FRANK ASSESSMENT FROM NEW AHPRA BOSS Ophthalmic leaders respond to Justin Untersteiner's commitment to improve
INSIDE THE WORLD OF AN OPTICAL DISPENSER
Findings from a major survey into workplace satisfaction and pay rates
SOLVING THE PRESBYOPIA PUZZLE Presbyopes now have an abundance of options to correct their vision deficit
Ophthalmic leaders have welcomed the candid, reform-focused message from Ahpra’s new CEO, Mr Justin Untersteiner, who used a major speech to acknowledge regulatory shortcomings and chart a course through pressing challenges like workforce shortages, telehealth, and the rise of artificial intelligence (AI).
Untersteiner, who began as the Australian Health Practitioner Regulation Agency (Ahpra)’s second-ever CEO in May 2025, spoke at the Australian Medical Association’s Colleges, Associations and Societies (CAS) meeting in Canberra on 23 June. His remarks were closely watched across the health professions, coming at a time of intense scrutiny on regulatory processes and amid growing concerns about practitioner wellbeing.
Much of his address focused on one of the most significant challenges for Ahpra: rebuilding confidence in the notifications system.
For the system to work, he acknowledged the patient complaints process needed to be timely, transparent, procedurally fair, empathetic and accessible.
But he wasn’t convinced the current end-to-end system was achieving this, leading to “a loss of confidence and a loss of trust in the scheme”.
Much of this was highlighted in an independent review by Ms Sue Dawson – the former NSW Health Care Complaints Commissioner –into “unproductive and unnecessary complexity” within the system that regulates optometrists, ophthalmologists and other health professionals. Publishing this so early in his tenure has allowed Untersteiner
performance in several areas,” he said.
“There is a perception that we have moved too slowly, and at times taken decisions that appear to be made in isolation without a deep enough understanding about flow-on consequence and risks.”
The vast majority of optical dispensers in Australia feel they are not being fairly compensated for their role, according to a national survey providing new insights into optometry support sta pay rates and working conditions.
The Optical Dispensers Australia (ODA) 2025 National Wage Survey – that garnered a significant 451 responses – revealed the most common wage bracket was $25-30 per hour (35%) for optical dispensers and other practice support sta , with 31% paid $30-35 per hour.
It also found around one in five are working more than 40 hours per week and that optical assistants who become dispensers through
don’t always get a meaningful pay increase.
ODA CEO Ms April Petrusma was motivated to conduct the survey after regularly fielding calls from the industry seeking clarity around pay rates, awards, and employment contracts.
“The strong response rate likely reflects just how widespread these concerns are – people are eager to have their voices heard and to gain insight into how their pay and conditions compare to others,” she said.
Petrusma said it was apparent optical dispensers felt undervalued.
While hourly rates between $25-35 may seem reasonable at first glance, she said they often fall short when considering the level
of expertise and accountability expected of dispensers.
“The majority of survey respondents expressed frustration that their wages do not reflect the specialised nature of their work,” she said, noting dispensing also isn’t a typical retail job.
“Serving patients often requires staying back to complete administrative tasks, finalise orders, manage complex prescriptions, or ensure a patient receives the care they need – no matter the time.
“Optical dispensing is a skilled profession that requires ongoing learning, precision, and problem-solving – yet it's often not recognised or rewarded
This transparency was welcomed by Optometry Australia (OA) which acknowledged “the leadership shown” by Untersteiner in his address and welcomed his recognition of the need for “a more responsive and proactive approach to promoting
“It’s encouraging to see a positive response to the recommendations made through the Dawson Review and recognition of the need to transform the notifications system and timeliness,” CEO Ms Skye Cappuccio said.
“Our members who have experienced a notification know that a timely approach is much needed.”
RANZCO similarly welcomed Untersteiner’s approach of crafting a
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Shaping excellence
Melissa Downing remembers the eye exam that first revealed
21 Independents converge
The uniqueness of independent optics was on show at ODMAFair25, along with useful tips for practice owners.
Refractive revolution
Dr Aanchal Gupta was Australia’s first surgeon to perform a new corneal-based treatment for presbyopia.
46 Putting out fires
Dr Leigh Plowman on his use of lifitegrast while he tries to understand what is driving dry eye in his patients.
There’s a sense 2025 may well be remembered as the turning point for some of the biggest workforce challenges facing the ophthalmic sector. Across the main four professions – optical dispensing, optometry, orthoptics and ophthalmology – a series of new (and separate) studies have surfaced, bringing new data and documented anecdote to some simmering issues. A wise person once told me feedback is a gift. While it might make for uncomfortable reading in some cases, we now have a clearer idea of where the pressure points lie, and how we might begin to address them.
In optical dispensing, the 2025 National Wage Survey by Optical Dispensers Australia, released this edition on page 17 in partnership with Insight, revealed more than 70% of respondents feel they are not being fairly compensated for their role.
Earlier in 2025, an Optometry Australia-backed survey called for an urgent redesign of the optometry workplace to avoid “squeezing in” follow up appointments and “moral distress” caused by KPIs and other pressures. This is in addition to another study showing there are currently too many optometrists for the number of patients currently accessing eyecare, but a potentially significant shortfall if everyone requiring eyecare actually visited an optometrist.
The future of orthoptics is in the spotlight too. A La Trobe University study revealed the emotional toll of negative clinical placement experiences on students, many of whom reported feelings of humiliation, self-doubt, and even depression.
And in ophthalmology, the Grattan Institute’s June 2025 report into accessing specialist medical care laid bare issues from limited training capacity to poor public access, describing a system that forces patients to choose between long waits or significant out-of-pocket costs. But where the accountability lies is a contested issue after the Australian Society of Ophthalmologists said the analysis painted a "one-sided" picture. These findings may be confronting for some – but that’s why it’s so valuable. In many cases we now have a baseline to work o . Plus, greater transparency gives us the chance to ask better questions, explore solutions, and galvanise the workforce.
It won’t happen overnight, but these 2025 studies should be viewed through a constructive lens. It's an opportunity for progress.
MYLES HUME Editor
Just as Insight went to print, DIABETES
AUSTRALIA released a report showing more than 560,000 Australians with diabetes are reducing their risk of blindness by over 90% thanks to KeepSight. An average of more than 8,000 new participants join the program each month, and more than 60% of those receiving reminders return for ongoing eye checks within the recommended timeframes. “Nearly a third of those who registered with the program had not seen an eyecare provider in more than two years. These
A recent case report has cautioned against cosmetic eye whitening procedures that can have both acute and delayed ocular complications. The 64-year-old man presented with blurry vision, pain and photophobia, primarily in the right eye. On examination, he was found to have scleromalacia and macular edema – seemingly delayed complications from the eye procedure.
Aston University optometrist Professor James Wol sohn has determined an optimum blinking exercise routine for dry eye, and has developed an app, MyDryEye. His team found the best technique is a close-squeeze-blink cycle, repeated 15 times, three times per day. Participants found while doing their exercises, symptom, severity and frequency decreased, and the number of incomplete blinks decreased. Within two weeks of stopping, their symptoms returned, showing e cacy of the exercises.
Ms Hannah Thomas, a Greens candidate who competed against Prime Minister Mr Anthony Albanese in his Sydney seat, has undergone surgery amid fears she could lose vision in an eye after clashing with police at an anti-Israel rally. NSW police launched an investigation into how a 35-year-old was harmed while being arrested at a pro-Palestinian protest. She was one of roughly 60 people outside a manufacturing facility in Belmore during the "unauthorised" protest, according to the ABC
people are now engaging in regular cycles of eyecare to safeguard their vision," KeepSight clinical director Professor Peter van Wijngaarden said. IN OTHER NEWS, Queensland University of Technology's Dr Rohan Hughes has secured significant funding to investigate the early warning signs of myopia in Australian children. Supported by the American Academy of Optometry Foundation, it will be the first of its kind in Australia to investigate pre-myopia. “We’re aiming to provide insights that can help optometrists pinpoint the appropriate time to intervene before myopia takes hold," he said.
FINALLY, a homegrown eye health campaign involving 1001 Optical won a Gold Lion at the Cannes Lions International Festival of Creativity 2025. Titled ‘The Hidden Eye Test’, the campaign was led by marketing and communications agency VML in partnership with 1001 Optometry and AI artist Prospex Park and "flipped the typical eye exam on its head”. Instead of asking patients to read what they can’t see in a clinic, the campaign took to public spaces, embedding hidden messages in visually stunning creative work that only those with certain vision impairments could detect.
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Most Australian females experience menopause – a key driver of dry eye disease –between 45 and 60 years of age. The average age of menopause is 51 years. Page 41
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This year’s program focuses on binocular strabismus and ocular oncology, featuring experts such as Dr Craig Donaldson, Ms Soojin Nam, and Mr Tim Fricke. tlc.optometry.org.au
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“listening, learning and responsive" regulator.
“Wide stakeholder engagement is key to ensuring the important, and nuanced, work of health regulation meets the needs of the population and supports colleges and other groups in providing the very best in patient and community care,” president Professor Peter McCluskey said.
Discussing workforce strains, Untersteiner said it was an issue being felt in many jurisdictions globally, but highlighted local factors such as shortages in regional and remote areas, and the low numbers of Aboriginal and Torres Strait Islander health practitioners.
While he praised recent reforms such as the Kruk Review’s somewhat controversial faster pathways for overseas-trained professionals, he stressed that more was required to ensure Australians could access timely, a ordable care.
“We need to accelerate accreditation reform, and we must work across the system to improve workforce outcomes in the health sector,” Untersteiner said.
On the workforce issue, Cappuccio said OA had been calling for regulatory reforms to support therapeuticallyendorsed optometrists to work to their full scope, including through appropriate oral prescribing. The body also wants greater regulatory attention to issues a ecting professional safety and performance, such as working conditions that limit clinical autonomy.
“These matters are critical to the delivery of timely patient care and to practitioner safety and sustainability,” she said.
McCluskey said RANZCO agreed with Untersteiner’s summation that Australia is facing ongoing issues of supply and demand and questions around patient access and a ordability.
“The college is already playing a constructive role in addressing these issues through initiatives like Vision 2030 and beyond. RANZCO is looking forward to working with Ahpra under Justin’s leadership,” he added.
Untersteiner devoted significant time in his speech to the disruptive forces reshaping healthcare, from the growth of telehealth to the rapid advance of AI. He pointed to benefits such as greater flexibility and improved access to care but highlighted emerging regulatory risks.
This included concerns about telehealth being misused and causing harm, plus comments around how AI can produce e ciencies, access to information and automation of low-risk activities but could compromise patient safety through bias, privacy breaches, or misleading advice.
Cappuccio said with the evolving areas of telehealth and AI use in healthcare, OA recognised these as key areas requiring “strong, proactive guidance from the regulatory body to ensure patient safety”. Throughout his address, Untersteiner underlined his vision for Ahpra to become
“WIDE STAKEHOLDER ENGAGEMENT IS KEY TO ENSURING THE IMPORTANT, AND NUANCED, WORK OF HEALTH REGULATION MEETS THE NEEDS OF THE POPULATION AND SUPPORTS COLLEGES AND OTHER GROUPS.”
PROF PETER MCCLUSKEY,
a more responsive regulator. He has already spent his first two months in the role meeting with health ministers, colleges, associations and practitioners to hear their concerns directly.
“I am reminded as I meet with many across the professions and the communities that we serve that we live in a time of dramatic change,” he said.
“Geopolitical challenges are accelerating a loss of trust in institutions – an issue that has been on the rise in recent times and certainly impacts Ahpra and other authorities.”
Untersteiner made clear there would be no quick fix but stressed “the question is not whether Ahpra and the scheme should reform – the question is what does reform look like and when do we get there”.
“Australia’s health system is one of the most respected in the world. It can only maintain that reputation through a robust regulatory system that ensures the public can have confidence in the care they receive,” he said.
“The work we do together – across professions, jurisdictions and communities, underpins the safety, quality and trust that Australia’s rightly expect from their healthcare system.”
Cappuccio agreed there was a collective responsibility.
“We are committed to continuing to work with Ahpra, the Optometry Board of Australia and other key stakeholders to strengthen the optometry profession by building a more responsive and future-focused system that can keep pace with the changing needs of practitioners and the public alike,” she said.
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accordingly in pay structures. This disconnect needs to be addressed if practices want to attract and retain skilled dispensers who contribute so much to their success.”
One of the most striking outcomes for Petrusma was that more than 70% of dispensers felt they are not being fairly compensated.
“That’s a significant number and speaks volumes about the disconnect between the value of the work and the recognition it receives,” she said.
Several respondents reported infrequent or minimal pay increases that do not keep pace with the rising cost of living or their
increasing experience and responsibilities. Many also highlighted the absence of penalty rates for late nights, weekends, public holidays, and out-of-hours meetings. The lack of loading on annual leave was also a point of contention.
“Another common concern among respondents was the presence of unqualified individuals earning similar wages to those who are formally trained,” Petrusma said.
“This not only undermines the value of the [Cert IV] qualification but can also discourage further professional development within the field.”
The survey found if dispensers were being paid according to an award, it was more likely to be the General Retail
Industry Award, rather than the Health Professionals and Support Services Award.
This has created “strong resentment” among respondents and was demoralising, Petrusma said.
There is now a “a clear and growing call” within the industry for the creation of an award specifically for optometry practice support sta , including qualified optical dispensers.
“This was strongly reflected in the survey results and aligns with the feedback I regularly receive from members,” Petrusma said.
NOTE: For in-depth analysis and comment on the survey, turn to page 17.
New thyroid eye disease (TED) drug Tepezza (teprotumumab) has been recommended for listing on the Pharmaceutical Benefits Scheme (PBS), which is expected to spark a major update to the way patients are treated in Australia.
The therapy – which comes in a powdered form administered by intravenous infusion –was first approved in the US in 2020. It was registered with the Australian Therapeutic Goods Administration (TGA) earlier in 2025 for moderate-to-severe TED.
At the same time, it was also being considered by the Pharmaceutical Benefits Advisory Committee (PBAC) that advises the Australian Government on which medicines should be subsidised through the PBS.
At the committee’s May 2025 meeting, it recommended listing Tepezza after assessing a submission from supplier Amgen Australia.
Dr Jwu Jin Khong, a leading oculoplastic surgeon and TED expert in Melbourne, said this was a significant moment for Australia’s TED community. TED is a serious, progressive and vision-threatening rare
autoimmune disease. As it progresses, it can cause serious damage – including proptosis (eye bulging), strabismus (misalignment of the eyes) and diplopia (double vision) – and in some cases can lead to blindness.
Typically, patients have been treated with methylprednisolone, a steroid delivered by infusion. Dr Khong said the PBAC recommendation would likely trigger a change in clinical management guidelines within the Orbital Plastic and Lacrimal Unit at The Royal Victorian Eye and Ear Hospital, where she works.
“This is a big deal. We are likely going to be using teprotumumab as our preferred first-line treatment for patients with active, moderate-to-severe TED,” she said.
“But we will be needing to screen the patients for safety first, such as having a baseline audiogram to check they don't have major hearing issues to start with. We will also have to make sure patients are not pregnant because a lot of our patients are women in their reproductive years.”
Tepezza is a monoclonal antibody and a targeted inhibitor of the insulin-like growth factor-1 receptor (IGF-1R). A typical course
Melbourne's Dr Jwu Jin Khong says it’s a big win for affected patients. Image: Jwu Jin Khong.
is administered to patients once every three weeks for a total of eight infusions.
Earlier in March 2025, the PBAC knocked back PBS-listing of the therapy, citing “the complexity of the economic model led to a high degree of uncertainty” and that a price reduction would be required to address this and achieve a cost-e ective listing.
At the May 2025 meeting, the PBAC appeared satisfied with an amended submission from Amgen.
“The PBAC rea rmed its previous view that there is a high clinical need in the requested patient population, and that the evidence demonstrated that teprotumumab is more e ective in improving proptosis and diplopia compared to current standard of care, which may also lead to a reduction in eye surgery,” the body said.
“The PBAC considered that the economic model remained uncertain. However, the PBAC noted that changes to the economic evaluation and financial estimates had reduced uncertainty and addressed the committee’s concerns. The PBAC considered that teprotumumab would be cost-e ective at the price proposed in the resubmission.”
Tokai's original honeycomb structure ensures both natural appearance and comfortable wear while effectively controlling myopia progression
Optometrists can now access the Victorian Virtual Specialist Consults (VVSC) service for online access to an ophthalmologist for advice on patients' cases. “In collaboration with The Royal Victorian Eye and Ear Hospital, this service supports optometrists by providing direct online access to an ophthalmologist for patient management advice,” Optometry Australia said. “Although particularly valuable for optometrists in regional and remote areas, it is available to all Victorian optometrists, including those based in metropolitan areas.” Optometrists can make use of this new service in two main ways. Firstly, they can book a joint consultation where the patient, optometrist and online ophthalmologist are all present. Or they can access an in-person discussion with the ophthalmologist about a patient case or management plan without the patient present.
Design Eyewear Group (DEG) – behind many iconic eyewear brands found in Australian independent optical practices – has acquired the Menrad brand and secured licensing agreements with Jaguar, JOOP!, and Morgan. The expansion of DEG's brand portfolio followed insolvency of Menrad. DEG will be taking over full proprietary ownership of Menrad, including its design rights and technical assets while the licensing deals mark “an exciting new chapter”. “These brands each bring a distinctive identity, established customer base, and international recognition that align with our values and expertise in eyewear design and distribution,” a DEG statement said. “With the addition of these brands, we’re strengthening our presence, especially in Germany, and we also see major potential to expand in the US, Canada and other major eyewear markets globally.” VMD Eyewear has been named the exclusive distributor of Jaguar Eyewear in Australia.
Australian optical lens manufacturer CR Labs has been nominated for the 2025 Endeavour Awards. Presented annually by Manufacturers’ Monthly, the Endeavour Awards are the premier national awards program recognising outstanding achievement in the Australian manufacturing industry. And, for the first time, manufacturers in healthcare are invited to get involved. Organisers have introduced the Innovation in Healthcare Technology Award, which recognises “technologies that improve healthcare and medical manufacturing”. Melbourned-based CR Labs has been nominated in that category. It is among a number of new categories in the growing event. Others include the Outstanding Start-up, Innovation in Aerospace, Innovation in Food and Beverage Manufacturing, and Technology Application awards.
EssilorLuxottica’s new invisible open-ear hearing solution for perceived mild-tomoderate hearing loss, Nuance Audio Glasses, are expected to be available in Australian optical practices soon, pending approval.
The product – blending sound engineering and “world-class smart eyewear design” –was on display in June at ODMAFair25 in Sydney before its expected launch to the national market. It’s already available in several European countries and the US.
“The Australian hearing solutions market remains underserved, much like the vision market decades ago, where consumers are often hesitant to wear corrective devices due to factors such as stigma, discomfort, cost, and limited accessibility,” the company said.
With Nuance Audio Glasses, EssilorLuxottica wants to overcome these barriers and meet the needs of around 5.3 million Australians with mild-to-moderate hearing loss.
Subject to inclusion on the Australian Register of Therapeutic Goods, Nuance Audio Glasses will be available through independent stores and the group’s retail network including OPSM, Laubman & Pank and EyeQ Optometrists.
The technology is designed to enhance hearing in situations such as restaurants and crowded places, enabling wearers to focus on
Discreetness is a big feature of the technology. Image: EssilorLuxottica.
certain voices with directional microphones limiting background noise interference.
According to EssilorLuxottica, the product’s lightweight, open-ear speakers can o er all-day comfort, and directional microphones and beamforming can enhance speech clarity. It’s also said to be simple to set up with a user-friendly experience.
