MAY 2014
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Transitions Optical has closed down its Australian operation based in Lonsdale, SA, with 14 staff members being put off
Fred Hollows used as inspiration The later Fred Hollows’ life has been chosen to inspire the next generation of young leaders by a $100m foundation
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Transitions closes Its SA operation
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The ‘good old days’ – not so good? The so-called ‘good old days’ in the 1940s were not all that they were cracked up to be, according to a contributor
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MAY 2014
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Transitions Optical closes down its operation in South Australia T ransitions Optical has closed down its Australian operation based in Lonsdale, South Australia, with 14 out of 17 staff members being put off and the remaining three staying on to finalise affairs. The decision to close the facility at Lonsdale, South Australia, was announced on 14 April – two weeks after Essilor International bought the 51 per cent it did not own in its Transitions joint venture with PPG in the United States, thereby giving it 100 per cent ownership of Transitions. Essilor maintains it is unable to comment on the takeover until the deal with PPG over Transitions is complete, as, even though a binding agreement to purchase has been signed, there is always the risk of a last-minute hitch. Also, Transitions is based in Florida in the United States, which probably means armies of lawyers being involved in the negotiations and final agreement(s), including comment restrictions on both parties. At the time of going to press, there had been limited, if any, information provided by Essilor Australia to the laboratories here that use its product, which frustrated a number of them. In short, it appears the laboratories will continue to obtain product from the same sources overseas that they had previously used, but no longer via the South Australia facility. However services that the Transitions facility in SA provided for their client laboratories
Transitions Optical’s premises in Lonsdale, South Australia and their practitioner clients, such as consumer advertising campaigns (spends of more several million dollars a year were not uncommon), provision of promotional material for practices, a dedicated national product sales force, and technical advice, will no longer be available from a Transitions facility here and will have to be provided by client laboratories and/or practitioners themselves or from local or overseas Essilor sources. It is not yet known how Essilor Australia will handle the newly-acquired Transitions business here. Transitions’ operations in New Zealand have also been closed down, as have those in
India. There was no news at press time of the fate of the rest of Transitions’ operations globally. The president of Transitions, Mr Paddy McDermott, in a statement to Insight on 14 April said: “Transitions Optical communicated to our Australia employees on April 14 that we are restructuring our commercial organization to focus on supporting our direct customers, optical lens manufacturers. “Fourteen of our Australia and New Zealand associates are affected and will receive a comprehensive package of separation benefits appropriate to their positions and tenure, including outplacement services. The company is committed to
helping impacted employees find new employment as professionally and respectfully as possible. We do not take these decisions lightly and have made these changes to increase efficiency, continue to strengthen the Transitions brand, and drive growth across the photochromic category for all of our customers. “The international optical market continues to evolve, and supply routes of Transitions product into Australia and New Zealand have evolved greatly in recent years. The majority of the product destined for the ANZ market is supplied to laboratories in overseas locations. That development has greatly reduced the necessity for a dedicated operation in Australia. “Transitions Optical strategic focus is to provide our supply partners with technical and marketing support to enable and leverage their already extensive resources within the Australia and New Zealand markets. Both markets are very important for us and this change in approach is focused on optimizing our partner relationships to our mutual benefit.” ■
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Future of Clearly. com.au in doubt; strong rumour
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Transitions Optical has closed down its Australian operation based in Lonsdale, SA, with 14 staff members being put off
Fred Hollows used as inspiration
The later Fred Hollows’ life has been chosen to inspire the next generation of young leaders by a $100m foundation
34
Transitions closes Its SA operation
30
MAY 2014
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The ‘good old days’ – not so good?
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strong but unconfirmed rumour says that the recentlyopened bricks-and-mortar Clearly.com.au store in Sydney’s George Street will be closed down or sold soon after Essilor International completes its $C430million takeover of parent online company Coastal.com, due to be completed in the first half of May. According to the rumour, Essilor does not want the distraction of owning an online supplier of prescription glasses and sunglasses, which has already met with concerns by its existing bricks-andmortar customers about prices for those products, as well as for contact lenses. At least two buying groups and one wholesale company say they have been told that Clearly.com. au’s retail store in George Street will be closed down (as will a newlyopened store in Auckland, New Zealand), so as not to be a distraction from Essilor’s core business of prescription-lens manufacture and distribution. Industry sources here say Essilor Australia’s claim could be a reaction to antagonism by some, including buying groups, towards the expectation that the $C430million takeover of parent Coastal.
com and it being regarded as the largest online provider of contact lenses and glasses in the world, with a claimed five million clients, which would be in direct competition with Essilor’s clientele. Neither Essilor nor Clearly.com. au had any comment to make. Commenting on the announcement of its planned acquisition of Coastal.com on 27 February, Essilor International’s chairman and chief executive officer, Mr Hubert Sangieres, said: “The internet, if used properly, can help to drive market growth … Essilor is acquiring a recognised online vision-care platform. Our commitment is to contribute to shape this distribution channel for the benefit of the entire industry as well as consumers.” ■
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RETAILING
Essilor completes purchase of Coastal.com online retailer A s Insight was going to press on 29 April, Essilor International announced that it had completed the acquisition of all outstanding common stock of Coastal.com, a leading online vision-care retailer. The transaction, announced on 27 February, was approved by Coastal.com shareholders at an extraordinary meeting on 16 April and has also been cleared by regulatory authorities. Based in Vancouver, Canada, Coastal.com designs and distributes a wide selection of optical products, including contact lenses, prescription and non-prescription
eyeglasses, sunglasses and accessories. It reported revenue of $C218 million for the fiscal year ended 31 October 2013. The price of the transaction was $C12.45 per Coastal.com share, which represents an equity value of approximately $C430 million. “The acquisition of Coastal. com is fully aligned with Essilor’s efforts to make the Internet a powerful driver of growth across the optical industry,” Mr Hubert Sagnieres, Essilor’s chairman and chief executive officer, said on 27 April. “Online sales offer strong
LATE NEWS
Expansion plans for Clearly.com stopped Following completion of Essilor International’s takeover of Coastal.com, expansion plans for Clearly.com.au bricks-and-mortar stores in Sydney and Auckland were stopped immediately, Essilor Australia’s chief executive officer and country manager ANZ, Mr Tony Gray, told Insight on 29 April. None of Essilor’s key brands will be offered to Clearly.com from now on and the standing offer by Clearly.com.au of a free first pair of glasses will be discontinued as soon as possible, Mr Gray said.
growth potential and this platform, used properly by Essilor, will help to educate consumers and make it more convenient for them to enjoy good visual health for the benefit of all industry players.”
Coastal.com will be consolidated by Essilor from 1 May and Coastal.com shares will be withdrawn from trading on the Toronto Stock Exchange and the NASDAQ on the same date. ■
Glaucoma-treatment guidelines are current major issue: RANZCO president
T
he decision of the Optometry Board of Australia to amend the glaucoma treatment guidelines is a current major issue, the president of The Royal Australian and New Zealand College of Ophthalmologists, Dr Stephen Best, said on 21 March at the college’s New South Wales Branch meeting in the Hunter Valley. There was little consultation with the college and its submissions were disregarded, Dr Best said. Independent management by optometrists was recommended and it was a matter of change by legislation rather than education and experience, he said.
There is great concern that it could potentially put patients at risk of irreversible loss of vision from glaucoma. Dr Best said the board’s decision disregarded the National Health and Medical Research Council’s Glaucoma Guidelines 2010 which were formulated by optometrists, ophthalmologists (ANGIG) and other health-care professionals based on available evidence based on international studies and guidelines with an Australian emphasis. There was a vigorous response to the board’s decision by both RANZCO and the Australian Society of Ophthalmologists.
A meeting in early 2013 at the Australian Health Practitioner Regulation Agency’s premises in Melbourne, brokered by the Commonwealth chief medical officer, Dr Chris Baggoley, with optometrists/chairs of the OBA and the Medical Board of Australia, failed to agree. That was followed by the initiation of legal action by RANZCO and ASO in the Supreme Court of Queensland in July 2013, which was challenged on the right of those two organisations in terms of “standing to bring the case”. The matter was heard in August and decided in late December, with some frustration reported by the judge.
The matter is now scheduled to be heard in August. Expert witness statements have been lodged by two ophthalmologists in diagnosis and management of glaucoma. Dr Best recommended that college fellows should discuss with their patients the difference between the training and experience of optometrists and ophthalmologists, and to also discuss the matter with referring optometrists. Furthermore, they should contribute to the ASO’s ‘fighting fund’. The long-term aim is a collaborative, integrated team treatment approach to ensure best outcomes for patients, based around the 2010 NHMRC guidelines. ■
Health spending grows 37%: minister
F
ederal health minister Peter Dutton says new figures showing an escalation in health spending demonstrate why the government must cut ‘’waste’’ in health.
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Figures to be published by the Productivity Commission show that between 2002-03 and 2011-12, federal government spending on health grew at an average of 4.9 per cent a year, while state government
spending grew at 6.8 per cent a year, and non-government spending – by individuals and insurers – grew by 5 per cent a year. Health spending per head by all governments rose 37 per cent
over the period in real terms, from $4474 to $6230. Adjusting for inflation, non-government health spending per person rose from $1259 to $1802 over the same period. ■ MAY 2014
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A New Vision for Presbyopia Ask Eye Care Practitioners (ECPs) which new lens is top of their wish list and many might include a silicone hydrogel (SiH) daily disposable multifocal in their answer. This should come as no surprise in view of the fact that daily disposable modality, along with SiH material, represent the biggest growth areas in contact lenses today. Given the ageing population, the interest in keeping our presbyopic contact lens wearers in lenses for longer is an ever-increasing aspiration of both practitioner and wearer. However, when patients reach their mid-40s, while the number of spectacle wearers increases sharply the contact lens drop-out rate also increases dramatically. In fact the presbyopic age group shows the highest patient dropout from contact lenses of any age1.
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Innovation has been the key to driving contact lens growth and, with the significant improvement in lens design and material, multifocal fitting is growing (Figure 1). However, until now, despite its popularity the daily disposable modality has been relatively underrepresented in terms of multifocal with, until recently, the hydrogel Focus® DAILIES® PROGRESSIVES All Day Comfort™ being the only daily disposable multifocal on the market. Sauflon have now launched clariti® 1day multifocal, the world’s first SiH daily disposable multifocal; closing the gap between consumer/practitioner desire and product choice. Along with the clariti® 1day sphere and clariti® 1day toric, clariti® 1day multifocal makes this the world’s first SiH daily disposable family. The benefits of SiH are well documented with health and comfort being among the most important and the current fitting trends indicate that SiH is now accepted as the industry gold standard in contact lens materials. The benefits of the daily
disposable modality are also well accepted with current fitting trends showing 31% percent of fits worldwide are now in a daily disposable modality and around one-third of these are SiH3.
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LOW Incorporating the patented AquaGen™ technology, the unique clariti® SiH material balances a Dk/t of 86 delivering up to 97% corneal oxygenation, with a low modulus of 0.5MPa (being among the softest of SiH materials) and a high water content of 56% supporting biocompatibility with the ocular surface. All clariti® lenses have UVA and UVB filters, giving added protection against ultra violet rays. The characteristic properties of this low modulus add high water content lens, allow for easier upgrade for the hydrogel wearer, an important consideration when introducing wearers to new lenses. The ageing eye presents several challenges to contact lens wear in terms of comfort, vision and physiology. The right balance of health, comfort and biocompatibility becomes especially important. Endothelial changes with age mean corneas may become less able to tolerate oxygen deprivation therefore a high Dk/t material becomes increasingly important to maintain wearing times. Tear films also tend to degrade with age and eyes become drier. Research suggests that SiH material gives improved comfort and helps prevent early drop out due to reduced wearing times4. SiH is an ideal choice, along with the daily disposable modality for minimising some of these challenges faced by the maturing contact lens wearer. clariti® 1day multifocal, with its optimal balance of properties delivers a long-awaited lens for presbyopes, widening the choice available to the ECP and helping to reduce the significant drop-out from lens wear as mid life approaches. This is of particular importance to those wearers already benefiting from a SiH daily disposable who on reaching presbyopia will in the past
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clariti® 1day multifocal is a simultaneous, centre near design. It has a fully progressive intermediate power zone allowing clear, uninterrupted vision through near, intermediate and far distances. As with all multifocal lenses, good centration and a stable fit is very important and the aspheric back surface periphery ensures good fit and stabilisation. With low and high ADD powers (Figure 2) and a comprehensive power range (Table 1), clariti® 1 day multifocal will suit a wide range of presbyopes. For optimal fitting success clariti® 1day multifocal is supported by a simple, four-step fitting guide designed for minimal chair time and an enhanced patient and practitioner fitting experience. Sauflon is confident that clariti® 1day multifocal, in addressing many of the current barriers practitioners face to multifocal contact lens fitting, will be an extremely valuable addition to the multifocal contact lens portfolio. clariti® 1day multifocal provides new opportunities for ECPs to keep existing patients in contact lenses for longer, while attracting the non-contact lens wearing emerging presbyope with the convenience and flexibility of daily disposable multifocal contact lenses.
