholds VF Testing plus Neuro, Kinetic, Ptosis and Esterman tests FDT Testing Stereopsis Visual Acuity and Contrast Sensitivity Colour Testing (Ishihara, D15 and Advanced Colour Tests) Eye Mobility and Strabismus

People you know.....Products you trust Telephone: (02) 96437888

Email: sales@bocinstruments.com.au

Toll Free: 1800804331

Website: www.bocinstruments.com.au

MACULAR DISEASE

Images: CERA

.

Prof Robyn Guymer AM, Centre for Eye Research Austr alia.

FAF image (righ t) shows a shar ply defined border in GA , making it simple to detec t and mo nitor progress ion.

Forging a new path Patients diagnosed with late-stage age-related macular degeneration have entirely different prospects, depending on what form they have. But for those with geographic atrophy – still without a treatment – their fortunes may soon turn, creating a new set of challenges and opportunities, says PROF ROBYN GUYMER.

A

s one of Australia’s foremost experts on macular disease, Professor Robyn Guymer AM has a simple message for her eyecare colleagues: if you’re confronted with a geographic atrophy (GA) patient interested in the new wave of potential treatments, capture retinal images, ideally OCT and fundus autofluorescence (FAF).

Up until this point, a GA diagnosis led to a slow demise in patients’ vision.

Without an approved treatment yet in Australia, they eventually lose their fine, central vision and often rely on low vision support and services to get by in life. Eventually, difficult discussions come about driving and their independence.

It’s a grim reality Prof Guymer has grappled with throughout her 28-year career, but one that could be addressed if two promising therapies already approved in the US are cleared for use in Australia.

This is the reason she wants Australian optometrists and ophthalmologists to begin imaging the macula with OCT (ideally with high scan density) and FAF scans. If they have access to the technology, it will help to obtain a baseline of patients’ GA lesions and determine who’s progressing and how fast. It’s all vital information that could inform which patients are best suited for treatments if approved by the Therapeutic Goods Administration and subsidised via the Pharmaceutical Benefits Scheme (PBS).

“If treatments are approved, ideally we’d like to know the growth rate before the patient started treatment as people progress at different rates and this information will be part of a complete picture to be considered when counselling patients,” say Prof Guymer, deputy director and head of macular research at Melbourne’s Centre for Eye Research Australia (CERA).

“It’s vital we begin capturing this information now so that in six to 12 months’ time, if a therapy is approved, we will be able to best counsel people considering opting for treatment.”

The Australian ophthalmic sector has been watching the GA therapy landscape closely after the US Food and Drug Administration (FDA) approved the disease’s first ever therapy in February 2023. Pegcetacoplan injection, developed by Apellis Pharmaceuticals and marketed in the US as SYFOVRE, was a historic moment for the macular disease community.

It was followed by another approval six month later, avacincaptad pegol intravitreal solution, marketed as IZERVAY by Astellas Pharma.

Since then, other markets haven’t been as swift to follow.

Shortly after pegcetacoplan injection became widely adopted in the US, rare occurrences of retinal vasculitis cases were reported.

Prof Guymer, who is on the international and local advisory board for Apellis, says while this raised safety concerns, there doesn’t seem to have been increasing numbers reported with ongoing uptake in the US. She says the bigger challenge has been obtaining market clearance in Europe where regulators are yet to approve the therapy. One issue has been that the trials were not able to show a visual acuity benefit in the treatment group over the sham arm of the studies.

Instead, the first of two Phase 3 studies showed in patients with GA secondary to age-related macular degeneration (AMD) that pegcetacoplan reduced the rate of lesion growth through 24 months by 22% with monthly injections and 18% with every-other-month injections (OAKS study n=637). In the second study (DERBY n=621), this was 18% for monthly treatments and 17% for every-other-month. Both were compared alongside a sham group.

But Prof Guymer questions the emphasis on visual acuity when considering approving a GA therapy.

She says it is common to have good visual acuity until very late in the disease, but there is considerable loss of retinal function in the surrounding areas. The function of these surrounding areas can be tested by a technique called microperimetry.

That’s why, together with Associate Professor Zhichao Wu at CERA, they are working to develop a more appropriate perimetry test that can help detect changes in retinal function over time, and allow companies a better chance of detecting and demonstrating differences in retinal function with their treatments.

“It helps to think about the aims of treatment for GA like the aims of treatment for some cancers where extending life is the goal. With GA, it’s about slowing it down and seeing how much longer central foveal vision can be saved. If I can give you a year or two more allowing you to read and drive, that might be enough benefit to you to want to undergo the treatment regimen,” she explains.

“We know GA often starts out away from the dead centre of the macula and works its way towards the fovea, so that’s why we would not expect visual acuity to change in most people over the course of a 12-24 month trial. The FDA has understood that if you can save photoreceptors from dying, that’s got to be good for your vision and is an acceptable outcome.”

INSIGHT October 2024

69

MACULAR DISEASE

Serial FAF imaging of GA. FAF is ideal for monitoring progression and to help explain to patients their progression rate.

A WHOLE NEW CONVERSATION Prof Guymer remembers a time in her career having tough conversations with patients with neovascular AMD (nAMD), resigned to severe irreversible vision loss. But their fortunes changed in 2007 when the first anti-VEGF therapy was listed on the PBS. While similar hope is held in GA, she says it’s important to differentiate how therapies will work for GA versus nAMD patients.

For example, with a nAMD diagnosis, essentially everyone is offered treatment.

“In nAMD, the aim is to stop people from losing more vision and in some cases potentially improve vision. You can clearly show people after a few injections that their retina looks much nicer too. It’s a slam dunk,” she says.

“Whereas in GA, patients are going to lose vision, just at a slower rate if they’re treated. Patients might wonder why they have been receiving theses injections for years and they’re still losing vision, why should they continue? But they most likely would have been worse if they didn’t undergo the treatment, so it’s all about how you can explain that to a patient.”

Prof Guymer is hopeful Australia’s first GA therapy will be approved in the next 12 months.

She says it’s widely acknowledged the emerging crop of treatments, if approved, are an important starting point.

“The bottom line is that GA is the commonest cause of poor vision in poeple over 50 years of age in Australia and here comes our first treatment that slows down the rate of growth. It’s a start and it’s certainly not the end of advances in GA management. No one thinks that injecting an eye every month is going to be the definitive way we will end up treating GA, but it’s going to get us used to identifying GA patients in the community, following their change over time, understanding risk and benefits of treatment and how treatments are perceived in the community,” she says.

“It’s going to slow down that rate of vision loss for patients and will reframe the discussion around the length of time we can save a person’s central vision. It’s a whole new conversation for us and for the patient.”

BRACING FOR GA PATIENTS It’s also igniting discussion among Australia’s ophthalmic organisations. How can a stretched ophthalmology workforce treat a whole new patient group?

Already RANZCO has updated its Referral Pathway for Age-Related Macular Degeneration (AMD) Management to advise that GA patients should be non-urgently referred to an ophthalmologist if they are interested in a potential treatment or to learn more, so they can make an informed decision.

But finding capacity to administer GA injections is a major hurdle.

Anti-VEGF injections are difficult to access in the public hospital system

70

INSIGHT October 2024

already, with most delivered in private clinics (some who bulk bill).

According to Prof Guymer, the challenge will be creating capacity for GA patients, while ensuring those potentially at greater risk of more rapid vision loss – nAMD and diabetic eye disease – don’t miss out.

But there are ongoing conversations within the eyecare community as to how to deal with this inevitable increase in patient load.

In terms of retinal imaging, it appears more optometrists are acquiring ultra widefield devices with FAF capability. Prof Guymer says that it might be possible to offer potential reading centres that could receive images to help identify patients with GA, including those who might fit certain criteria, making them ideal candidates for treatment, as well as those who may not be suitable.

This, as well as other initiatives, may need to be considered to determine who might fit criteria to possibly access public hospital clinics.

“There will most likely be a need to triage patients, but we will first have to wait for the government decisions on access to treatment and if there are any eligibility criteria for subsidised treatment via the PBS,” she says.

“WITH GA, IT’S ABOUT SLOWING IT DOWN AND SEEING HOW MUCH LONGER CENTRAL FOVEAL VISION CAN BE SAVED.” “Some studies have only allowed people with GA not affecting the foveal centre to be included, aiming to stop progression to the fovea. However, in the real world, even in people where atrophy has started encroaching on the fovea, vision can still be fairly good and as such stopping further encroachment would still be a worthwhile aim. It is these people who are desperately trying to keep driving vision for example.”

For Prof Guymer, as she sees her GA patients now, she feels there are more people than first expected that she would consider for treatment.

“Initially I thought maybe 10% of patients would likely consider the currently [US] approved treatments, but now it’s probably more like 50%.

Whether they say yes given the side effects and the burden of having the injections is another thing.”

Either way, it will be an interesting 12 months for the GA community.

“We should know whether one or two drugs have been approved in Australia within the next year,” Prof Guymer says.

“There’s also several other GA trials under way that are also of interest.

These are in gene therapy – a once-off treatment rather than forever ongoing treatments – there’s trials of oral medication, subcutaneous injections – all different ways to attack the same problem.

“In the next 12 months some of those trials will be read out, so we’ll know what else is coming not too far down the track. If a treatment gets approved, then patients will quickly know about it, and we need to get ready and ensure we can cater for them.”

*Bas 1. W Surg J Ca

©2

PA

WITH ALCON'S CLARE ON®

COLLE CTION YO U CA N

Offer your patients Alcon's most advanced lens platform.1 •

Smooth optic delivers among the lowest levels* of surface haze#1

•

Proprietary precision edge designed to help reduce PCO and edge glare#2,3

Clareon Collection now featuring PanOptix® and Vivity® Visit MyAlcon.com.au for more information

*Based on in vitro evaluation compared with Tecnis ZCB00, Tecnis OptiBlue ZCB00V, Eternity W-60, enVista MX60, and Vivinex XY1. #Based on data for Clareon IOL (monofocal).