Subject to regulatory registration – a Nuance Audio Remote Control will be able to be purchased separately.
“The Nuance Audio App will also be the essential Nuance Audio Glasses companion,” EssilorLuxottica said. “The app will be required for audio calibration and firmware updates and will allow users to personalise the Nuance Audio experience.”
It's expected to be available in two styles.
Doctors from, or trained in, rural settings are more likely to practise in those areas. Image: BJP7images/stock. adobe.com.
Australia’s specialist medical colleges are implementing what they describe as groundbreaking changes to their training selection processes to address the chronic shortage of specialist doctors in rural and remote communities.
The Council of Presidents of Medical Colleges (CPMC), working with the National Rural Health commissioner, has released new guidelines requiring all specialist medical colleges to prioritise candidates with rural backgrounds and experience when selecting new trainees.
“Too many rural Australians are waiting too long for specialist care, or having to travel hundreds of kilometres to access it,” said Associate Professor Sanjay Jeganathan, chair of CPMC.
“We know that doctors who come from rural areas or have trained in rural settings are far more likely to return and practise in these communities.”
Under the new framework, medical colleges, including RANZCO, will have standardised criteria recognising candidates who spent significant childhood years in rural areas, medical students who completed 12-plus months of rural placements, and junior doctors who gained experience in rural hospitals.
“The initiative from the colleges to apply practical strategies to improve medical workforce distribution to rural and remote communities by recognising the predictors of rural practice in selection processes – being rural origin and positive rural experience prior to training – is welcome,” said Professor Jenny May, National Rural Health commissioner.
A/Prof Jeganathan added: “We’re moving beyond good intentions to systematic change.
“Every college will now use consistent definitions and transparent processes that recognise the value of rural medical experience.”
Melissa Downing has helped influence the modern OPSM eyecare strategy.
From holding a torch during cataract surgery to leading eyecare teams across three Australian states, MELISSA DOWNING has packed plenty into her 20 years with EssilorLuxottica. Along the way, she’s mentored future leaders, embraced change, and remained focused on the life behind the eyes in her chair.
Ms Melissa Downing still remembers the eye examination that first revealed she was myopic, a moment that altered the course of her life. More surprising to her mother was the discovery that her younger sister and much younger brother were also short-sighted.
“That day marked a turning point for all of us as we began our journey with clearer vision,” she recalls.
The experience left a lasting impression. Not only did corrected vision improve her life academically, but socially too, giving her the confidence to participate in sport thanks to contact lenses.
“The genuine care shown by the optometrists during that time inspired me to pursue a career in optometry,” she says. “From then on, the path I wanted to follow was clear.”
This year, Downing is celebrating her 20th year within the EssilorLuxottica business. She marvels at the technological changes that have enhanced the optometrist's work over that time, along with the way leaders within the OPSM network have shaped the national eyecare landscape.
Downing’s journey as an optometrist with OPSM began after completing her graduate years and seeking the next phase in her career. She had already experienced optometry through various care models and settings across Melbourne, regional Victoria and Tasmania before joining OPSM.
At the time, Luxottica (now EssilorLuxottica) had only just acquired OPSM. She started as the principal optometrist at Malvern, then progressed to managing optometrist at Southland, before joining the eyecare leadership team in multiple roles where at one point she was responsible for eyecare across three states.
“I really appreciated the flexibility and opportunity to work part-time while my boys were young, and then transition back into a full-time senior leadership role when the time was right for my family,” she says.
Over the years, she continued to take on new challenges.
Putting her hand up and saying “yes” to the chance to be a managing optometrist, area eyecare manager and professional services manager provided the opportunity to influence and support a diverse team.
It also helped her shape patient care beyond her consulting room.
Coaching and mentoring others has remained a highlight of her work.
“Helping others grow their confidence, clinical skills, knowledge and professional development continues to be an incredibly rewarding part of my role every day.”
Downing values the chance to contribute beyond clinical care – something made possible by the breadth and scale of the EssilorLuxottica business.
During the past 20 years, she’s taken part in a various projects and collaborations, as well as contributing externally to the profession.
Clinical teaching at The University of Melbourne (UniMelb) was a highlight, along with serving as a board member and then-president of Optometry Australia Victoria Division, joining the board of the Australian College of Optometry, and currently being a member of UniMelb’s Department of Vision Sciences Course Advisory Committee.
“I am passionate about inspiring growth in my team through connection and relationships to deliver excellence – always putting ourselves in our customers’ shoes,” Downing says.
“As optometrists, we need to take a holistic approach when it comes to our customers’ needs and wants to really connect with and care for the life behind the eyes in our chairs.”
She adds that no two OPSM practices are the same. This diversity is a strength.
“Our unique team culture and individual connection with our patients is what keeps customers coming back to OPSM over 90+ years of heritage, and what keeps us strong and growing into the future.”
Reflecting on the evolution of the profession, Downing points to technology and innovation as some of the biggest changes in eyecare.
Over the years, investments have been made to expand the footprint of ultra-widefield digital retinal imaging, OCT with biometry, as well as the Clarifye digital eye exam experience to help provide a better standard of care to patients.
She feels privileged to have been part of what she describes as a progressive and forward-thinking eyecare leadership team.
Downing is also proud of the many students and early career optometrists she has mentored and supported on placements and as graduates – many of whom have gone on to become leaders themselves.
“Their passion and hunger to inspire growth and success through striving for more keeps me motivated on our purpose to positively impact lives through excellent care every day,” she says.
The lives Downing has impacted goes beyond Australian shores too.
The One Sight EssilorLuxottica Foundation “is such an important part of our cultural fabric” at EssilorLuxottica, and she’s been privileged to contribute to many di erent clinics.
One of the most memorable was in a remote clinic in Tuvalu, a small
island nation in the Pacific Ocean (about midway between Hawaii and Australia) with no permanent eyecare services.
“As a team we provided sunglasses, eye examinations, and disease screening for hundreds of patients over the course of a week,” she recalls. “We triaged, assisted with surgery, and provided post-op care.”
Within that there was one powerful moment.
“The Funafuti hospital generator failed, and I stood in the dark holding up a torch so the surgeon could complete cataract surgery and close up the patient’s eye," she recalls.
"The smile on that patient’s face the next day when I took o their eye patch
and they could see 6/9 unaided – it was life-changing, for both them and for me.”
As she reflects on 20 years with EssilorLuxottica, Downing feels lucky to be part of a team that keeps customer care at its heart.
“It’s rewarding to have such a clear purpose. Every day we strive to help our customers see more and be more through high quality eyecare, premium tailored solutions and genuine care and connection,” Downing says.
“I feel privileged to have had 20 years of my career with EssilorLuxottica, with connection and support from a team continually striving to do their best every day for the benefit of our customers and I am so excited for what the years ahead hold.”
Whether you’re a recent graduate or experienced optometrist, aspiring optical dispenser or have a few years in the optical industry, at EyeQ, we believe in providing our people with the best personalised support to maximise their potential.
Opportunities exist right across Australia both in metro and regional locations.
Start your career in a well-established practice with state of the art equipment, modern fitouts and a great team of people around you to support you through your journey.
Each subspecialty
one hour, ensuring balanced coverage and time for questions.
Ophthalmology Updates! is returning for a ninth time with its most ambitious program yet, including a new cross-specialty session on pregnancy and ophthalmology. Along with an intimate atmosphere, it’s an ideal opportunity for ophthalmologists to brush up on vital practical knowledge.
As a practising vitreoretinal specialist, Professor Adrian Fung understands the relentless demands on ophthalmologists as well as anyone. The rapid pace of clinical work, administrative responsibilities, and technological change can leave little time to reflect on one’s own patch – let alone cross-specialty learning.
That’s why events like Ophthalmology Updates! exist.
“Ophthalmology is changing more rapidly than ever,” says Prof Fung, who founded the conference nine years ago and continues today as its convenor, juggling this alongside his academic commitments.
“It’s hard enough to keep up-to-date with one subspecialty, let alone talking about all of them. Yet, even for sub-specialists it’s important for us to have an understanding of what is changing outside our area of expertise so that we can make appropriate referrals and not miss important diagnoses.”
Set to return to the Fullerton Hotel in Sydney over the 30–31 August weekend, Ophthalmology Updates! continues its mission of delivering practical, current knowledge in a format that is both collegial and engaging. With more than 100 delegates already registered (at the time of writing with two months to go), interest remains high for what has become a staple in the ophthalmic calendar.
“The key elements that makes Ophthalmology Updates! successful are its combination of excellent speakers, interactive discussions and the feeling from delegates that they can take home important practical knowledge that will improve their patient care,” Fung says.
Since its 2016 inception, the event has grown from a modest gathering of local speakers and five sponsors into a renowned national event. The 2025 meeting boasts five international speakers and a record 12 sponsors – more than at any previous event. Delegates now consistently attend from every state
and territory, with much of the event’s reputation built through word-of-mouth.
When designing the meeting’s structure, Prof Fung and his organising team are laser-focused on equipping both generalists and subspecialists with up-to-the-minute knowledge in areas often overlooked elsewhere.
“Ophthalmology Updates! specialises in rapidly updating general and subspecialty ophthalmologists in areas that they may not be familiar with,” he explains. “Each year we look to revise a common area that might not get the limelight at other meetings, as well as focussing on ‘what’s new’ in that subspecialty over the last year.”
Each subspecialty is allocated one hour, ensuring balanced coverage and allowing ample time for audience engagement.
“The addition of diagnostic or management case dilemmas lends a ‘real world’ perspective, free of any industry bias,” Fung adds.
This year, attendees can look forward to an innovative content schedule that includes a unique cross-specialty session on ‘Pregnancy and ophthalmology’. This discussion will explore crucial clinical questions such as: How does pregnancy a ect cataract surgery, uveitis, or thyroid eye disease? What glaucoma drops should be avoided? Are anti-VEGF injections safe in pregnancy?
Among the most anticipated speakers are Associate Professor Jay Sridhar and Associate Professor Richard Allen – both internationally recognised for their expertise and educational contributions.
“A/Prof Jay Sridhar is one of the best retinal speakers in the world,” says Prof Fung. “He is based in Los Angeles and runs the weekly podcast ‘Straight from the Cutter’s Mouth’, which discusses all issues related to medical and surgical retina. He has a wealth of knowledge and is able to stimulate his audience to view issues outside of just the clinical trials, from a real-world experience.”
Meanwhile, A/Prof Allen will bring insights from Houston, Texas, where he is renowned for curating the world’s most comprehensive online oculoplastics surgical video archive.
“He’s not only an expert in complex orbital disease, but can give practical advice on how to perform simple oculoplastic surgery for the general ophthalmologist,” says Fung.
“Ophthalmologists understand the importance of lifelong learning and attending this meeting is a fun and stimulating way to achieve that in one weekend. It’s also a wonderful opportunity to catch up with colleagues and share experiences outside of our usual ‘silos’.”
For more information, visit: www.ophthalmologyupdates.com
RETINA (Diabetic macular oedema; Photobiomodulation for AMD; Ocular trauma; Proliferative vitreoretinopathy) – A/Prof Jay Sridhar (US)
CORNEA (Cataract surgery in corneal patients; Paediatric corneal transplantation) – A/Prof Simon Fung (US)
OCULOPLASTICS (Oculoplastics surgical videos; Medical therapies for thyroid eye disease) – A/Prof Richard C. Allen (US)
NEURO-OPHTHALMOLOGY (Ocular myasthenia gravis; Lifestyle interventions in neuro-ophthalmology) – Dr Sui Wong (UK)
CATARACT (Astigmatism management; Real world experience with the latest IOL designs) – Dr Ben LaHood (Australia)
GLAUCOMA (A glaucomatologists guide to NTG; WTF is MIBS?) –Dr Jennifer Fan Gaskin (Australia)
MEDICAL RETINA (PAMM!; Macular telangiectasia type 2 and CNTF) –Dr Amy Cohn (Australia)
UVEITIS (Di erentiating infectious from immune uveitis; Birdshot chorioretinopathy) – Dr Jo Sims (New Zealand)
PAEDIATRICS (Nasolacrimal duct obstruction; Paediatric cataract surgery and IOLs) Adjunct A/Prof Parth Shah (Australia)
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† Based on worldwide IOL unit sales, 2024.
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^ Clinical studies were performed on the AcrySof ® IQ PanOptix ® IOL; AcrySof ® IQ PanOptix ® and Clareon® PanOptix ® are optically equivalent. In response to QUVID questions: In the Past 7 Days, How Much Were You Bothered By Starbursts?; In the Past 7 Days, How Much Were You Bothered By Halos?; In the Past 7 Days, How Much Were You Bothered By Glare?; n=127.
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References: 1. Market Scope IOL Report 2024; [REF-24516]. 2. lcon data on file . 3. Modi S, Lehmann R, Maxwell A, et al. is al and atient re orted o tcomes o a di ractive tri ocal intraoc lar lens compared with those of a monofocal intraocular lens. Ophthalmology. 2021;128(2):197–207. doi:10.1016/j.ophtha.2020.07.015. 4. Kohnen T, Lapid-Gortzak R, Ramamurthy D, et al. Clinical outcomes after bilateral implantation o a di ractive tri ocal intraoc lar lens orld ide ooled anal sis o ros ective clinical investigations. Clinical Ophthalmology. 2023;Volume 17:155–163. doi:10.2147/opth.s377234. 5. Lane S, Collins S, Das KK, et al. Evaluation of intraocular lens mechanical stability. J Cataract Refract Surg. 2019;45(4):501–506. 6. Bala C, et al. lti co ntr clinical o tcomes o a ne nondi ractive res o ia correcting intraoc lar lens. J Cataract Refract Surg. 2022;48(2):136–143. 7. McCabe C, Berdahl J, Reiser H, et al. linical o tcomes in a . . registration st d o a ne intraoc lar lens it a non di ractive design. J Cataract Refract Surg. 2022;48(11):1297–1304. doi:10.1097/j.jcrs.0000000000000978. 8. Alcon Data on File, 2024; [REF-25409]. 9. AcrySof ® IQ Vivity ® Directions for Use. 10. Clareon® Vivity ® IOL Directions for Use. 11. lcon data on file, . © 2025 Alcon Laboratories Pty Ltd. AUS: 1800 224 153; Auckland NZ: 0800 101 106. ALC2439 07/25 ANZ-CLI-2500011.
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Optical Dispensers Australia has conducted arguably the most comprehensive survey into the working lives and pay rates of optometry support staff in Australia. Insight reveals the most pertinent findings.
As Ms Carly Toms began scrolling through the findings of a new optical dispensing workplace survey conducted in Australia, it reinforced many of her own experiences after 20-plus years in the industry.
On the one hand, there’s immense pride in the life-changing nature of her work, and the value she’s brought to the businesses she’s worked in. But on the other, there’s a perception that much of this great work hasn’t been adequately recognised and remunerated.
This is all occurring as the demands on dispensers intensify.
“Optical dispensers are the keystone of the practice, and many dispensers are unaware of their value,” says Toms, who has shifted her career from the practice into the classroom as the ANZ training manager for the Australasian College of Optical Dispensing (ACOD).
“Profits garnered from optometry testing do not define the success of the business; this comes down to a good dispensing team. We are the advisors, the educators and the problem solvers. We sell the lenses and necessary treatments to enhance the refraction, we recommend and style frames to match personality, face shape, lifestyle and profession. This is where the business can thrive.”
Few would argue a strong optical dispenser is a pivotal player on the practice team, yet the new Optical Dispensers Australia 2025 National Wage Survey paints a sobering picture about how many of these professionals feel about their careers.
Released in partnership with Insight, some of the topline figures show:
• More than 70% of respondents feel they are not being fairly compensated for their role.
• The most common wage bracket is $25-30 per hour (35%), with two thirds paid less than $35 an hour.
• More than 30% don’t know what award they’re being paid under.
• For those paid according to awards, they are more likely to be paid under the General Retail Industry Award rather than the Health Professionals and Support Services Award (HPSS).
• More than a third of respondents have worked at their current place for less than three years.
• Around 17% work more than 40 hours per week.
The findings have prompted calls for a new pay award specifically dedicated to optometry practice support sta , and questions around how optical dispensers can be recognised for the extra responsibilities shouldered during – and after – work hours. There’s also concerns about how low morale and dissatisfaction may impact the future of optometry practices and society as a whole.
ODA CEO Ms April Petrusma believes the industry has been hungry for a survey like this, which provides a new level of understanding and a baseline for optical dispensing workplace conditions.
ODA collated 451 anonymous responses over a five-week period from qualified optical dispensers (the majority of respondents), unqualified optical assistants, students studying the Cert IV, qualified and unqualified practice managers, locums and other support sta .
“I regularly receive phone calls from both employers and employees seeking clarity around pay rates, awards, and employment contracts,” she says.
“The strong response rate to the survey likely reflects just how widespread these concerns are – people are eager to have their voices heard and to gain insight into how their pay and conditions compare to others. It shows there's a genuine appetite for transparency and guidance when it comes to navigating employment rights.”
None of the results came as a huge surprise for Petrusma, who has worked as an optical dispenser for the past 12 years across independent practices, corporate settings, and within the training sector.
But some stood out.
“The combination of low pay, high workload, and limited recognition is leading to dissatisfaction and burnout,” she says.
“One of the most striking findings was that over 70% of dispensers feel they
are not being fairly compensated for their role. That’s a significant number and speaks volumes about the disconnect between the value of the work
Mr Jake Hansen, a director of Eyecare Plus practices in Orange and Parkes, echoes this disappointment. Optical dispensers are “absolutely vital” to his business.
“Especially in a country practice like ours, where patients often know us by name, have been coming for years and expect a high level of personalised care that they don’t get anywhere else in town. Our dispensers are just as much the face of the practice as the optometrists are,” he says.
What stood out to him was the large number of dispensers feeling undervalued from a financial and professional perspective.
The fact more than 30% of respondents don’t know what award – if any –they’re being paid under tells him “there’s a real lack of communication and a breakdown of transparency between practice owners and dispensers across the industry”.
Petrusma notes this is one of the contentious industry topics, with some employers paying under the General Retail Industry Award while others work to the HPSS Award.
“This confusion stems from the complex and fragmented nature of an unregulated profession, made worse by the absence of a dedicated award specific to optical dispensers,” she says.
Many of the findings align with Toms’ experience. She’s worked as an optical dispenser in the corporate world for around 14 years, plus for a small boutique in Bondi.
She believes the biggest challenges are two-fold: workload expectations without any standardisation nationally.
“From my personal experience – echoed by years of conversations with optical assistants – I’ve consistently heard stories of sta arriving early for team briefings, missing breaks and meals due to understa ng, and coping with the intense demands of large, busy practices,” she says.
“Many also describe how work-related communication through software applications extends their responsibilities into personal time. These expectations are rarely formalised or openly stated, yet they’ve become the norm and are completed without pay. Optical dispensers are often expected to arrive early, work long days, stay late, and respond to messages after hours.”
She agrees these challenges are exacerbated by the lack of a nationally recognised optical dispensing award, and there are pay disparities across the industry.
“Further to this, opportunities for pay increases are not clearly linked to performance, qualifications, or experience.”
knowledge and training.”
Petrusma says it’s vital employers recognise qualifications, such as the Certificate IV in Optical Dispensing.
Even when an optical assistant obtains this, she says this doesn’t always lead to a meaningful increase in pay, echoing Toms’ experience, with some seeing little or no change to their salary.
“Sadly, it can be undervalued by some employers – often due to a misconception that a certificate-level qualification is somehow less rigorous or important. That simply isn’t true,” Petrusma says.
“A common concern among respondents was the presence of unqualified individuals earning similar wages to those who are formally trained. This not only undermines the value of the qualification but can also discourage
further professional development within the field.”