Mintel Optical Goods and Eye Care report 2006. Morgan P.B. et al. International Contact Lens Prescribing in 2012. Cont. Lens Spectr. 2013;28:31-38 3 Morgan P.B. et al. International Contact Lens Prescribing in 2013. Cont. Lens. Spectr. 2014;29:30-35 4 C Riley et al. Eye Contact Lens. 2006; 32;6:281-286. 1 2
For more information and free trials contact Sauflon on: T: 1800 632 456 E: sales@sauflon.com.au W: sauflon.com.au
INVESTIGATION
French Competition Authority steps up probe of possible AMD-drugs collusion
T
he French Competition Authority, Autorité de la concurrence, has stepped up its probe of potential Lucentis price-fixing. As The Times of London reports, the anti-trust regulators on 11 April said they raided local offices of Roche and Novartis, looking for evidence of collusion. According to a statement on the competition authority’s website, regulators went on ‘search and confiscation’ manoeuvers on 8 April in their probe of treatments for wet age-related macular degeneration. The regulators didn’t name the companies involved, but Roche and Novartis confirmed that competition authorities had
launched the probe. The raids follow a month after Italian watchdogs fined the two Swiss drug-makers in a similar case. According to the Italian Competition Authority, Roche and Novartis worked together to block Avastin, the cheaper alternative to Lucentis, their injectable drug for wwet age-related macular degeneration. One of Roche’s own cancer drugs, Avastin is often used off-label to treat AMD.
$271m fines in Italy As reported in the April issue of Insight, Italy slapped Novartis with €92 million ($A135 million) in fines, and levied another €90.5
million ($A136 million) worth of penalties against Roche. Developed by Roche’s Genentech unit, Lucentis is marketed in Europe by Novartis. At the time, both Swiss drugmakers said they would appeal the fines. “We strongly deny allegations about anti-competitive practices between Novartis and Roche in Italy,” the companies said in a statement. The companies denied the latest allegations as well. “Roche confirms there is no agreement between Roche and Novartis that restricts competition,” the company said. Though Lucentis is similar to Avastin, Genentech developed
the eye drug specifically for ophthalmic use. But ophthalmologists have continued to use Avastin, which has to be repackaged into syringes for injection into the eye. As a vision treatment, it’s much less expensive than Lucentis, at less than $100 per dose, compared with the Lucentis’ $2,000-per-dose list price. But as Roche and Novartis have repeatedly warned, repackaging the cancer drug for eye use can cause contamination; several clusters of serious eye infections in the United States have been traced to repackaged Avastin. Lucentis brought in $US1.9 billion in sales for Roche last year. ■
AMA calls for federal govt to engage with medicine and end speculation
T
he president of the Australian Medical Association, Dr Steve Hambleton, has called on the federal government to engage in meaningful consultation with the medical profession about the future of primary health care, and put an end to the “crazy policy speculation being floated in the media”. Dr Hambleton said on 9 April that reports of a possible charge for ‘low acuity’ patients treated in emergency departments are further proof that policymakers are more focused on budget savings than patient care. “Category 4 and Category 5 emergency department patients are not necessarily GP patients – they are the patients who can safely wait for care,” Dr Hambleton said. “They are not clogging up the emergency departments, so the proposal is trying to solve a problem that does not exist. The problem in emergency departments is lack of capacity in the hospital to move sick people out of the 8
MAY 2014
emergency department into inpatient beds.” Dr Hambleton said it is not possible to develop significant health policy that works without first consulting with the people who work in the front line of the health system every day. “The government needs to clarify its position on primary care, especially general practice,” Dr Hambleton said. “Making policy on the run is no way to equip the health system to meet future needs. “All the speculation ahead of the Budget is about GP co-payments, freezing Medicare rebates, means testing, and now a charge for patients who go to emergency departments with minor ailments. “Those proposals are targeted at the wrong end of the health system, they would produce disincentives for people to see their doctor, and they would create loads of new red tape for medical practices. “There is already means testing
in the health system through processes such as the application of the Family Tax Benefits to Medicare Safety Net thresholds. The new proposals would put a means test on top of a means test. “The GP co-payments idea could actually lead to increased costs to the health system, and should be ruled out immediately. “Freezing Medicare rebates would have a compounding effect on patient out of pocket costs, creating another disincentive for people to see their doctor. “Targeting GP services for savings is a false economy that would lead to greater costs down the track. “General practice is a very efficient part of the health system, helping minimise the number of people who end up needing far more expensive hospital or chronic care. There is not a significant problem with supposed unnecessary use of GP services. That is a furphy. “The greater concern is putting barriers in the way of people seeking
relatively inexpensive GP treatment for health complaints. Forcing people to avoid seeing the doctor for minor ailments is a dangerous and expensive policy direction. Minor ailments become major ailments if not treated early.” Dr Hambleton said the international evidence shows that the key to a sustainable health system that delivers high quality outcomes for patients is to ensure the barriers to accessing primary care are low. “Rather than looking to make savings in general practice, the government should be investing more in primary care and prevention,” he said. “The main problems facing our health system are the ageing population and the growing incidence of complex and chronic diseases. “We need to do more to decrease the impacts of alcohol, tobacco, and obesity on our population. “We need to keep people out of hospital, where care is much more expensive.” ■ www.insightnews.com.au
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COMMENT
Editorial CPD: worth the candle?
T
he insistence of the Australian Health Practitioner Regulation Agency that members of the 14 registered health-care-practitioner groups under its control, including medical practitioners and optometrists, undergo a certain number of hours and certain types of continuing professional development in order to retain their registration, is becoming a farce in that it is now easy to cheat so as to seemingly comply with the regulations without doing the required work demanded by their respective national boards – the Medical Board of Australia and the Optometry Board of Australia, particularly the latter. How it works is simple: if a magazine that is pitched to, say,
optometrists, includes articles approved by the OBA’s organisation of choice to administer its CPD program, Optometrists Association Australia, and has a self-administered question-andanswer section at the end, two CPD points are usually awarded to those who successfully complete the Q&A section. But, as is being shown right now, there is nothing to stop someone completing that section and circulating the results to interested (or is it disinterested?) colleagues, who merely copy the answers and send them to OAA, claiming the two CPD points. But optometrists wouldn’t do that, would they? Well a good (and increasing) number are doing it because they’re fed up
with hearing much of the same from many of the same speakers at CPD-points-earning events. Since its introduction as a mandatory requirement for registration, CPD has become a haven for speakers on ophthalmic matters of all kinds, and a great earner for professional associations through registration fees to attend their conferences and charges for companies to exhibit at accompanying trade exhibitions. Clearly the time has arrived for a comprehensive and serious look at the whole area of CPD participation. For example, are the speakers bringing words of wonder and wisdom to audiences, or are they churning out the same old stuff, with perhaps a slight tweaking to
make it look different to the time before? Are the audiences receiving value for their money, or are they participating simply to meet the requirements for maintaining registration? Are the procedures for marking submissions on material published in magazines sufficiently secure to prevent blatant copying? Are the bodies, on contract to the respective registration boards to provide CPD services, adequately providing same? And, most importantly, are recipients of care from practitioners improved by the whole CPD experience? Who knows? Well let’s find out. ■
Global eyewear market expected to reach $US142 billion by 2020: US research
T
he global market for eyewear is expected to reach $US142.18 billion by 2020, according to a new study by Grand View Research in the United States. The study attributes that to expanding wearer base coupled with increasing penetration of eyewear for vision correction, with a large percentage of the population in rural areas of developing markets not having access to eye-care facilities and services, which represents considerable untapped market potential for industry participants. The report ‘Eyewear Market Analysis And Segment Forecasts To 2020’, is available now to Grand View Research customers and can also be purchased
directly at http://www.grandviewresearch.com/industry-analysis/ eyewear-industry. Inquiry Before Buying at http://www.grandviewresearch. com/inquiry/32. Early entry of children into the corrective eyewear space as well as aging population is expected to positively impact demand on a global level. Growing urbanisation and disposable income, along with awareness regarding the need for protecting the eyes against UV rays has led to high demand for plano sunglasses. However acceptance of alternative methods of vision correction including refractive surgeries such as LASIK and PRK are estimated to restrain market growth over the forecast period.
Further key findings from the study suggest: The global eyewear market was estimated to be 2,750.3 million units in 2012, which is expected to reach 3,507.7 million units by 2020, growing at a growth rate of 3.2% from this year to 2020. Spectacle frames and lenses accounted for over 50% of the total eyewear shipments in 2012; they also contributed significantly to revenue in the same year, primarily on account of high replacement rate of lenses, due to changing prescription. The advent of high-index lenses has also led to a surge in product demand, which is expected to continue through the forecast period. Plano sunglasses are expected to be the fastest growing
product segment, at an estimated change rate of 8.1% in terms of revenue from 2014 to 2020. Demand for high-end sunglasses sold at premium prices is the key factor for high expected-revenue generation. Polarised sunglasses contributed over 20% of overall shipments in 2012, with CR-39 expected to remain the largest lens material segment. North America dominated global demand in 2012; while Asia Pacific is expected to be the fastest growing regional market, at an estimated growth rate of 3.7% from 2014 to 2020. In terms of revenue, Europe accounted for over 40% of the total market in 2012, because of significantly high selling prices as compared to the global average. ■
EVERYBODY READS INSIGHT! 10
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HEALTH AND VISION CARE
Vision 2020 Australia Parliamentary Friends Group meet in Canberra A panel of four diverse speakers turned the spotlight on eye health and vision care on Monday, 17 March at the biannual Vision 2020 Australia Parliamentary Friends Group event at Parliament House. Brad Horsburgh (RANZCO), Kate Johnson (Optometrists Association Australia), Lauren Henley (Blind Citizens Australia) and Alf Bamblett (Victorian Aboriginal Community Services Association) shared rare insights into ophthalmology, optometry, low vision and Indigenous eye health from an onthe-ground perspective. This year’s dinner was also an important opportunity to highlight critical eye-health issues in Australia and to hear about what is happening in Australia’s eyehealth and vision-care sector.
Barry Jones. Brian Doolan and Michael Jeffery The panel, which was facilitated by ABC radio 666 morning program presenter, Genevieve Jacobs, engaged the audience of more than 100 attendees which included parliamentarians, advisers and departmental staff. The event also saw the launch of ‘Our Eyes — Our Journey’, a short video that seeks to increase the number of Aboriginal and
Jennifer Gersbeck, Hugh Taylor, Jane Halton and Fiona Nash
Torres Strait Islander people receiving eye-health and vision-care services across Australia. Special guests included former governor-general Major General Michael Jeffery, assistant health minister Fiona Nash, secretary of the Department of Health Jane Halton, parliamentary secretary to the minister for foreign affairs Brett Mason and assistant
health integration and chronic disease, health department, Kirsty Faichney. The event was sponsored by the Brien Holden Vision Institute, CBM Australia, The Fred Hollows Foundation, The Royal Australian and New Zealand College of Ophthalmologists and Optometrists Association Australia. ■
ACO awards 2 life memberships
T
honourary life membership of the college, acknowledging their service to the college and to the profession of optometry. In the 1970s, their research, at the National Vision Research Institute (now a division of the ACO) generated the LogMAR system for visual acuity charts, which they described in their seminal and widely-cited paper in the American Journal of
he Australian College of Optometry has recently awarded honorary life membership to two people whose names are universally recognised in the world of optometry and vision science. On 4 April, a ceremony was held to honour the careers of Professor Ian Bailey and Professor Jan Lovie-Kitchin at which they were presented with
Google eyes smart contact lens
F
inger pricks may be a thing of the past for people with diabetes if Google’s latest development becomes a reality. The technology giant is working on a smart contact lens that will measure glucose levels in tears using a wireless chip and tiny
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MAY 2014
glucose sensor embedded between two layers of soft contact lens material. “We’re investigating the potential for this to serve as an early warning for the wearer, so we’re exploring integrating tiny LED lights that could light up to
indicate that glucose levels have crossed above or below certain thresholds,” Google said in its blog. But it’s early days with Google still in the process of conducting studies that they hope will refine their prototype. ■
Optometry and Physiological Optics, in 1976. The LogMAR system became internationally accepted as the standard scale for visual acuity both in clinical practice and clinical trials. ■ Image caption: Ian Bailey and Jan Lovie-Kitchin and their logMAR visual-acuity chart
PBS cost $1bn less
P
BS spending and scripts processed declined again in November 2013 compared to the same period last year with the number of scripts processed now showing nine months of successive falls and spending almost $1bn below the previous 12 months. ■
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Healy Optical Pty Ltd P: 02 9420 3200 F: 02 9420 3222 E: sales@healyoptical.com.au www.healyoptical.com.au
03/03/14 08.27
EDUCATION
Deakin University admits first graduates to BVisSc degree
The graduates and university staff are happy
O
n 4 April, just two years after launching its optometry program, Deakin University in Geelong, Victoria, admitted its first graduates to the Bachelor of Vision Science. Just over 75 students received their degrees, all but a handful ‘with Distinction’. A full complement of 15 optometry academic staff celebrated the occasion, along with senior university heads including vice-chancellor Professor Jane den Hollander, pro-vice chancellor Faculty of Health, Professor Brendan Crotty and School of Medicine head, Professor Jon Watson. A memorable address was delivered by optometry student, Jacqueline Kirkman, who brought smiles and laughter to the audience by cleverly weaving her memories of The Spice Girls into her serious message about the importance of the health professions. Deakin took those first students into its accelerated optometry qualification in March 2011. The first year of the program combines health, science, vision and business units to form a foundation for the problem-based learning curriculum that follows from second year onwards.