1. Werner L, Thatthamla I, Ong M, et al. Evaluation of clarity characteristics in a new hydrophobic acrylic IOL in comparison to commercially available iols. Journal of Cataract and Refractive Surgery. 2019. 2. Das KK, et al. In vitro and schematism eye assessment of glare or positive dysphotopsia-type photic phenomena: Comparison of a new material IOL to other monofocal IOLs. J Cataract Refract Surg. 2019;45:219-227. 3. Clareon IOL Directions for Use. © 2024 Alcon Laboratories Pty Ltd. AUS: 1800 224 153; Auckland NZ: 0800 101 106. ANZ-CLV-2400022

PANOPTIX ® | PANOPTIX TORIC | VIVITY ® | VIVITY TORIC | MONOFOCAL | TORIC

30666_VEI_InSight_Full Page Ad_Aug24_FA_OL.indd 1

29/8/2024 2:53 PM

4 2:53 PM

RANZCO PREVIEW

To the

City of Churches

The 55th RANZCO Congress is heading to Adelaide with a tantalising speaker line-up and some tweaks to the conference format to improve the attendee experience. recognising the centre as a leader in reducing waste, water, energy, and greenhouse gas emissions in the Australian business events industry.

“RANZCO is fully on board, and we’re thrilled to have Tim Jarvis as our Congress Opening Speaker, bringing his expertise in environmental leadership,” Aranciaba says, noting that he will also discuss leadership and problem-solving skills learned from retracing legendary polar explorer Sir Ernest Shackleton’s 1916 Antarctic journey using the same equipment, clothing and technology from the era.

“Together, we’re introducing a host of initiatives aimed at carbon offsetting – think tree purchasing, cycling to carbon offset, reusable cup wash stations, and more. It’s all part of our commitment to making a positive impact while delivering an unforgettable congress.”

For the 2024 event, RANZCO has also put plans in place for an “unforgettable Welcome Reception”. Falling within Diwali celebrations, organisers are transforming the evening into a dazzling ‘festival of light’ at Adelaide Oval.

“Expect a feast for the senses with stunning visuals, captivating performances, and flavours that will make this event an absolute must-attend,” local convenors Dr Jo Black and Dr Matt Little say.

Many of these opportunities wouldn’t be possible without the location of this year’s congress: Adelaide. Renowned for its easy access, exceptional food, wine, and coffee, all set against the backdrop of a stunning city with incredible surroundings, it represents the ideal circuit breaker for ophthalmologists, as well as practice managers and orthoptists holding their own programs alongside the main congress.

“For those planning to turn congress into a mini-break, you couldn’t ask for a better destination,” Dr Black and Dr Little say.

“Plus, the alignment with congress and RANZCO values around health, wellbeing, and sustainability is spot on. Daily morning activities will make the most of the convention centre’s scenic surrounds, offering fresh air and sunshine.”

Image: trabantos/Shutterstock.com.

I

s a whole eye transplant really possible in ophthalmology? What lessons were learned from retracing a Shackleton trip thought by some as the greatest survival journey of all time? And what insights on uveitis can be gained from an Adelaide professor considered one of the industry’s most engaging speakers?

These questions – to be answered by keynote speakers – indicate the 2024 RANZCO Congress in Adelaide taking place 1-4 November may one of the liveliest yet. And the numbers support this, with organisers “blown away” by the response to early bird registrations, at the time of print.

“Delegate numbers are soaring, already up 10% from last year and an impressive 25% from 2022,” says Think Business Events, the outfit tasked with delivering another congress.

“With this kind of momentum, Adelaide is shaping up to host one of our biggest and most vibrant Congresses yet.”

A breakdown of the key presentations can be found on the following pages, but Professor Adrian Fung and Dr Clare Fraser, the new Scientific Program Committee co-chairs, are particularly excited about a few.

“Professor Justine Smith (Flinders University) is one of the world’s most engaging speakers and will update us on the ‘Wide World of Uveitis’ when she delivers the Council Lecture. Professor Robyn Jamieson (Children’s Medical Research Institute) has the honour of delivering the Dame Ida Mann Lecture and will outline cutting edge advances in precision medicine and genetics,” they say.

“We also have six international speakers giving update lectures. Professor Vas Sadda from UCLA Los Angeles will discuss metabolic imaging of the retina, whilst Professor Rosa Braga-Mele from Toronto will present the latest on phacoemsulfication surgery technology. But an especially thought-provoking lecture will be given by Professor Jeffrey Goldberg when he discusses whether whole eye transplantation is possible within the Clinical Controversies session.

“We’re also pleased to host Dr Reeta Gurung from Tilganga Institute of Ophthalmology, Nepal, who will show us how her country has been able to achieve world class ophthalmic care with limited resources.”

Each year, RANZCO explores ways to improve the congress experience. In 2023, the traditional fourth day (Tuesday) was cut from the program. The new three-day congress (which officially starts on Saturday 2 November) has been well-received and will remain.

The college is also continuing to offer an online experience, a fixture since COVID. “While this provides flexibility, we know there’s nothing quite like the energy of being there in person. Our experience has shown that delegates are eager to return to face-to-face events, craving the spontaneous, organic interactions and vibrant atmosphere that simply can’t be replicated online,” says RANZCO’s head of member support Ms Alex Aranciaba.

In other changes, the Graduation and Awards Ceremony is being flipped for 2024. The graduation will run first, and awards second, to cater for new fellows who have families and young children waiting in the audience.

As one of the medical colleges leading the charge on sustainability, RANZCO has again made this a congress priority.

The Adelaide Convention Centre boasts impressive sustainability credentials, including an emphasis on local produce and the latest EarthCheck audit

The congress is taking place at the Adelaide Convention Centre.

INSIGHT October 2024

73

KEYNOTE SPEAKERS

RANZCO PREVIEW

CONGRESS OPENING LECTURE

TIM JARVIS

An environmental scientist, adventurer, author, public speaker and film-maker, Jarvis will discuss retracing Sir Ernest Shackleton’s famous 1916 Antarctic journey.

In 2013, he led a team of six using the same equipment, clothing and technology as Shackleton, sailing a replica lifeboat 1,500 kilometres before traversing a mountainous area, recreating what many, including Sir Edmund Hillary, regard as the greatest survival journey of all time. Jarvis will share lessons in leadership, problem solving, resilience, teamwork, motivation and goal setting. He will also share the importance of the type of leadership Shackleton stood for to tackle climate change and biodiversity loss today.

THE COUNCIL LECTURE

PROF JUSTINE SMITH

Prof Smith is a Distinguished Professor at Flinders University and consultant ophthalmologist at SALHN-Flinders Medical Centre. She heads a translational research program focused on basic mechanisms and clinical outcomes of different types of uveitis, and will leverage this expertise in her lecture, ‘Wide world of uveitis’. She served as editor-in-chief of Clinical and Experimental Ophthalmology from 2020 to 2023, and is a past-president and executive vice-president of ARVO.

THE DAME IDA MANN MEMORIAL LECTURE

PROF ROBYN JAMIESON

As a Professor of Genomic Medicine at the University of Sydney, and head of the Eye Genetics Research Unit at Children’s Medical Research Institute, Prof Jamieson is well placed to discuss ‘precision medicine’ in ophthalmology. With retinal organoids – used to test therapies on – gene transfer, CRISPR/Cas and other types of DNA and RNA editing and modulating tools offering hope for people with previously untreatable blinding conditions, she will argue that a comprehensive and integrated approach across various parties will be key to reaping the benefits of this technology in a sustainable way.

THE FRED HOLLOWS LECTURE

DR REETA GURUNG

Dr Gurung will detail the important work of the organisation she leads today as CEO, Tilganga Institute of Ophthalmology (TIO), which implements the Nepal Eye Programme. Initial support from The Fred Hollows Foundation funded two ophthalmologists and a few paramedics to perform outreach work in 1992. Today, TIO has a central hospital with 40 ophthalmologists and three other secondary hospitals. The organisation has also set up a factory producing low cost, high quality IOLs. It has significantly lifted cataract surgery rates, and contributed to Nepal’s declining prevalence of blindness from 0.81% in 1980/81 to 0.3% in 2010.

CATARACT UPDATE LECTURE

PROF ROSA BRAGA-MELE

A Professor of Ophthalmology at the University of Toronto, Canada, Prof Braga-Mele is a cataract subspecialist and educator. Her talk will include emerging technologies in cataract diagnostics, phacoemulsification surgery and IOL development. It will also touch on innovative techniques for nuclear removal, and anterior chamber stabilisation during and at the end of cataract surgery and showcase techniques for challenging cases.

GLAUCOMA UPDATE LECTURE

PROF JEFFREY GOLDBERG

Prof Goldberg, chair of ophthalmology and director of the Byers Eye Institute at Stanford University, will delve into the science of retinal ganglion cell (RGC) neurodegeneration and how this now points to multiple targets for biomarkers. He will also discuss the implications for treatments and new ways to promote RGC survival (neuroprotection) and function (neuroenhancement). In recent years, him and other have been transitioning these findings out of the lab, which he will outline at the congress.

PAEDIATRICS UPDATE LECTURE

ELISE HÉON

After gaining access to the voretigene neparvovec, known as Luxturna in Australia, in 2023 in Canada, Dr Héon will cover lessons learned from the new world of gene therapy for inherited retinal disorders (IRDs). She is a clinician scientist and Professor of Ophthalmology at the University of Toronto and a staff paediatric ophthalmologist at The Hospital for Sick Children since 1996. Early experience with the therapy has prompted modifications in medical and surgical approaches, she says, noting that conversations with patients and families must highlight the known potential risks and benefits, the unknowns and expectations. Importantly, she says even a small improvement in rod function and retinal sensitivity has been life changing for patients.