A systematic change, she says, would ensure qualified optical dispensers are recognised and compensated accordingly. This comes back to the issue of awards, and the lack of a dedicated framework that aligns with the clinical and technical responsibilities of optical dispensing.
This was reflected in the survey results. Many feel being paid under the General Retail Industry Award undervalues the depth of their skills, and that optical dispensing should be recognised as a distinct profession, potentially within the healthcare sector, with its own appropriate award and regulations. Similar to pharmacy technicians.
It’s an idea Hansen, as an employer, sees merit in.
“Based on the survey results it seems abundantly clear that proper pay structures – ideally a dedicated award that reflects the role’s complexity –may go a long way to helping,” he says.
The most common wage bracket was $25-30 per hour, with two thirds paid less than $35 an hour.
“More importantly, there also needs to be a broader cultural shift where we are acknowledging that good dispensers are not just salespeople, they’re key players in delivering quality eyecare.”
Stronger employment arrangements like this might address another pain point highlighted: the number of optical dispensers carrying heavy workloads.
Almost one in five works more than 40 hours per week, another indication optical dispensing isn’t a typical retail job, Petrusma notes.
The realities of serving patients means sta are often required to stay back to complete administrative tasks, finalise orders, manage complex prescriptions or ensure a patient receives the care they need regardless of the time, she says.
“What’s concerning is that many of these extra hours are unpaid or not fairly recognised in their compensation."
The survey highlighted that more than a third of the survey respondents had worked at their current place for less than three years. Turnover isn’t a new problem for optical dispensing, but it’s one that has changed in recent years.
Hansen has found investing in training is key to reducing sta ng churn.
“Being such a busy practice, we can’t a ord to have team members feeling stuck or unsupported. Training is an investment – not just in the business, but in people,” he says.
Dispensers were divided on whether their current workplace offered a career pathway or development opportunities, despite almost 80% feeling dispensing can offer them a lifelong career.
“We have had great success with the ACOD course and financially support our prospective dispensers to do the course and cover costs of travel and accommodation. We also try to make sure our dispensers have access to ongoing education and feel confident in what they do, because when they grow in their role, they’re more engaged and likely to stay.”
This kind of commitment to training and recognition, he says, is what helps maintain a low turnover and fosters pride among his sta .
Without this, Petrusma says the departure of experienced optical dispensers can have significant consequences for both the industry and the patients it serves. It’s something that was acutely felt when sta turnover rates accelerated around COVID-19, with many optical dispensers jumping into di erent industries.
With better pay, greater flexibility, and the ability to work from home, many did not return.
At the practice level, Petrusma says frequent turnover can have a lasting impact; it disrupts continuity of care, increases the burden on remaining sta , and requires ongoing investment in recruitment and training. It can also a ect patient experience and retention, as strong relationships and trust are built over time with consistent sta .
“Practices lose not just technical expertise but also the deep product knowledge, clinical understanding, and patient communication skills that take years to develop,” she says.
“This results in a less experienced workforce, which can impact the quality and consistency of patient care. Practices may see increased errors, longer wait times, or diminished trust.”
Digital measuring systems, advanced lens simulation tools, and pre-testing
integrated and sophisticated.
How will optical dispensers – the human element – fit into this new future for the profession?
Rather than replacing dispensers, Petrusma predicts automation is likely to enhance their role, freeing up time for more personalised patient care, complex troubleshooting, and advanced product consultations.
It means optical dispensers must prioritise continuing professional development, upskilling in emerging technologies, and broadening their clinical knowledge.
“Those who invest in their development now will be well-placed to lead in a more technology-driven, patient-focused future, while those who don’t risk being left behind,” she says.
It’s a sentiment Toms agrees with. She wants to see a shift in culture that places education at the centre.
“There are so many career trajectories within the industry and the foundation for these is the Cert IV in Optical Dispensing,” she says.
“By o ering current employees the opportunity to complete this training, and by hiring new sta with a clear pathway for career development through immediate enrolment in the Cert IV, we can begin to shift perceptions and enhance the value and recognition of our profession.”
Ultimately, Hansen says employers face a challenging realty: ensuring optical dispensers are compensated for the true value they bring, while ensuring the business operates sustainably.
“It’s a balancing act,” he says.
“We try to focus on building a strong workplace culture, providing opportunities for professional growth, and being flexible where we can. If sta feel valued then they give more, and that benefits everyone in the long run.”
ODMAFair25 struck at the heart of what makes independent optics so unique, while also confronting some of the biggest challenges practice owners face. Insight was there for the big moments in the education program and on the tradefloor.
If there’s one clear takeaway from 2025’s biggest independent optical gathering in Australia, it’s that the industry is at a pivotal point – figuring out how to operationalise AI, alongside lifting wellbeing standards and finding new ways for practices to sharpen their point-of-di erence.
These topics shone in a rich and engaging ODMAFair25 held across 27-29 June 2025 at International Convention Centre Sydney (ICC Sydney) that welcomed more than 3,250 people working in optical practices across Australia, New Zealand and internationally. That’s more than double the turnout of the Optical Distributors and Manufacturers Association (ODMA)’s last Sydney event, and even more than the organisation’s last major show, O=MEGA23 in Melbourne.
Some key moments stood out. In the education program, it was Mr Adam Spencer’s lively panel discussing with three independents about how AI is “turbocharging” clinicians, while a “signature scent” Melbourne optometrist Mr Jayson Stone had developed for his practice made his peers think about the little touches that can elevate the patient experience.
On the trade floor – alongside new frames and lens releases – were future-facing products like EssilorLuxottica’s Nuance Audio Glasses, which use directional microphones and open-ear speakers to help people with perceived mild-to-moderate hearing loss. Subject to inclusion on the Australian Register of Therapeutic Goods, expect to find these in practices across Australia soon, including independents.
The new Ray-Ban Meta AI glasses were also a hit on the EssilorLuxottica booth. Delegates trialling the technology looked at a sheet of Italian text, and upon the request, the glasses translated it into English through speakers discreetly hidden in the frames just above the ear. Then looking at two limes, the glasses could recognise what fruit it was, and o er a cocktail recipe.
Stepper Opti AI was a new addition this year, showcasing its new virtual reality-enhanced vision assessment to prescribe progressive lenses.
“It’s also been a year of strong collaborations on the trade floor between frame and lens companies,” said ODMA CEO Ms Amanda Trotman, the event’s key organiser.
“We saw De Rigo alongside Rodenstock, and CR Labs next to Safilo to drive interest in their Full Circle ‘complete pair’ initiative.
“Some exhibitors came to strengthen ties with existing clients, while others wrote significant business. It’s always a good sign when you see frame
companies with cases scattered across the floor.”
The combined speaker schedule and trade floor expo helped draw a crowd that exceeded ODMA’s expectations.
ODMAFair welcomed 2,700 optical practice visitors, plus around 550 suppliers and exhibitors, taking total attendance to around 3,250 people. When factoring in 730 ‘revisits’ the final count reached close to 4,000 visits. Friday was the busiest day with 1,660 visits, followed by Saturday with 1,280 and Sunday with 1,025.
But it was the calibre and diversity of attendees that most impressed Trotman most.
“We saw many practices sending multiple sta , and we’re thrilled with that. Having the owner, the optometrist, and both practice and dispensing sta all together is extremely valuable,” Trotman said.
“Twenty-four per cent of attendees were optometrist owners, 24% were employed optometrists, 20% were practice managers/sta , 18% dispensing and 14% classified as ‘other’.”
ICC Sydney, a larger venue than the Hordern Pavilion used for the boutique O-SHOW24, plus favourable weather, laid the foundation for a successful event. It also benefited from delegates flowing in from Optometry NSW/ACT’s Super Sunday and the Australasian College of Behavioural Optometry conference.
The most-attended education sessions o ered insights into the big challenges and opportunities facing the independent optical industry.
'Establishing your practice’s point-of-di erence' with optometrist
“We saw many practices sending multiple staff, and we’re thrilled with that. Having the owner, the optometrist, and both practice and dispensing staff all together is extremely valuable.”
Amanda Trotman ODMA
futurist, who’s opening keynote breakfast provided a high-level view of AI in business, before drilling down into what digital transformation and integration means for the optical industry in his second session.
Three independent Australian optometrists sat down with him to explore how AI is reshaping their practices – from automating patient records to crafting marketing that speaks in patients’ own words, plus more.
Dr Wilson Luu, who runs Lumiere Eyecare in Sydney with his partner Megan, uses AI enthusiastically for patient handouts, slide decks, and even coding tweaks for his website.
“I’m not a computer programmer, however I learned how to code through using AI,” he said.
Ms Heidi Hunter was a hit, along with '21st century tools for the optical dispenser' by Mr Steve Daras. 'Optimising inventory' with ProVision, and 'How to compete with the corporates' panel discussion moderated by Ms Emma Gillies were also well attended, along with 'Marketing to Gen Z in 2025' with Ms Allison Abdullah.
The 'Optical Dispensers Australia frames repair workshop' was sold out. Plus, the inaugural 'Women in Optics Breakfast' and keynote speaker Mr Adam Spencer’s talk on how technology is reshaping business drew large crowds.
Trotman was also buoyed by the energy around this year’s awards (see page 23 for winners), which attracted many nominations and more than 2,100 votes from across the industry.
“People said they’d never seen an awards with so many watching – there was a buzz and lots of cheering, which was heartening,” she said.
“I had people like Kristy Gierisch from Eyes Right Optical, who won joint Sales Representative of the Year, tell me how thrilled they were. Everyone was excited for her – many eyewear suppliers voted for her simply because she’s such an amazing person. It really shows the camaraderie in this room and a willingness to give praise where it’s due.”
The proliferation of AI wasn’t just a notable di erence on this year’s trade floor – it featured in the education program too.
This was spearheaded on day one with keynote speaker Spencer, a
He’s also leveraging AI tools to organise meetings but says AI medical scribe technology hasn’t sped things up from a transcription perspective yet. He prefers to touch type right now, but sees value in the patient summary reports from AI scribes.
On tricky cases, he’ll input de-identified details into AI to get a list of di erential diagnoses: “Then I can start working through to find out what’s the actual condition, how it’s happening and translating that to my patients.”
Mr Michael Jones, optometrist and partner of RJK Optometry in Co s Harbour, has trialled AI medical scribe tools like iScribe and Heidi to capture patient consultations.
But he’s still on the fence until it can be fully integrated with the practice management software in his practice.
“It felt a little bit false having the microphone there,” he said. “You’re talking about grandkids, what they’re up to, and then you’re having to read out your findings for them to be included in the notes when usually I’d use a shortcut on my keyboard – it just didn’t seem personal enough.”
He still sees promise in emerging AI imaging platforms, although notes the cost companies are currently seeking is “disproportionate to what we’re going to get out of it.”
Ms Laura Reale, principal optometrist and founder of Lifestyle Optical in Westfield Sydney, sees perhaps the biggest shake-up in marketing. By mining her patient records for language and trends, she’s creating deeply tailored campaigns.
“Patients do not stop talking, and we’re looking for the chief complaint, but we’ve missed everything else in between,” she said. “I can’t write anything down that fast, so AI’s going to fill the gaps – and then I’ve got more content for marketing, in the patient’s language, not in the university’s language.”
She’s excited by the shift, but it did stir debate about how such practices can be conducted with incoming changes to Australian privacy laws.
“This is the first time optometry can do customised marketing to patients based on clinical information. There’s no way we could have done that legwork, or gone that deep, and then written copy,” Reale said.
Spencer summed up the bigger picture, noting AI isn’t taking over, but “turbocharging” professionals and eliminating the “drudge work”.
“You’re not losing your job to AI, but if you’re sitting next to the person at work using it, you’re going to struggle to keep up because they’re doing the job 30% more e ciently.”
In an optical market with an expanding corporate footprint, the di erentiation factor becomes even more important for independents.
That was the underlying theme when Ms Emma Gillies, director of Purple Key Consulting, hosted a panel of three Australian independent optometrists, who shared creative ways they carve out their own niche and keep patients coming back.
For Mr Jayson Stone, who opened his boutique practice Seekers Optical on Gertrude Street in Melbourne five years ago, it all began with a vision shaped by his background in architecture.
Wanting to avoid the clinical look, he briefed his interior architect friend with a simple idea: “If [skin care group] Aesop came to you and said, ‘Will you design us a store?’ – what would you do? That’s what I want, but I’ll put glasses on the shelves instead of little brown bottles.”
His creativity didn’t stop there. Seekers also boasts a custom signature scent, pumped through the practice and infused into every glasses case.
“Scent is the biggest trigger of memory,” Stone said. “The idea is patients come in, have a good experience, and every time they open that case at home, that scent brings them back to us. It keeps that connection with the customer daily.”
Ms Rowena Beckenham, who has run her practice on Sydney’s northern beaches for 26 years and chairs the ProVision board, believes time is her biggest di erentiator.
“We treat every patient like they’re family,” she said.
Her team has meticulously refined patient flow, breaking consultations into clear stages: from diagnosing problems to explaining them in everyday language, then moving to a handover where a lens-first dispense takes place. The dispenser is held up as the front-of-house expert.
“It’s about giving reassurance that we’re doing preventative eyecare, and also making sure people walk out with the best solutions,” she said.
Joining this panel discussion too, Dr Wilson Luu, who left a health fund role partly because he was questioned on why he had so many reviews despite doubling the practice revenue, said independence allows him to
Independent Practice of the Year: Northam Optical, Western Australia
Instrument of the Year: iCare Tonometer, ParagonCare
Sales Representative of the Year: Kristy Gierisch, Eyes Right Optical, and Mr Vineet Chauhan, EssilorLuxottica (joint winners)
Supplier of the Year: HOYA
Top Customer Service Team: HOYA
Versatile Frame of the Year: Face à Face Didot 1
Window Dressing: Basecurve Optical and Kenmore Plaza Optometrist (joint winners)
invest heavily in the patient relationship.
In his practice, visits can last 45 minutes to an hour, but not all on the eye test.
“We’ll probably spend 15-20 minutes just chatting. It might sound like you’re not getting much from a return perspective, but it’s the things money can’t buy – building relationships across generations.”
“Double vision”. That was the name of Mr Brendan Dowd’s presentation – a nod to the two most powerful forces currently reshaping the optical market.
“We can see 35% of our population was over 40 about 40 years ago,” he explained. “It’s now 48%. It's an interesting age bracket, because it's often an age where people start to rely a lot more on optical devices.”
“At the same time, over that same period, the incidence of myopia has doubled.”
Dowd, who heads up the ANZ sales and customer success team at global research giant NielsenIQ, provided some fascinating insights into the consumer psyche, optical industry sales trends, and where things are heading.
At the heart of the market is the patient. Drawing on Nielsen’s global data, he highlighted the five top values for Australians: protecting the family, honesty, authenticity, stable relationships and freedom.
“Thriftiness also stands out a lot higher in Australia compared to other countries,” he said, noting this could shape how optometrists should approach messaging.
“If it’s helpfulness, it’s trying to maybe engender loyalty in a time when it’s sorely lacking. If it’s thriftiness, it will obviously impact the way they shop. Consumer values drive consumer behaviour.”
Cost of living pressures are unsurprisingly top of mind for consumers. But he warned that doesn’t necessarily translate to chasing the lowest price.
“Nearly 50% of consumers said they’d prefer a lower cost-to-use, versus just 12% who wanted a lower upfront cost to buy. It’s value for money that matters – not simply what’s cheap.”
Dowd shared local research showing 70% of patients at Australian practices are repeat customers, and nearly half of practices are independently owned. Globally, price changes for spectacle lenses (+5%), sunglasses (+5%) and optical frames (+2%), all grew year-on-year, largely outpacing inflation.
That growth, he pointed out, is largely being driven by price rather than sheer volume.
“People are spending more on these products on average than they have been in the past,” he said.
Progressive lenses are doing much of the heavy lifting. They account for around 60% of overall spectacle lens value, with sales up 2%, even as single vision and proximity lenses dipped 3% and 5%, respectively.
Dowd also flagged sustainable eyewear and smart glasses are poised for growth.
“We can also see fashion sells, especially with sunglasses, so speaking to patients around fashionable, thin and lightweight frames, along with eco-friendly options, will only help drive your results with your patients.”
But the growth pales in comparison to myopia control.
“When we looked at overall growth for standard lenses and contacts, it was around 5-6%,” Dowd said. “But for myopia control lenses, it’s 26% for contacts and 29% for spectacle lenses. That’s about five to six times the growth rate.”
So where does this leave Australian eyecare? Dowd concluded on an encouraging note, showing about 80% of eyecare providers expect the business climate to be at least stable into 2026, with 40% within that expecting it to improve.
“I don’t know many other industries that would love to see results like that,” he said.
“From a global perspective, practitioners felt under-prepared for AI, advanced technology, but also telehealth, so that’s something to be ready for, it you’re not looking into it already.”
ODMAFair25 may well go down as an inflection point for female empowerment and engagement in Australian optical industry.
Several informal groups – along with individuals – came together for the inaugural Women in Optics Breakfast. The sold out event is expected to serve as a springboard for more formal activities in future, helping to galvanise an increasingly feminine optometry industry.
Hosted by Corporate Wellbeing Hub's Ms Carli Phillips and sponsored by ProVision, it delved into many of the struggles women face, ranging from high mental loads and balancing family life, through to handling relationship breakdowns and being taken seriously as a new business owner.
Phillips shared the moment she realised she was taking on too much. What was seemingly an innocuous cold deteriorated so badly that she ended up in hospital completely burnt out physically and mentally.
"The cardiologist came into my room, leant over my bed and he said to me, 'you're 39 years of age, and you look pretty fit and healthy. What on earth is going on in your life for you to be so immunocompromised that you are now here lying in a hospital bed?'. I said 'nothing, just all the things I see other women doing, I'm parenting, I'm running a business, I'm doing two jobs. I'm looking after my partner, renovating the house and doing my MBA at night," she said.
"He said, 'stop'. And this is when time stood still for me. I actually remember staring at the lines in the palm of his hand. He said to me, 'stop – you need to start looking after you'."
Phillips revealed findings from a survey of Australian optometrists showing 61% are living well despite having struggles, 25% are not feeling terrible but are just getting by, 8% are on top of the world, and 6% are really struggling. The biggest causes of struggles were caring for others, work issues, and navigating change, with one in 10 saying they don’t have anyone they can talk to about their mental health.
The session reached its crescendo with a panel discussion featuring Ms Hanna Kim, optometrist-owner of Strathfield Eyecare, Ms Jacque Katsieris, managing director of eyewear supplier ProOptics, Ms Alisha Shastri, optometrist-owner of iOptical in Melbourne, and Ms Rowena Beckenham who featured on the earlier practice di erentiation panel.
Some pearls they o ered were: Prioritise and block time out to work on yourself – whether it’s a pilates class or walk in the fresh air – ensure this time isn’t moved. Recognise early if you're not OK, so that you don't pay a bigger price later. Things like increased screentime and eating poorly can be indicators when stressful things like sta ng shortages crop up.
Shastri discussed how outsourcing is key, such as social media marketing, so owners and optometrists can focus on the practice’s core activities and seeing patients.
Katsieris reminded attendees they’ve got to hold their own hand first before holding someone else's.
The event marked the unveiling of ProVision's new Wellbeing Program that is available to its members and will cover modules such as: the art of working smarter, high energy health eating, women's health and midlife tools, and energy and workload management.
Looking ahead, ODMA’s next event will be O-SHOW26, set for Melbourne from Sunday 16 to Monday 17 August 2026.
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HOYA is going from strength-to-strength in Australia, winning two ODMAFair25 awards and bringing to market new Sensity Colours.