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Even happier! Students universally agreed that the second year of the program was far more intense than the first, frequently having classes that spanned the day from 8am to 6pm. In addition, students undertake several week-long rotations per trimester through the Deakin Optometry Training Facility at the Australian College of Optometry from second year, onwards (and are currently seeing patients in the college clinic). While the first students still have another 15 months before
qualifying as optometrists, after the graduation ceremony, director of optometry Professor Harrison Weisinger told Insight that he was “extremely proud” of both his team and the students and “it’s days like this that justify the collective effort that went into starting an optometry program from scratch. That we have been able to develop, deliver and robustly assess three years of education in two years with minimal student attrition is a testament to the dedication and efforts of staff
and students alike”. Deakin Optometry has just enrolled its third cohort numbering approximately 75 into the Bachelor of Vision Science, while the first cohort now moves into the four-trimester Master of Optometry. The final two trimesters are spent in ‘residential’ placements, the first of their kind in Australian optometric education. The Deakin Optometry program was accredited, with conditions, in 2013. ■
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FOR THE FULL SPECTRUM OF CAREER OPPORTUNITIES... GO TO SPECTRUM-BLOG.COM – ParTnershiP, emPlOymenT, lOcum, sTudenT and GraduaTe rOles. In early 2013, we quietly launched a new website for optical professionals across Australia and New Zealand – spectrum-blog.com. Its aim? To present, in realtime, all the emerging Partnership, Locum, Student, Graduate and general Employment opportunities on offer in our new and current stores. Now, just one year later, we’re already welcoming more than 450 unique visitors each week to the site, on average. More than 1500 optical professionals have signed up to receive regular email updates on particular types of role, as and when they emerge. The big benefit? It’s easier than ever before for us to match up optical professionals just like you with the roles you may have your heart set on in one of our stores. So, if there’s a particular role, in a particular location in a particular region of Australia or New Zealand that you’re seeking, visit Spectrum to see what’s on offer and then contact one of our recruitment team members... the key individuals are all listed on the site’s ‘Contact Us’ page.
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RANZCO HOBART MEETING
Glaucoma: beyond intraocular pressure
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rofessor Helen DaneshMeyer, Professor of Neuroophthalmology and Glaucoma, University of Auckland (New Zealand), gave the core presentation at the Allergansponsored breakfast at the 45th Scientific Congress of The Royal Australian and New Zealand College of Ophthalmologists in Hobart late last year. The title of her presentation was ‘The Secret and Not So Secret Thoughts in the Glaucoma Consultation – Beyond IOP’. Once high IOP is announced, the patient questions flow: “Will I go blind?, How long have I got tolive?, How fast will it progress?”, etc. The risk of blindness is higher in primary open-angle glaucoma (POAG) but poor compliance and little or no follow-up add significantly to the likelihood of a poorer outcome. Prof Danesh-Meyer was able to provide some guidance on lifeexpectancy depending on first-degree relatives’ ocular history, e.g. if a patient is 80 and if parents lived beyond 80 and grandparents lived beyond 80 also – add 1 year for each grandparent, if first-degree relative had a heart attack or
stroke – subtract 4 years, exercise 3 or more times a week – add 2 years, married and still together – add 1 year, separated or divorced female – subtract 3 years, separated or divorced male living alone – subtract 2 years, and never married female subtract a year for each decade they are aged over 25. If the patient is happy and/or a ‘smiler’, that is likely to be beneficial to their life expectancy. Does the glaucoma patient drive a motor vehicle? If yes they have a 3x greater risk of accidents, males are worse, and driving at night, especially if suffering from bilateral field defects, runs not only the risk of accidents but also a reduced chance of seeing pedestrians. Glaucoma patients as pedestrians walk more slowly than agematched normals’, have a 2x to 4x greater chance of suffering a fall, and a 60% greater chance of a hip fracture. They also have 5x greater difficulty reading, especially in the presence of bilateral field reductions, and experience greater difficulty in poor light. After dealings with their glaucoma practitioner, patients are found to think their practitioner
is highly-strung especially as their eyes are “fine” and “why do I need drops in my eye, my eyes aren’t dry so why do I need fluid in them?” Glaucoma is divided almost equally between the sexes and the level of glaucoma knowledge among sufferers is only marginally higher than controls. Duration/experience of the disease correlates poorly with disease knowledge although ‘private’ patients know more. That may also mean that compliance issues are easy to explain. About 96% of patients knew that glaucoma was a disease of the eyes only, 90% knew that regular checks were required, and only about 85% knew there was an hereditary aspect to the disease. Many had no idea that symptoms and progression were not apparent to the sufferer, that treatment was life-long (unlike a course of antibiotics for example), were unaware of the sideeffects of the medication(s) as not all side effects are connected in an obvious way, and fully 80% had no idea that the drops they took could also affect other body sites. Many were unaware that the disease could not be ‘cured’.
Prof Danesh-Meyer estimated that usually less than 1% of glaucoma patients will be blinded by their disease but that fact was not widely known. She described it as a ‘silent’ disease. She was also critical of the poor level of knowledge surrounding the instillation technique emphasizing the need to block the puncta by finger pressure (for 30 seconds to 2 minutes). She also counselled against the use of words that are ambiguous to the average patient, e.g. the disease has ‘progressed’ is regarded by many as good news – use ‘worse’ or ‘more advanced’ instead. Similarly, “you have large cups” may be a confusing statement/description to some, especially if they are not female. Yet other patients are frustrated (no empowerment) by negative answers to questions such as “Is there anything I can do for my eyes?” Citing articles in IOVS, Prof Danesh-Meyer revealed that sleeping position influences IOP – it increases when lying down, when sleeping on the side (can lead to asymmetric IOPs), head-high may lower IOP, headflat may raise IOP. ■
Blindness can decrease life expectancy
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he international ophthalmology session was wound up by keynote speaker Dr David Chang who noted that blindness can decrease life expectancy by as much as 67%. He believes that to make headway systems are required for expert surgeons to operate on huge numbers of patients (calling the
late Prof Fyodorov, inventor of the surgical production line). In lesser circumstances Dr Chang recommended manual SICS (MSICS) rather than phaco because the latter resulted in too many local complications, secondary cataract, corneal complications, and pseudoexfoliation. Dr Chang estimated that
phaco took more than twice as long and costs more than four times as much as MSICS to perform. In situations where throughput was paramount the time factor alone was unacceptable. He claimed that the safety and outcomes of both techniques were the same.
Citing studies from Aravind Eye Hospital in Madurai, India, Dr Chang stated that outside the first world, manual nucleus removal was the way to go. To that end Aravind has produced teaching videos to assist with the training of eye surgeons in the surgical art of doing more with less. ■
Sourcing equipment and supplies
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r Geoff Cohn (Sydney, NSW)) wrapped up the individual presentations by speaking about sourcing equipment and supplies. He counselled against going overboard by selecting
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equipment he described as ‘aspirational’ and select adequate equipment instead. Regardless of the tools chosen, they needed to be durable and serviceable, possibly more so in
field-trip situations as the tools are more likely to be mishandled than those in normal practices where they are better maintained by more experienced staff. He suggested new equipment be
employed where possible but he believes that quality is a more important consideration. Where possible he suggested local equipment suppliers be used, giving them guidance if necessary as to what to stock. ■ www.insightnews.com.au
EYE COMPLICATIONS
Diabetes task force established to develop new national strategy T he Australian government will develop a new national strategy to tackle the growing diabetes epidemic, recognising the role of obesity and other chronic diseases, the health minister, Peter Dutton, has announced. A newly-formed expert advisory group led by the new Diabetes Australia president, recently-retired MP Ms Judi Moylan, and chair of the World Diabetes Council, Professor Paul Zimmet, has been charged with reviewing the evidence and consulting with stakeholders to develop the National Diabetes Strategy. The plan will inform future health spending to target diabetes prevention and management. The strategy will provide an up-to-date high-level policy framework for action in diabetes prevention and care, which will build on existing work to enhance current investment; it will be underpinned by “the best available” evidence and it will focus on high-impact achievable actions while recognising the fiscal outlook facing all governments. The strategy will occur at the same time as broader considerations on the National Chronic Disease Strategy, and will be a valuable opportunity to adopt an integrated approach to policy on a national level as well as maintaining an alignment with key work progressing in the international arena. Ms Moylan established the bi-partisan Federal Parliamentary Diabetes Support Group in 2000 and last year she was awarded
the Sir Kempson Maddox Award for her contribution to diabetes prevention. Professor Zimmet was founder and director of the International Diabetes Institute, Australia’s first institute dedicated exclusively to diabetes. He holds many positions including honorary president of the International Diabetes Federation. In 2001, he was appointed to the Order of Australia for services to medical research, particularly in the field of diabetes. The advisory group will identify gaps in services and develop a best practice model which draws on existing national and international approaches to diabetes prevention and management. It will deliver the strategy within 12 months and will consider activities which will be designed to: • Improve early identification of diabetes; • Enable optimal management of patients by general practice and the primary health care sector; • Improve health literacy and support for self-care, including applications to enhance monitoring of an individual’s condition; • Ensure timely responses to prevent and manage complications caused by diabetes such as kidney and heart health, eye and foot complications; and • Focus on those at most risk, such as Aboriginal and Torres Strait Islander people and pregnant women. ■
Unsolicited merger proposal by Valeant for Allergan
A
llergan confirmed on 23 April that it has received an unsolicited proposal from canada-based Valeant Pharmaceuticals International to acquire all of Allergan’s outstanding shares for a combination of 0.83 of Valeant common shares and $48.30 in cash per share of Allergan’s common stock. Allergan issued a statement indicating that its board of directors, in consultation with its financial and legal advisors, “will carefully review and consider Valeant’s proposal and pursue the course of action that it believes is in the best interests of the company’s stockholders”.
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Valeant, which had total revenue of $5-8 billion in 2013, bought Bausch+Lomb in August 2013. What will be interesting to watch is the reaction of various United States competition authorities to the proposed purchase of Allergan by Valeant. Michael Pearson, chairman and chief executive officer of Valeant, said: “This proposal represents an undeniable opportunity to create extraordinary value for both Allergan and Valeant shareholders by establishing an unrivaled platform with leading positions. ■
So SIMPLE
A.M.D.
Nanoparticle delivery system for AMD could mean end of eye injections D rugs used to treat blindnesscausing disorders could be successfully administered by eye drops rather than eye injections, according to new research led by scientists at the University of California, Los Angeles, and could be a breakthrough for the millions worldwide suffering from age-related macular degeneration and other eye disorders. The research findings are significant due to growing patient numbers and an increasing demand for the eye injections that halt the progression of AMD, which one in five people over 75 have in the United States. The research, demonstrated in animal models and just published in nanotechnology journal Small (‘Topical Delivery of Avastin to the Posterior Segment of the Eye in vivo using Annexin A5-associated Liposomes’), demonstrates that it is possible to create formulations of tiny nanoparticles loaded with the off-label drug Avastin and effectively deliver significant
concentrations to the retina. Lead author Professor Francesca Cordeiro (UCL Institute of Ophthalmology) said: “The development of eye drops that can be safely and effectively used in patients would be a magic bullet – a huge breakthrough in the treatment of AMD and other debilitating eye disorders. “The current treatment of injecting drugs into the eye is uncomfortable, detested by patients and can need repeated monthly injections in hospital for as long as 24 consecutive months. It’s impossible to exaggerate the relief patients would feel at not having to experience injections into their eyes.” The National Health Service in the United Kingdom is currently over-burdened with patients who need repeat eye injections and the numbers are set to rise exponentially over the next ten years. Demand is so high that injections are difficult to administer, timeconsuming and expensive (depending on which drug is injected).
The treatment also carries a risk of infection and bleeding, increased by the frequency of recurrent injections into the eyes. In the United States, well over one million ocular injections were given in 2010. In the UK, 30,500 injections were estimated to have been given in 2008 – a 150-fold increase in 10 years. Effective delivery of drugs to the retina of the eye is considered one of the most challenging areas in drug development in ophthalmology, due to the presence of anatomical barriers. It was previously thought that drugs used to treat AMD such as Avastin and Lucentis have molecules that are simply too large to be effectively transported in an eye drop. First author Dr Ben Davis (UCL Institute of Ophthalmology) said: “There is significant interest in the development of minimally-invasive systems to deliver large drug molecules across biological barriers including the cornea.