74

INSIGHT October 2024

KEYNOTE SPEAKERS

RANZCO PREVIEW

RETINA UPDATE LECTURE

DR SRINIVAS SADDA

Focusing on metabolic and functional imaging of the retina, Dr Sadda will discuss the shortcomings of current imaging techniques, but how there’s hope with emerging technologies such as hyperspectral imaging, flavoprotein fluorescence, fluorescence lifetime imaging ophthalmoscopy, and new photoreceptor imaging capabilities with OCT. Dr Sadda, director of AI and imaging research at the Doheny Eye Institute and Professor of Ophthalmology at the University of California – Los Angeles, says with the dawn of targeted pharmacotherapeutics and gene therapies, these advances will be particularly useful.

SIR NORMAN GREGG LECTURE

PROF STUART MACGREGOR

Professor Stuart MacGregor, head of the QIMR Berghofer Statistical Genetics Group in Brisbane, has been influential in developing a new saliva-based test to predict both disease risk and progression. It’s already in clinical use in Australia using polygenic risk scores (PRS). He will explore enabling more widespread use of PRS in eye disease, including barriers such as performance variations by genetic ancestry and recent efforts to develop more robust tests. He will also say more evidence is required to show the practical utility of PRS in preventing morbidity, and cover recent work on developing and validating PRS for risk of developing age-related macular degeneration and keratoconus.

OCULOPLASTIC UPDATE LECTURE

DR RAYMOND DOUGLAS

Dr Douglas is a renowned oculoplastic surgeon in the US who completed a subspecialised fellowship in Orbital Facial Plastic and Reconstructive Surgery at the UCLA Jules Stein Eye Institute. In addition to a private practice in Beverly Hills, Dr Douglas is the director of the Orbital and Thyroid Eye Disease program at the Cedars-Sinai Medical Center in Los Angeles. In 2021 he also founded Thrive Health IV infusion centers to treat thyroid eye disease (TED) as well as research and clinical trials for TED and other rare ophthalmic diseases.

Separate measurements, combined assessments.

The Winning Duo for your refractive practice

Corvis ST ®

Pentacam Family ®

Minimise risks and complications through the integration of biomechanical and tomographic data to treat more patients safely.

• Improve identification of refractive patient's at risk of developing corneal ectasia.

• Have a precise procedure for early detection of keratoconus available.

DV1499-0924

Get in touch

1800 225 307 enquiries@dfv.com.au dfv.com.au

Higher certainty in refractive screening.

The combination of corneal biomechanics and tomography increases the precision of refractive screening thanks to the Tomographic Biomechanical Index (TBI).

Screening values in comparison tp populations of healthy (green) and keratoconic (red) patients

Tomographic Biomechanical Index (TBI)

Belin / Ambrósio D value (Pentacam®)

4 Maps Refractive (Pentacam®)

Developed by Prof. Renato Ambrósio, the TBI is calculated using an artificial intelligence approach to optimise ectasia detection.

This index has the highest accuracy for the detection of subclinical keratoconus compared to all other tested methods.1

Understand the full story and customise the refractive procedure for each patient.

1 Ambrósio et al.: “Integration of Scheimpflug-1 based Corneal Tomographic and Biomechanical Assessments for Enhancing Ectasia Detection.”

Journal of Refractive Surgery, 2017 - Volume 33 • Issue 7: 434-443.

EXHIBITORS

RANZCO PREVIEW

SEE FIRST-HAND HOW ELLEX LASER DEVICES ARE MADE Lumibird Medical’s combined Ellex | Quantel Medical product portfolio offers a suite of advanced treatment solutions to drive greater value to ophthalmologist customers – much of which can be discovered at the congress.

On display will be the company’s range of multi-modality YAG lasers – including the latest Reflex Technology platforms spotlighting PROcap – and its retinal laser portfolio, providing some of the most advanced treatment solutions and covering a broad range of pathologies, the company says.

Furthermore, RANZCO delegates are exclusively invited to a ‘behind-the-scenes’ facility tour at the company’s Technolgy Park production site to see first-hand how Ellex's world-class ophthalmic laser devices are manufactured 100% locally from the ground up.

“This opportunity is a unique insight behind Ellex, its rich history and manufacturing medical device processes,” the company says.

Registration is available via the RANZCO delegate registration website.

Limited avaiablity.

Both: 25-28

REDEFINING OPHTHALMIC DAY SURGERIES Ophthalmologists are being encouraged to visit the Vision Hospital Group (VHG) booth to understand how the day hospital group can provide a new edge to their surgical work.

VHG prides itself on offering cutting-edge operating suites and specialist theatre teams in a seamless, well-managed environment. With 11 day surgeries across New South Wales, Victoria, Queensland, and South Australia, the network is “uniquely positioned to deliver exceptional care and optimal patient outcomes”.

“Accommodating over 100 ophthalmologists who perform more than 33,500 procedures annually in our specialised facilities, excellence in eyecare is not just our aim – it’s our standard,” VHG says.

“If you’re an ophthalmologist seeking a day surgery with world-class patient satisfaction (as evidenced by our net promoter score), competitive fees, contracts with all major health funds, and flexible session options, visit our booth.”

Interested parties can also contact Ms Kylie Bennett, national director of nursing, at kylie.bennett@visionhospitalgroup.com.au or 0409 443 636.

Booth: 63

78

INSIGHT October 2024

THE LATEST EVOLUTION OF iSTENT MIGS iStent technology has revolutionised the treatment of glaucoma in Australia and New Zealand since its introduction in 2016. Now, manufacturer Glaukos will showcase the latest innovation of its platform, iStent infinite.

As the smallest implantable device in the human body, the company says its technology has been a game-changer for patients diagnosed with glaucoma by effectively reducing eye pressure and medication burden – with more than one million successful implantations worldwide.

Approved by Australia’s TGA in 2024, the iStent infinite is designed to provide foundational, 24/7 therapy that gives ophthalmologists the power to deliver optimised treatment for patients with primary open angle glaucoma, currently treated with glaucoma medication including those who have failed prior medical or surgical intervention, while minimising the unwanted side effects of more invasive treatment options. iStent infinite is also listed on the Prosthesis List. Glaukos can provide more information and a hands-on dry lab on its booth.

Booth: 101 & 102

ZEISS DEBUTING MICROSCOPES In what is expected to be a busy four days on the ZEISS booth, the company is urging delegates to gain some hands-on experience with multiple product launches.

This includes the new ARTEVO 750 and ARTEVO 850 ophthalmic microscopes.

“Throughout the meeting you can join our short on-booth presentation sessionP s and hear directly from experts detailing their experiences with solutions from across the ZEISS Ecosystem,” the company says.

"Attendees can also join ZEISS on Sunday morning 3 November for a breakfast session where the focus will be placed on the diagnosis and treatment of retinal disease.

“The session will highlight the valuable role that ZEISS Retina Workplace plays in assessing retinal disease by bringing together multi-modality image."

Booth: P4

EXHIBITORS

RANZCO PREVIEW

PORTABLE VR SYSTEM TO SHINE ON BOC BOOTH BOC Instruments, a well established supplier and service provider for the national ophthalmc sector, will have a suite of reputable equipment on display at RANZCO. The company’s range includes Frey slit lamps, retinal cameras, Optovue OCTs, hand-held autorefractors, chair & stands, innovative dry eye products and acuity charts, plus more.

“We shall be demonstrating an evolution in visual field testing with the VF2000 NEO virtual reality portable field tester with eye tracking,” the company says. “This innovative device provides unsurpassed accuracy and efficiency at exceptional value as also includes abundant additional vision testing features.”

According to BOC, the VF2000NEO is extremely compact, and can be used anywhere. It provides the same reliability as the “gold standard”. The device is supplied complete with a tablet PC, test reports can be uploaded up to the cloud and accessed remotely through the user’s unique portal.

Booth: 81 & 82

OPTIMED SHOWCASING TAKAGI TECH Industry supplier OptiMed is marking its return to the RANZCO Congress with an expansive range of specialist ophthalmic equipment.

This includes products from Japanese precision manufacturing powerhouse Takagi with its new operating microscope.

On display will also be F.I.S.O refraction stands, the latest in an expanding range of high-end ergonomic solutions, and EssilorLuxottica will also be displaying its groundbreaking liquid crystal refraction instruments.

Booth: 95-97

RAYNER AND ITS SUITE OF CATARACT SURGERY PRODUCTS

OPTOS DEVICES TAKE CENTRE STAGE Optos is encouraging ophthalmologists to discover the future of retinal imaging by visiting its stand where the California and Silverstone devices will be on show.

According to the company, the California device offers unparalleled ultra-widefield imaging, capturing up to 200° of the retina in a single image, ensuring comprehensive examinations and early detection of retinal conditions. Meanwhile, the Silverstone model goes a step further by integrating ultra-widefield imaging with OCT, providing both structural and functional insights into the retina.

“These innovative tools are essential for any practice committed to delivering the highest standard of eyecare,” Optos says.

“Don’t miss the opportunity to experience firsthand how Optos technology can enhance patient outcomes and elevate your practice.”

At the Optos booth, delegates can see the devices in action and speak with experts about how they can transform their approach to retinal imaging.

Booth: 67

80

INSIGHT October 2024

Rayner is a British company and the only manufacturer of intraocular lenses (IOLs) in the UK. The company also has a presence in Australia and New Zealand with a comprehensive range of IOLs, ophthalmic viscosurgical devices (OVDs), the Sophi phaco system and HASA single use instruments.

There’s also RayPRO which is a comprehensive patient reported outcome measurements (PROMs) platform that allows clinics to gain essential data on patient outcomes which can be used to inform their approach.

Rayner’s flagship IOL is the RayOne EMV and EMV Toric. It’s an extending range of vision IOL delivering up to 1.5 D of high-quality vision when used with an emmetropic target.

“The range of vision can be extended further with a customisable offset for enhanced monovision outcomes,” Rayner says.

“Developed in collaboration with Professor Graham Barrett, RayOne EMV’s truly non-diffractive optic utilises positive spherical aberration to uniquely extend vision whilst avoiding the problems that can arise with diffractive lenses.”