ODMAFair25 was a busy event for ophthalmic lens manufacturer HOYA.
The key supplier to independent practices not only won two prestigious awards at the Australian optical industry’s showcase gathering in Sydney at the end of June, but also unveiled a new line-up of colourful tinted photochromic lenses – Sensity Colours – with a strong focus on fashion and function.
Mr Craig Chick, managing director of HOYA Vision Care Australia & New Zealand, says the awards and the new additions to its Sensity family are a testament to the commitment the company has to creating the best vision care products and to support the practices it services.
On the opening evening at ODMAFair25, HOYA won Supplier of the Year while its Victorian team helped it take out the Top Customer Service Team award, as part of an awards program that attracted more than 2,100 industry votes.
“It's pretty exciting, we didn't quite know what to expect,” says Chick, adding that the awards recognise the company’s strong performance in the industry – voted by HOYA’s own customers.
In the Supplier of the Year category, the Optical Distributors and Manufacturers Association (ODMA) said HOYA was nominated for its resilience and commitment to supporting Australian practices, even amid industry-wide challenges.
The company was recognised for consistently going above and beyond to deliver quality products and services, maintaining strong communication and dependable support. HOYA’s ability to adapt and remain responsive under pressure also reinforced its reputation as a reliable and forward-thinking partner to the optical community.
Meanwhile, the nomination for the customer service award noted the Victorian team’s dedication and flexibility.
“Whether resolving issues, assisting with urgent requests or o ering practical solutions, the team is always willing to help – no matter the situation. Their responsive and can-do attitude makes them a reliable and valued part
of the service experience," the ODMA nomination said.
Chick says the company’s customer service team in Victoria are a close-knit, passionate team who care about their customers and the company.
HOYA has committed to putting local labs and teams in each state that are well trained and responsive to customers’ needs.
Chick says ODMAFair plays a key role in bringing the industry together and it was great to see it back in Sydney after a few years away.
“It's a great opportunity to showcase the latest innovation, to learn about any research and development that's happened across many parts of the industry,” he says.
It was also a chance for HOYA, a diamond sponsor of the event, to demonstrate its own innovations. The new Sensity Colours lens range, which launched o cially on 7 July 2025, was a major drawcard on the company’s booth.
The latest addition to its well-established Sensity range, Sensity Colours is an extended collection of fashionable, smart, light-adaptive spectacle lenses.
The company says Sensity Colours are the “perfect complement” to
“We are very excited to launch the Sensity Colours collection at this pivotal moment when the gap between fashion and prescription eyewear is narrowing. We are expecting the range to generate a great deal of interest.”
Craig Chick HOYA
the upcoming spring season, and a quintessential addition for “trending eyewear enthusiasts looking for functional photochromic lenses that appeal to their personal style”.
The six di erent light-adaptive lens colour options o er wearers the chance to customise their look, “o ering a perfect blend of comfort, convenience, style, and protection, all within a coloured prescription spectacle lens”.
The colours o ered include Lovely Pink, Green Zen, Orange Splash and Aqua Blue in gradient tints, as well as Energizing Orange and Dynamic Yellow in solid tint options.
“The orange and yellow tints are designed to enhance contrast for outdoor activities, making them the perfect choice for fashion-conscious individuals and sports lovers seeking stylish and functional prescription eyewear,” says HOYA.
HOYA’s Sensity photochromic layer, incorporated into Sensity Colours, o ers the wearer neutral, true-to-life visual experiences when outdoors, reaching sunglass darkness levels when activated by the sun, while also providing 100% protection against UV rays. By combining this technology with sleek and stylish tints, Sensity Colours is being described as a unique solution in the fashion eyewear photochromic segment.
Plus, the Sensity Colours range is available with three coatings: Hi-Vision SUN Pro, Light Mirror Copper, and Light Mirror Blue.
These coatings add either a neutral reflection for dark lenses with a high scratch-resistance layer or a mirror enhancement that provides an added layer of sophistication and enables consumers to express their personality in any light.
Chick says: “We are very excited to launch the Sensity Colours collection at this pivotal moment when the gap between fashion and prescription eyewear is narrowing.
“We are expecting the range to generate a great deal of interest in Australia and New Zealand, judging by the reaction of those attending ODMAFair25.”
He says the HOYA booth, featuring the new lenses, was just as popular as its award-winning customer service team.
“We had so many people come to the stand. It was a real drawcard,” Chick says.
“We had an LED wall with all the dynamic imagery, and then we also had a set of frames made up of the colours in di erent coloured frames, di erent shape frames, to really showcase the versatility of the range.”
He believes the Sensity Colours range will appeal to a younger audience interested in fashion and style, but who would benefit from having a photochromic option.
Looks like the customer service team is going to be busy.
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From advanced spectacle and contact lenses to cutting-edge surgical techniques and implants, presbyopes have an abundance of options to now correct their near vision deficit.
For people living with presbyopia, everyday life is filled with small but relentless challenges. Reading a text message, scanning a restaurant menu, checking a price tag in the supermarket – these all become moments of inconvenience that can snowball into a significant impairment for this large patient cohort.
Many find themselves constantly reaching for glasses, pulling them o , or tilting their heads to find the “sweet spot” through progressive lenses. Others can battle eye fatigue and headaches after long hours in front of screens, unaware that the culprit may be their changing vision.
Presbyopia, the gradual loss of the eye’s ability to focus on nearby objects, is an inevitable part of ageing. According to the Australian Institute of Health and Welfare’s self-reported data, it a ects around 690,000 Australians aged 55 and over – though with 25% of the world’s population thought to be presbyopic the true figure is likely higher here.
As Australia’s population ages, so too does the urgency for more e ective, tailored solutions.
From next-generation spectacles and contact lenses to advanced surgical techniques and even eye drops on the horizon, today’s presbyopes have access to an enviable suite of treatments – and it’s often up to the optometrist or ophthalmologist to help them figure out what works best.
For patients seeking a less invasive intervention with a lower upfront cost, this usually begins in the optometry setting.
While progressive and occupational lenses have been a mainstay, multifocal contact lenses also play a role. Plus, in 2025 the industry has even seen the establishment of the “early presbyope” category with a lens targeted at people in the late-30s to mid-40s experiencing the first symptoms of this condition.
In Mr Paul Fotkou’s Adelaide City Optometrists, presbyopes are one of the most important patient cohorts, creating a predictable and ongoing income stream for both the consult room and eyewear sales due to regular eye tests.
“Presbyopic patients are often more motivated; they are willing to invest in comfort, convenience and multiple pairs. They often require task-specific eyewear,” he says.
“I have positioned the practice of o ering premium lens options – and we are not just selling a lens, we are delivering a tailored visual solution that commands higher prices. Lens sales represent approximately 50% of the practice sales.”
For Fotkou, one of the biggest considerations in today’s presbyopia landscape is the shift in work culture and ergonomics. More practices are embracing ‘second pair’ conversations with presbyopes regarding the need for occupational lenses, helping them avoid the common ‘head tilt’ to look through the near portion of a progressive lens.
“Now, I'm more conscious of ergonomics. My learning curve involves asking questions about people socially interacting with colleagues, in meetings, versus being desk-bound, and the ergonomics of looking at one, two, or three monitors or a laptop, and di erent working positions,” Fotkou says.
“What's compounded this is the end-of-day fatigue that comes with close work. There might not be a refractive problem, but just fatigue that requires
relief, often through eye-relaxing lenses to counter computer or o ce fatigue.”
Fotkou emphasises the importance of ensuring patients are well informed – he has captured a large, recurring presbyopic patient base using a targeted and consistent communication strategy.
Often presbyopia can be dismissed as a sign of aging that people put up with, or resolve with a pair of readers from the pharmacy, but the optometrist can provide a higher quality solution.
“We're very active in communicating with our database, sending monthly newsletters discussing fatigue, presbyopia, headaches, and early signs of presbyopia like headaches, blur, and end-of-day fatigue. This proactive communication helps to educate our patients,” he says.
“When I first started, I'd see people every two or three years. Now, I tend to see most people at least once every 12 months.”
He adds that, as a result, his patients are a lot better informed of their choices, whether it's about their lens supplier options or a specific contact lens.
With spectacle lens options, Fotkou says the level of personalisation that can be achieved with modern progressives is unprecedented.
Through a combination of precision manufacturing techniques and advanced design informed by highly personal measurements, the very best spectacle lens options – often referred to as premium progressive lenses –aim to provide a tailored eyewear solution to match a patient’s physiology and daily activities.
The big breakthrough came in the early 1980s with the use of Computer Numerical Control (CNC) technology in the manufacturing process, known as digital or freeform surfaced progressive lenses.
“Presbyopic patients are often more motivated; they are willing to invest in comfort, convenience and multiple pairs. They often require task-specific eyewear.”
Traditionally, lenses were designed with the power of progression on the front of the lens, however the advent of digital and freeform surfacing has allowed this to also be done on the back.
It meant lenses could be designed factoring in the wearer’s prescription, frame measurements, and specific visual habits.
Today, most, if not all, major manufacturers utilise freeform technology to craft progressive and single vision lenses that precisely meet the wearer's specifications.
“Instead, we educate patients that they need time to neuro-adapt. Charging appropriately for contact lens fittings reflects confidence in the product and encourages patient buy-in. It shows confidence in the product and encourages the patient to persevere. However, it’s also vital to set realistic expectations: while multifocal glasses o er better vision for many tasks, they have limitations.
“By clearly communicating both the benefits and drawbacks, we can better manage patient expectations and ensure satisfaction.”
But could patients circumvent the need for spectacles, contact lenses or surgery altogether?
Since 2021, Vuity eye drops (pilocarpine HCI ophthalmic solution 1.25%) have been available via prescription in the US to provide relief for presbyopic patients. According to its manufacturer Abbvie, it is a a daily, prescription eye drop that works in as early as 15 minutes and lasts up to six hours to improve near and intermediate vision without impacting distance vision.
It features a formulation of pilocarpine delivered with proprietary technology that allows Vuity to rapidly adjust to the physiologic pH of the tear film. It then uses the eye's own ability to reduce pupil size, improving near vision.
The FDA approval of Vuity was based on data from two pivotal Phase 3 studies involving 750 people aged 40-55 with presbyopia. Participants were instructed to administer one drop of Vuity or placebo once daily in each eye. Both studies met their primary endpoints with a statistically significant proportion treated with Vuity gaining three lines or more in mesopic (in low light), high contrast, binocular distance corrected near visual acuity (DCNVA), without losing more than one line of corrected distance visual acuity (CDVA) at day 30, hour three, versus placebo.
“The lens supplier we use tailors lenses to whether the patient is retired or working in an o ce, considering their occupation,” Fotkou says. “We use digital mapping for frame and lens choices, customising the corridors. We discuss with clients about their lifestyle to choose the right lens design.
“Generally, we opt for the latest free-form designs, only reverting to conventional multifocals if price is an issue.”
Although less popular in the presbyope demographic, contact lenses are another option – and a potentially under-utilised one, according to Melbourne optometrist Ms Jessica Chi.
The Cornea and Contact Lens Society of Australia Victorian president says contact lenses for presbyopes can overcome some of the shortfalls and limitations of spectacles, such as impeding daily activities, the inconvenience of having to take spectacles on and o , or the challenge of locating the ‘sweet spot’ for progressive spectacles.
Although prescribing them often requires a greater chair time, Chi says the payo for both practitioner and patient is worthwhile.
“Fitting contact lenses can take longer compared to spectacles, but it’s an investment in a lifelong patient relationship. Contact lens wearers are more loyal, and more likely to return for additional purchases, including glasses,” she says.
“Unlike some glasses-only patients who might not replace their glasses for up to 10 years, contact lens patients often need both lenses and glasses, leading to more frequent visits and increased revenue.”
Recent advancements in multifocal contact lens design and materials have also significantly improved comfort and vision for presbyopic patients, making them a more viable and appealing alternative to traditional spectacles, she notes.
Chi adds that when it comes to fitting multifocal lenses, the process should not be rushed. Allowing lenses to settle and ensuring the patient has adequate time to adjust is crucial.
“Imagine if we treated multifocal glasses the same way – quickly discarding them if the initial impression wasn’t perfect,” she says.
Additionally, the drops were well-tolerated, with less than 5% of participants reporting side e ects such as eye-irritation, altered vision and headaches.
The eye drop isn’t approved for Australia, but if it was, Fotkou believes it won't replace the need for glasses.
“I see more it more as an evolution in therapy and an addition to things like contact lens wear and surgical solutions – it will not be a replacement,” he says.
Chi notes Vuity is simply a miotic resulting in a smaller pupil to try and increase depth of field. Common side e ects can be headache, eyebrow ache or pain, ocular discomfort and di culty in dim lighting and when changing focus between objects.
“Less commonly there could be risk for traction on the retina in susceptible individuals – i.e. high myopes and those with retinal issues. I am also uncertain whether Vuity will even gain approval in Australia,” she says.
For presbyopes seeking a more permanent, spectacle-free solution, then it’s o to the ophthalmologist with a referral in hand.
Huge advancements in IOL designs such as extended depth of focus (EDOF) or multifocal lenses – with diminishing but not-fully-resolved dysphotopsia profiles – are opening up new possibilities, while also heaping greater demands on the skills of ophthalmologists.
One of those is Dr Joanne Goh, a Victorian-based cataract and refractive surgeon who sees many patients seeking spectacle independence.
She says that a big shift in those seeking surgical presbyopic solutions has been an emerging younger cohort.
“Many want refractive lens exchanges to get rid of glasses for distance and near vision because they want freedom from glasses or are not adjusting well to multifocals,” says Dr Goh, director of City Eye Surgeons in Melbourne.
As culture and technology shift – especially with the increased use of screens – people are becoming more conscious of their symptoms at an earlier stage.
“I think awareness plays a big role. Patients are more aware of the options available, often through friends or family who have had the procedure done and are happy with the results. People come in knowing what they want,” Dr Goh says.
But patients sometimes find the solution isn’t always straightforward. The state of their tearfilm, corneal topography and even their retina can have a big bearing on the course of action.
Similarly, Dr Goh says a key concern for those seeking a premium IOL is whether their surgery will meet their expectations regarding the level of spectacle independence and quality of vision.
“We're fortunate to have many options, ranging from lenses to laser options,” Dr Goh says.
“Not all options are suitable for every patient, and while we are very good at correcting presbyopia, we're still not perfect. Patients need to understand the limitations of what we can and cannot do.”
Dr Goh clearly defines the benefits and disadvantage of each option.
“Presbyopia correction is a significant part of my practice. It's important to counsel patients about their suitability for these lenses, as some may not be good candidates due to their personality or expectations. Sometimes, other options like glasses, which are low risk, might be better for them,” she says.
“Managing expectations means discussing all the potential side e ects and making sure patients understand that achieving greater spectacle independence comes with trade-o s.”
Even for the optometrist this is an important issue. It’s something Fotkou sees when patients return to his care post-operatively.
“Expectations can be high, especially post-surgery when people have lens replacements,” Fotkou says. “Patients often expect perfect results because of the high accuracy of surgeons today.
“For example, they might now have 6/6 vision but complain about dryness or slight discomfort, and their expectations need to be managed realistically –they need to know that near perfect outcomes are not realistic.”
Melbourne ophthalmologist Dr Anton van Heerden believes another form of refractive surgery is the future of presbyopia treatment. One that doesn’t inflict quite as much trauma on the eye and is better suited to younger presbyopes.
One of the directors at Eye Laser Specialists in Melbourne, he is a proponent of laser blended vision surgical technology, which is an extended depth of focus surgical option for presbyopic patients who don’t have cataract.
He says the concept is very similar to some EDOF IOL optics: there is a greater depth of focus per eye, which allows good binocular distance, intermediate and near vision.
One such example is ZEISS’s Presbyond Laser Blended Vision. In this system, the company product information states the dominant eye is corrected for distance vision to plano, while the non-dominant eye is corrected to be slightly myopic for near vision to -1.50 D. The algorithm controls the amount of spherical aberration induced in each eye which gives an extended depth of focus and a full range of binocular vision.
In 2020, approximately a third of Dr van Heerden’s refractive laser patient cohort were in the presbyopic age range and had Presbyond laser vision correction.
Improvements in contact lens materials have made this modality more palatable.
Now, he says this cohort has expanded and make up about 40% of his laser vision practice.
“Patients come wanting a presbyopic solution, and Presbyond, being non-invasive, is far safer, more accurate and predictable than IOLs. So, if someone is suitable for both IOL and laser vision correction, I'll recommend laser vision correction,” he says.
Additionally, he says the procedure is favourable for the younger presbyobic cohort with no other ocular pathology.
“It's a fantastic solution for younger presbyopic patients without lenticular problems who want a safe, quick, and accurate procedure. It's much better than lens exchange in this cohort.”
Dr van Heerden expects that presbyopic laser vision correction will be more popular due to the safe and accurate nature of these procedures. However, the uptake is limited by the capital outlay and experience required to deliver this surgical option.
“I believe the role of corneal refractive surgery in the presbyopic space will continue to grow due to its benefits. Presbyond and other presbyopic laser solutions are gaining popularity. We were early adopters, and I expect interest to increase,” Dr van Heerden says.
For the patients that do not qualify for refractive laser surgery, Dr van Heerden says EDOF IOLs are the future.
However, the success of EDOF lenses hinges on better diagnostics and patient selection – choosing the right patients who will benefit most from these lenses is crucial.
“Currently, EDOF lenses can give unpredictable and variable outcomes. This is partly because as a society, we have been ignoring pre-existing corneal spherical aberration, pupil size and angle kappa. If we improve diagnostics, EDOF lenses will have more predictable and better outcomes,”
Dr van Heerden says.
“While we are very good at correcting presbyopia, we're still not perfect. Patients need to understand the limitations of what we can and cannot do.”
Dr Joanne Goh
Dr Goh adds: “There are now refractive lenses aiming to reduce dysphotopsia, such as glares, halos, and starbursts, which are promising. If they can provide good functional near vision without these side e ects, it would be a significant advancement.
“We're getting closer to this ideal, and hopefully, a lens will eventually meet these expectations.”
Today, surgeons and patients must make trade-o decisions when selecting an IOL. For example, a lens can o er clear sight at all distances without spectacles, but at the price of possible night-time visual disturbances.
Dr Goh says a dysphotopsia profile that is comparable to a monofocal IOL with little to no halo, glare, and starbursts is what she hopes to see in her armamentarium in the future.
As one of the latest extended depth of focus intraocular lenses to enter the Australian market, DR CHRISTOPHER GO shares why and when he reaches for the TECNIS PureSee IOL.
r Christopher Go considers himself a vitreoretinal subspecialist first and foremost, although general ophthalmology accounts for a significant part of his work, with around 2,000 cataract surgeries performed in his career to date.
Familiarity of platform is important, but when deciding which intraocular lenses (IOLs) to implant, it’s his own experience, predictability, IOL technology and design, and the feedback of his peers that carry the most weight.
Dr Go became acquainted with the TECNIS family of IOLs from Johnson & Johnson (J&J) MedTech as a trainee, but his perspective broadened during a project at Westmead Hospital where he first implanted the company’s presbyopia-correcting IOL technology.
After retinal fellowships in Taiwan, Hong Kong, and the UK, Dr Go returned to Australia in 2024 to begin working in private practice where EDOFs have become the new standard of care in his clinic – now implanted in more than 50% of cases.
It’s motivated him to pay close attention to the premium lenses that work best for his patients. And after test driving four EDOF designs, J&J’s latest EDOF design, the TECNIS PureSee IOL with Simplicity Delivery System, has become one of his most-implanted EDOFs today.