“We have shown in experimental models a formulation system to get substances including Avastin across the barriers in the eye and transport them across the cells of the cornea. In theory, you could customise the technology for different drugs such as Lucentis, commonly used for AMD treatment in the UK, as it is a smaller molecule than Avastin so likely to be delivered effectively via this method. “All the components we used are safe and well established in the field, meaning we could potentially move quite quickly to get the technology into trials in patients – but the timescales are dependent on funding.” The paper includes functional data showing that the Avastin administered stops the blood vessels from leaking and forming new blood vessels, the basis for ‘wet’ AMD. The technology has been patented by UCL’s technology transfer company UCL Business and the researchers are seeking commercial partners to accelerate development. ■
Optique Line and OGS launch ‘One-for-One Eyewear Initiative’
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ased on a ‘buy-one, giveone’ concept, Optique Line will make a donation to Optometry Giving Sight for every one of it Gemini Collection or Aura Flex frames purchased. When customers purchase either a Gemini collection or Auraflex frame (regardless of what lenses they choose), Optique Line will make a donation to Optometry
Giving Sight to cover the cost of an eye examination and the glasses (frames and lenses). Customers can locate participating retailers via the company’s web directory oneforoneeyewear. org. “It is a startling figure,” John Nicola of Optique Line said referring to the more than 600 million people around the world are blind or vision
impaired due to lack of access to an eye examination and glasses. “This program is something that we have been wanting to do for some time. Giving our customers the satisfaction of knowing their purchase will transform the life of someone less fortunate is far more powerful than any freebie we could offer.” Ron Baroni, country manager
of Optometry Giving Sight, said: “Providing someone with an eye examination and a pair of glasses can literally mean the difference between a life of poverty, and a life of opportunity. Empowering customers to give the gift of sight with each purchase is an inspiring thing.” Information: Toll free: 1800 649 527 or (03) 9853 0796. ■
Specsavers to sponsor English cricket umpires
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he England and Wales Cricket Board has agreed sponsorship deal with Specsavers. The British high-street chain of optometrists the official optometry and hearing partner of English as the principal partner of the Association of Cricket
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a three-year has become cricket and, Officials, its
branding will appear on umpires’ clothing in all English domestic fixtures. Specsavers will also sponsor a number of awards for umpires and its branding will be worn by umpires in the later stages of national club and age-group competitions. ■ www.insightnews.com.au
A.M.D. INSIGHT
‘Don’t be in the dark about macular degeneration’: theme D on’t be in the dark about macular degeneration – the eye disease that affects one in every seven Australians over the age of 50. That’s the message being communicated by Macular Disease Foundation Australia this year in Macular Degeneration Awareness Week on 25-31 May. Throughout May, in addition to Macular Degeneration Awareness Week activities, the foundation will run a national television and radio campaign with new advertisements promoting the week’s key message. Macular degeneration is the leading cause of blindness and severe vision loss in Australia, affecting central vision of primarily older Australians. Over 1.15 million people over 50 in Australia show some evidence of this disease and that number will increase to over 1.7 million by 2030 (in the absence of effective prevention and treatment measures), creating an even greater burden on Australia’s health, disability and aged care system. To enable eye care professionals to be involved in the week, a direct mail ‘Awareness Kit’ is being posted to practices nationally, arriving late April. Included in the kit is a poster with the
Don’t be in the dark about Macular Degeneration
How practices can be involved • Talk to patients about the importance of regular eye tests and the use of the Amsler grid between visits. • Develop a promotional display in practice during Macular Degeneration Awareness Week. • Purchase the Foundation’s DVD - What is Macular Degeneration? for in practice promotion. Available for $25 (plus postage and handling). • Generate awareness on your website and through facebook and twitter. • Refer patients to Macular Disease Foundation Australia for ongoing support. In support of the theme, the key messages for consumers over 50 are: • Have your eyes tested and make sure the macula is checked. • Never ignore any changes in vision. • Eat an ‘eye-friendly’ diet and maintain a healthy lifestyle. Additionally, the Amsler grid will be a major focus of the campaign. The foundation’s longterm aim is to have an Amsler grid on the fridge of every Australian over 50! The Foundation’s Amsler grid is included in the Awareness Week kit and eye care professionals can order more with the re-order form provided in the kit.
theme, key information on macular degeneration, Amsler grid, and material reorder form with a special free-postage period.
Eating for Eye Heath
Macular Degeneration is the leading cause of blindness in Australia and affects central vision
If you’re over 50 • Have an eye test and make sure your macula is checked • Never ignore any changes in vision • Eat an “eye friendly” diet and maintain a healthy lifestyle
For a free information kit and support contact Macular Disease Foundation Australia
1800 111 709 www.mdfoundation.com.au
This year’s poster for Macular Degeneration Awareness Week ISL-249-PB (MD A2 Poster 2014).indd 1
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13/03/14 11:23 AM
The Foundation’s original Eating for Eye Health cookbook, co-authored by Ita Buttrose and Vanessa Jones, will be re-launched in May. The book is loaded with recipes made up of the foods to eat to keep our eyes in tip-top condition. The book features more than 90 recipes, carefully selected to make it easy to prepare delicious, nutritious meals that are good for eye health, featuring fish, yellow and dark-green leafy vegetables, fresh fruit and nuts; all readily available ingredients. The cookbook will be available for $27 in selected retailers and can also be ordered direct from the foundation (postage applies). ■
So VERSATILE
OPINION
Saks on Eyes Alan P Saks MCOptom [UK] Dip.Optom [SA] FCLS [NZ] FAAO [USA]
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feedback on this column. It’s nice to know we’re on the right track. Please keep in touch as I welcome suggestions for topics you want covered.
On The Go
Air Miles
It’s been a hectic year so far with time in Africa, in the bush, seeing the Big 5, friends, family and fun. I’ve also done a few speaking gigs in AUS and NZ and seeing patients in between. As usual it’s been a pleasure to catch up with good friends in the optometric and ophthalmological professions and related industries. We are fortunate to have diverse and amazing professions; there are so many niches and specialities. As to the people, they’re an amazing bunch too: Clever capable people, slick organisers, fine surgeons, amazing academics, smooth talkers, tech-savvy tinkerers, super salesmen, precise professionals, broad thinkers; you can pretty much name it and there’s someone that comes to mind. There are some pretty eccentric personalities too but I guess that comes with the territory and boy can they party. Over the years I’ve done a fair bit of travelling and presenting in Australia and met many great people along the way. Each trip I meet a few more and learn a few more things. Despite all the travel and places I’ve been, I’ve only just scratched the surface of what Australia has to offer. I intend to remedy that as I’m working on a plan to spend a few months on a road trip around parts of Oz. So if you want a speaker for a local meeting or some personalised consulting in your practice; relating to IT and communication, integration, contact lenses, marketing and so on, get in touch. Thank you to everyone in the various cities for their kind hospitality and to those that take the time to have a chat and provide
In the process of all this local and international travel, I’ve earned a few air miles and come to appreciate my Platinum status with QANTAS. If you fly a lot, anything that makes it easier and more pleasurable is worth having. Especially since the nutters made security such a big, time-consuming concern. Platinum status pays off big time. If I’m lucky I can go from kerbside at Melbourne, Sydney or Auckland and be in the 1st Class lounge in ten minutes, on a good day. On a busy, bad day it’s even more beneficial. Basically I have no, or very few queues. Priority check-in and express lanes through customs and security, electronic passport scanning and priority bag tags mean I rarely get bogged down. Then of course there’s the 1st class lounge. Sydney rates as one of the top in the world, with Melbourne a smaller version. One is treated to great views of the working airport and runways, luxurious seating, welcome showers after a long haul and a massage from the PAYOT ladies. Then of course there’s the food: Designed and monitored by one of Australia’s top chefs, Neill Perry, I get to eat better at the 1st lounge than I do at many an expensive restaurant. I’ve been a fan of Neil’s food since my early days in Oceania. The wine and champagne is not Mickey Mouse either. OK so I digress – but this is no brag – it’s a way of pointing out how important loyalty is. A while back I had to choose between Air NZ and QANTAS. I chose QANTAS, for a variety of reasons. Sometimes it would be easier for me to fly direct from
MAY 2014
Auckland to say Bangkok or Hong Kong on another airline – but maintaining my status means I choose (or am forced?) to go QANTAS (even if it means an extra stop). That said I don’t mind transiting, with a nice Neil Perry meal in the lounge.
Loyalty How does this relate to us? Some larger eye-care groups have affiliations with frequent-flyer or a variety of loyalty schemes. Smaller optometrist and independents are from time to time also offered such schemes. An NZ group was affiliated with one of the large loyalty schemes in NZ. That relationship just terminated. So there are such schemes but they’re not primary drivers of new business or loyalty. Loyalty schemes may be limited in eye care but loyalty isn’t. What seems to be having some effect in NZ is the provision of ‘Free Eye Tests’. For over a year we’ve had free exams for members of the AA at one of the chains. In recent times another chain has offered a similar deal to members of the largest medical insurance company. Thus around 40% of Kiwis have access to such ‘free eye tests’. In Australia this is not such a big thing: Patients perceive Medicare as providing a free eye test. There are thus other things that are used to obtain loyalty and new business. As mentioned last month nothing beats professional service, personal attention and quality products. Despite the commercialisation and attempted dumbing down of eye care, patients (not customers) still actually care about their eyes. They know vision is their most important sense. They want the best possible care to ensure it. They’re happy to pay for a professional full-scope eye exam or additional fancy, diagnostic tests. They feel
there’s a difference between that and a ‘free eye test’. Every week I see patients who relate such stories to me. They say they had a quickie eye exam, at a local store in a mall, because they broke their glasses. They needed some urgent spares but have come back to me for the service that they’re used to. That’s not to say a TPA qualified practitioner in the store didn’t do a thorough exam, dilation, imaging and maybe even gonio and applanation tonometry. It’s all about perception and loyalty. Many people are also quality and fashion conscious. I mean hell they have $3000.00 handbags, sixhundred-dollar shoes, a ten-grand watch and a two-grand suit. Their car cost 200k and the tyres cost a grand or two, each. Why the hell wouldn’t they settle for a high-end frame and some super deluxe hitech progs for two grand? While they’re at it they take a similarly priced and configured pair of Rx sunglasses, an occupational office pair and some contact lenses too. At the same time don’t prejudge any patient. The guy in the torn jeans and thongs could be a billionaire. People will keep coming back if you provide what they want and beyond. It’s the small things that count. Successful independents know this. They deliver and there are still many out there. Don’t run scared because there are stories of independents going to the wall. These failed businesses are usually poor operators who became complacent in the good old days. They didn’t re-invest in hightech gear, computers and practice re-fits. They didn’t keep up with the market and trends, digital media and marketing. When they woke up the train had left the station. Sad but true: Don’t make the same mistakes. You too can deliver and thrive. ■ www.insightnews.com.au
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SOUTHERN REGIONAL CONGRESS REPORT
Keynote SRC speakers from USA T
he Optometrists Association Australia (Victorian Division) Southern Regional Congress’s changed time slot this year did not seem to affect attendance figures or delegate enthusiasm. The weather was excellent but attributing that to good luck or seasonal variation (or OAA Victoria’s CEO Ms Terri Smith’s ‘special connections’) would make for an interesting and lively discussion. Keynote speakers were both first-timers from the United States, Dr Jeffry Gerson, a practitioner and partner in WestGlen Eyecare located in Shawnee, Kansas and Dr Marc Bloomenstein an adjunct assistant professor at the Southern California College of Optometry in Fullerton which has now become the Marshall B Ketchum University (MBKU) after some 110 years of history. MBKU is not widely known yet but as SCCO it certainly was. Ketchum was a medical practitioner who founded the Los Angeles School of Ophthalmology and Optometry in March 1904 and who remained as college president until 1920. Later [1922] it became simply the Los Angeles School of Optometry and in 1950 it became the Los Angeles College of Optometry [Prof Robert Mandell is among LACO’s most famous alumni]. Later still it became the SCCO and now it is MBKU).
HB Collin Research Medal The home-grown international speaker was Prof Robert Hess, director of research in ophthalmology at McGill University in Montréal, Canada. Prof Hess is originally a Queensland Institute of Technology (now Queensland University of Technology) optometry graduate (and that institution’s first ever graduate to proceed to a PhD) who then did an MSc in neurophysiology at Aston University, Birmingham, United
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Kingdom. That was followed by a PhD in visual perception at the University of Melbourne. As a result of an outstanding research and academic career spanning three countries, several decades, and by now 321 published papers, he was awarded a DSc in vision sciences by Aston University in 1998. At SRC 2014 Prof Hess was awarded the HB Collin Research Medal (2013, nominations for the 2014 award are currently open with the CEO, national OAA) and he delivered the HB Collin Lecture as part of the award.