Booth: 59-60

©2024 Rayner Group, all rights reserved. Rayner, RayOne, Sophi, HASA OPTIX and RayPRO are proprietary marks of the Rayner Group. Rayner, 10 Dominion Way, Worthing, West Sussex, BN14 8AQ. Registered in England: 615539. EC 2024-113 AU 05/24

EXHIBITORS

RANZCO PREVIEW

NEW DATA REAFFIRMS NOVATEARS’ STRENGTH NovaTears will be a major focus of the AFT Pharmaceuticals stand at RANZCO 2024 off the back of the pivotal Phase 3 Gobi study reinforcing its effectiveness as a treatment for evaporative dry eye.

NovaTears was first approved in Australia in 2018, and the recent Gobi study laid the foundation for FDA approval in the US in May 2023 where it is marketed as MIEBO. From as early as two weeks, the therapy demonstrated statistically significant and clinically meaningful improvements in the signs and symptoms of dry eye disease associated with meibomian gland dysfunction.

In Australia and New Zealand, AFT also supplies NovaTears + Omega-3, a variation of the original NovaTears eye drop that contains concentrated, high quality Omega-3 of plant origin to provide enhanced lubrication and protection for dry and irritated eyes.

AFT has a significant presence in the preservative-free dry eye space, offering a range of options such as HYLO Forte, HYLO Fresh, and Opti-Soothe heat and eyelid wipes.

Booth: 64

CSL SEQIRUS MARKS RANZCO RETURN Pharmaceutical company CSL Seqirus is continuing its support of the RANZCO Congress where it will showcase its two products for dry eye disease.

“Our friendly and knowledgeable team will be there and are always more than happy to answer any questions you may have about Cationorm and Ikervis (ciclosporin 0.1%),” the company says.

“Cationorm sample packs will be available to healthcare professionals across the duration of the conference. We look forward to seeing you.”

Booth 11-14

B+L’S NEW STANDARD-SETTING MICROSCOPE RANZCO will see the launch of Bausch + Lomb (B+L)’s new ophthalmic surgical microscope in Australia, SeeLuma.

The company says its fully digital surgical visualisation platform, equipped with 3D 55-inch and 31-inch monitors, promises to transform the way ophthalmic surgery is performed. The microscope, it says, is setting new standards in surgical precision while empowering ophthalmologists to deliver the best outcomes for their patients.

“The world’s first digital binoculars, intuitive user interfaces, and a design that allows surgeons to look straight at a heads-up monitor without having to twist their neck, make SeeLuma a game-changer in ophthalmic surgery,” B+L says.

With Mater Private Hospital Redland in Brisbane the first to have SeeLuma installed, congress delegates can see a demonstration of the microscope’s benefits on the B+L booth. They can also learn more at the B+L Symposium Breakfast on Saturday 2 November.

Meanwhile, B+L’s pharmaceutical business will have the Blink Dry Eye

82

INSIGHT October 2024

range on display too.

This includes blink Intensive Tears PLUS, which is a thicker, more viscous, advanced lubricating eye drop formulation that adapts to dry eye needs and provides long lasting relief. The drop has been specially formulated for enhanced ocular comfort, is recommended for both day and night use, contains hyaluronic acid, and is for moderate to severe dry eye.

Another product, blink Intensive Tears, will be a feature on the booth.

B+L says this advanced lubricating eye drop is formulated to provide protection and comfort for eyes that are dry, irritated or uncomfortable.

It too contains hyaluronic acid and may be used with contact lenses.

Booth: 15-20

TH E POW E R O F 3

The Beginning of the Interventional Glaucoma Revolution

infinite possibilities Brought to you by the founder of MIGS, iStent infinite® is built on the #1 MIGS platform worldwide and is designed to provide

powerful technology that delivers foundational, 24/7, long-term IOP control in glaucoma patients on ocular hypertensive

medications, including those who have failed prior medical and surgical intervention1. iStent infinite® can be performed in combination with cataract surgery or as a standalone procedure.

REFERENCE 1. Glaukos Data on File.

IMPORTANT SAFETY INFORMATION INDICATION FOR USE. The iStent infinite® Trabecular Micro-Bypass System Model iS3 is intended to reduce intraocular pressure in adult patients diagnosed with primary open-angle glaucoma (POAG) currently treated with ocular hypertensive medication. The device can be implanted with or without cataract surgery. CONTRAINDICATIONS. The iStent infinite System is contraindicated under the following circumstances or conditions: In eyes with primary angle closure glaucoma, or secondary angle-closure glaucoma, including neovascular glaucoma, because the device would not be expected to work in such situations; In patients with retrobulbar tumor, thyroid eye disease, Sturge-Weber Syndrome or any other type of condition that may cause elevated episcleral venous pressure. WARNINGS. Gonioscopy should be performed prior to surgery to exclude congenital anomalies of the angle, PAS, rubeosis, or conditions that would prohibit adequate visualisation that could lead to improper placement of the stent and pose a hazard. MRI INFORMATION. The iStent infinite is MR-Conditional, i.e., the device is safe for use in a specified MR environment under specified conditions; please see Directions for Use (DFU) label for details. PRECAUTIONS. The surgeon should monitor the patient postoperatively for proper maintenance of IOP. Three out of 61 participants (4.9%) in the pivotal clinical trial were phakic. Therefore, there is insufficient evidence to determine whether the clinical performance of the device may be different in those who are phakic versus in those who are pseudophakic. ADVERSE EVENTS. The most common postoperative adverse events reported in the iStent infinite pivotal trial included IOP increase ≥ 10 mmHg vs. baseline IOP (8.2%), loss of BSCVA ≥ 2 lines (11.5%), ocular surface disease (11.5%), perioperative inflammation (6.6%) and visual field loss ≥ 2.5 dB (6.6%). CAUTION. Please see DFU for a complete list of contraindications, warnings, precautions, and adverse events. © 2024 Glaukos Corporation. Glaukos® and iStent infinite® are registered trademarks of Glaukos Corporation. All rights reserved. PM-AU-0262

EXHIBITORS

RANZCO PREVIEW

BRILLIANCE ON THE ALCON BOOTH Image: Monkey Business Images/Shutterstock.com.

Alcon is encouraging delegates to join the company at RANZCO to experience how together they are “making a brilliant impact on lives, through innovation, for the planet”.

This includes offering choice for cataract patients by discovering how the IOL Clareon collection, alongside Alcon’s comprehensive patient education and practice resources, can enhance the patient experience.

Delegates can also hear about the company’s minimally invasive glaucoma surgery (MIGS) treatment, the Hydrus Microstent, and its effectiveness in glaucoma management and established long-term safety.

Optimising phaco surgery will also be a focus on the booth too, where ophthalmologists can learn more about fine-tuning their settings for enhanced patient comfort and surgical efficiency.

And in terms of experiencing complete, connected care, the Alcon Vision Suite will be on display. It’s a complete end-to-end product portfolio of diagnostic, visualisation and connectivity solutions that empowers practices to deliver excellent patient outcomes.

To reduce their environmental impact, ophthalmologists can also ask about Alcon’s custom packs and its plastic offset program.

During the Alcon Symposium, experts will discuss shaping the future of cataract surgery and ophthalmology together.

Booth: P3

EIKANCE 0.01% EYE DROPS TO SLOW MYOPIA PROGRESSION IN CHILDREN Eikance 0.01%, the first pharmacotherapy registered on the Australian Register of Therapeutic Goods to slow the progression of myopia in Children aged 4 – 14 years1#, may be initiated in children when myopia progresses ≥-1.0 D per year.1 EIKANCE 0.01% single-use ampoules are sealed in foil pouches and are available in packs of 30 x 0.3 mL ampoules.

The ophthalmic solution is sterile and preservative-free.

EIKANCE 0.01% is a private, prescription only medicine available at community pharmacies across Australia.

To access Product Information and PBS status, visit www.tga.gov. au/resources/artg/331960 Stand: 66 NOTE: Pack image not to scale.

References: 1.Eikance Approved Product Information # Australian Register of Therapeutic Goods. Accessed: 15 August 2023.

Aspen Australia, St Leonards NSW 2065. Prepared: August 2023. AU-ATR-082023-06771

LIGHT UP YOUR PRACTICE

PTS 2000 AUTOMATED PROJECTION PERIMETER FUNDUS-ORIENTED ESTERMAN PERIMETRY

Fast & Faster Thresholding

DPA™ Progression Analysis

Head Tracking

Blink Detection

Virtual Eye

For further information email sales@optimed.com.au Ph: 1300 657 720

Voice Guide

Images: petergardnerphotography.

OPTOMETRY

The OneSight team that delivered eyecare in Melbourne recently.

Delivering the gift of sight Many millions of people around the world have benefitted from the OneSight EssilorLuxottica Foundation’s clinics. EssilorLuxottica provides OneSight leave for the optometrists, retail and field teams to support communities to provide better access to vision care. Australian optometrist PETER GARDNER recalls his own experience helping people in Victoria and how the benefit of that work goes both ways.

I

t was such an immense privilege to be a team member on the OneSight Victorian regional clinic and I would like to take this opportunity to share my experience and show the work OneSight is doing in our communities in 2024.

My experience may encourage others to take part in future missions, if they have not yet had the chance to do so.

These clinics, supported by the OneSight EssilorLuxottica Foundation, have provided permanent access to vision care for 110 million people around the world so far this year, with 5 million spectacles and 2000 sustainable access points provided as well.

Australia, New Zealand and the wider Pacific Region OneSight have helped equip almost 60,000 people with a pair of spectacles, as they are working across multiple countries across the Pacific and have had almost 35 clinics involving 444 volunteers and helpers.

I have been taking part in OneSight clinics for several years, starting with the CrocFest events in the early 2000s, and I was thrilled when I got the news that I had been selected for this year’s Victorian Regional Clinic in June.

But the week turned out to be very different to my previous experiences.

Previously I had worked predominantly with kids’ school screenings or in remote communities used to visiting medical practitioners.

My experience at the Victorian clinic was something new, humbling and fulfilling.