“If patients tell me they don't mind wearing reading glasses and are seeking excellent distance and intermediate vision, these are the cases I tend to recommend and implant TECNIS PureSee,” he says.
“Nowadays, EDOFs are my main lens of choice, even if patients tell me they're using an iPad, Kindle or phone. This is because the font can be enlarged on these devices, and they then have less of a side-e ect profile. I only implant trifocals for patients who would like to read small fonts without glasses like with books; that makes up about 5% of my cases.”
With the EDOF category gathered momentum in recent years, having clarity on patient selection criteria has been a top priority for surgeons, including Dr Go. This is especially important because presbyopia-correcting IOLs providing greater tolerance to refractive errors can
“The refractive outcome has been spot on for my target. Most of my patients achieve 6/6 distance visual acuity and N8-12 at near, and they're all pretty happy.”
Dr Christopher Go NSW ophthalmologist
potentially benefit patients and alleviate surgeons’ concerns around quality of vision and loss of contrast visual acuity with refractive misses.1
Early on, when the TECNIS PureSee IOL became available in Australia around mid-2024, Dr Go was encouraged by the comments of his
“I heard from many colleagues implanting TECNIS PureSee who were happy with the results and the predictability of refractive outcomes, which is one of the most important things I look for in a lens,” he says. “This supports why it’s one of my preferred lenses today.”
The TECNIS PureSee IOL is described as a purely refractive lens o ering excellent distance and intermediate vision, and functional near vision. Other advantages include and high image contrast in all lighting conditions.
It’s also been shown to o er a dysphotopsia profile comparable to a monofocal IOL, 6 even in the presence of residual refractive error. Excellent contrast sensitivity,7 and high patient satisfaction have also been demonstrated. 8
According to J&J, the results of a study – which involved Australian
surgeons – indicate that the tolerance to refractive errors could be driven by the combination of the extended depth of focus and high-quality distance vision.1
It’s these consistent visual outcomes and predictability that Dr Go looks for in a presbyopia-correcting IOL.
“Predictability is what I’ve liked most about the TECNIS PureSee,” he says. “The refractive outcome has been spot on for my target. Most of my patients achieve 6/6 distance visual acuity and N8-12 at near, and they're all pretty happy,” he says.
But the lens stands out for other reasons too, helping to address unmet needs in some key areas of cataract surgery.
Surgeons have come to appreciate the TECNIS platform's strength in providing good contrast in all lighting conditions, something J&J has worked to maintain in TECNIS PureSee IOL.
As such, J&J reports the lens has been shown to provide superior distance image contrast and less pupil dependency than other EDOFs. 9-12
In low light conditions at 5 mm, TECNIS PureSee IOL has been demonstrated to provide better modulation transfer function (MTF) values compared to competing EDOFs. And when assessing the relative MTF decrease when the pupil increases from photopic (3 mm) to mesopic (5 mm) light conditions, the lens has been shown to be consistent with the smallest percentage of change compared with competing EDOFs, according to J&J. 9-12
“Good contrast sensitivity makes me more comfortable in implanting these in patients with mild retinal diseases,” Dr Go adds.
One of the big advances in the EDOF category has been the ability of manufacturers to reduce dysphotopsia profiles so they’re comparable to monofocal IOLs.
The TECNIS PureSee IOL has been shown to have a dysphotopsia profile similar to J&J’s TECNIS Eyhance IOL and TECNIS 1-piece monofocals — even in the presence of defocus. 6
Dr Go is still mindful of the potential for dysphotopsias even in monofocals, so makes a point to counsel all patients on this. But the TECNIS PureSee IOL, with a purely refractive EDOF design, is helping open the presbyopia-correcting category to more patients who might have otherwise settled for a monofocal.
Dr Go would exclude patients with significant maculopathies such as moderate-to-severe macular degeneration or a previous macular hole repair from an EDOF lens, but as a vitreoretinal surgeon he says not all retinal pathology cases are excluded from the EDOF conversation.
For example, those with a mild epiretinal membrane that’s been stable for a long time may still qualify.
“I still o er these patients the option, but I warn them that the performance of the lens may not be as good. I have implanted the lens in a few patients who either have had retinal membrane surgery with good recovery, or have a mild epiretinal membrane, and they have been happy with the results,” he says.
REFERENCES:
1. Black, D.A., Bala, C., Alarcon, A. and Vilupuru, S., 2024. Tolerance to refractive error with a new extended depth of focus intraocular lens. Eye, pp.1-6. 2024REF4934
2. TECNIS PureSee™ IOL with TECNIS SIMPLICITY™ Delivery System, Model DEN00V, DfU INT, Z311782, current revision.
3. DOF2023CT4043 – Clinical Investigation of the TECNIS™ IOL, Models C1V000 and C2V000. Patient Satisfaction Outcomes. 18 July 2023
4. Corbett, D., Black, D., Roberts, T.V., Cronin, B., Gunn, D., Bala, C., Versace, P., Tsai, L., Papadatou, E., Alarcon, A. and Vilupuru, S., 2024. Quality of vision clinical outcomes for a new fully-refractive extended depth of focus Intraocular Lens. Eye, pp. 1-6.
5. DOF2023CT4036 – Clinical Investigation of the TECNIS™ IOL, Models C1V000 and C2V000. Contrast Sensitivity Outcomes. 17 July
6. DOF2023CT4011 Simulations of visual symptoms under defocus for TECNIS PureSee™ IOL. 29 March 2023.
7. DOF2023CT4036 Clinical Investigation of the TECNIS™ Intraocular Lens, Models CV1000 and CV2000. Contrast Sensitivity Outcomes. 17 July 2023. Corbett, D., Black, D., Roberts,
ABOVE: In 120 eyes (60 bilateral implants), the TECNIS PureSee IOL provided good distance visual acuity in more than 92% of eyes, at the level of monofocal IOLs, in the presence of defocus and astigmatism.
ABOVE: OCT scan of a 78-year-old male with a mild epiretinal membrane implanted with the TECNIS PureSee IOL, plus Hydrus MIGS stent. He achieved 6/6 distance and N6 near vision.
“Most of them actually achieve the level of vision I’d expect in someone with no retinal problems at all.”
And in the case of high myopes?
“I would still, for example, implant a PureSee lens because they're made from a hydrophobic material. If it was hydrophilic, I’d be less inclined, since they may need retinal surgery later.”
All in all, he says the TECNIS PureSee IOL is o ering a compelling option for surgeons seeking to provide patients greater freedom from spectacles.
And patients appear happy with the results: in one study, 97% said they would recommend the lens to friends or relatives, 88% were satisfied with their overall vision without glasses, and 100% did not need glasses for distance. 8
These findings align with Dr Go’s observations.
“Overall, patients have been satisfied with the IOL,” he says, “and are definitely benefiting from reduced spectacle dependence following TECNIS PureSee implantation.”
T.V., Cronin, B., Gunn, D., Bala, C., Versace, P., Tsai, L., Papadatou, E., Alarcon, A. and Vilupuru, S., 2024. Quality of vision clinical outcomes for a new fully-refractive extended depth of focus Intraocular Lens. Eye, 38(Suppl 1), p.9-14. 2024REF4935
8. DOF2023CT4043 – Clinical Investigation of the TECNIS™ IOL, Models C1V000 and C2V000. Patient Satisfaction Outcomes. 18 July 2023.
9. DOF2023CT4017 – MTF of the Bausch & Lomb LuxSmart IOL. 28 March 2023.
10. DOF2023CT4025 – MTF of TECNIS PureSee™ IOL and other lens models in low-light conditions. 4 April 2023.
11. DOR2023CT4028 – Simulated VA of the TECNIS PureSee™ IOL compared to Vivity. 24 April 2023.
12. Alarcon, A., Canovas, C., Koopman, B., Pande, M.V., Koch, D.D. and Piers, P., 2023. Optical bench evaluation of the effect of pupil size in new generation monofocal intraocular lenses. BMC Ophthalmology, 23(1), p.112.
Disclaimer: This article reflects the opinion of Dr Christopher Go. Dr Christopher Go was not paid for this article. Images have been provided by Johnson & Johnson at the request of Insight.
DR AANCHAL GUPTA, from IVISION LASER, was Australia’s first surgeon to perform the Allotex procedure – a new corneal-based treatment for presbyopia.
Presbyopia remains one of the most complex challenges in refractive surgery. Although established treatments like monovision, PresbyLASIK, and multifocal IOLs o er solutions, each involves trade-o s – whether it be reduced depth perception, night-time visual disturbances, surgical invasiveness, or irreversibility.
Allotex, a novel allogenic corneal inlay made from processed human corneal tissue, o ers a promising alternative.
In early 2025, I became the first surgeon in Australia to perform the Allotex procedure, an important advancement in corneal-based treatment for presbyopia now available locally. The procedure aims to restore near vision while preserving distance vision.
Allotex is derived from donor human corneal stroma that has been decellularised, electron-beam sterilised, and precisely shaped using excimer laser technology. The result is a transparent, ultra-thin (20 μm), dome-shaped lenticule approximately 2.5 mm in diameter, with an edge thickness tapering to less than 1 μm. The lenticule is implanted into a corneal pocket or under a LASIK flap, typically in the non-dominant eye. A single donor cornea can be used to derive multiple Allotex implants.
This tissue-addition technique o ers a compelling alternative to ablative laser procedures. It works by increasing depth of focus through a controlled induction of fourth and sixth order spherical aberration, improving near and intermediate vision without compromising distance acuity.
A recent prospective three-year study published in the Journal of Cataract and Refractive Surgery reported outcomes in 25 patients implanted with Allotex in one eye. Key results included:
• Uncorrected near visual acuity improved from J6 to J2 in treated eyes.
• Uncorrected distance visual acuity (UDVA) remained largely una ected.
• 88% (22/25) of patients were spectacle-free for near tasks at three years.
• No cases of haze, inflammation, rejection, or explantation were reported.1
Similar results were reported by the multicentre EU study in 101 consecutive eyes2 (references available upon request). The defocus curve analysis showed a usable depth of focus of 2.8 D in treated eyes compared to 1.1 D in untreated eyes. The inlay mimics the performance of extended depth of focus (EDOF) IOLs, making it an attractive option for early presbyopes with clear lenses.
The core advantage of Allotex lies in its biocompatibility and tissue-preserving approach. Unlike synthetic inlays, which have historically been associated with complications like haze or foreign body reaction, Allotex uses a biologic, transparent collagen matrix that integrates naturally into the corneal stroma. Because it’s a non-ablative and reversible procedure, the inlay can be easily removed by lifting the flap and irrigating the lenticule if needed – o ering flexibility rarely available in refractive procedures.
Ideal candidates include:
• Emmetropic presbyopes used to good distance vision.
• Low hyperopes, or low myopes (-3.00 D to +2.00 D).
• Those intolerant of monovision techniques.
• Younger presbyopes with some residual accommodation and concerned about invasive intraocular surgery.
• It may also o er an option for pseudophakic patients with monofocal lenses who wish to improve their near vision.
A thorough preoperative assessment – including topography, tear film analysis, aberrometry, pupil dynamics, and dominance testing – remains essential.
In our practice, Allotex is especially valuable for patients wanting enhanced near function without committing to intraocular surgery. It complements existing options like PresbyMAX, phakic ICLs, and lens replacement, allowing a more customised approach to presbyopia correction.
Performing Australia’s first Allotex implantation at IVISION LASER was a milestone, and at the time of writing this article we had completed the most Allotex procedures in the country.
The procedure closely resembles standard LASIK with an added step of lenticule placement. Attention to flap handling and centration, is critical, as is postoperative topography monitoring.
Recovery is smooth, with most patients experiencing near vision improvement within days, with distance vision optimising over subsequent months with epithelial remodelling. Like all presbyopia procedures, clear preoperative counselling is vital to set realistic expectations.
Allotex represents an exciting evolution in corneal-based vision correction. It brings together the advantages of biologic tissue, reversibility, and depth-of-focus enhancement, all within a minimally invasive and familiar surgical framework.
At IVISION LASER, we’re proud to bring this technology as a powerful addition to the toolbox for personalised presbyopia correction.
Multifocal contact lenses could be the ideal solution for a growing cohort of presbyopes, says CooperVision. A Melbourne optometrist and practice owner discusses why he thinks the company is right.
When Mr Stewart McConnell talks about contact lenses, his patients know to listen.
That’s not just because he’s been involved in the optometry industry for many decades.
It’s not just because he’s the owner-optometrist of a small family business – Lewis & McConnell Optometrist – in Mt Waverley, Victoria, and is a practitioner who specialises in contact lenses.
What really lends weight to his words and accuracy to his advice is that he’s been wearing contact lenses for the past 40 years and they know he walks the talk.
A few years ago that talk was all about his single vision lenses.
“But I found them a bit problematic in the consulting room, and I think it was about that time that the MyDay multifocal contact lenses came out,” he says.
“I like to give everything a bit of a try and I was quite impressed the moment I put them on; I thought, this is fantastic, they make my vision highly functional in my workplace.”
Those multifocal contact lenses came from CooperVision, which he is happy to talk about and promote to the many patients that visit his business in Melbourne’s south-east.
Having lived and worked in the area for so long, he sees plenty of the children he used to treat many years ago. They’re now parents bringing their own kids into McConnell’s practice.
That’s on top of the older patients who have settled and retired in the area, who bring so many of the vision issues associated with aging.
A growing cohort are the relatively youthful presbyopes, those in their early 40s suddenly discovering the need for some help with faltering vision.
“They’ve got to 45 and never needed glasses, they've been blessed with fantastic vision,” he says.
“They've hit presbyopia, they're really upset. They've got to take glasses
with them everywhere they go . . . the possibility of being able to wear contact lenses really appeals to them.”
But McConnell is such a strong advocate for contact lenses that everyone who comes through his door is at least given the option, no matter their age.
“A lot of patients who've been with us for years are looking for alternatives to their glasses and I'll bring that possibility to their attention, and that might drive a few more people into it,” he says.
A few? McConnell says his own practice records show a 300% increase in multifocal contact lens sales in the last three years.
And the majority of that has been CooperVision’s MyDay daily disposable lenses.
“Obviously, I have had great success with multifocal contact lenses and therefore I promote that to my patients.”
Those patients have become “fans” of the product, he says.
“It’s reliable, I think the quality control is excellent.
“I find the vast majority of my patients will comfortably wear a CooperVision lens.”
McConnell is not just impressed with the company’s range of multifocal contacts.
“Our relationship goes back a fair way because of their support for independent optometry, and I’ve always been very appreciative of the way they've looked after us as a small business,” he says.
“Their customer service has been outstanding, and their product has been outstanding.”
That extends to giving McConnell the option to stock exclusive CooperVision brands that are only available to one independent optometrist in any locality, helping to build wearer loyalty to the practice.
And CooperVision works with Lewis & McConnell Optometrist on pricing structures that support the relationship between patient and practitioner.
“For a typical practice, there's no shortage of multifocal contact lens candidates, because there's so many 40-plus year-old patients who walk into an optometry practice every day. So there's a really big opportunity there.”
Julia Kwok CooperVision
“We are able to do a 12-month supply-type deal for patients that makes it quite attractive for them to continue to buy it from us and have the support from us,” McConnell says.
“And if a patient buys a 12-month supply and, eight months down the track, their prescription changes, CooperVision will swap packs over to new prescriptions.”
He says patients love the arrangement because they get a discount, and the practice is equally enamoured because it builds trust and loyalty, plus referrals.
Of course, not everyone is swayed by McConnell’s passionate advocacy.
“Some individuals have just got an absolute fear of putting a contact lens in their eye. So it's pretty hard to get past that barrier.
“And there are those who are a bit interested but a bit wary; it really comes down to just singing the praises of the lenses and saying, look, we can give it a try. We can do a little experiment when you're out choosing your frames. We can put some lenses in just to see what it feels like.”
Patience is a virtue.
“I had a patient who only wanted lenses for a wedding, and the experience was so good they've ended up coming back and wanting to wear them a lot more.”
This can all take time, which some practices might see as valuable chair time wasted.
But as Ms Julia Kwok points out, time spent discussing contact lenses with patients is well worth it as it’s planting the seed for future growth.
The professional a airs manager for CooperVision ANZ educates optometrists and others about the company’s range of contact lenses and helps them get the best out of the products.
Investing a little time upfront to get patients – especially presbyopes who are often overlooked – started with contact lens wear can pay o in the long
run by setting the practice apart and building patient loyalty.
“For a typical practice, there's no shortage of multifocal contact lens candidates, because there's so many 40-plus year-old patients who walk into an optometry practice every day.
"So there's a really big opportunity there.”
She says CooperVision has a large range of multifocal lenses for patients in all stages of presbyopia.
Kwok recommends using three key products: MyDay multifocal (daily disposable); Biofinity multifocal (monthly); and Biofinity toric multifocal (monthly).
The range demonstrates the great choices practitioners have to match the right products with the needs of their patient.
A limitation of progressive glasses is their reliance on gaze direction for clear vision, which can make certain visual tasks challenging for patients.
Multifocal contact lenses overcome this limitation; they feature concentric zones of distance, intermediate and near powers to create simultaneous vision and achieve gaze-independent vision.
She says that is great for many patients, including those working on multiple screens and also tradespeople with multiple tasks at di erent focal points.
And those benefits are maximised if practices follow CooperVision’s fitting guides.
As with most things in life, there’s an app to make that easier – the CooperVision OptiExpert app. (Full terms and conditions are available at http://coopervision.net.au/practitioner/terms-and-conditions or http:// coopervision.net.nz/practitioner/terms-and-conditions.)
It calculates the lens powers based on the patient’s refraction, vertex distance and sensory eye dominance to optimise first-fit success.
Kwok believes practices can do more for their patients by giving them the option of contact lenses and better understanding their benefits, particularly of multifocals.
CooperVision’s own market research in Australia and New Zealand shows that 71% of existing contact lens wearers were not aware of multifocal contact lenses. 1
Other research in the US shows that three out of four current single-vision contact lens wearers would consider multifocal contact lenses, as would three out of five current spectacle wearers. 2
That suggests a substantial opportunity for many practices.
It’s one optometrists like McConnell are harnessing to help di erentiate their business in a competitive environment.
“I recommend independent practices get on to multifocals to build their practice, enjoy the feedback and outcomes that they get from their patients when they can, and help change their lives.”
FEEL PROUD of making a di erence to customers through the help and care you provide. Can you see yourself in Specsavers? spectrum-anz.com/ careers-at-specsavers
TECNIS PureSee™ IOL with TECNIS Simplicity™ Delivery System is a purely refractive presbyopia correcting EDOF lens that’s easy to use,1-3 giving patients consistent4-5 high image contrast in all lighting conditions6 with a monofocal-like dysphotopsia profile.7
References: 1. TECNIS PureSee™ IOL, Model ZEN00V DFU INT, Z311973, current revision. 2. TECNIS PureSee™ IOL, Model DEN00V DFU INT, Z311782, current revision. 3. DOF2023CT4043 - Clinical investigation of the TECNIS™ IOL C1V000 and C2V000. Patient Satisfaction Outcomes 18 July 2023. 4. Black D. et al. Clinical investigation of tolerance to residual refractive errors following implantation with a refractive extended-depth-of-focus (EDF) IOL. Abstract ESCRS 2023. REF2023CT4129. 5. DOF2023CT4041 – Clinical investigation of the TECNIS™ IOL, C1V000 and C2V000 Tolerance to Refractive Error. 17 July 2023. 6. DOF2023CT4036 – Clinical Investigation of the TECNIS™ IOL, Models C1V000 and C2V000. Contrast Sensitivity Outcomes. 17 July 2023. 7. Vilupuru S, et al. Clinical evaluation of a new Extended Depth of Focus intraocular lens based on a refractive technology. Abstract ISOP 2023. REF2023CT4178. For healthcare professionals only, please refer to the Directions for Use (DFU) before considering if appropriate for your patients. Australia: AMO Australia Pty Ltd, 1-5 Khartoum Road, North Ryde, NSW 2113, Australia. Phone: 1800 266 111. New Zealand: AMO Australia Pty. Ltd. 507 Mount Wellington Hwy, Mount Wellington, Auckland 1060, New Zealand. Phone: 0800 266 700. © Johnson & Johnson Surgical Vision, Inc. 2024. 2024PP07178
Menopause is gaining recognition as a key driver of dry eye, with hormonal changes triggering inflammatory processes affecting the ocular surface. MARTIN ROBINSON and DR ROBIN ABELL explore ‘inflammopause’ and share practical strategies for supporting menopausal, perimenopausal and postmenopausal patients.