Adult amblyopia Prof Hess’s presentation titled Eye Wide Open was certainly among the more interesting at SRC 2014 because it revealed to many for the first time, some of the recent findings regarding amblyopia generally and adult amblyopia ex anopsia specifically. The central tenet of current thinking, especially in his laboratory, is that amblyopia is primarily a binocular problem secondary to a loss of binocularity and that, contrary to previous views, the adult visual cortex can still demonstrate plasticity, a feature that is exploited in his team’s research. Importantly, his research is not promising miracles in that it is limited to small-angle strabismus only and large deviations are beyond the realms of their research currently. The brain’s plasticity can be confirmed by various means including contrast sensitivity testing in which adaptive optics systems are used to bypass the eye’s optics and even without training and in the presence of higher-order aberrations, improvements can be realized. Similarly, using methods of direct brain stimulation, e.g. transcranial magnetic stimulation of the visual cortex, small improvements in the brain’s sensitivity can be made. Prof Hess stated categorically
Robert Hess that vision in adult amblyopia (implying a very long-standing deficit of vision that is well entrenched) can be improved and, somewhat counter-intuitively, the greater the amblyopia, the greater the improvement that can be made, and vice versa. As the improvements made by simple training are only transient, repetition of the training programme over several days or weeks is required to improve vision in amblyopic eyes. Some of the improvement resulting from just three sessions of stimulation were still measurable some 78 days later. However, the technique involves significant use of technology because NMR imaging is required to locate area V1 of the occipital cortex accurately enough for the stimulation to be effective. Other direct stimulation methods include simple DC stimulation using a single 9-volt battery and suitable electrodes. Apparent contrast can be altered by that technique but again the effects are small.
Amblyopia is a binocular problem When amblyopia is a secondary problem, the resulting amblyopia is the brain’s way of diplopia avoidance. However, when amblyopia is the primary issue, the suppression apparent may be a cause of the amblyopia and not a response to it.
Regardless, suppression and amblyopia operate hand-in-hand in that greater suppression means greater amblyopia. To date, the binocular outcomes of amblyopia treatment have been poor. One ongoing issue has been the measurement of suppression. Test used have included signal elements on a screen moving in a single direction, noise elements in random directions, and determining so-called signal to noise ratios (that have different meanings in other fields of science) in which a signal is presented to one eye and noise to the other and the result interpreted by the brain as a combination of the inputs. When the latter technique, a so-called dichoptic technique, is applied to normal eyes it is irrelevant which eye gets what input but in an amblyopic eye the noise signal is more likely to be seen if the signal to the good eye can be presented at lower contrasts (until a balance point is reached). The essence of the technique in Prof Hess’ laboratory is to apply noise to the amblyopic eye and then adjust (lower) the contrast of the stimulus to the good eye until a stage is reached in which the amblyopic eye sees the noise stimulus at which point suppression eliminated. Eventually, interocular contrast ratios can be ‘normalized’ by contrast lowering and repetition. Experiments have shown that it is possible to go beyond ‘normal’ in that amblyopic suppression can become apparent in the ‘good’ eye.
Suppression and/or fusion While the excitory path is straightforward there are also inhibitory factors in play. Normally, the inhibitory factors are in balance and therefore have little effect. However, in cases of suppression there is an imbalance of inhibitory factors and one way used to explore them is to use differing stimulus contrasts. Continued on 24
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SOUTHERN REGIONAL CONGRESS REPORT
Continued from 22 Using experimental techniques it has been possible to get amblyopes to stereopsis, a binocular state beyond simply getting both eyes to ‘see’ simultaneously (remember these results are confined to those with small-angle eye deviations, miracles were not being claimed). That was achieved by manipulating the signal contrasts (high to the amblyopic eye, lower to the ‘good’ eye) to lower the manifest levels of suppression. That also proves that binocularity is not lost in amblyopic eyes and also suggests that suppression is likely to be the primary cause of the amblyopia.
Binocular treatment of suppression Their laboratory research has led Hess’ team to binocular-based amblyopia treatment. Initial trials were for 1-2 hours per day for 4-6 weeks and the results showed reduced suppression and a move towards fusion (implying binocularity). The team now believes that fusion, and ultimately stereopsis, can be recovered because trials of just 1 hour per day for 6 weeks
have led to 3D vision. Unfortunately, there are large individual variations in depths of amblyopia and some subjects did not improve at all despite the team’s best efforts. Many did improve however and somewhat surprisingly, so too did their visual acuity (VA). Importantly, none got worse as a result of the trials. Although many different stimuli were tried, simple dot stimuli proved to be as good as any in those dichoptic trials. Subsequent trials deployed a head-mounted display, delivering 18, 2-hour sessions of treatment using dot stimuli on amblyopes aged from 20 to 60 years of age. Interestingly, there was no clear age effects and significant improvements were achieved just by reducing suppression. Results from another trial of five, 1-hour session over just one week (school lunch hour) showed only a slight improvement in visual acuity. Simultaneous dichoptic and direct DC stimulation trials have also been considered.
More sophisticated treatments The trial stage has now moved
to video games played on smart phones (iPhone and iPod Touch, among the more economic and widely available ‘computer’ platforms available currently) using a lenticular screen and the autostereographic principle. Because head alignment is critical with such technology, the phone’s front camera is used to monitor the subject during the trial. The games are based on the Tetris concept (falling coloured blocks that must be stacked efficiently) in which one eye sees the game frame and stacked blocks while the other only sees the falling coloured blocks. A poor score is interpreted as the task being too difficult and the contrast is lowered automatically by the software for the next session’s game. A good score is interpreted as the eyes seeing both the blocks and the stacked blocks and frame, in which case the contrast will be increased for the next round. Even just an hour a day for 20 days usually sees significant improvements with suppression lowered but not eliminated and fusion strengthened. If such a
trial is extended to an hour a day for 6 weeks most subjects showed improvement. As before, some subjects did not make any gains at all. No regression of VA due to suppression was noted in the trials. Prof Hess closed by saying that, from his team’s work, he does not believe that children need patching. He also expects the preliminary nature of their treatments to evolve into more sophisticated and more effective treatments that promise better outcomes that those already achieved for all ages. Marketing of the technology has already started (visit: www.amblyotech.com). Further information about this evolving area of research is available from: Hess RF et al., 2014. Binocular vision in amblyopia: structure, suppression and plasticity. Oph & Physiol Optics. 34: 146 – 162 or from: http://onlinelibrary.wiley. com/doi/10.1111/opo.12123/pdf (full article available). A successful third-party study using the techniques developed by Hess and team and deployed on an iPad was the subject of a recent clinical trial (see: http://www.medscape.com/viewarticle/823439). ■
WA medical students speak out against a third medical school: government is ‘myopic’
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estern Australian medical students have branded their state government “myopic” after it was announced that a third medical school is scheduled to open in WA in 2016. Plans by Curtin University to boost medical student numbers with a new school are “extremely concerning” say students, who claim the move would only exacerbate the current shortfall of internship places for new graduates.
“This will put further pressure on an already overburdened training system, without addressing the workforce issues affecting our communities,” Mr Sebastian Leathersich, president of The Western Australian Medical Students’ Society, said. Critically, Mr Leathersich said, the Curtin University proposal would not address the existing rural misdistribution. “The only evidence for increasing the proportion of students
going on to practice in rural areas is to increase the recruitment from rural areas, or to train students for extended periods in rural areas,” he said. With the lowest number of medical practitioners per capita in the country, according to the latest Australian Institute and Welfare report, Western Australia is set to benefit from additional registered doctors, but the students say creating more undergraduate places is not the solution.
Ms Jessica Dean, president of the Australian Medical Students’ Association agreed with the WA student bodies, that more jobs and training were needed to match the excess of graduates in the state that already exist. “The medical training pipeline is full,” she said. “Without further government funding, both on a state and federal level, there is little sense in adding more students into the system.” ■
Kentucky College of Optometry to open in 2016
T
he Kentucky College of Optometry is to open at the University of Pikeville http://www.upike.edu/ in 2016, with 60 students admitted per 24
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class, for a total of 240. While the University of Pikeville already has many of the facilities necessary to accommodate the college, plans to build a
new educational facility are under way, according to a statement from the university. A national search for a dean has begun.
According to the United States Bureau of Labor Statistics, the need for optometrists is expected to grow, by 33 per cent through 2020. ■ www.insightnews.com.au
Sunday 25 May 2014 Melbourne Exhibition & Convention Centre preliminary program 7.40
registration
8:00
Diagnosing the watery eye patient Dr Justin Friebel
8:40
Eyelid lesions & masses - a diagnostic guide Dr Justin Friebel
9:20
Managing acute uveitis Dr Lyndell Lim
10:00
Acute secondary angle closure after implantable collamer lens (ICL) implantation diagnosis and management Dr Tu Tran
10:40
morning tea
11:00
Endothelial keratoplasty - past, present & future Dr Jacqueline Beltz
11:40
Corneal grand rounds Dr Jacqueline Beltz & Dr Dermot Cassidy
12:50
lunch
1:30
Update on childhood cataract Dr Jonathan Ruddle
2:10
Glaucoma... under 40 - You’ve got to be kidding Dr Jonathan Ruddle
2:50
Vitreo-macular disorders - New insights & novel treatment strategies Dr Jonathon Yeoh
3:30
Latest clinical applications of corneal cross-linking Dr Rick Wolfe
4:10
afternoon tea
4:30
Update on diabetic retinopathy Dr Edward Roufail
5:10
Diagnosis of ocular media conditions Dr Edward Roufail
5:50
close
EVENTS
Diary Dates 2014 MAY 4-8 ARVO 2014, Association for Research in Vision & Ophthalmology Location: Orlando, Florida, USA. Contact: www.arvo.org
8-10 12th Wenzhou International Optics Fair Location: Wenzhou, China Contact: http://www. chinaexhibition.com/ Official_Site/11-2460-WOF_2013_-_ The_11th_Wenzhou_International_ Optics_Fair.html
20-22 2014 Royal College of Ophthalmologists Annual Congress Location: International Convention Centre Birmingham, UK Contact: http://www.rcophth.ac.uk/ page.asp?section=518§ionTitle=Ann ual+Congress+2014
21-23 XIII Ukrainian Congress of Ophthalmologist Location: Filatov Institute Odessa, Ukraine Contact: http://www.tou.orgua/en/ events/congresses/xiii-congress-ofophthalmologists-calendar
JUNE
AUGUST
6-9
16-17
BCLA Clinical Conference & Exhibition Location: ICC, Birmingham Contact: www.bcla.org.uk
Western Australia Vision Education (WAVE) Location: Pan Pacific, Perth Contact: Ph +61 08 9321 2300 Email: admin@optometrywa.org.au
22-24 Association of Regulatory Boards of Optometry Inc. (ARBO) 2014 Annual Meeting Location: Philadelphia, Pennsylvania Contact: Website: www.arbo. org/2014_meet.php
SEPTEMBER 13-17 ESCRS 2014 Web site: http://www.escrs.org/ Location: London, United Kingdom
24-27
25–28
Manchester Royal Eye Hospital Conference Location: Manchester Conference Centre Manchester, United Kingdom Contact: www.mreh200.org.uk
112th DOG Congress of Ophthalmology Contact: http://www.dog-kongress.org
27-29 Retina International 2014 World Conference Location: Paris, France Contact: www.retina2014.com
JULY
1-31 JULY
26-28 2nd Asia-Pacific Glaucoma Congress held in conjunction with the 10th International Symposium of Ophthalmology – Hong Kong Location: Hong Kong Contact: venuscheung@iso-hk.org or website http://apgc-isohk-2014.org/
OCTOBER 1-4 EVER 2014 Congress Location: Acropolis Convention Ctre Contact: http://www.ever.be/c_page. php?id=277
18-21
MACULAR DEGENERATION AWARENESS WEEK
AAO Annual Meeting 2014 Location: McCormick Place Chicago, Illinois, United States Web site: http://www.aao.org
RANZCO EYE FOUNDATION
WWW.EYEFOUNDATION.ORG.AU
25-31 MAY Contact: 1800 111 709 or www.mdfoundation.com.au
www.insightnews.com.au
NOVEMBER
19 - 20
12-15
NACBO Vision Conference 2014 Location: Coogee, Sydney Contact: www.acbo.org.au or Email: info@acbo.org.au
2014 Italian Society of Ophthalmology Annual Meeting Location: Rome, Italy Contact: www.soiweb.com
22-26 46th Annual RANZCO Scientific Congress Location: Brisbane Convention and Exhibition Centre Contact: www.ranzco2014.com.au
25-27 Vision-X Optometry Conference Location: Dubai World Trade Centre Contact: www.vision-x.ae/ optometry-conference
DECEMBER 1-4 International Strabismological Association Meeting Location: Kyoto International Conference Center, Kyoto, Japan
2015 JANUARY 24-30 Ski Conferences for Eyecare Professionals Rusutsu Ski Resort,Hokkaido, Japan Contact: www.skiconf.com
APRIL 15-17 World Cornea Congress VII Location: San Diego, California, USA Contact: http://corneasociety.com
MAY 3-7 ARVO Annual Meeting 2015 Location: Denver, Colorado, USA Contact: http://www.arvo.org/ Annual_Meeting/
DO YOU HAVE AN EVENT FOR OUR CALENDER? PLEASE EMAIL YOUR DETAILS TO: INSIGHTNEWS@BIGPOND.COM
MAY 2014
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PHILANTHROPY INSIGHT
Fred Hollows’ life chosen to inspire by $100m Westpac Foundation
Fred Hollows. Photo courtesy of Michael Amendolia
T
he late Fred Hollows’ life has been chosen to inspire the next generation of leaders through the $100-million Westpac Bicentennial Foundation. “I am so proud that Fred’s life has been chosen to inspire Australia’s next generation of leaders through the Bicentennial Foundation,” his wife and founding director of the Fred Hollows Foundaton, Mrs Gabi Hollows, said on 2 April. Westpac chairman Mr Lindsay Maxsted said the company wanted to set up an ‘‘enduring initiative’’ as it prepared to celebrate its 200th anniversary in 2017. Westpac Bicentennial Foundation scholarships start rolling out from 2015, growing to 200 scholarships in 2017 to mark the company’s bicentennial. From 2018, 100 scholarships will be awarded each year. The foundation is forecast to give away more than 10,000 scholarships over the next 100 years. After a beyond-closed doors build-up, Westpac chief executive Mrs Gail Kelly on 2 April unveiled a $100 million gift, one of the largest philanthropic donations in Australian history, and emerged as an unlikely champion for IT geek girls nationwide. The Westpac Bicentennial Foundation will offer up to 100
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Gail Kelly