Our core team of EssilorLuxottica volunteers comprised five optometrists from Perth (me), Brisbane, Sydney, Melbourne and Cairns, and six staff members from across the business, including some of our senior managers from head office, all led by the awesome Yolanda Roustan, the new clinic manager for OneSight. She is incredibly passionate and just loves her work, and I don’t think the smile left her face the whole week!

The team spent five days travelling to the suburbs of Melbourne, where we worked in conjunction with the Salvation Army, screening visual health and providing glasses to many people.

We travelled to five locations, working in Salvation Army centres, getting up at the crack of dawn and leaving our accommodation by 7am. After grabbing coffee, we set up our clinics to start at 9am and see as many people as possible each day.

The days were busy, and the Salvation Army team did a great job supporting those people who desperately needed care but were unable to afford even a pair of ready-mades.

Our set-up started with reception, where people were greeted and registered.

They were asked to complete a questionnaire so we had a basic history, often helped by Salvation Army volunteers for those who could not speak English or were unable to read or see the form.

“I had a few people I saw who left with huge smiles on their face after I handed them a pair of simple +2.00 readymades and they were able to read again for the first time in years.”

Peter Gardner Optometrist

INSIGHT October 2024

85

OPTOMETRY

Optometrist Tiffany Lee, from OPSM Southland in Melbourne, helps a patient during the Victoria OneSight clinic.

From there they moved on to the vision station where entering visions were recorded. Auto refraction followed, before the patient was handed over to the optometry team for history and symptoms, IOP’s and fundoscopy.

At this point, if ocular health was clear and vision was satisfactory, the patient was discharged. Often patients just needed a pair of readers, which, for them, could improve their quality of life by helping them to fill out an online form or job application.

I had a few people I saw who left with huge smiles on their face after I handed them a pair of simple +2.00 readymades and they were able to read again for the first time in years.

On quite a few occasions we identified patients with high IOP’s, advanced diabetic retinopathy, or visually significant cataracts.

While the OneSight clinic is a screening and dispensing clinic and not set up for ophthalmology referrals, where screening identified a condition requiring

referral, we were able to direct patients to the hospital eye department or provide a referral back to the local OPSM store for follow up and management.

This Included one lady with a suspected retinal tear, who was seen at her local store for dilation that afternoon. We provide vision vouchers so that ongoing care within OPSM can be free of charge.

From the eye health station, patients who needed correction were seen at the refraction station. A final script was provided by the optometrist, who then handed the patient over to our dispensing team. For simple scripts we had a selection of three frame styles with a bank of ready cut spheres, which could be clipped into the frame, and the patient could leave with a new pair of glasses.

For higher spheres and cyls, the glasses were ordered to be made up and then collected from the Salvation Army over the following month.

Our 11 team members were supported daily by local optometrists and store staff, and I was incredibly grateful to those people who gave up their day off to help us.

Over the week, we had the best part of a thousand people come through the doors. Of these, 501 patients were refracted, 109 people left with glasses that day, and 377 pairs of glasses were made to order. Forty-seven people were issued with vision vouchers and referred back to a local OPSM practice for follow up and further management.

As is always the case, the week was over all too soon. It was an honour and privilege to work with such an awesome team of professionals who all did such a fantastic job.

I can’t thank the other team members enough for their hard work and dedication over the mission.

Overall, the week was a truly humbling and emotional experience. A big thank you to OneSight for the opportunity.

NOTE: For more information on Onesight, visit: onesight.essilorluxottica.com

See more, know more with Insight Insight’s new website keeps you updated on the latest industry news and information. With a world-class responsive design, Insight is now accessible seamlessly on any device, 24/7.

Sign-up FREE to our eNewsletters and industry reports delivered weekly straight to your inbox.

Get to know the newest products from suppliers across Australia

www.insightnews.com.au

Find jobs and advance your career with Insight’s Classifieds

Insight is mobile and tablet friendly

PEARLS FROM AN EXPERIENCED HAND Name: Lyn Simeon Position: Practice manager Location: Teachers Health Centre, Parramatta, NSW. Years in industry: 53

1. What attracted you to optical dispensing?

Leaving school after year 10 and not feeling a career in the bank was for me, I applied for a traineeship with OPSM and completed my Cert IV in Optical Dispensing. Working in numerous Sydney stores and climbing the ladder to manager, I was eventually responsible for employing and training new staff obtaining their optical dispensing licenses and would train them in cutting and fitting in-store. I also became the lens specialist for the region, supporting those with difficult prescriptions.

My time at OPSM spanned 35 years but I was interested in new opportunities, so jumped ship with our optometrist who opened her own business. This was quite a change from corporate to private, and I stayed as manager for seven years, including some casual work at Specsavers Blacktown. After flirting with other opportunities, suddenly a job came up at Teachers Eyecare Parramatta, and now I have worked as the center manager of eyecare, dental, and membership for 11 years.

2. What are your career highlights?

Achieving my dispenser’s licence stands out, but helping train new staff was an ongoing highlight. Another has been winning numerous excellence in customer service awards whilst manager of OPSM Wetherill Park and as manager at Teachers Health Centre Parramatta. It showed how I managed staff to make customer service the most important part of business, along with professionalism, knowledge, skills and friendliness. Contacting The Children’s Hospital at Westmead and setting up the supply of free spectacles for children whose parents are unable to afford them, and given support from Teachers Health to do this, was memorable. An 8-year-old saying, “Thank you for giving me glasses that my dad could not afford”, brought a tear to my eye.

3. What are your strengths as an optical dispenser?

My experience, my love of training and my customer relationships. Return visits are the way to keep and build your business in a competitive market. To stand out you need good customer skills, training, knowledge and presentation. I come from a teaching family and feel I’ve achieved it in my own field. Nothing excites me more than a new employee with no experience becoming an amazing optical dispenser that our patients and customers will ask for.

4. What advice would you give to yourself at the beginning of your career?

You should complete a Cert IV in Optical Dispensing training.

5. What are the key opportunities and challenges facing optical dispensing?

In an ever-growing industry, you need something different and better than your competitors. Since deregulation, there are many unskilled people with no understanding of optics.

To maintain a level of education, like ODA is offering, is the only way you can offer the level of service and understanding patients deserve.

Not only their sight, but their appearance is in your hands. Correct fitting and adjustment of their frames, correct lenses for their prescription, quality of products and, of course, the trusting relationships you build. Ongoing education through online courses or in-store training is essential.

at 6.30am and finishing at 8-9pm, arriving back after two- to three-hour drives from the rural areas we visited. ODA left its footprint in all the schools we visited, screening students, teachers and elderly villagers and supplying free glasses.

7. What would you say to others thinking of joining ODA? I have encouraged my junior optical dispenser and senior casual optical dispenser to join and would encourage the same for everyone else. It has a great support program and resources.

You can liaise with others in the industry and, perhaps like me, form great friendships.

Education has played a big part in my life and I’m forever encouraging people to continue learning, no matter how long they’ve been in the industry. ODA will ensure you get all the up-to-date information and training.

BELOW: Lyn Simeon says customer service is the most important aspect of optical dispensing, along with professionalism, knowledge, skills and friendliness.

6. Why did you become a member of ODA? I saw an opportunity to continue learning and hear new ideas from colleagues from different states and practices. Even though I’ve spent my whole life in optics, ODA has taught me many new things. I have also built some wonderful relationships, with the pinnacle being the recent Fijian outreach program. I have a passion to give back to communities and have been a weekend respite foster carer for nine years now.

Giving the gift of sight to those less fortunate than us is mind-blowing. The smiles on children’s faces in Fiji and the elderly with sight problems was unforgettable. The group of 10 dispensers and two optometrists were put to the challenge of living together in humble accommodation and working long days starting

Images: Lyn Simeon.

DISPENSER DETAILS

Founded in 2022, OPTICAL DISPENSERS AUSTRALIA’S mission is to transform the optical dispensing industry by creating a community where optical dispensers and their associates can feel supported and inspired through education, events, networking, and employment advice, plus more. Visit: www.odamembers.com.au

INSIGHT October 2024

87

OPTICAL DISPENSING

DEMENTIA-FRIENDLY DISPENSING Image: XMarianne Coleman.

What is dementia and why do we need dementia friendly eyecare? In the first instalment of this two-part series, MARIANNE COLEMAN and ELAINE GRISDALE explain the relevance to optical dispensers.

Image: Elaine Grisdale.

DR MARIANNE COLEMAN

ELAINE GRISDALE

“RECENTLY, A MAJOR REPORT FROM LEADING MEDICAL JOURNAL THE LANCET ADDED UNTREATED SIGHT LOSS TO THE LIST OF RISK FACTORS FOR DEMENTIA.”

WHAT IS DEMENTIA, AND WHAT IS IT NOT? • Dementia is an umbrella term for diseases with symptoms caused by accumulation of protein in different areas of the brain. Although we may be familiar with some common types of dementia, such as Alzheimer’s disease or vascular dementia, there are over a hundred different types of dementia (Futurelearn, 2018).

•D ementia is a leading cause of disease burden in Australia, even ahead of other conditions such as cancer. It is estimated that 411,100 Australians were living with a dementia in 2023, with numbers

IMAGE: Andrey Sayfutdinov/Shutterstock.com.

BELOW: An ordinary eye examination and associated communication can be mentally exhausting for some people with dementia.

A

round the world, people are living longer. This increase in the ageing population is accompanied by an increase in the prevalence of dementia, the most common neurodegenerative condition worldwide. This means increasing numbers of people living with dementia will be seeking eyecare, for simple refractive error and for age-related ocular pathologies.

What does this mean for optical dispensers? This two-part article will provide an overview of common features of dementia and how they may impact an everyday visit to your practice, or eyecare activities in residential aged care. We will share simple yet impactful changes to create a dementia-friendly eyecare experience.

88

INSIGHT October 2024

projected to double by 2058 (Australian Institute of Health and Welfare, 2024) • Dementia is not a normal part of ageing, but it can affect many older people (almost one in 10 aged over 65 in Australia).

• Dementia is not just a memory problem. Some types of dementia can start with communication difficulties or changes in mood or behaviour, with memory relatively unaffected.