Menopause, defined as the permanent cessation of menstruation due to the age-related depletion of the ovarian follicle reserve, typically occurs between the ages of 45 and 55 and is diagnosed after 12 consecutive months of amenorrhea. It is preceded by the menopausal transition – commonly referred to as ‘perimenopause’ – a phase that can span several years (on average four to seven, but potentially up to 14 years).
Increasingly, the menopausal transitional phase is being recognised as ‘inflammopause’, highlighting the rise in systemic and local inflammatory processes driven by fluctuating hormone levels.
Ocular surface disease (OSD) is often attributed to general aging, but epidemiologic data consistently demonstrates significant sex-based di erences, with women experiencing OSD at rates two to four times higher than men of the same age group.1 This disparity becomes even more pronounced following menopause, implicating hormonal decline as a contributing factor in the development and exacerbation of dry eye disease (DED).
At the completion of this article, the reader should be able to…
• Assess the limitations and potential risks of systemic hormone replacement therapy (HRT) in managing dry eye disease (DED) and understand the importance of interdisciplinary care.
• Understand the impact of menopause and fluctuating sex hormones on ocular surface health, particularly in relation to DED.
• Incorporate the B.E.I.S.T.O. protocol to systematically evaluate and manage the multifactorial drivers of ocular surface disease.
• Recognise the role of sex hormone receptors in ocular structures and their influence on tear film components, meibomian gland function, and inflammation.
Given that women can now spend more than half of their lives in a postmenopausal state, it is critical for eyecare professionals to recognise the broader ocular implications of oestrogen and progesterone deficiency. A foundational understanding of sex hormone physiology and its role in ocular surface health is essential to addressing the full spectrum
• Increase in acinar cell activity, glandular volume and secretory activity
• Suppresses inflammation
• Stimulates lipid metabolism and transport
• Suppresses keratinization
• Stimulates cell proliferation, wound healing
• Modulates ocular surface immune function
The ocular effects of menopause is something that all eyecare professionals should consider:
• Dry eye disease – the most significant link.
• Corneal elasticity increases – contact lens fitting changes.
• Glaucoma – increased risk.
• Cataracts – increased prevalence.
of menopause-related eye conditions – beyond just dry eye.
Sex hormones play a vital role in ocular surface health, exerting significant influence on corneal development, homeostasis, and disease through receptors found in key ocular structures. The ocular surface and its associated glands are hormoneresponsive, expressing functional receptors for androgens (AR), oestrogens (ERа and ERß), and progesterone (PR). These receptors are found throughout the cornea, conjunctiva (including goblet cells), lacrimal glands, and meibomian glands. Their activity helps explain the growing recognition of sex hormones as important factors in the development and regulation of ocular surface disease (OSD).2
These receptors also have the capacity to synthesise endogenous sex hormones through localised enzymatic activity. 3 This suggests
• Suppress inflammation
gland
gland Cornea and conjunctival epithelium
• Induces lacrimal gland regression
• Suppresses lipid production and secretion
• Suppresses acinar cell maturation
• Upregulates pro-inflammatory cytokines
• Modulates conjunctival epithelial cell maturation and goblet cell mucin production
FIGURE 1. Illustration of key cellular processes on the ocular surface that are regulated by sex hormones. These hormonal effects may influence various factors involved in the development of dry eye disease.5
a more complex, tissue-specific hormonal microenvironment that may influence both ocular surface integrity and disease susceptibility. The primary classes of sex hormones relevant to ocular function include androgens, such as testosterone; oestrogens; progestogens; and gonadotrophins, specifically follicle-stimulating hormone (FSH) and luteinising hormone (LH).4
Meibomian glands are crucial, producing lipid secretions essential for the tear film that prevent evaporation and maintain ocular surface integrity. Their lipid-producing cells, meibocytes, release meibum via holocrine secretion during blinking. Meibum's complex composition is highly specialised; subtle alterations destabilise the tear film, driving ocular inflammation and dry eye symptoms.5,6
Androgens (e.g., testosterone), vital sex hormones
atrophic post-withdrawal or with HRT, leading to reduced tear secretion.8
Hormones critically a ect meibomian glands and thus the tear film's lipid layer. Androgens are essential for meibomian gland function, stimulating lipid production and cell di erentiation while suppressing ductal hyperkeratinisation. Androgen deficiency (from ageing, menopause, Sjögren’s, or anti-androgen therapies) is a key driver of meibomian gland dysfunction (MGD), causing ductal obstruction, altered meibum, gland atrophy, and tear film instability. Conversely, oestrogens may inhibit meibomian lipid production and promote keratinisation/atrophy, potentially explaining why oestrogen-containing HRT can worsen MGD.9
Hormonal influences also impact tear film stability. Deficient meibum increases tear evaporation, shortens tear break-up time (TBUT), and causes tear hyperosmolarity. This triggers ocular surface inflammation (cytokine/MMP release, immune cell recruitment). Resulting damage to epithelial and goblet cells reduces mucin, further destabilising the tear film in a self-perpetuating ‘vicious cycle’. Hormonal changes can exacerbate this by promoting inflammation and lowering the DED threshold.1,10
in both genders, are now seen as protective against DED. While oestrogen decline was once the primary suspect, reduced androgen levels are now more directly linked to DED development and progression, particularly in women.5,7
Menopausal hormonal changes disrupt the lacrimal functional unit, causing tear film instability, hyperosmolarity, and ocular surface inflammation. Anatomical impacts include: Aqueous
Hormones a ect lacrimal glands, influencing the tear film's aqueous component. Androgens support lacrimal gland function and may be anti-inflammatory; their age-related decline contributes to lacrimal gland inflammation and reduced aqueous production. Oestrogen's role is complex: protective physiologically, but potentially pro-inflammatory or
Systemic HRT's relationship with DED is complex and not fully understood. Though oestrogen replacement was hypothesised to alleviate DED, large studies (e.g., Women's Health Study) often show no benefit or even increased DED risk with systemic HRT, especially oestrogen-only formulations.11 Impact likely varies by hormone type, administration route, and individual factors. Current recommendations for HRT and DED, include:
• Systemic HRT is for managing systemic menopausal symptoms (vasomotor, bone health, urogenital atrophy) based on a GP's or specialist's risk-benefit analysis.
• Systemic HRT is not currently a primary DED treatment.
• Optometrists should note HRT use in patient history, but not advise starting/stopping HRT for ocular reasons alone. GP collaboration is key if HRT status is relevant.
Research on topical ocular hormones (e.g., androgen/oestrogen eye drops) is ongoing, but not yet standard practice.
As with all ocular surface and dry eye evaluations, start with a detailed case history and identify
key drivers (modifiable and non-modifiable, medication and hormone related). The number of drivers of multifactorial DED can be overwhelming, which is why it is imperative to take a systematic approach, starting with a detailed case history as detailed in Table 1.
Patient responses inform triage and risk factor analysis. Plus, distinguishing modifiable factors requiring intervention from non-modifiable contributors need discussion. Diagnostic testing should follow.
A slit-lamp and fluorescein are fundamental for diagnosing DED. To determine an aqueousdeficient subtype, Schirmer testing or tear meniscus assessment (via imaging) can be employed. Classification of evaporative DED is aided by slit-lamp examination combined with an eyelid push assessment. While meibography o ers valuable insights, it is not essential, as modern diagnostic tools increasingly streamline the diagnostic process.
Identifying the DED subtype clarifies the underlying pathophysiology, enabling targeted treatment:
• Evaporative DED: Management focuses on lid and lash hygiene.
• Aqueous-deficient DED: Treatment involves tear supplementation and combination therapies.
Cancer history
Menopausal status
Systemic conditions
Computer/device use
OSDI/DEQ-5
HRT use
Ocular symptoms/asymmetry
Medications
Lifestyle factors Environmental/trigger factors
Contact lenses
Smoking
B: Bacteria saponification/Biofilm
Hypochlorous acid, IPL, azithromycin, doxycycline B: Bugs-demodex
E: Enzymatic dysfunction Pre and post biotics, Omega-3, IPL, Mediterranean diet I: Inflammation Steroids, ZEST, IPL
S: Stasis Mastrota expression, RF IPL T: Temperature If rosacea, beware of heat. Heat useful for stasis
O: Obstruction Lid debridement, mastrota expression, RF
Managing OSD requires a tailored approach based on specific clinical findings. DED is multifactorial, and simply increasing lubricating drops or attributing symptoms solely to menopause is insu cient and outdated. Individualised care is especially important in patients with systemic conditions like Sjögren’s syndrome. Optometrists can use the B.E.I.S.T.O. protocol, developed by Dr
Laura Periman, to guide a structured evaluation and inform targeted treatment. This framework helps identify and address key drivers of DED – bacteria, enzymatic dysfunction, inflammation, stasis, temperature sensitivity, and gland obstruction. Each clinical sign should guide an appropriate intervention. For example, incomplete blinking may require blink training, lagophthalmos may benefit from sleep goggles, and significant staining might
call for ciclosporin or amniotic membrane therapy. A systematic, evidence-based approach ensures each element of DED is addressed. Clinical management should be dynamic: review, adapt, and escalate care based on patient response. Drawing from di erent stages of treatment is often necessary to meet individual needs.
Multifactorial DED in a postmenopausal patient with Sjögren’s syndrome
This case highlights the complex interplay of hormonal, autoimmune, surgical, and therapeutic factors in a postmenopausal woman with Sjögren’s-related DED.
Patient A, a 58-year-old female, was referred in 2023 for a dry eye assessment following her return from overseas. She had a long-standing, multifactorial history of DED, with multiple contributing factors. Her ocular history included LASIK surgery, cosmetic blepharoplasty, antibody-positive Sjögren’s syndrome, and several courses of intense pulsed light (IPL) therapy. She entered perimenopause at age 51 and reported abrupt onset of menopause at 55, following a Pfizer COVID-19 vaccination. Sjögren’s syndrome was diagnosed the same year. Current systemic medications included hydroxychloroquine (Plaquenil) and meloxicam (an NSAID).
Her treatment regimen had included both local and internationally sourced therapies: autologous serum eye drops, Regener-Eyes (a biologic drop not approved in Australia), Ikervis (ciclosporin), Thealoz Duo, Ivizia drops, and the Umay Rest neuromodulation device. She also used oral curcumin (Kurk), Bobby Brown mascara, and Blephadex (a tea tree-based lid cleanser).
On examination, tear meniscus height was borderline normal at 0.32-0.4 mm, suggestive of tear film collapse rather than high volume. Non-invasive tear break-up time (NITBUT) exceeded 15 seconds. Interferometry showed a severely reduced lipid layer, with increased viscosity on dynamic tear film analysis. Meibomian gland expressibility required moderate pressure; glands appeared structurally intact but obstructed at the lid margin.
Conjunctival staining was graded R2 and L3, with no corneal staining. Conjunctivochalasis was significant (Grade 3). Blinking was incomplete (Grade 3) with an elevated rate (>20 blinks/min). Lashes were clean, with no signs of Demodex, though excess lid margin froth suggested saponification. The Ocular Surface Disease Index (OSDI) score was 30, with symptoms worsened by wind, air conditioning, and screen use.
Clinical interpretation and management plan
Despite Patient A’s diagnosis of Sjögren’s syndrome, her tear meniscus height and NITBUT were within normal limits. This initially appears inconsistent with a severe aqueous-deficient profile, but is explained
by her current regimen, which includes frequent instillation of high-viscosity, non-preserved artificial tears. This suggests that the aqueous deficiency component is relatively well managed. However, interferometry and tear film analysis revealed a markedly deficient lipid layer and increased tear viscosity, indicating a mixed DED profile – both evaporative and aqueous-deficient in nature.
Of all the topical treatments she was using, only Ikervis includes an oil component, and this is used only at night, o ering minimal daytime lipid support. An oil-based lubricant was therefore recommended for daytime use.
Meibomian gland obstruction and reduced expressibility further supported the diagnosis of evaporative DED. Thermal lid therapy and gland expression were advised. Given the absence of demodex and the pro-inflammatory potential of tea tree oil, she was instructed to discontinue the Blephadex foam, which could be exacerbating her ocular rosacea. The presence of froth and telangiectasia indicated saponification and microbial imbalance, so Avenova (hypochlorous acid spray) was prescribed to reduce lid margin bacterial flora.
Patient A’s can achieve meaningful improvements in comfort and ocular surface health. With the adjusted management plan, her OSDI score dropped to 8 – a reduction of more than two-thirds from the baseline.
Menopause significantly a ects ocular health due to hormonal shifts, primarily causing DED driven by MGD, tear film instability, and inflammation. Beyond DED, menopause may also impact corneal health and elevate risks for glaucoma and cataracts. Proactive management by eyecare professionals is crucial, involving thorough evaluation according to TFOS DEWS II guidelines and accurate subtyping. Treatment demands a tailored, stepwise strategy focused on MGD management and reducing inflammation. While systemic HRT isn't a primary DED treatment, awareness of its potential ocular e ects is necessary. An integrated approach, considering the patient's overall menopausal health and potentially involving collaboration with other specialists, provides the best path to maintaining ocular well-being and quality of life during this transition.
“DRY EYE DISEASE IS MULTIFACTORIAL, AND SIMPLY INCREASING LUBRICATING DROPS OR ATTRIBUTING SYMPTOMS SOLELY TO MENOPAUSE IS INSUFFICIENT AND OUTDATED.”
Conjunctival staining, without corneal involvement, can improve with both bacterial load reduction and anti-inflammatory agents. As Patient A had only recently initiated Ikervis (within three days), continuation of this therapy was supported. Notably, she demonstrated incomplete blinking and a high blink rate, both of which contribute to mechanical friction and inflammation, potentially worsening CCH and meibomian gland dysfunction. Blink training and screen-use modification strategies were discussed.
Summary and recommendations
This case highlights the value of structured analysis in managing complex DED presentations. Clinicians should always correlate exam findings with patient-reported symptoms and treatment history (ensuring alignment between clinical signs and subjective experience). Assumptions must be reassessed, as normal-appearing findings may be influenced by intensive topical therapy. Management should target each element of dysfunction – aqueous deficiency, lipid layer instability, blink mechanics, inflammation, and ocular flora – both individually and within a holistic framework. Unnecessary or counterproductive treatments (e.g., inflammatory cleansers in rosacea) should be discontinued. Treatment plans should be re-evaluated and adjusted at follow-up based on clinical response. By isolating contributing factors and tailoring interventions, even complex cases like
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8. Bhuyan, J, Bishnu PD, Deka B, Paul R. Menopause and Dry Eye Disease – A Review Article. Indian Journal of Applied Research. 2018;8:69-70.
9. Wang LX, Deng YP. Androgen and meibomian gland dysfunction: from basic molecular biology to clinical applications. Int J Ophthalmol. 2021 Jun 18;14(6):915-922.
10. Ablamowicz AF, Nichols JJ, Nichols KK. Association Between Serum Levels of Testosterone and Estradiol with Meibomian Gland Assessments in Postmenopausal Women. Invest Ophthalmol Vis Sci. 2016 Feb;57(2):295-300. doi: 10.1167/iovs.15-18158. PMID: 26830366; PMCID: PMC4736742.
11. Schaumberg DA, Sullivan DA, Buring JE, et al. Prevalence of dry eye syndrome among US women. Am J Ophthalmol. 2003;136:318–326. doi: 10.1016/s0002-9394(03)00218-6.
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.
DR LEIGH PLOWMAN discusses a key drug that tackles the symptoms of dry eye disease while he tries to understand what is driving the condition with his patients.
Many dry eye su erers have got it pretty tough.
Itchiness, dryness and pain are some of the symptoms they have to deal with.
But possibly the bigger challenge is the change in lifestyle they must consider if they are to tackle why they are having issues with their eyes.
Optometrists with expertise in dry eye are increasingly aware the disease is often a symptom of wider problems in their patients’ health and lifestyles, from what they eat to how they work and sleep.
To tackle that bigger fire, they must first cool the symptoms and calm the patient before they can discuss the wider, more holistic changes that may be needed.
Dr Leigh Plowman likes this analogy.
Often, when dry eye patients visit his independent optometry practice in Colac, Victoria, he suggests steroids to tackle the wider set of symptoms, followed by a course of lifitegrast 50 mg/mL (brand name: Xiidra), a prescription eye drop that Bausch + Lomb took over form Novartis in September 2023.
“Steroids are like a fire truck to put out a bush fire; they really help to douse it [symptoms] down,” he says. “And then an immunomodulator like Xiidra is like a garden hose to put out the spot fires and help prevent flare-ups.”
Dr Plowman knows that feeling of joy and relief from the symptoms of dry eye. He too has su ered from the disease.
Which is why he is always “excited” by the opportunity to help dry eye patients and improve not only their vision but their wellbeing.
“To me, the real motivation is when I can see the improvements in patients’ quality of life, how they can get by a whole day with not thinking about their eyes, not having this frustration.”
Before they can get to that point, he needs to better understand their lifestyle and the causes of dry eye. And before that he must first put out those fires.
“Inflammation is the key driver of dry eye,” says Dr Plowman. “We know that it is a chronic, progressive condition, and we've got this double vicious cycle from meibomian glands getting blocked up, causing evaporation, and reduced tear production, so less moisture.
“Both of those perpetuate themselves in real time, and they cause this cycle of inflammation, and that causes damage to the surface.”
Xiidra – which comes in single-use ampoules – helps to break that cycle.
“We know that it works on T cells,” he says. “It targets the LFA [lymphocyte function-associated Antigen-1] receptor on T cells and helps to inactivate these so that they can't perpetuate the cycle of dry eyes.
“We know that it works on the surface of the eye, definitely on the conjunctiva, and it was recently discovered that there are T cells on the cornea.
“There's also been some evidence that Xiidra can migrate to the lacrimal
gland [which helps to keep the eye surface lubricated and clean] and reduce inflammation inside the gland itself.”
Dr Plowman recommends a 12-month course of Xiidra, which he says gives patients the maximum benefit of the drug.
Studies have shown that those benefits can be enjoyed long before that.
Real-world research involving 12 eyecare providers and 1,288 patients showed “significant symptom resolution within one to three months for most patients”.
The study, led by Dr Francis Mah, director of cornea and external disease and the co-director of refractive surgery at Scripps Clinic Medical Group in San Diego, was presented at the 2025 American Society of Cataract and Refractive Surgery (ASCRS) annual meeting earlier this year.
It said that improvement in symptoms was sustained over the course of the treatment, “with a mean duration of 29 months”.
The US Food and Drug Administration (FDA) approved the therapy in 2016 based on the drug's success in four studies.
In those studies, a larger reduction in the eye dryness score (EDS) was observed with Xiidra at six and 12 weeks. In two of the four studies, an improvement in EDS was seen with Xiidra at two weeks.
The most common adverse reactions reported in 5 to 25% of patients were irritation, altered taste sensation (dysgeusia) and reduced visual acuity.