educational scholarships and awards each year, looking to address a lack of females in the IT industry, provide up to 40 places for undergraduate students to study in Asia and foster community leaders. Mrs Kelly said the scholarships, some worth up to $330,000 over three years, would ‘‘have the potential to shape Australia’s future’’. The size of the corporate gift, together with the tight control exerted by Westpac over its operation in partnership initially with the University of Sydney, University of Melbourne and University of Wollongong, is a significant development in higher education. It follows mining magnate Andrew Forrest and his wife Nicola giving $65 million to the University of Western Australia to fund 25 international PhD students and six postgraduate researchers a year, as well as the construction of accommodation. Last year Graham Tuckwell, founder of ETF Securities, donated $50 million to fund the Tuckwell scholarship program over 20 years at the Australian National University. The Westpac Bicentennial Foundation is a way for Australia’s oldest company to promote its view of where the future of the nation lies, primarily in linking
up with Asian economies as well as technology and education, yet it also reflects the personal interests of its chief executive. While hardly an IT geek, Mrs Kelly said the foundation would be a vehicle for female inclusion, particularly in the male-dominated tech industries where women were ‘‘woefully unrepresented’’. A former Ovid-reading, highschool Latin teacher who grew up in apartheid South Africa, Mrs Kelly said the overall motivation behind the gift was the promotion of further education and postgraduate research in Australia and overseas. It would develop the skills and capabilities needed to enhance Australia’s
competitiveness in the future. ‘‘I have certainly been very front-footed about increasing our gender representation at Westpac,’’ Mrs Kelly said. ‘‘But it [the foundation] allows our company to say what can we do to drive more inclusiveness and workforce participation of women in our society because you want to provide an environment where women can balance having children ... with having successful and exciting careers.’’ Professor Michael Spence, the University of Sydney vice-chancellor, said the gift was a ‘‘huge good news story for higher education’’. He said by international standards the Australian corporate sector had not been generous to education until now. Professor Sue Elliott, the University of Melbourne’s deputy provost, said targeted philanthropy was the future for wealthy individuals and corporations. She said they had a clear idea about how they wanted their funds spent rather than making blind donations. ■
The scholarships and awards programs: Currently planned scholarships and awards programs will include: • Future Leaders: Up to 17 scholarships will be awarded to new or recent graduates for post-graduate study at a prestigious global institution, with preference given to those working on Australia’s relationship with Asia and technology and innovation. Each are worth $120,000 over two to three years. • Best and Brightest: Up to three post-doctoral scholarships a year, each worth $330,000 over three years. Two post-doctoral researchers in Australia’s leading research universities will be selected annually whose work could contribute to enhancing Australia’s competitive position in technology and innovation, or towards helping strengthen Australia’s ties with Asian economies. • Young Technologists: Between 30 to 40 three-year undergraduate scholarships each year, each worth $15,000 over three years and awarded for merit, to address the heavily under-represented female presence in technology disciplines and overcome economic disadvantage. • Asian Exchange: Between 30 to 40 Australian undergraduates will spend a semester at a leading Asian university, each on a $10,000 a year scholarship, with a focus on increasing the number of Asia-literate graduates in Australia. • Community Leaders: The program will provide 10 awards annually of $20,000-$50,000 to community leaders in the not-for-profit sector to undertake personal educational opportunities to benefit their work.
www.insightnews.com.au
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CONTACT LENSES INSIGHT
2nd Scientific and Technology Awards Program announced F
or the second consecutive year, CooperVision is offering its CooperVision Science and Technology Awards Program for 2015. The goal of the awards program is to bring recipients and CooperVision scientists together to explore new areas of technology advancement in contact lens applications. CooperVision says it recognises and highly values the discovery of innovative ideas that have the potential to deliver benefits to current and future contactlens wearers around the world. “CooperVision is want to foster translational research from external sources, and this awards program is the ideal platform to act on that,” Mr Arthur Back, chief technology officer for CooperVision, said. “The fiscal year 2014 program was a great success with multiple awards funded. Those awards allow scientists to bring their ideas forward as well as provide the means to translate the award recipients’ theories into practical opportunities that expand the applications
Scientists in CooperVision’s Pleasanton, California, laboratory with contact lenses,” Mr Back said. The CooperVision S&T Awards Program is comprised of two awards: The CooperVision Seedling Award and the CooperVision Translational Research Award. Research proposals should demonstrate “significant potential for research discoveries and technological advancements
that CooperVision can rapidly commercialise to improve the performance, enhance the functionality, and/or broaden the use of contact lenses”. The CooperVision Seedling Award is intended to provide incentive collaborations with the company in a new research area
for a one-year period. The award enables investigators to generate preliminary data that could be used toward a future CooperVision Translational Research Award. The maximum total cash amount for a CooperVision seedling is $100,000, including indirect costs. A CooperVision Translational Research Award is a multi-year award for a substantive translational research project. Research under that award is milestonedriven in order to remain focused on a well-defined goal. It provides funding for up to two years, totalling up to $400,000, including indirect costs. A maximum of $250,000 can be requested for any one year, however it may be considered for renewal at the end of the initial research period. Based in Pleasanton, California, CooperVision, a unit of The Cooper Companies Inc, is one of the world’s leading manufacturers of soft contact lenses. The Cooper Companies Inc is a listed global medical-device company. ■
Blind woman robbed in Sydney on her way home
A
23-year-old blind woman on 22 April was robbed after she got off a train and
was walking home with a cane at Padstow, in Sydney’s south west. She was approached from
behind by a man who stole her bag which contained her phone, wallet and an online player/recording
device used by visually impaired people to download talking newspapers and other audio files. ■
REMINISCING
The Good Old Days? From Times Past A reader has kindly sent Insight this piece for publication, asking that he remain anonymous, which of course we respect. We hope you enjoy it, whether you’re young or not so young.
W
e all have our personal memories of the years spent at Tech. There were the returned servicemen, older and wiser than we who were coming straight from school. We school leavers survived on the Tech cafeteria (ugh) whilst the older, wiser ones would try various cafes and regale us with their assessment of the waitresses. Remember our first year and being used to try out the rowing machine for Professor Cotton? The taking of pulses and blood pressures after running up those stairs. The hours spent slaving over slide rules (how much easier if there had been calculators and computers in those days). It was a wonder we did not all end up suffering the same migraines as Jack Prince. The sharing of a chemistry course with the chemistry diploma students and sitting up the back, looking down through the blinking fluorescent lights. The physics course where the professor would go off on a tangent, working out problems on the black board, oblivious to us students. Remember the chess games, the making of fishing lures and jewellery, and the reading that then took place. That epidiascope that kept all awake (except for Treble who put his head down as he sat in front of the lens). The problems we set our poor lecturer, Alshuller, that were unsolvable. The psychology course when the returnedservice members bought whole libraries to use up their book allowance whilst we ‘schoolies’ scrounged information from the local libraries. I think the best stunt we ever pulled was when several of us did a paper on the psychology of vision and used the same fictitious authors and introduced ideas the lecturer had no grasp of whatsoever. It was quite a change from his predominant Freudian teachings.
‘Five-and-a-half-day working week and five nights a week at Tech’ Remember Joe Lederer calling for a volunteer to demonstrate how easy it was to fix an esophoria, spending over half an hour before giving up. The victim should have warned him that he had a real problem and what the solution had been. How we eventually were able to understand the terms ‘sick and sin’ lenses. Remember Canon, who was working in a plastic factory whilst doing the course, being 34
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Sydney Technical College, Ultimo, Sydney made manager and deciding he could make more money than in optometry? Remember Bruce Chiene doing the same when selling clothing. The only girl in our class quitting after first year. Keith Yates graduating but going into the Patents Office. The night we saw the wool building catch fire in the next block. Most of us had met our future spouse by the end of the course, and were juggling the problems of courting and studying. Those doing their degree these days think they have it tough. They cannot visualize working a five-and-a-half-day week and at the same time being given one afternoon off a week to go to Tech as well as attending Tech five nights a week. There is not much difference in the time we spent at Tech and the time they spend full time at University. There is a big difference in our having worked full time for four years for an optometrist compared to their one day a week for one year seeing what one optometrist does. Over the years, attending COE it is still is amazing to see optometrists, who have graduated and been working for years, making copious notes on things that we learnt back in the Tech days. We were lucky to do optometry when we did. Take away the automatic equipment and the new graduates are a bit lost. They have
missed that basic training we had in both dispensing and refraction. They have not had the opportunity to develop our ability to be able to compromise, and innovate. That basic training that allows us to start from scratch – the ability to realize the limitations of automation and to be able to make it work for us. We enjoyed an era of patient loyalty. Patients would wait to see us. Today, in many cases, if you do not see them as they walk in they go next door. I have visited a number of practices and found that those relying solely on automation are not getting many clients coming back. I had one check my eyes and had him repeat it a number of times and ended up with a number of different answers. He now uses an automatic refractor like we used a retinoscope – as a starting point. We all have our own memories of the hardships and sacrifices made to complete the course. Memories that we can now push to one side whilst we enjoy the fruits of our labour and the love of our families. Sixty years is a long time and not all have made it. Give a little pause, a moment to reflect upon those no longer with us. If their stories could have been told they would probably outshine us all. ■ www.insightnews.com.au
SECURITY
A ‘dongle’ can replace all passwords with an eye scan to unlock U sing biometrics to replace passwords has been a hot topic as of late. In the mainstream, for example, Apple’s latest iPhone lets a fingerprint scanner be used to unlock a device, with no password required. A company called EyeLock has spent the last seven years developing iris-scanning software that recognises users by their eyes. Here’s an interesting statistic: the false acceptance rate of the average fingerprint sensor (how often a scanning system is fooled by the wrong finger) is once in every 10,000 scans, while for iris scans, it’s only 1 in 2.25 trillion scans. (Plus, people have already been complaining about other problems with their iPhone scanners, too.) EyeLock’s cutting-edge scanning hardware and software were previously only available in enterprise environments, but the company has announced that it will be launching Myris, a USB-powered iris scanner for consumers. Here’s how it works: Five people can create accounts through each Myris ‘dongle’. Each person will use the dongle to scan their eyes and create their unique, encrypted code based on their iris. Myris has a little mirror below the scanner to make sure each person stares at the right place, moving the scanner back and forth in front of the face. It takes less than 20 seconds
for the device to scan a person’s eyes and create his/her unique iris authentication. Once you’re scanned in, you create your own profile within EyeLock software which only you can access through your eye scan where you store all your important passwords. You’d ideally reset all your passwords to long, tough-to-crack strings of characters since you would never have to memorise them again. When visiting any password-protected accounts on a site — for online banking, social media, email, Internet VPNs, whatever — Myris can be used to get instant access. When scanning the correct eye, the light around the Myris mirror glows green and access is granted. Using a video of someone’s eye in front of the device won’t work: Myris has ‘live’ sensors and can recognise photographs or dead eyes. Myris claims to be the first consumer-facing solution to password fatigue that is both safe, very simple to use and relatively cheap. Although at present EyeLock is selling its technology to consumers through a dongle, its software has been certified by the Fast Identify Online Alliance (FIDO). With that approval and partnerships in the works, the company plans to start integrating its tech into mainstream devices in the future. Myris will be available for purchase within the first half of this year, and will cost somewhere in the $US200 to $US300 range. ■
Google and Luxottica announce strategic partnership for Glass
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uxottica Group and have announced that they have agreed they will join forces to design, develop and distribute a new breed of eyewear for Glass, which will include the involvement of Ray-Ban and Oakley brands from within Luxottica’s portfolio. In its own statement, Google added: “Luxottica’s retail and wholesale distribution channels will serve us well when we make Glass more widely available down the road.” The announcement is described in Luxottica’s statement as “a far-reaching strategic partnership between Luxottica and Google to work together across multiple efforts on the creation of innovative iconic wearable devices. Through this relationship,
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Luxottica and Google will match up hightech developers with fashion designers and eyewear professionals. “In particular, the two corporations will establish a team of experts devoted to working on the design, development, tooling and engineering of Glass products that straddle the line between high-fashion, lifestyle and innovative technology.” Luxottica said that the two major proprietary brands of the group, Ray-Ban and Oakley, will be part of the collaboration with Glass. Luxottica cited Oakley’s “10-year heritage in wearable technology that has evolved from MP3 to HUD devices.” The company said details about the new products will be disclosed at a later stage. ■
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EXHIBITIONS INSIGHT
Silmo 2014 to be held on 4 days – Friday to Monday S ilmo 2014, the international optics and eyewear trade fair in Paris, will be held on four consecutive days – from Friday 26 to Monday 29 September. The organisers are confident the additional scope provided by those dates will offer new business opportunities to exhibiting companies and should enable more practitioners to attend the fair. Silmo says it wants to offer the best business platform, an essential stage in forward planning, support companies in their development projects, demonstrate the industry’s creative and innovative know-how and strengthen a solid network of practitioners
Ab Fab Lab, Luxury, Sport, Village, Frames, Lenses, Contact Lenses, Opticians’ Equipment, POS Equipment, Conncected Opticians & Low Vision.