WHY DOES GOOD EYESIGHT MATTER IN DEMENTIA? Being able to see well is very important to both people with dementia, and the people who support them. The 2022 World Alzheimer’s report identified that looking after the senses for people with dementia enables them to be and do what matters most to them in their daily lives (Alzheimer’s Disease International, 2022). Two thirds of people with dementia live in their communities, and we all want to live in our own homes as we age, so maintaining independence and daily activities is important.

Recently, a major report from leading medical journal The Lancet added untreated sight loss to the list of risk factors for dementia (Livingston et al, 2024). Emerging evidence suggests that having well-corrected vision (and hearing) can improve quality-of-life and independence for people with dementia (Littlejohn et al., 2022). Sight loss and dementia, when experienced together, can make things challenging for people with dementia and their carers/ supporters. Good eyesight can support a sense of time and the use of visual aids to memory, such as reminder boards or assistive technologies. Essentially, poor eyesight can cause many problems for people with dementia, and is not uncommon (Aldridge and Newsome, 2022).

A previous UK study (Bowen et al., 2016) found up to one in three people with dementia can experience some level of sight loss, and over 40% of this was remediable through simply updating or replacing spectacles.

There is a huge role for eyecare

professionals in dementia care. We must work together to help people with dementia have a great experience when having their eyes tested, and when interacting with eyecare professionals.

We want people to go away happy, and seeing as well as possible. That is “dementia-friendly eyecare”.

HOW CAN DEMENTIA IMPACT THE WORK OF DISPENSERS? It is helpful to have an understanding of some key features of dementia, and how these may impact the eye test and any subsequent dispense: 1. Cognitive fatigue: An ordinary eye examination and associated communication can be mentally exhausting for some people with dementia.

2. D ifficulties with decision-making: This can be personal or financial.

3. R esponsive/changed behaviours: Previous research suggests that anxiety and agitation are key behaviours that some people with dementia may experience when visiting for an eye test. Watch for hand-wringing, avoidance of eye contact or abruptly leaving the room.

4. Memory loss: Misplacing glasses or accessories, appointment non-attendance.

5. Altered perception: Spatial vision for navigation and depth perception can be affected. Time perception can be affected too – a short wait can feel like an eternity.

How can we help people with dementia to have a great eyecare experience? Stay tuned for top tips in Part 2 of this article in the November issue of Insight.

NOTE: References will be available upon request and in the online version of this article.

ABOUT THE AUTHORS: Marianne Coleman works within the National Centre for Healthy Ageing at Monash University & Peninsula Health.

Elaine Grisdale is the director of development at the International Opticians Association and scientific director of the SILMO Academy.

BRINGING VISION TO THE OUTBACK BEN WHITHAM shares his experience working as a senior orthoptist with the Outback Eye Service, reflecting on the challenges and rewards of providing crucial eyecare to remote communities in NSW.

BEN WHITHAM

“I OFTEN RECEIVE FEEDBACK FROM THE LOCALS ABOUT HOW LUCKY THEY ARE TO HAVE THE EYE TEAM VISIT THE TOWN, BUT I FEEL AS THOUGH I AM THE LUCKY ONE TO HAVE FOUND A CAREER THAT IS AS EQUALLY FULFILLING.”

Images: Ben Whitham.

I

have experienced four plagues in my life, and all of them have been while working as an orthoptist in remote NSW over the past 12 years. They were mice, locusts, fall armyworm moths and stink bugs, each somehow finding their way into my bed after a very long day’s work.

I always joke about how, once a month, I have the world’s longest commute. The alarm goes off at 4:45am. I drive my car to Bankstown Airport. I get a taxi to Sydney Airport where I enjoy a coffee among the bustling business people. I fly to Dubbo, collect a car from the hospital and set off on the four-hour drive due north-west to my final destination: Bourke, New South Wales.

Nine hours away from the warmth of my bed, I start the process of setting up the IOLs in numerical order and calibrating the diagnostic and surgical ophthalmic equipment. If there has been a rain shower, I have to phone the local shire to confirm the roads are still open so the community transport can get through.

I also must ensure every patient on the surgery list for the next two days has overcome any roadblocks that might prevent them accessing their surgery These are the final steps to ensure the next two days run smoothly. The pressure is on: months worth of phone calls, ordering, social work, transport bookings, accommodation reservations and linking medical services with government services will come to a head, and 17 patients will access potentially life-changing cataract surgery in their own backyard.

But it hasn’t always been this way.

Professor Fred Hollows pioneered this remote vision care in the 1970s, recognising a significant gap for Aboriginal and Torres Strait Islander communities in remote NSW. Some 50 years later – and against the odds – we deliver a remarkably resilient and comprehensive ophthalmic service called the ‘Outback Eye Service’. This is headed by the Department of Ophthalmology at Prince of Wales Hospital and has expanded to 16 ophthalmologists, two nurses and I; the senior orthoptist.

My training in orthoptics has been

ABOVE: On an outback trip, Dr Helmut Yu (from left), Ben Whitham and Dr Gayatri Banerjee.

instrumental in delivering high-quality care, enabling me to screen, diagnose, and manage eye conditions effectively.

This comprehensive approach ensures that patients are treated promptly and appropriately, often reducing the need for them to travel long distances to access care.

Looking back, there are countless stories of memorable moments, tears, hardships but – most of all – some good old-fashioned yarns. These have become the stories I get to share with my friends, family and colleagues. For example, a patient forgot their post-operative drops after attending the day-one check. This ended with me leaning over a remote property gate, yelling the patient’s name as loudly as I could while I was confronted by two hungry dogs trying to eat me through a fence that had seen a few too many summers.

Some people experience more hardship than others, for a multitude of reasons. It has taken me many years to gain the knowledge and skills necessary to recognise those challenges and barriers to ensure each patient is equal.

But it goes beyond this. For clinicians, adopting a diverse, patient-centred approach is crucial. This not only ensures that all patients can access the same services but also means when clinicians provide certain resources and apply their knowledge, they can make patients feel able, comfortable, and willing to seek

care. It is this, in my experience, that differentiates the city and the country, the private and the public.

This approach can only be established by building rapport with the local community. I have visited the same towns for so many years that I have become well-known and recognised. For example, I can shop locally at a supermarket near my home and only get acknowledged by the odd parent from my child’s local school. But, when I am in Bourke, someone would spot me refuelling the car and pull over to ask me about a pain in their eye and what drops I think they should use.

I often receive feedback from the locals about how lucky they are to have the eye team visit the town, but I feel as though I am the lucky one to have found a career that is as equally fulfilling to me as it is essential to the patient.

ABOUT THE AUTHOR: Ben Whitham is senior orthoptist at Prince of Wales Hospital. He completed a Bachelor of Applied Science (Orthoptics) from Sydney University in 2006. He spent the first part of his orthoptic career working in private clinics across southern Sydney and joined a volunteer group of eyecare professionals on a mission to Peru and later continued his work in outback NSW. ORTHOPTICS AUSTRALIA is the national peak body representing orthoptists in Australia.

OA’s Vision is to support orthoptists to provide excellence and equity in eye health care. Visit: orthoptics.org.au

INSIGHT October 2024

89

MANAGEMENT

A CHANCE FOR PRACTICE MANAGERS TO LEVEL UP

LARA SULLIVAN “I’M EXCITED ABOUT THE IMMERSIVE AND COMPREHENSIVE PRACTICE MANAGERS’ SCHEDULE OVER THREE DAYS, ADDRESSING THE MOST PRESSING ISSUES IN HEALTHCARE MANAGEMENT AND OPHTHALMOLOGY.”

90

P

ractice managers are often the unsung heroes of ophthalmology practices across Australia – forever implementing business and clinical frameworks so that ophthalmologists are unburdened to concentrate on what they do best.

To drive best practice in areas like business and practice management, communication, Medicare changes, HR regulations, health funds and cyber security, ophthalmic practice managers have become more organised and professional over the years, supported by RANZCO. Most notably, practice managers have a dedicated stream during RANZCO’s Annual Scientific Meetings. Early on, Mrs Colleen Sullivan from Queensland was a driving force in getting the speakers and program together. And in 2007 RANZCO introduced a new Associate Member category for ophthalmic practice managers, enabling them to be part of RANZCO memberships.

As we gear up for the next RANZCO Congress in Adelaide, I’m excited about the immersive and comprehensive practice managers’ schedule over three days (1-3 November), addressing the most pressing issues in healthcare management and ophthalmology.

It covers so much: leadership, becoming an employer of choice and ‘greening’ ophthalmology. Mr Tim Wong, a super engaging speaker, will discuss something all practice manager’s know well – managing difficult conversations.

Other thought-provoking sessions include Ms Lisa O’Neill, author and motivator, who will leave the audience inspired with her discussion on “leading with energy and authenticity”. We’re also excited about filmmaker Ms Tsu Shan and her glimpse into movie production and the use of this platform to tell the story of those suffering visual problems.

We instituted a ‘Focus on a Fellow’ session some years ago to learn more about the personal interests and passions of RANZCO fellows. This year Associate Professor Alex Hunyor will speak about his voluntary work with a large veterinary practice providing ophthalmic care to all sorts of creatures.

Another one to watch is Mr Matthew

INSIGHT October 2024

Image: RANZCO.

Image: Xxx

With ever-increasing demands on clinic compliance, HR and cyber security, so much falls on the practice manager’s shoulders.

But it’s important to stop, upskill and return to the clinic a better leader, writes LARA SULLIVAN.

ABOVE: Tim Wong, presenting here in 2023, is returning the RANZCO Practice Manager’s Conference to discuss handling difficult conversations.

Cameron, from Vibe IT, and his discussion on cybersecurity and AI. With AI being the way of the future, we need to be on the front foot, so this is essential listening.

CONFERENCE DETAILS To kick off the conference, practice managers will join the main RANZCO session along with the fellows for a Welcome to Country and Congress Opening. This will be followed by a keynote speech from Mr Tim Jarvis, an adventurer and environmental scientist, setting the tone for the event.