Dr Plowman has treated up to 20 patients with Xiidra and says those reactions are very brief and can be mitigated by getting patients to close their eyes for 30 seconds after using the drops.
“That helps to close o the tear ducts so that it doesn't drain into their throat.”
Despite those brief reactions, he says many of his patients “find their
“We'll ask them how well do you sleep at night? Do you feel refreshed in the mornings? Or do you ever snore sometimes? Also, how's your cholesterol? Do you have any insensitivities with food like gluten or dairy.”
Dr Leigh Plowman
Dry Eye Directory
Lifitegrast 50 mg/mL (brand name: Xiidra), a prescription eye drop that Bausch + Lomb took over form Novartis in September 2023.
eyes feel so comfortable that they want to continue with it longer than 12 months”.
But he prefers to see the drug as an opportunity to settle the patients’ symptoms while he takes the time to find out what is really behind their dry eye disease.
“We'll ask them how well do you sleep at night? Do you feel refreshed in the mornings? Or do you ever snore sometimes?” he says.
“Also, how's your cholesterol? Do you have any insensitivities with food like gluten or dairy.
“I like to involve the GP with this, so I'll be writing to the GP and saying, I can see ocular surface inflammation and I'd love it if you could have a look at some key blood tests for me and see if there are any inflammatory markers, nutritional markers or genetic risk factors that could be there for inflammation.”
Like many others, he believes lifestyle plays a key part in dry eye disease and its treatment.
“We tend to be more o ce-based, not moving around as much, sitting at a desk, staring at a screen,” he says.
“All of those demands seem to place more on the body, and in the meantime our diet may not be 100%, we might not be getting the right nutrients and adding to that tiredness, stress and the demands of life.”
That can be compounded for patients with rheumatoid arthritis, lupus, Sjögren's syndrome, rosacea, and other autoimmune conditions.
Dr Plowman says these patients, in particular, can benefit from Xiidra.
But it might not be for everyone.
Xiidra is part of the health department’s Black Triangle Scheme used to monitor the safety of new prescription medicines and those used in new ways. Optometrists can access it via the Special Access Scheme (SAS), meaning they must document why their patients need this particular drug and whether they have tried more freely available alternatives, such as cyclosporine in the case of dry eye.
Dr Plowman says this is often not a problem and approval can be sorted in a few days, as long as practitioners are able to demonstrate why the drug is warranted clinically.
“Sometimes the patients have tried cyclosporine in the past but maybe not tolerated it well.”
Also, because it is on the SAS, patients must either cover it with their health insurance or pay out-of-pocket.
Dr Plowman says that equates to about $150 a month in Australia.
For many of his patients, that’s a small price to pay for long-lasting relief from symptoms and some “sanity”.
For Dr Plowman, that small investment in Xiidra can help him make a bigger investment towards improving his patient’s quality-of-life.
Some of Australia’s top eye health researchers have been given financial support for projects to improve treatments, reduce the burden of macular disease, and help protect future generations.
tudies that aim to predict and prevent the progression of age-related macular degeneration (AMD), research into new imaging techniques, and a new gene therapy and targeted treatment for inherited diseases are among eight groundbreaking Australian research projects awarded more than $1 million in Macular Disease Foundation Australia’s (MDFA) 2025 funding round.
A number of Australia’s leading researchers have received significant support in the latest round of funding from the Grant Family Fund and Macular Disease Foundation Australia.
“We’re proud to extend our support for research that could redefine how macular diseases are diagnosed, treated, and ultimately prevent blindness – delivering real-world benefits for ophthalmologists, optometrists, and, importantly, people living with a macular disease.
Led by some of Australia’s top researchers, the new projects will help improve treatments, reduce the burden of macular disease, and help protect future generations from its impact.
This year’s investment marks the third round of funding from the Grant Family Fund, a generous bequest that supports blue sky research projects led by early career researchers.
The 2025 Macular Disease Foundation research grant recipients include:
• Dr Sushma Anand, Centre for Eye Research Australia.
• Professor Erica Fletcher, University of Melbourne.
• Professor Mark Gillies, Save Sight Institute, University of Sydney.
• Professor Robyn Guymer AM, Centre for Eye Research Australia.
• Dr Samuel McLenachan, Lions Eye Institute, University of Western Australia.
• Dr Danuta Sampson, Lions Eye Institute, University of Western Australia.
• Dr Jiang-Hui (Sloan) Wang, Centre for Eye Research Australia.
• Professor Joanne Wood, Queensland University of Technology.
The 2025 funding brings MDFA’s total research investment to $6.9 million across 42 projects since the launch of its research grants program in 2011.
The foundation remains the largest non-government funder of macular and retinal disease research in Australia.
“These projects have the potential to change lives, not just here in Australia, but globally,” says MDFA CEO Dr Kathy Chapman.
“This funding round also marks a significant step toward our goal of doubling the number of research projects we support by 2030. We’re empowering Australian researchers to lead the way in tackling macular disease.
“Macular Disease Foundation’s research funding is made possible thanks to the incredible generosity of the community, who are investing in fast-tracking world-class Australian research to help us move closer to prevention and cure.”
The MDFA research grants will be awarded by the Governor-General at Admiralty House in Sydney this month.
NOTE: To learn more about the funded projects or future funding opportunities, visit www.mdfoundation.com.au.
“This funding round also marks a significant step toward our goal of doubling the number of research projects we support by 2030. We’re empowering Australian researchers to lead the way in tackling macular disease.”
Dr Kathy Chapman
MDFA
deliver DNA to retinal cells to correct the genetic defect that causes Stargardt disease.
Samuel McLenachan
Dr Samuel McLenachan is the senior laboratory scientist of the Ocular Tissue Engineering Laboratory, which he co-founded at the Lions Eye Institute with Macular Disease Foundation’s Research Committee member and clinician-scientist Associate Professor Fred Chen. Dr McLenachan has established one of Australia’s largest retinal disease biobanks and provides DNA banking for the Australian Inherited Retinal Disease Registry. He seeks to deepen the understanding of PRPH2-associated retinal dystrophy (PARD) through his MDFA-funded research project. The investigators will study variations in the PRPH2 gene, along with other related genes (called ABCA4 and ROM1), to determine how the different mutations influence the clinical features of retinal dystrophy. Dr McLenachan and his team plan to use stem-cell models from people with PRPH2-associated retinal dystrophy to conduct their research.
Save Sight Institute, University of Sydney
researching retinal diseases, especially and has published over 150 articles on this topic.
Prof Fletcher and her team, supported by MDFA funding, will investigate reticular pseudodrusen, a type of waste material that deposits on the macula, that is associated with increased risk of late-stage age-related macular degeneration (AMD). The researchers plan to create a special type of cell called microglia, a type of immune cell in the retina, from blood samples of people with AMD – both with and without reticular pseudodrusen, as well as from people without AMD, to compare how effectively the microglia remove waste from the macula.
Prof Mark Gillies is a specialist ophthalmologist whose research focuses on the causes and treatment of retinal diseases, including age-related macular degeneration (AMD), diabetic retinopathy and macular telangiectasia (MacTel). He is the director of Research at the Save Sight Institute, University of Sydney, and is actively involved in patient care both through his ophthalmology practice and as head of the Medical Retina Clinic at Sydney Eye Hospital.
The goal of Prof Gillies’ project is to discover which of the six currently available anti-VEGF eye injection treatments for neovascular AMD are least likely to lead to macular atrophy or scarring beneath the macula. Prof Gillies and his team also plan to investigate whether tolerating fluid under the retina, a sign of active neovascular AMD, by injecting less frequently, is linked to a reduced risk of developing macular atrophy.
Professor Robyn Guymer Centre for Eye Research Australia (CERA)
Robyn Guymer AM is Professor of Ophthalmology at Melbourne University and a deputy director of the Centre for Eye Research Australia where she leads a team of researchers investigating age-related macular degeneration (AMD). She is also a senior retinal specialist at the Royal Victorian Eye and Ear Hospital. Her project aims to determine how common nocturnal hypoxia (low night-time blood oxygen levels) is in people with neovascular AMD compared to similarly aged people without AMD. The researchers are also interested in comparing the ‘aggressiveness’ of neovascular AMD for example, the age when neovascular AMD developed, whether one or both eyes are affected, and the need for more frequent eye-injections, in people with and without nocturnal hypoxia.
Dr Danuta Sampson is an internationally trained physicist and senior scientist at the Lions Eye Institute. She holds honorary appointments at the University of Western Australia, University College London and the University of Surrey, UK. She is dedicated to advancing global eye health by developing methods to standardise data collection and analysis to uncover new retinal disease patterns and improve clinical care.
Dr Sampson and her team of collaborators aim to standardise the computer software used to analyse OCT-A images, to enable faster, more accurate and consistent image processing and diagnosis reporting, so that the information can be shared across hospitals and clinics.
Dr Jiang-Hui (Sloan) Wang is an early-career scientist working towards developing next-generation retinal gene therapies for conditions such as Leber congenital amaurosis and Stargardt disease. He trained under a gene therapy pioneer in the University of Massachusetts Chan Medical School and has published his work in several scientific journals since.
Dr Wang’s research focuses on overcoming a major challenge in gene therapy for Stargardt disease: safely and efficiently delivering the large ABCA4 gene to the retina to repair the faulty gene involved in causing Stargardt disease. He plans to deliver the ABCA4 gene into retinal cells (photoreceptors) using a specially modified virus.
book chapters, and journal editorials, and has presented her findings at national and international conferences. Drivers with macular disease often experience a loss of independence if they no longer meet driver licensing standards. However, access to modern vehicle technologies, such as advanced driver assistance systems, and conditional licensing options may enable some people with macular disease to drive safely for longer. Prof Wood plans to further investigate these options by conducting focus groups and a nationwide survey with drivers at various stages of macular disease to explore their experiences, challenges and needs. A second nationwide survey will explore the conditional licensing practices of ophthalmologists who manage drivers with macular disease.
A little work and preparation can go a long way for practices dealing with neurodivergent children and their caregivers, says MS FAIOA WOLTERMAN.
“BY LEARNING A BIT MORE ABOUT EACH CHILD, OPTOMETRISTS AND OPTICAL DISPENSERS CAN BUILD MEANINGFUL RELATIONSHIPS THAT SUPPORT BOTH THE CHILD AND THEIR FAMILY.”
There is a growing awareness and acknowledgment of invisible disabilities, especially within neurodivergent communities.
Neurodivergent children often navigate highly stimulating environments that can exceed their capacity to self-regulate, leading to meltdowns or shutdowns. These are important signals that support is needed.
Optometry practices are in a unique position to positively impact the lives of these children and their families. A visit to the optometrist is more than just an eye check; it’s a chance to build rapport, trust, and to o er a calm, supportive experience from the moment the appointment is booked through to aftercare services.
Neurodivergence includes a range of neurotypes such as Autism, ADHD, Sensory Processing Disorder, and PDA (pathological demand avoidance), among others. Often, individuals have more than one diagnosis. Each child presents di erently, and their
can build meaningful relationships that support both the child and their family.
In a busy practice with short consultations, a neurodivergent child may not have the time or space needed to feel comfortable. This could lead to incomplete assessments or the need for unplanned repeat visits, which adds to the family's stress.
A meltdown during or after the appointment can be distressing for the child and their caregivers, potentially leading to avoidance of further vision care.
The consequences of delaying or avoiding care can be serious: conditions like myopia, hyperopia, astigmatism, amblyopia (lazy eye), and strabismus (eye turn) may go undetected and untreated.
These issues can impact the child’s learning and development and may even cause long-term damage if not addressed early.
A proactive, inclusive approach can make a significant di erence.
One useful concept is Spoon Theory, which uses "spoons" to represent the daily energy available to manage tasks.
A neurodivergent child might already use most of their spoons navigating a typical school day and home routine.
Attending an unfamiliar and possibly overstimulating appointment could exceed their capacity, leading to distress. By understanding and planning for this, optometry sta can help prevent overload. Start by gathering helpful information before the appointment, either via a form or phone conversation such as:
• What are your child’s special interests?
• Have they had negative healthcare experiences in the past?
• What are their sensory sensitivities and what strategies work?
• Do they benefit from movement breaks or specific seating aids?
• How does your child communicate best? This information allows the optometrist to modify the appointment to the child’s needs.
For instance, a “look-see” visit can
help the child become familiar with the environment. Social stories, visual schedules, or personal items like headphones, fidget toys, or blankets can also help regulate sensory input. Sometimes it may be appropriate to split the consultation over two visits: one focused on relationship building and one for clinical testing.
Some simple but e ective strategies can enhance the experience for neurodivergent children:
• Use clear, literal language: “Say what you’re going to do, then do it.”
• Speak in a calm, even tone and keep instructions brief and specific.
• Provide a quiet space with sensory supports like a beanbag or tent where the child can decompress.
• Allow for flexibility: if a child becomes distressed, let the parent take them to the car and complete payment there using a wireless EFTPOS terminal. These small adjustments help the child feel more secure and can reduce the likelihood of post-visit meltdowns. More importantly, they signal to families that their unique needs are respected and understood.
Creating a safe, welcoming space doesn’t just benefit the child during the appointment, it can have a ripple e ect on their overall wellbeing.
When a family feels seen and supported, they are more likely to return and to recommend your services to others. In turn, your practice not only helps improve access to essential vision care but also supports the emotional wellbeing of families navigating the complexities of invisible disabilities.
ABOUT THE AUTHOR: Faioa Wolterman is a senior optical dispenser and staff trainer at Bullseye Optometry and Sensory Clinic in Western Australia. She specialises in complex visual needs, including paediatric dispensing and support for patients with neurological and sensory sensitivities. She draws from her lived experience of having three neurodivergent teenager and pre-teens (13, 12 and 12) with differing complex needs.
This medicinal product is subject to additional monitoring in Australia. This will allow quick identification of new safety information. Healthcare professionals are asked to report any suspected adverse events at https://www.tga.gov.au/reporting-problems.
Name: Roxy Akers
Position: Owner/optical dispenser, Wangaratta
Eyecare
Location: North-east
Victoria
Years in industry: 18
the business and really loving the role. I learned everything on the job as I went along and then went on to study optical dispensing to continue to develop my skill set. My background in primary education has also shaped my career with a passion for children’s vision. This led to me opening a dedicated children’s vision clinic as part of our practice. During my time in the industry I have learned just how important a qualification in optical dispensing is as it gives you a great foundation of knowledge to build on.
2. What are the most influential moments and people that led you to this point?
Working as a husband-and-wife team is certainly not for everyone but thankfully it works for us. Paul has always encouraged and supported me in my role in the business and taught me how to understand the link between what happens in the exam room and out in the practice when dispensing, and that has definitely made me a better dispenser. We joined Eyebenefit for their support and networking and are so glad that we did. The support and education from a great team with a dispensing mindset has been so valuable to improve my dispensing through many conferences and opportunities to network with industry peers at these events.
3. What’s something you know now that you wished you understood at the start of your career?
Hindsight is always a wonderful thing. It’s certainly a job you are always learning on and every day is di erent.
4. Can you share a moment where you made a significant impact on a patient’s life?
My most favourite moments of my career have been times when I’ve given children their first pair of glasses and see their faces light up when they experience clear vision for the first time.
5. What innovations in eyewear or technology are you most excited about, and why?
I love the fashion element of the job and selecting frames that make the patient look and feel amazing. Some ranges are starting to o er more customisation where you can design a frame that is made especially for your patient. People love the one-of-a-kind element that this o ers. Lens technology is also ever-changing. At our practice we use Rodenstock lenses and individual customisation around these lenses with the DNEye technology has been very well received by our patients.
6. What skills or qualities do you believe are most important for an optical dispenser to thrive in today’s market?
Knowledge and understanding of how your dispensing can impact a patient in their everyday life, from being able to perform an excellent frame adjustment that helps the frame sit on the patient’s face without slipping, through to understanding how to choose a frame that will best suit the patient’s prescription. So often you see poorly selected frames for fit or suitability for the prescription
Image: Roxy Akers.
and the knowledge around this and being able to educate the patient with this makes a very big di erence in the outcome of the glasses they leave your practice with.
7. How do you ensure your skills and knowledge stay up to date and current in such a fast-moving industry?
I stay up to date by participating in training from lens manufacturers about lens technology, frame suppliers about their products and the di erent features they have, as well as attending conferences run by suppliers and networking with peers at these conferences. I always come away learning something new I can put into practice in my job.
8. Why did you become a member of ODA, and what value do you see in the organisation?
I remember being at a trade show a number of years ago sitting in a session talking about how the industry had changed with dispensing being deregulated and what should be done about it. There were many people there who were passionate about the industry and placed value on qualifications and training, even though it wasn’t mandatory. Without these qualifications and training we devalue the optical industry and what we have to o er people to make a di erence in their lives. I’m so glad that ODA o er so much CPD for dispensers to continue growing and learning in our field.
Orthoptics Australia president A/Prof AMANDA FRENCH offers her view on the 15th International Orthoptic Congress that recently took place in Brisbane.
OIMPORTANT ROLE OF ORTHOPTISTS IN PERSONCEN TRED EYECARE, STROKE AND DISABILITY, AND IN EMERGING ADVANCED ORTHOPTIC PRACTICE ROLES."
ver 300 orthoptists from across the world met in Brisbane on 27th-29th June for the 15th International Orthoptic Congress.
Orthoptics Australia was proud to host the 2025 congress, and to welcome international orthoptists to share research and innovations for practice.
The local organising committee was convened by Ms Jane Schuller and comprised Dr Felicia Adinanto, Ms Faren Willet and A/Prof Connie Koklanis. The Conference Scientific Program Committee was led by Mr Joel Hyndman from Canada, along with A/Prof Amanda French (Australia), A/Prof Darren Oystreck (Canada) and Ms Kyle Arnoldi (US). The congress was supported by platinum sponsor Vision Eye Institute, along with Tourism and Events Queensland and silver sponsor Bausch + Lomb.
This was the first in-person meeting of international orthoptists in almost a decade since the congress was held in Rotterdam, the Netherlands in 2016.
The International Orthoptic Congress is typically held four-yearly, however the Covid-19 pandemic resulted in the cancellation of the 2020 congress planned for Liverpool, United Kingdom, and instead, an online congress was arranged in 2022.
distinguished IOA orthoptist to honour their lifetime scientific and evidence-based clinical contributions.
In her lecture, titled A Vision for Vision, Prof Rowe discussed her research into care for those with vision impairment after strokes.
Early on it was identified that there were significant gaps in stroke vision care provision in the UK and a shared vision that orthoptists must be recognised as core members of the multidisciplinary stroke care team to address this.
Through her research, Prof Rowe established evidence for the prevalence and impacts of vision impairment after a stroke and the importance of vision assessment by qualified orthoptists. Based on this, UK stroke guidelines now reflect the need for orthoptic assessment for all patients following a stroke, as do guidelines from the European Stroke Organisation.
Prof Rowe’s vision for orthoptic practice was an inspiring reminder of the importance of developing evidence to drive progress and the immense value of orthoptists to delivery of e ective and person-centred eyecare.
BELOW: Conference
Scientific Program
Committee chair Joel Hyndman (from left), Local Organising
International Orthoptic Association (IOA) president Mr Jan Roelof Polling welcomed delegates to Brisbane and highlighted how important these opportunities are for orthoptists to come together as a community.
The Burian Lecture was delivered by Professor Fiona Rowe from the University
The remainder of the congress program explored a variety of topics, from stroke and vision rehabilitation to strabismus and ocular motility, and ophthalmic technologies, demonstrating the diversity of orthoptics.