who share the same goals. Building on the strengths that have cemented its appeal, Silmo is a major exhibition bringing together and uniting the talents in the optics and eyewear sector. In a bid to closely monitor economic changes, integrate market developments and meet the demands of both exhibitors and visitors, Silmo is making a number of changes in order to boost its appeal and continue to stand out as a must-visit
gathering: • A schedule more in sync with visitors; • A clearer layout; and • A more-extensive programme of events. The 2014 event will have a raft of invaluable services rolled out to exhibitors and visitors: SILMO ACADEMY, SILMO d’OR Awards, SILMO FASHION STYLE, MO by SILMO, MERCHANDISING WORKSHOP, Merchandising Workshop, SILMO TV by ACUITE
and LINK by SILMO. With close on a thousand companies occupying an exhibition area of some 80,000 m2, Silmo offers an in-depth overview of areas of expertise. In order to provide clearer signage and enable visitors to save time, Silmo has reorganised the way industry segments are sited. New categories will be added, with pictograms clearly identifying each of the 11 sectors that make up the industry. ■
Spring-Summer collection launched in Sydney
S
afilo Australia launched its Spring Summer 2014-15 Collection on 8 April at a press showing at ‘Establishment’ in Sydney, designed to coincide with Fashion Week and pitched at its attendant publication editors and writers. The showing covered all of the frame and sunglass collections distributed in Australia by Safilo, from basic styles through a host of smart fashion to highend stunners. While there were some common
(L-R) Safilo’s Amy Hill, Melanie Coupland and Ali Ible at the launch of the company’s Spring Summer 2014-15 Collection in Sydney
design threads in most of the collections, probably due to past experience of which overall designs work best from a wearer’s point of view, there were also interesting combinations of different materials and colours, as well as designs that were unique to their respective collections. If anything, the collections showed the effort to which designers will go to gain a satisfactory finished design that also has commercial appeal that brand owners of necessity seek. ■
Paul Beaumont Research Fellowship applications open
A
pplications are now open for the 2015 Blackmores Dr Paul Beaumont Research Fellowship, with electronic submission by 9 June (with confirmation hard copy submission by 11 June). The successful applicant will be announced on World Sight Day – 9 October 2014. The fellowship is open to
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researchers based in eligible Australian institutions to pursue research into nutritional and/or lifestyle aspects of macular degeneration, consistent with the mission of the Macular Disease Foundation Australia to reduce the incidence and impact of macular degeneration. In 2015 the Foundation will
provide a two-year research fellowship of A$50,000 per annum (excluding GST). It is a requirement that the cash and in-kind contribution of the applicant’s host institution at least matches the foundation’s contribution. The fellowship is on a full-time basis for two years. Full instructions, application
forms and other relevant attachments are available for download from the foundation’s website – http://www.mdfoundation.com. au/research/researchgrants/fellowship.aspx The fellowship is funded by Blackmores, The Blackmores Foundation and Macular Disease Foundation Australia. ■ www.insightnews.com.au
SUPPORT INSIGHT
PI-insurance provider and ASO formalise working relationship
M
DA National and the Australian Society of Ophthalmologists have formalised a long-standing working relationship with an agreement designed to benefit ophthalmologists across Australia, through premium discounts on their professional indemnity insurance and ongoing, in-kind support, such as assisting ophthalmologists to go to remote areas of Western Australia and Queensland. MDA’s national president and practising ophthalmologist, Assoc Prof Julian Rait, said the arrangement is a natural progression
stemming from the “ongoing synergy and collegiality” that the national medical indemnity provider shares with the ASO. “Our association will benefit shared members with reduced premiums on professional indemnity, specialty specific medico-legal information, CPD accredited education and peace of mind knowing they are backed by two very sound organsiations that respectively aim for the best possible medico-political and medico-legal outcomes for our specialty,” Assoc Prof Rait said. ASO president, Dr Arthur Karagiannis, said the agreement
Correction
T
has optimised the ASO’s relationship with MDA National to specifically benefit Australian ophthalmologists. “Our two organisations also share a focus on corporate social responsibility. As part of our association, MDA National is investing funds and in-kind support to further raise awareness and help expand the ASO’s community program “IRIS” (Indigenous and Remote Eye Health Service), which will enable continued improvements in rural remote eye health care,” Dr Karagiannis said. ■
he photos of Drs Patrick Versace and Ian Sebban on page 32 of the April issue of Insight were incorrectly captioned. They should have been:
Ian Sebban
Essilor 23rd ‘most innovative company’
F
or the third straight year, Essilor has made it on to United States magazine
Forbes’ list of the ‘World’s Most Innovative Companies’. This year, the lens maker
climbed from 28th place in 2012 to 23rd place this year. ■ Patrick Versace
W E N
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*UV-absorbing contact lenses are NOT substitutes for protective UV-absorbing eyewear such as UV-absorbing goggles or sunglasses because they do not completely cover the eye and surrounding area. Johnson & Johnson Vision Care, a division of Johnson & Johnson Pacific Pty Ltd., 45 Jones Street, Ultimo NSW 2007 Australia. Phone 1800 736 912. www.acuvue.com.au. ©Johnson & Johnson Pacific Pty Ltd 2013. ® TM Registered Trademark. CCP 8639/13
MAY 2014
SUSTAINING VISION
Lifetime of UV and high-energy – By Mark Mattison-Shupnick and John Lah*
I
ndependence, demanded by toddlers, tested by teens and coveted by seniors is significantly affected by vision. After all, independence is a part of each of our ability to earn a living, contribute to society and ‘drive at night.’ Certainly a fear of older people is that of dependence. How can eye-care practitioners contribute to sustaining a patient’s good vision as they age, especially as an essential part of independence? It’s essential to understand the senior’s vision, its components and the ways that eyewear can enhance it when needed. In this article, we investigate the effects of a lifetime of UV and high-energy visible light exposure on the human eye and vision. Currently there up to 350 million cases of age-related macular degeneration and cataract worldwide, a figure that may double in the next thirty years with the ageing population. If left untreated, those diseases will cause serious vision loss, blindness and significantly increase health and longterm care costs. UV and HEV are accumulated over a lifetime, and the senior population typically has not known that protecting their eyes is essential. Therefore, knowing the issues and the ways that quality outdoor eyewear can help improve a senior’s vision will help both your patients and your practice.
The senior, UV and their eyes As is known, acuity is the acuteness or clearness of vision, which is dependent on the sharpness of retinal focus. That means that the clarity of all of the ocular components and their media must transmit and receive light without issue. In an adult eye, the cornea and lens protect the retina from UVC (skin cancers), UVB (sunburn, blisters, skin cancers) and the UVA (skin ageing). UVB and UVC are serious agents of skin
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Aqueous: From glaucoma.org: “Glaucoma can make eyes highly sensitive to light and glare, with some glaucoma medications exacerbating the problem even further. Sunglasses are an easy solution that makes life more comfortable when outdoors, while also providing critical protection from the sun’s damaging ultraviolet (UV) rays.”
‘Advancing Pterygium, The Role of UV Damage in Ocular Disease’, Paul Karpecki, Review of Optometry, October 2012 tissue changes because the DNA directly absorbs them. The cornea and lens protect the retina by absorbing the greatest majority of radiation. As a result, only about 1 per cent of UV and HEV can reach the retina. However, the effects are accumulated over a lifetime and can become an issue for each of the senior’s anatomical parts of the eye. Here’s how. Cornea: This transparent window is susceptible to sunburn just like the epithelial layer of the skin. Over a lifetime, corneal ‘sunburns’ can be common from UVB overexposure, especially from reflection off surfaces like water, snow or even concrete. Artificial sources like welding arcs and UV tanning beds can also cause photokeratitis. Treatment consists of mostly time to allow the epithelial layer to heal and replace itself. If severe, there might be patching, some sort of lubricant and lots of artificial tears to keep the surface lubricated. Recurring sunburn may result in longer-term problems. Treatment/Prevention (photokeratitis): 100 percent UV absorbing and/or reflecting sunwear in which the lenses provide complete coverage both from the front as
well as the top and sides. Corneal sun protection is critical outdoors, especially when under extreme conditions such as at high altitudes or at the beach or near the equator. Sclera/Conjunctiva: Commonly attributed to UVA and UVB exposure (Chesapeake Bay Waterman Study), the nodule in the conjunctiva – a pinguecula – results in a bump nasal and/or temporal of the limbus. It is often rich in blood vessels that fill to make the eye appear very bloodshot after being in the sun too long or outdoors in the wind where the surface of the eye gets dry. Chronic sun exposure is also associated with pterygia, a wedgeshaped membrane or pinguecula crossing the limbus. If it grows close to or into the line of sight, the associated topographical shape changes make it necessary to remove it before there are dramatic vision changes. Unfortunately, pterygia reoccurs but newer techniques have been effective at halting the progression after surgery. Treatment: 100 percent UV absorbing sunwear; wraparound eyewear is a distinct advantage.
Treatment/Prevention: “Glaucoma is a complicated disease in which damage to the optic nerve leads to progressive, irreversible vision loss. Glaucoma is the second leading cause of blindness.” (glaucoma. org) Glaucoma patients are aided by quality sunwear that is 100 percent UV absorbing. Crystalline Lens: The lens absorbs UV and depending on its yellowness, HEV radiation. The accumulated radiation effects are associated with cataracts and agerelated macular degeneration. In a cataract (an opacity of the lens nucleus, cortex or capsule), lens cell proteins are changed by UV radiation. This results in a yellowing of the lens and a reduction of the light passed directly through the lens (opacification). The most harmful to the lens is UVB. Over a lifetime, the condition gets worse requiring removal of the lens and an optical replacement by an intraocular lens (IOL), contact or spectacle lens or a combination of these. Yellowing of the lens becomes apparent by puberty changing the amount of UVB that gets to the retina. But that means the lens is effectively transparent to UV in infants, toddlers and young children. The lens continues to yellow with age but a combination of genetics, diet, lifestyle and UV radiation causes some variability by the time we are seniors. A nuclear sclerotic or brunescent cataract is a lens that has become too dark yellow or brown, obstructs vision and requires removal. This colouring of the lens also
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SUSTAINING VISION
visible light: effects on ageing eye has implications to the way that colours are perceived. A brown lens absorbs the short wavelength blue light much like brown tints and polarised lenses. Colour changes in the lens slowly change the appearance of the world we see, reducing the blue. As a result, when practitioners deliver new glasses to a patient that has just had a very yellow to brown cataract removed and replaced by an IOL, they often hear from the patient, “Wow, that blue is so blue.” That’s because they are again seeing all the visible spectrum of colours. The change of colour sensitivity has less an effect on vision than does luminance or the amount of light. For the aged eye, that means the darkness of
sun lenses for outdoor use requires some discussion with your patients. Reading may become difficult for some nuclear cataract patients before removal is indicated since the opacity can alter the clarity and contrast of letters or images on a page. Larger cylinder and axis changes in prescription or increased minus are often indicators that a cataract has begun to affect vision. The results may be noticed as increases in scatter or haze, or a subtle lack of clarity. UVA in a lens also results in fluorescence when absorbed. Fluorescence produces scatter and haze, less noticed perhaps by a young eye but can reduce
important vision in an older eye with a smaller pupil and cloudy media. Treatment/Prevention: For cataract formation associated with the accumulation of UV radiation, UV absorptive spectacle or contact lenses, quality outdoor eyewear, UV absorbing IOLs. For reading problems with cataracts, single vision reading glasses provide more reading area and should be used in addition to their generalpurpose progressives. For the senior’s reduction in colour sensitivity, lens filter colours and polarisation that do a good job to increase colour contrast are the right choice. They are the typical browns, ambers
and green. However, new lenses have been formulated to improve colour contrast including grey. Anecdotally, when taking senior customers outside to sample grey or brown sun lenses, they typically choose a brown polarised. The increase in contrast improves the edges and visibility of the things they see while the darkness of the lens adjusts the too-bright sunlight just the right amount for a variety of shadows, bright sun and daytime driving. They are also very comfortable to wear. Vitreous: Floaters are probably the most common change to the vitreous noticed visually. Continued on page 40
AU 1800 637 654 w w w. e y e s r i g h t . co m . a u
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SUSTAINING VISION Continued from page 39
Lifetime of UV and high-energy visible light: effects on ageing eye There is some evidence that UV has an effect on making the vitreous more liquid, with floaters becoming more numerous and contributing to a posterior vitreal detachment. A detached vitreous, that is, when the vitreal membrane separates from the retina is common in the over 55. Patients will complain of a spider-like shadow. It may or may not be accompanied by flashes of light. Regardless, it should be checked by an eye-care practitioner.