Practice manager delegates will then head to the Riverbank rooms for sessions on medico-legal issues such as managing confronting situations and positive duty in the workplace. The day closes with a session on sustainable ophthalmology by Dr Jesse Gale, emphasising cost-effective and eco-friendly practices.

Sessions to watch out for on the second day include a discussion on the top three risks for ophthalmology and a focus on frontline leadership in healthcare by Epigroup’s Mr Alan Stevenson, a highly rated speaker in previous years.

Packed sessions are also expected on positive workplace culture by business consultant Mr Danny Haydon. The day ends with a special dinner for practice managers at Strathmore Hotel, offering a chance to

network and reflect on the day’s learnings.

The final day of the conference dives into future-facing topics. For example, delegates can gain insights into leveraging social media for ophthalmologists by CEO and founder of Puzzle Media Ms Tina Hay who will also cover Ahpra compliance.

The conference will round out with a presentation on the use of AI in healthcare and, a crowd favourite, Mrs Colleen Sullivan discussing the principles of healthcare practice management. Financial governance will be the final session by Ms Moira McInerney from Monash University, wrapping up with feedback and planning for 2025.

We’re excited with the program cultivated for 2024 that promises to equip practice managers with the tools, knowledge, and connections to navigate the evolving landscape of healthcare and ophthalmology.

As always, the committee is dedicated to curating an excellent Congress to educate and inform our delegates, who are committed to supporting RANZCO fellows.

ABOUT THE AUTHOR: Lara Sullivan is chair of the RANZCO Practice Managers’ Advisory Group and co-founder and director of Bayside Eye Specialists, a multi-disciplinary specialist practice in Victoria.

SOAPBOX

Image: Daisy Shu.

FROM DOWN UNDER TO HARVARD

BY DR DAISY SHU A few years ago, I would have baulked at the idea of trading the sunny beaches of Sydney for the coldscape of Boston.

Smuggly. Probably with a flat white in hand because, let’s be honest, the coffee in Sydney is on point (despite what Melbourne readers might have you believe). But life, as it turned out, had other things in mind.

It began during my optometry school days at UNSW Sydney. I got a taste for research thanks to Associate Professor Michele Madigan during a summer vacation research scholarship in my penultimate year. While my friends were hitting the beach, I found myself dissecting eyeballs and culturing cells – and loving every minute of it. There’s something strangely satisfying about understanding how things work at such a fundamental cellular level. After graduating, I worked as an optometrist for a couple of years, seeing countless patients with age-related eye diseases like cataract and age-related macular degeneration. Many weren’t improving with current therapies, and it spurred me to consider research as a way to develop novel therapeutics for these conditions.

So, I made a big decision. I traded my optometry uniform for a lab coat.

I enrolled in a PhD at the University of Sydney with Professor Frank Lovicu, focusing on cataract and growth factor signalling – essentially, cell-to-cell communication, like text messages between cells, but with much higher stakes.

When these messages go awry, it leads to pathologies, involving processes such as epithelial-mesenchymal transition (EMT) and wound healing. The transition from clinical optometry to the world of cell and molecular biology was a huge challenge. I suddenly found myself in a lab with nitrile gloves on my hands, trying to figure out how to handle antibodies and perform techniques like western blotting, immunofluorescence, confocal microscopy, and qPCR. But I had a great, supportive supervisor and lab mates who made all the difference.

In 2018, during my PhD candidature, a three-month research stint at Schepens Eye Research Institute of Harvard Medical School, cropped up in the lab of the late Professor James Zieske’s. There, I delved deeper into growth factor signalling, but this time in the context of corneal scarring.

Here, I met Associate Professor Magali Saint-Geniez, who would later become my postdoc supervisor. She offered me a position to work on macular degeneration, still focusing on EMT but with an emphasis on metabolism and mitochondria driving

these processes. I didn’t hesitate to accept.

So after completing my PhD, I packed my bags and headed back to Harvard in 2019, where I spent my postdoc years exploring the intricate ways in which metabolism influences retinal diseases.

The research was challenging, the winters were brutal but I wouldn’t have traded it for anything. The friendships during this time – fellow researchers who shared late nights, early mornings, and the excitement of discovery – became some of the most important relationships in my life.

But soon enough I began to yearn for the flat whites and sandy flats. After almost five years of navigating the imperial system and ordering cold brews at Dunkin' Donuts, I returned to Sydney in 2023. I was fortunate to be offered a position as a Scientia Senior Lecturer at UNSW. When I first landed, the sun was shining, the air was warm, and the coffee was aromatic. Coming home felt like slipping into a pair of jeans that fit just right, comfortable, familiar, and perfectly broken in. But I wasn’t the same person who had left. I had a suitcase full of new ideas.

Now, at UNSW, I’ve come back full circle to where it all began, building on everything I learned at Harvard. My lab focuses on developing novel metabolic targeting drugs to treat macular degeneration and exploring innovative drug delivery options. We’re continuing to push the boundaries of what we know about retinal diseases, always looking for new ways to help the patients who inspired this journey in the first place.

So here’s my advice: If you ever get the chance to do something bold – like moving across the world, shovelling snow, and trying to figure out if 32°F is warm or cold – do it. Jump in with both feet. The world is big, and it’s full of surprises. And trust me, the adventure is worth it.

Name: Dr Daisy Shu Qualifications: BOptom (First Class Hons), BSci, PhD, FAAO Affiliations: UNSW Location: Sydney Years in industry: 12

WHILE MY FRIENDS WERE HITTING THE BEACH, I FOUND MYSELF DISSECTING EYEBALLS AND CULTURING CELLS ... THERE’S SOMETHING STRANGELY SATISFYING ABOUT UNDERSTANDING HOW THINGS WORK AT SUCH A FUNDAMENTAL CELLULAR LEVEL.

INSIGHT October 2024

91

SP E C S AV E R S S T O R IE S: V I R G I N I A C A R LT O N WHY DID YOU PURSUE AN OPTOMETRY CAREER?

CHANGING LIVES THROUGH BE T TER SIGHT AND HE ARING

I’ve always had a passion for helping people and wanted a career in healthcare. I originally had a scholarship to study physiotherapy but having both my older brothers working in that field, I wanted to branch out to something different. One morning dad was reading the paper and read that Deakin was starting a new optometry school and that’s where my passion began. I started researching optometry and all the amazing things that optometrists can do and from there it was an easy decision.

HOW DID YOU COME TO WORK AT SPECSAVERS?

I had always seen the Specsavers ads on TV but didn’t really get exposed to the business until university when selecting my final six months of placement. The support office team talked to us and I was surprised and impressed at the guidance they were providing students with mentoring, selection of the right store location and more. Exposure to so many different types of patients due to the volume of patients also impressed me.

It was an easy decision and a great learning ground. I also had an optical dispensing opportunity in my preferred location (Waurn Ponds and Belmont), four weeks before the beginning of my placement. This gave me valuable insights into the retail side of the business as well as the store culture.

I knew then that this was a company I wanted to be a part of.

WHAT WAS YOUR FIRST ROLE WITHIN THE BUSINESS?

SPECSAVERS STATS Name: Virginia Carlton Current position: Clinical performance consultant VIC/TAS Location: Geelong Years within the business: 9

I was fortunate to be offered a graduate position while I was on my final placement. It was the perfect start in the industry.

I had an amazing opportunity to work between two stores that each had varied patient demographics.

Working in a L-XL store meant I had an excellent support network. I worked alongside seven optometrists who had an open-door policy for advice and support, allowing me to pick up many tips and tricks to assist me with varied clinical presentations as a graduate.

Specsavers YOUR CAREER, NO LIMITS

SO LET’S TALK! In a few short years, Specsavers has achieved market leadership in Australia and New Zealand with more people choosing to have their eyes tested and buy their prescription eyewear from Specsavers than any other optometrist. To learn more about these roles, or to put your hand up for other roles as they emerge, please contact us today: Joint Venture Partnership opportunities enquiries: Carly Parkinson on +61 (0) 478 201 057 or E carly.parkinson@specsavers.com Optometrist employment enquiries: Specsavers Recruitment Services anz.srsdepartment@specsavers.com Locum employment enquiries: ANZ.locumteam@specsavers.com Graduate employment enquiries: apac.graduateteam@specsavers.com

Visit spectrum-anz.com

WHAT GROWTH OPPORTUNITIES HAVE PRESENTED THEMSELVES? There have been many. I had the chance to become a graduate mentor and support young optometrists through their first two years in store. While I was doing this, the support office, and in particular the Graduate Department, had me present to Deakin students about joining Specsavers.

Around two years ago, I joined the Clinical Services Department within the support office as a clinical performance consultant for Victoria and Tasmania.

Our goal is to support our partners and team members in store to deliver consistent and exceptional service.

This role has helped me develop my public speaking, training abilities, influencing experience, leadership skills and more.

CAN YOU OUTLINE YOUR TOP CAREER HIGHLIGHTS AT SPECSAVERS? There are so many highlights due to the variety in each day. Some include: Seeing personal and professional development in graduate optometrists I’ve mentored along their journey to owning their practices; exposure to international stakeholders and having the opportunity to show them how we work in Australia; and winning the Support Office Excellence Award in November 2022.

WHAT EXCITES YOU MOST ABOUT TURNING UP FOR WORK EACH DAY? Each day brings a unique experience. It’s an honour to positively influence our patients’ lives by supporting our partners, optometrists, and in-store team members to deliver exceptional service daily. What’s even better is that I get to work alongside an amazing team and department who not only keep me motivated but make the whole experience more enjoyable and exhilarating.

ALL SPECSAVERS STORES NOW WITH OCT Optometrist Joint Venture Partnership Opportunity – Swan Hill, VIC We are currently on the lookout for expressions of interest for an Optometrist to join Specsavers as a Joint Venture Partner in our brand-new store opening in Swan Hill, Victoria. Swan Hill is a vibrant city in Victoria’s northwest that blends regional charm with urban convenience. Situated along the picturesque Murray River, the city boasts stunning riverfront views, fresh produce, and a warm climate. With an array of outdoor recreational activities, cultural attractions, and a welcoming community – Swan Hill has something to offer everyone!