The opening session discussed orthoptic scope of practice, advanced practice roles and orthoptist-led models of care, highlighting the importance of orthoptists working to the top of scope of practice to alleviate pressure on ophthalmology services and enhance patient care.
Four symposia were highlights. The International Strabismological Association (ISA) presented a symposium on anomalous head postures, with speakers ophthalmologists Dr Andrea Molinari, Prof Jonathan Holmes, Dr Lional Kowal and orthoptists Ms Daisy Godts and Prof Rowe.
Orthoptist Prof Gill Roper-Hall convened a panel of orthoptists (Ms Renee Hernandez and Mr Roelof Polling) and ophthalmologists (Dr Shivanand Sheth and Dr Lional Kowal) to discuss challenging neuro-ophthalmic cases.
The Asia Pacific Strabismus and Paediatric Ophthalmology Society
(APSPOS) convened a symposia on the role of imaging in paediatric cases, including orthoptists from Children’s Hospital Westmead (Ms Katie Geering and Ms Stephanie Crofts) and ophthalmology colleagues (Dr Caroline Catt, Dr Rasha Altaie, Dr Deepa Taranath and Dr Susie Luu). Finally, the myopia symposium provided an overview of the impact of lifestyle factors on myopia development and current evidence for strategies for prevention and management, including researchers at the forefront of this work, Prof Ian Morgan, Prof Jason Yam and orthoptists Prof Kathryn Rose, A/Prof French and Dr Adinanto. Three presenters received awards for their work. Dr Gareth Lingham (Australia) received the IOA Research Award for his work titled Biometry equivalent refraction as a screening tool for refractive error in children. The IOA Early Career Scientist-Clinician Research Award was presented to Mr Vijay Tailor-Hamblin (UK) for Low concentration atropine a ects near point of accommodation, but not near visual acuity, and the Student Research Award was presented to Mr Rani Bahho (Australia) for The Relationship between Motor Fusion and Stereoacuity in Adults with Normal Binocular Single Vision
The congress emphasised the diversity of orthoptic practice, the important role of orthoptists in person-centred eyecare, stroke and disability, and in emerging advanced orthoptic practice roles such as in ocular emergency, paediatric ophthalmics and advanced ophthalmics.
The strength of orthoptic research and the profession as a whole was evident across the congress program and as president Mr Roelof Polling highlighted in his closing remarks, the orthoptic profession is stronger together and we are very glad to have this opportunity to once again connect as a community.
ABOUT THE AUTHOR: Associate Professor Amanda French is the president of Orthoptics Australia and head of orthoptics at the University of Technology Sydney.
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
The October 2025 issue will feature the Insight Dry Eye Directory, Australia’s most comprehensive source for dry eye care.
Back by popular demand, this all-in-one resource is a valuable purchasing guide for practices, showcasing available Therapies and Diagnostics in Australia. It will also feature a comprehensive list of dedicated Dry Eye Clinics.
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Whether it’s addressing a staff member’s underperformance or an unhappy patient, difficult conversations are a daily reality in private eyecare practices. Experienced healthcare leader SCOTT BELL provides some useful pointers.
“CREATING A PRACTICE CULTURE WHERE REGULAR FEEDBACK IS EXPECTED AND WELCOMED … CAN MAKE THESE CONVERSATIONS FEEL LESS PERSONAL AND MORE ABOUT ALIGNMENT AND GROWTH.”
Few of us are naturally comfortable with di cult conversations. The thought of providing tough feedback to a colleague, or telling a patient about a di cult diagnosis or unexpected surgical outcome, is not only unpleasant but stressful. It often leads to procrastination, anxiety and poor execution which can make the situation worse.
But a well-timed, well-delivered di cult conversation with sta can improve clarity, understanding and alignment among your team. And a challenging conversation handled well with a patient shows empathy and respect, which will in turn build trust and support informed decision making.
Knowing the principles of handling di cult conversations will not only serve you well professionally, but in life generally.
Below we discuss two broad types of challenging conversations.
1. Addressing under-performance in staff
In a busy ophthalmology clinic, e ciency and accuracy are critical – whether it’s administrative sta managing your appointment schedule and surgical bookings, or orthoptists conducting pre-operative workups. When a sta member fails to meet expectations, ignoring the issue not only perpetuates the problem, it can impact patient flow, safety, and culture.
Leadership similarly reported inconsistent or unclear feedback was a leading cause of disengagement among clinical and administrative sta .
To e ectively address sta underperformance, clarity, accountability, and culture should be front of mind:
• Clarify roles and expectations upfront. Ensure each team member understands their responsibilities. This includes clear position descriptions and written policy and procedures.
• Give timely, specific feedback. Nothing should be a surprise for a sta member at an annual performance review. If someone isn’t meeting expectations, provide feedback promptly.
• Adopt a coaching mindset. Begin with curiosity and support: “I’ve noticed you’ve had few patients where the full workup wasn’t completed – can we talk about what’s going on and how I can help?”
• Document and follow through. If improvements aren’t made, document discussions and follow formal performance management processes to uphold fairness and clarity.
• Encourage reflection. Ask open questions: “How do you feel things are going in your role?” or “What could help you improve in this area?”
trust and transparency matter:
• Lead with empathy. Begin by acknowledging emotion: “I understand this has been upsetting for you, and I appreciate you taking the time to discuss your concern.”
• Avoid rushing to justify. Allow the patient to speak fully before o ering a clinical explanation. This signals respect and will make them feel ‘heard’.
• Validate their feelings. Even if the issue is a known risk of surgery, show you understand their perspective: “It’s reasonable to feel disappointed, this wasn’t the result either of us hoped for.”
• Be clear and honest. Avoid jargon. Explain what happened, what the expected recovery now looks like, and what support will be provided.
• O er solutions and next steps. Reassure them that you’re committed to achieving the best possible outcome from this point forward.
Of course, in incidents that could give rise to a complaint, speak to your medical indemnifier early for advice and practical support.
BELOW: A coaching mindset with curiosity and support can be a useful way to approach
Research published in the Harvard Business Review (2016) found nearly seven in 10 managers avoid di cult conversations about performance. In healthcare, this avoidance can lead to resentment among high-performing colleagues and erode your practice’s standard of care and reputation with referrers.
A 2020 study in the Journal of Healthcare
Creating a practice culture where regular feedback is expected and welcomed – both upward and downward – can make these conversations feel less personal and more about alignment and growth.
You may want to look into the SBI feedback model (Situation-Behaviour-Impact) as a useful framework for feedback.
2. Difficult conversations with patients Ophthalmology is highly satisfying specialty, but complications happen. Whether it's a refractive surprise, a complication, or dissatisfaction with their experience, patients in private ophthalmology settings can feel particularly vulnerable – especially when out-of-pocket costs are involved.
According to a 2021 BMJ Open study, patients who felt heard, acknowledged, and kept informed were far more likely to remain loyal to a practice – even if they had experienced complications – than those who felt dismissed.
When addressing an unhappy patient,
Interestingly, a 2018 review in the Journal of Patient Safety found clinicians trained in empathy and apology techniques maintained higher trust levels after adverse events.
Whether you’re an ophthalmologist or a practice manager, di cult conversations aren’t an interruption to your day – they are a fundamental part of your role as a leader.
The way you handle sta performance or concerns, or respond to patient dissatisfaction, will impact the reputation of your clinic, team culture, and even clinical outcomes.
By setting clear expectations and providing feedback, fostering open communication, and approaching each conversation with empathy and professionalism, you can turn di cult conversations into defining moments.
ABOUT THE AUTHOR: Scott Bell is the CEO of SMS Healthcare, with 14 ophthalmology clinics and eight refractive laser centres across the east coast of Australia. He’s previously been a director of Day Hospitals Australia, co-founded Nexus Hospitals and is a director at Sapphire Eye Care, a leading UK private ophthalmology group.
Marking nearly 15 years in Australia, Astellas is a world leader in the development of innovative new medicines, employing more than 17,500 people globally. With a strong foundation in Oncology, Urology, and Transplant, we are now broadening our horizons to include new therapeutic areas such as Ophthalmology.
By combining our expertise in eye biology with cutting-edge technologies, we’re pioneering new approaches including novel cell- and gene-based therapies.
We’re looking forward to meeting with the ophthalmic community and engaging in the latest scientific discussions, as we believe that together we can deliver meaningful value to patients who are urgently waiting.
Contact your local MSL to learn more.
Alex Abalos NSW, ACT
MBBS B.Sc (med) Ophthalmology t. 0439 605 923 e. alex.abalos@astellas.com
Natalie Buckman QLD, WA, NT
MOptom MPH BVisSci GCBus FBCLA AFHEA t. 0401 192 393 e. natalie.buckman@astellas.com
Michelle Waugh VIC, SA, TAS
BOptom, MPhil, PhD, MBA t. 0413 139 151 e. michelle.waugh@astellas.com
to protect patient choice and limit PHI influence, successfully lobbying in 2015 to stop pre-approval activities and leading the ‘Your Right to Switch’ campaign since 2018 that educates consumers on their right to change PHIs without a ecting waiting periods, if they’re dissatisfied. Our 2021 ‘Send the Eagle Home’ campaign prompted the Australian Competition and Consumer Commission to impose strict criteria on a US health fund from extending its ‘buying power’ and influence across the Australian health fund sector.
All of these issues remain live, however, a crumbling private hospital sector is now the backdrop, where PHIs stand to cash in as facilities close their doors and become available for sale at reduced rates.
There are questions around whether this has been an intentional PHI move to limit the premiums returned to private hospitals, contributing to their demise, and ultimately their own profit-driven, managed care interests.
a clear conflict of interest.
An example currently under the microscope is Bupa’s Medical Gap Scheme (MGS). Concerns have been raised about whether this current structure disincentivises consumers from using hospitals outside Bupa’s network.
ASO president Dr Peter Sumich has written to Bupa several times, the latest on 2 April 2025, requesting clarity around the impacts to hospitals without a Bupa contract and subsequently on second-tier default benefits:
right to choose their doctor, their procedure or treatment, and their preferred hospital or facility.
It also brings an increased risk that many consumers will be priced out of healthcare, with the domino e ect crippling an already struggling public health sector in Australia.
The Australian Society of Ophthalmologists’ (ASO) recent e-petition (EN6877) through the Parliament of Australia is not the first time the association has lobbied the government in the interests of Australian patients – which is pending a formal response from the Minister for Health.
Launched in late 2024, the e-petition called for the government to establish a Private Health Commission or Independent Authority to play referee to a divided private health sector, where hospitals are losing their footing as private health insurers (PHIs) reach for greater control and influence.
The ASO is not alone, with the Australian Medical Association (AMA) and numerous other bodies requesting the same as current mechanisms prove ine ective, at best.
The ASO has long campaigned
What Australian patients need to know, and the government needs to factor into decision making, is the cons outweigh the pros with managed care.
Whilst it may arguably help to control healthcare costs and increase system e ciencies, as shown in the US, it comes with major losses for patients and their long-term health outcomes.
Patient choice can become significantly restricted with an inability to see preferred providers and incur out-of-network penalties, even in emergencies, if they are outside of the PHI’s doctor and hospital network.
We fear the ultimate decision to proceed with a procedure or treatment will no longer reside with the patient and be informed by advice from their treating doctor.
Pre-authorisations may often be requested by a PHI for procedures, tests or medications that can lead to treatment delays, denial of coverage if deemed “not medically necessary”, and result in added emotional and psychological distress for patients seeking to appeal such decisions.
There’s a risk comprehensive patient care will take a back seat to profits, with some examples reported to o er financial rewards to their in-network providers for limiting services or reducing costs
“It is understandable that the hospital fee paid to the day surgery by the private health insurer will be according to the contracts between those parties. However, the gap scheme product used by the surgeon should have nothing to do with the hospital’s contractual status. The financial arrangement between the doctor and the patient is separate to the financial arrangement between the patient and the hospital,” he said.
“Bupa are e ectively penalising a patient because they are receiving treatment at a hospital which has decided for its own separate financial considerations not to adopt your contractual arrangements and therefore chosen second-tier default benefits.”
The facilities most at risk are smaller, independent sites operating outside of metropolitan cities and hubs. Australians living in regional and remote communities are already at a geographical disadvantage when it comes to accessing healthcare and being provided with local choice.
No Australian patient or doctor should be intimidated from visiting an accredited hospital or day surgery operating under second-tier default benefits, let alone the members of our community doing it the toughest with minimal resources.
NOTE: See the online version of this article for Bupa's response.
ABOUT THE AUTHOR:
Name: Katrina Ronne
Qualifications: BBus (IR), MBA
A liations: Australian Society of Ophthalmologists, CEO
Location: Brisbane, Queensland
Years in industry: 15
THERE’S A RISK COMPREHENSIVE PATIENT CARE WILL TAKE A BACK SEAT TO PROFITS, WITH SOME EXAMPLES REPORTED TO OFFER FINANCIAL REWARDS TO THEIR INNETWORK PROVIDERS.
AUGUST 2025
OPTOMETRY CLINICAL CONFERENCE
Melbourne, Australia
17 – 18 August occ.optometry.org.au
ASIAPACIFIC ASSOCIATION OF CATARACT AND REFRACTIVE SURGEONS (APACRS) MEETING
Ahmedabad, India
21 – 23 August apacrs2025.org
OPHTHALMOLOGY UPDATES!
Sydney, Australia
30 – 31 August ophthalmologyupdates.com
2025
EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEON (ESCRS) MEETING
Copenhagen, Denmark
12 – 16 September congress.escrs.org
SPECSAVERS CLINICAL CONFERENCE 2025
Melbourne, Australia
13 – 14 September specsaversclinicalconference.com.au
TASMANIA'S LIFESTYLE CONGRESS
Tasmania, Australia
20 – 21 September tlc.optometry.org.au
2025
ORTHOKERATOLOGY SOCIETY OF OCEANIA MEETING
Benowa, Australia 10 – 12 October oso.net.au
AMERICAN ACADEMY OF OPHTHALMOLOGY MEETING AND EXPO
Orlando, US 18 – 20 October aao.org/annual-meeting
2025
WHY DID YOU PURSUE AN OPTOMETRY
I never really knew what I wanted to do throughout high school, but I always felt a pull towards science and health fields, liked the idea of helping solve people’s problems, and took an interest in optometry. I stuck with it, got through university, and here I am on the other side as a qualified optometrist. It’s not a glamorous beginning to the story but I suspect it's relatable for many.
HOW DID YOU COME TO WORK AT SPECSAVERS?
Specsavers is well known as one of the major players in the optometry sector. As an optometry student, I wanted to get experience beyond the clinical side, understand the business models and learn the roles of team members in a practice beyond the optometrist. I wanted to understand the practicality of how eyecare is delivered in the private sector. So it was a no-brainer that I applied for an optical assistant role during my final years of study. From being a student to optical assistant to optometrist, one aspect that has never changed is that I am a strong believer in the level of care and accessibility Specsavers provides to its patients.
Location: Australia, nationwide Years within the business: 6
WHAT GROWTH OPPORTUNITIES HAVE PRESENTED THEMSELVES?
During my time as an optical assistant, I was recommended by my store director to provide support at a new store opening elsewhere in metropolitan Sydney. This pushed me to step up and take on a more senior dispensing role that included training others. Eventually upon graduation from university, it was time for me to trade in my dispensing hat for an optometry one. Everyone around me knew I wanted to explore beyond Sydney, and I had the support of all
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: Kimberley Forbeson +61 (0) 429 566 846 or Ekimberley.forbes@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
the store directors I had worked for, alongside the graduate recruitment team. Securing my graduate optometry position was e ortless because of them all. My graduate optometry position was in regional NSW, a newer store that was only beginning to find its feet when I joined. I got the opportunity to drive the growth and development of that store, both on the optical and retail fronts – it wasn’t easy but it was a genuinely rewarding experience. I eventually moved on and found myself in the lucky position of becoming a member of the Specsavers mobile optometry team. Without a doubt, this chapter of my career has been the most growth-inducing yet. Every new location, every day, every patient. It’s all an opportunity to grow as a clinician, as a team member, as a person.
WHAT ARE YOUR TOP CAREER HIGHLIGHTS SINCE JOINING SPECSAVERS?
For me, it’s never been the awards or clinical statistics or status. It’s the moments I know I’ve made a positive di erence to someone's vision and quality-of-life. It’s the recognition I get from individual patients who come back to share their gratitude no matter how big or small.
WHAT EXCITES YOU MOST ABOUT TURNING UP FOR WORK EACH DAY?
Now that my role entails travelling and providing support to regional locations all over Australia, I’m just excited to show up. I approach each location with the mindset that I am here to help. Every location I have been to has welcomed me warmly. The patients and colleagues I’ve met along the way have given me some great laughs and memories.
Designate Optometrist Partnership Opportunity in KarrathaPotential to Earn Up to $250,000
Specsavers Karratha is o ering an exciting opportunity for an experienced Optometrist to join the brand as a Designate Partner, with the potential to earn up to $250k. Located in the beautiful coastal town of Karratha, this new Specsavers store will bring the latest in optical technology and store design. The opportunity is a unique 2-year ‘try before you buy’ partnership model, setting you up for long-term success. Successful applicants will benefit from Specsavers’ award-winning support, including recruitment assistance, business development, and end-to-end financing for new stores.
Join a Best Place to Work - Recruiting Across WA
Whether you’re after the buzz of city life or the relaxed pace of a coastal or regional town, Western Australia has it all. Specsavers are looking for passionate Optometrists for full-time and part-time roles across WA – from Belmont and Cannington to Bunbury and beyond! Join an accredited Best Place to Work 5th year running, with clinical variety, and a lifestyle that truly delivers work-life balance. We o er relocation support if needed, and give you clear career pathways - there’s never been a better time to explore what’s next with Specsavers in WA!
Optometrist opportunity – Specsavers Wellington CBD, NZ
Join the team at Specsavers Wellington CBD, where you’ll work with a diverse patient base in a vibrant, walkable city known for its culture and lifestyle. Enjoy a supportive team, modern technology including OCT, and flexibility with full-time or part-time hours. Explore life as a Specsavers optometrist in the heart of Wellington!
Graduate Opportunities
If you’re a final-year student looking for your first graduate role, Specsavers could be the perfect fit. As the largest employer of Graduate Optometrists across Australia and New Zealand, we’re passionate about delivering expert eye care and supporting your growth from day one. Our comprehensive two-year Graduate Program is designed to accelerate your development and help you thrive in your career. Want to learn more? Reach out to your Graduate Recruitment Consultant or email us at anz.graduateoptometry@specsavers.com.
INSIGHT'S MONTHLY BULLETIN TO KEEP THE AUSTRALIAN OPHTHALMIC SECTOR UPDATED ON NEW APPOINTMENTS AND PERSONNEL CHANGES, NATIONALLY AND GLOBALLY.
Ms Yvette Safier has joined ProVision as a Queensland business coach. She brings more than 20 years of industry experience, including 11 years as high performance manager at Eyecare Plus, with extensive expertise across wholesale and buying group retail environments. Her track record in business coaching and analytics will be instrumental in helping ProVision members
Mr Craig Johnston has joined Opticare as its new national training and development manager, bringing more than 40 years of experience in optics, including senior training and leadership roles at HOYA and Younger Optics. In this role, Johnston will lead learning initiatives across both Opticare's customer and internal teams, ensuring "consistent, practical, and growth-focused support
Ms Tegan Matheson is starting a new position as eyecare senior manager for Australia and New Zealand at EssilorLuxottica. After previously serving as country eyecare manager New Zealand, based in Auckland, she was then appointed into the role of senior professional services manager NSW/ACT in 2024. Now, in her new role, she will be responsible for overseeing direct-to-consumer eyecare strategy and hopes to expand her impact in advancing eyecare excellence across ANZ.