Optometrist Joint Venture Partnership Opportunity – Katoomba, NSW Specsavers have an amazing opportunity for an Optometrist looking to accelerate their career by becoming a Joint Venture Partner within our well-established Katoomba store.

Specsavers Katoomba is located in a high street location with a large established database of loyal patients. The store is 160sqm in size with 2 Optical test rooms, 4 dispense desks, over 1100 frames on display, and state of the art equipment including OCT. Full-Time Optometrist Opportunity – Specsavers Orange, NSW Specsavers Orange is looking for an Optometrist to join their experienced and supportive environment. Thrive in a team with opportunities for continuous professional development and career progression, including Pathway to Partnership. Our Orange store has a proven track record of guiding team members successfully through the partnership journey. Expand your skills by working with a varied demographic, with a special focus on Orthokeratology in a 4-test room store. A relaxed lifestyle in a beautiful regional city known for stunning natural scenery and welcoming community. There are also numerous recreational options in the region, including exploring the nearby wineries and hiking Mt Canobola.

Optometrist opportunity – Specsavers Invercargill, NZ Seeking a talented optometrist to join our extraordinary team at Specsavers Invercargill.

We offer cutting-edge technology, a friendly environment, and a commitment to professional growth. Embrace the relaxed pace of life and enjoy a perfect work-life balance.

Explore stunning coastal views and enjoy a fantastic outdoor lifestyle. Don’t miss this incredible opportunity to be part of Specsavers Invercargill.

Graduate Opportunities Looking at starting your career with a dedicated mentor to support you during your first steps in the Optometry community? Specsavers are the largest employer of Graduate Optometrists across Australia and New Zealand and we have continued to develop our comprehensive two-year Graduate Program, providing a support network and structured program to assist you in your development.

EVENTS CALENDAR Image: ODA.

Image: Tinxi/Shutterstock.com.

To l i s t a n e v e n t i n o u r c a l e n d a r e m a i l : m y l e s . h u m e @ p r i m e c r e a t i v e . c o m . a u

ODMA Fair is returning to the International Convention Centre in Sydney’s Darling Harbour precinct in June 2025.

MARCH 2025 100% OPTICAL Optical Dispensers Australia is collaborating with the International Opticians Association for its biennial two-day dispenser conference in Sydney in March 2025.

EYECARE PLUS NATIONAL CONFERENCE & AGM Sydney, Australia 18 – 19 October eyecareplus.com.au/conference/

NOVEMBER 2024 RANZCO CONGRESS 2024 Adelaide, Australia 1 – 4 November ranzco2024.com

ORTHOPTICS AUSTRALIA CONFERENCE Adelaide, Australia 2 – 4 November orthoptics.org.au

FEBRUARY 2025 MIDO EYEWEAR SHOW Milan, Italy 8 – 10 February mido.com

ODA INTERNATIONAL CONFERENCE Sydney, Australia 7 – 8 March odamembers.com.au

JUNE 2025

ANZGS CONGRESS

ODMA FAIR

Perth, Australia 14 – 16 February anzgsconference.com/

Sydney, Australia 27 – 29 June odma.com.au

Image: Tinxi/Shutterstock.com.

OCTOBER 2024

London, UK 1 – 3 March 100percentoptical.com

ASIA-PACIFIC VITREO-RETINA SOCIETY CONGRESS Singapore 22 – 24 November 2023.apvrs.org

SILMO ISTANBU Istanbul, Turkey 23 – 24 November silmoistanbul.com

DECEMBER 2024 INTERNATIONAL SOCIETY OF OCULAR ONCOLOGY Goa, India 3 – 7 December isoo2024.com

MIDO in Milan will have seven pavilions and eight exhibition areas to highlight the whole sector, including lenses, machinery, frames, cases, materials, and practice furniture.

INSIGHT October 2024

93

CAREER

People

on the move

HOYA APPOINTS NSW STATE SALES MANAGER

Glen Jones has been appointed as the new NSW State Sales Manager for HOYA Lens Australia.

With five years’ experience within the company’s sales team, he has become a key figure, bringing extensive expertise in both wholesale and retail markets. In this leadership role, all NSW sales consultants will report to Jones.

Associate Professor Lauren Ayton has joined the Centre for Eye Research Australia (CERA) executive team. She is known as a champion for innovation in vision research and her passion for improving the lives of people living with vision loss and blindness.

A/Prof Ayton takes on this new role alongside her current senior positions at CERA and the University of Melbourne, Department of Optometry and Vision Sciences while continuing engagements with patient advocacy, industry and eyecare professional groups.

Image: CooperVision.

COOPERVISION PROMOTES FROM WITHIN FOR NEWLY CREATED APAC ROLE

Shannon Morrow has been appointed to the role of Head of Communications, APAC, at CooperVision.

In this newly created role, she will be responsible for building the reputation of the CooperVision brand with external and internal audiences, driving master brand communications, campaigns and ESG initiatives with customers, industry and the public, and supporting the APAC leadership team with communications and team engagement programs.

Morrow was previously Marketing Communications Manager for CooperVision ANZ.

Image: Rodenstock.

Image: HOYA.

OptiMed, part of EssilorLuxottica and a leading supplier of diagnostic instruments, pharmaceuticals, dry eye solutions and ancillary items for eyecare professionals, has appointed “highly-experienced industry maverick” Will Robertson to its sales team. Well known in the industry as a successful sales and relationship professional he brings “strong technical grounding and a tremendous amount of knowledge in ophthalmic instruments”.

With more than 23 years’ experience, his practice ‘know how’ and ‘can do’ attitude adds a further layer of customer relationship experience to the growing group synergies, OptiMed said.

A/PROF LAUREN AYTON ELEVATED TO CERA EXECUTIVE TEAM

Image: HOYA.

‘HIGHLY EXPERIENCED INDUSTRY MAVERICK’ JOINS OPTIMED

Image: Anna Carlile/CERA.

Image: OptiMed.

INSIGHT'S MONTHLY BULLETIN TO KEEP THE AUSTRALIAN OPHTHALMIC SECTOR UPDATED ON NEW APPOINTMENTS AND PERSONNEL CHANGES, NATIONALLY AND GLOBALLY.

NEW SALES CONSULTANT ‘A PERFECT FIT’ FOR HOYA’S VISION

Mavis Nissirios is a new NSW Sales Consultant for HOYA. She brings two decades of optical industry experience. “Having worked in various retail environments, she has honed her skills and deepened her knowledge, making her a perfect fit for our company’s goals and vision,” HOYA stated.

“Mavis’s expertise will be a tremendous asset as we continue to grow and innovate in the optical field.”

DO YOU HAVE CAREER NEWS TO SHARE?

RODENSTOCK AUSTRALIA PROFESSIONAL SERVICES ROLE FILLED

Alex Rigby will be progressing into the Professional Services role at Rodenstock Australia over the coming months. As an optometrist with more than 20 years’ experience, he is excited to be taking this next step within the company. He also hold qualifications as a dispensing optician and began his career working in lens manufacture.

Email editor Myles Hume at myles.hume@primecreative.com.au to be featured 94

INSIGHT October 2024

EFFICIENT INTEGRATED DIAGNOSTICS

Argos Biometer.

Measures up better than the rest.

1–6

Connected surgical planning starts with the ARGOS® Biometer. Experience faster,†1-4 easier‡2 and better§1-2,5-6 optical biometry, even for dense cataracts. Combine with one touch planning and VERION™ image guidance for integrated workflow from the clinic to the operating suite.7,8 Ask Alcon for a demonstration today.

† Based on acquisition rates compared to IOLMaster* 700 (n=622; p<0.0001),1,4 IOLMaster* 500 (n=107-188; p-value not reported),2,3 LENSTAR* LS900 (n=107; p-value not reported).2 ‡Based on a higher success rate of acquiring the axial length (AL) measurement in eyes with dense cataract (96% of cases for ARGOS® compared with 77% for the IOLMaster* 500 and 79% with LENSTAR* LS900; p-value not reported).2 §ARGOS® Biometer has shown better acquisition rates in dense cataract compared to IOLMaster* 700 (n=622; p<0.0001),1 IOLMaster* 500 (n=107; p-value not reported)2 and LENSTAR* LS900 (n=107; p-value not reported).2 ARGOS® Biometer has shown better predictive accuracy in medium-long eyes

(n=23; p<0.001)5 and precise measurement (n=318; p-value not reported)6 than IOLMaster* 500. *Trademarks are the property of their respective owners. References: 1. Tamaoki A et al. Ophthal Res 2019;19:1–13. 2. Shammas HJ et al. J Cataract Refract Surg 2016;42:50– 61. 3. Hussaindeen JR et al. PLoS ONE 2018;13(12):e0209356. 4. ZEISS* IOLMaster* 700 510k Submission 2015. 5. Whang W et al. Sci Rep 2018;8(1):13732. 6. Shammas HJ. Accuracy of IOL power formulas with true axial length versus simulated axial length measurement in 318 eyes using an OCT biometer. 2019 ASCRS ASOA Annual Meeting. May 2019. 7. VERION™ Reference Unit User Manual 2019. 8. ARGOS® Biometer User Manual 2019.

©2023 Alcon Inc. Alcon Laboratories (Australia) Pty. Ltd. ABN 88 000 740 830. Phone: 1800 224 153.

Auckland New ZealandNZBN 9429047030480 Phone: 0800 809 189. ALC2055 12/23 ANZ-ARB-2300008.

Join the OPSM team. We have the scale and resources to help you personalise your position and choose your career path based on your goals.

OCTOBER 2024

CUSTOMISE YOUR ROLE TO YOUR CAREER ASPIRATIONS

Accelerate your career aspirations with OPSM. Visit opsm.com.au/careers today.

WWW.INSIGHTNEWS.COM.AU