when there is sufficient light. These structures are also terribly sensitive to the toxic effects of UV and HEV. While the cornea and lens protect the retina from this radiation, except as a child, excesses of both continually bombard our eyes. As a result, protection of the retina is required throughout life. UV is implicated in age-related macular degeneration due to high exposure to UV over a lifetime. AMD is the major cause of vision impairment in the over-50 group, and its prevalence is expected to increase
How can eye-care practitioners contribute to sustaining a patient’s good vision as they age, especially as an essential part of independence? It’s necessary to understand the senior’s vision, its components and the ways that eyewear can enhance it when needed. Prevention/Treatment: There is usually no treatment for floaters other than assuring your customer that while they are normal, review by an eye-care practitioner is always recommended. The shadow that is noticed will also usually disappear as the eye/brain learns that the shadow is there and ignores it. Retina: The retina is exquisitely sensitive to light. The rods are able to detect motion and assemble the visual scene with very little light for night vision while the cones provide exceptional clarity and colours
as the number of those aged over 60 increases. Newer research about the effects of HEV, in particular the wavelengths centered around 430 nm (±20 nm) also show that this blue light plays a role in the incidence and severity of AMD. In both cases, free radical damage to the cells of the retina by UV and HEV is suggested. While the ageing retina is more susceptible to this damage, the yellowing of the lens and the absorption of some of the blue might help reduce blue light exposure. However, oxidative damage of the
retina continues to occur with ageing and its own protective mechanisms become less effective with age. Fluorescent phototoxic chromophores accumulate in the retina; blue light reacts with them, stops the regenerative process and kills the cells that nourish the cones. The result is a greying, then total loss of central vision. Aphakes (post cataract, no IOL) and pseudophakes (post cataract, with IOL) should be protected from blue light since the crystalline lens’ protective mechanism is absent. Good UV/Bad UV: Good Blue/ Bad Blue is a distinction also for retinal consideration since UV is important for the production of vitamin D, and the long wavelength blue is used to control circadian rhythm. As a result, vitamin D supplements may be recommended or up to 15 minutes daily in the sun wearing of course, a quality pair of sunglasses. The short wave blue (430 ±20 nm) is implicated in AMD while the longer wave to 500 nm is needed to help regulate sleep patterns. Prevention/Treatment: Protect the retina from UV and short wavelength blue. That means wearing quality sunglasses outdoors and the use of the newer blue light blocking indoor lenses. Know whether an older customer has had a cataract removed. Understand that the senior has
other visual issues that affect your recommendations for lens colour and darkness. Polarised lenses that enhance contrast also work well. Colour contrast enhancing lenses also improve performance outdoors.
End of Part 1; Part 2 next issue Armed with knowledge of the effects of UV and HEV, what specifically should your advice be to patients? Part 2 of this article describes a recommended plan for examination, lens performance, colour vision considerations, driving advice and when corrections no longer make a difference, low vision tools for the visually impaired.
*Mark Mattison-Shupnick, ABOM, is currently director of education for Jobson Medical Information LLC, has more than 40 years of experience as an optician, was senior staff member of SOLA International and is a frequent lecturer and trainer. John Lahr, OD, FAAO, is vice president of provider relations and medical director of EyeMed Vision Care.
‘Vision’s declaration of independence—Part 1 – UV, HEV and the Ageing Eye’ was originally published in 20/20, a publication of Jobson Medical Information LLC. ■
International companies invited to join UK’s Federation of Manufacturing Opticians
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he United Kingdoms respected optical trade body, The Federation of Manufacturing Opticians (FMO) is inviting companies outside of the UK to join and share in many of the benefits of membership. With central London offices, 40
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The FMO is an ideal meeting place with a choice of rooms available to members at its Paddington address. In addition, all FMO members benefit from the optical expertise which exists within the three FMO industry focus groups – for frames, lenses and technology.
“We are a valuable, and much used, reference point for our members and handle a broad range of technical queries about all aspects of manufacturing optics,” FMO chief executive, Malcolm Polley, said. FMO membership, for some,
is the most-cost-effective way of keeping in touch with changes to European Optical Standards and to find out about optical training. “The FMO brings a great depth of knowledge to the world of optics and is a valued source of reference to its members.” ■ www.insightnews.com.au
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*High oxygen transmissible lenses, Dk/t=156 @ -3.00D References: 1. Alcon data on file, 2011. 2. Brennan N. Contact lens-based correlates of soft lens wearing comfort. Optom Vis Sci 2009;86:E-abstract 90957. 3. Coles CML, Brennan NA. Coefficient of friction and soft contact lens comfort. American Academy of Optometry 2012;E-abstract 125603. 4. Kern JR et al. Assessment of the relationship between contact lens coefficient of friction and subject lens comfort. ARVO 2013;E-abstract 494, B0131. 5. Thekveli S et al. Structure-property relationship of delefilcon A lenses. Cont Lens Anterior Eye. 2012;35(suppl 1):e14. 6. Angelini TE et al. Viscoelasticity and mesh-size at the surface of hydrogels characterized with microrheology. ARVO 2013;E-abstract 500, B0137. See package insert for complete wear, care, and safety information. 息 2014 Novartis Alcon Laboratories (Australia) Pty. Ltd. ABN 88 000 740 830 10/25 Frenchs Forest Rd East, Frenchs Forest NSW 2086. Phone: 1800 025 032. DAILIES TOTAL1速 is a trademark of Novartis AG. 04/14 ALC0153 PCLC14045
INDUSTRY INSIGHT
Business Briefs Vision Eye Institute’s gross income steady at $54.9m Listed ophthalmology practices company Vision Eye Institute has reported gross income for the six months ended 31 December was steady at $54.9 million versus $54.5 million in the same period the year before. • Gross profit was down 5% from $25.0m to $23.7m, showing a decrease in gross profit margin from 45.9% to 43.2%. • EBITDA was down from $13.3m to $12.5m, while EBIT up from $10.5m to $11.8m. • Net finance costs were down from $3.4m to $1.0m. • Profit before tax rose from $7.1m to $10,8m, while after-tax profit rose from $4.9m to $7.5m. • Earnings per share were down 18% from 5.5c to 4.5c. • During the interim period, bank debt was reduced from $47.5m to $40.0m. Net debt as at 31 December was $29.5m. • Bank debt facility was extended until 31 July 2016 on more commercial reurns. • Total shareholder equity increased from $66.2m to $73.8m. • Net bank debt to equity dropped from 60% to 40%. • Interest cover increased from 3.1x to 9.7x, while net bank debt to EBITDA dropped from 2.5x to 1.2x. • Market earnings guidance for the 2014 financial year at the EBITDA level has been revised upward from $23-25m to $25-27m. Vision Eye Institute operates in New South Wales, Victoria and Queensland and currently has 77 ophthalmologists (an increase from 68 at October 2013), including 35 partners, 23 associates and
19 visiting surgeons offering cataract surgery, vitreo-retinal surgery and treatment for macular degeneration, refractive surgery, glaucoma treatments, corneal surgery and ocular plastics treatment and surgery.
Essilor opens new lens plant in Laos Essilor International has opened a new production plant near Savannakhet in Laos. According to Essilor, the facility is part of the group’s strategy “to leverage its industrial capability to meet the vision needs of people in every region of the world”. The Laotian plant will contribute to the group’s growth by accelerating its mid-tier offer to meet increasing demand from middle class consumers, especially in emerging markets. The new facility will be dedicated to producing finished polycarbonate lenses for which consumer demand is increasing by 4-5% per year. In its first production phase, the facility will employ 250 people. It will produce 20 million lenses per year when at full capacity, enabling the group to provide competitive polycarbonate products to major customers. “Our global industrial network is key to support the development of the group. It connects our production plants with distribution centres and more than 450 prescription laboratories around the world to serve eye-care professionals and consumers,” a spokesman for the company said. “Thanks to our new plant in Laos we will continue to strengthen our global offering of visual health solutions that help improve lives by improving sight.”
Safilo’s profitability rose in 2013 Safilo said on 5 March its profitability rose in 2013 and pledged to focus on developing its proprietary and licensed brands, taking advantage of growing demand for fashionable eyewear. The manufacturer and distributer of Gucci- and Dior-branded eyewear said its adjusted core earnings rose 5.8%, leading to a margin of 10.9% in 2013. Safilo posted full-year adjusted net profit of €39 million in 2013, excluding one-off costs including an Italian tax provision. Prior to the adjustment, group net profit came in at€15.5 million for the full year. The loss of a valuable license to make eyewear for Armani to market leader Luxottica at the end of 2012 had prompted Safilo to trim its sales and profitability expectations Safilo, which generates around 80% of revenue from eyewear made under licence, said it would develop the brands it owns, such as Carrera and Polaroid, and selectively agree new licences. “Our focus is on leveraging and expanding our proprietary brands to their fullest potential,” Ms Luisa Delgado, who was appointed chief executive officer of the company last October, said. New licenses must “complement our portfolio ... we are not looking indiscriminately at just adding brands,” Ms Delgado said. Chief financial officer Mr Vincenzo Giannelli said a new licence to manufacture sunglasses for Kering’s Fendi should generate €40-50 million ($US54.96 million-$68.7 million) in 2014 and 2015.
Luxottica expects the Armani licence to be worth €160 million in sales in 2014. Analysts say changes in consumer behavior worldwide, including growing popularity of sunglasses in China, have made eyewear a lucrative market.
Essilor places $1,185-million bond issue Essilor International announced on 9 April that it has successfully placed an €800-million ($A1,185-million) bond issue “under very favourable terms and conditions”. Rated A2 (stable outlook) by Moody’s, the issue comprised two fixed-rate tranches: • A €500-million tranche of seven-year, with a 1.750% coupon. • A €300-million tranche of tenyear, with a 2.375% coupon. It was the lowest coupon ever obtained on an inaugural sevenyear issue by a non-financial issuer and the lowest ten-year coupon obtained by a non-financial issuer so far this year. The issue was amply oversubscribed, illustrating investor confidence in Essilor’s business model and the quality of its credit profile. It has enabled Essilor to diversify its sources of financing and investor base and to support its growth strategy. Essilor International reported consolidated revenue of over €5 billion in 2013 and employs more than 55,000 people. It distributes its products in some 100 countries with 28 plants, more than 450 prescription laboratories and edging facilities, as well as several research and development centres around the world. ■
Luxottica wins 10-year Michael Kors licence
M
ichael Kors Holdings and Luxottica Group announced on 17 April that they have signed a new 42
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and exclusive 10-year licence agreement for the Michael Kors Collection and Michael Kors eyewear.
The first collection produced by Luxottica will be launched next January. Currently, Marchon has the
licence to produce Michael Kors eyewear. ■
www.insightnews.com.au
PEOPLE
New general manager for CooperVision ANZ C ooperVision has promoted Mr Greg Sampson to general manager Australia and New Zealand. He was previously national sales manager for the company, since April 2013.
Prior to joining CooperVision, he was of general manager of sales as well as sales and marketing director for Argus, a business specialising in biometric software applications and prior to that he led a division at Panasonic, where he was also
strategic marketing manager. Mr Sampson, who has a Masters of Business complementing his Bachelor of Applied Sciences in Microbiology, replaces Mr Wayne Reuben, who has transitioned into a new role as vice-president sales
operations and sales excellence for Asia Pacific. Mr Reuben remains based in CooperVision’s Sydney office and, as part of his new role, continues to be involved in the ANZ business. ■
Australian Achiever Award rating for Eyes Right Optical
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n its seventeenth year, the Australian Achiever Awards has rated Eyes Right Optical “a highly recommended” 94.28 per cent, whereby any score over 80 per cent is considered to be exceptional and reflects outstanding customer service. The unbiased award system is based on assessment ratings from a business’ own customers based on
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seven criteria: time-related service, addressing client needs, care and attention, value, attitude, communication, and overall perception. Eyes Right Optical was assessed within the ‘Optical Frame Wholesale & Distribution Services’ category. Gaye Wymond, a director, told Insight: “We are absolutely delighted to receive such an exceptional rating from our customers. I’m very proud
of everyone in our team. “When I read customer comments in the survey like ‘Eyes Right Optical are innovators in a field not particularly known for its innovation’, I guess we must be doing something right; but I would welcome any ideas which would lead us to achieving a 100% customer satisfaction next year,” Ms Wymond said. ■
Eyes Right Optical directors Gaye and David Wymond
BECOME AN OPTOMETRY PRACTICE SUPERVISOR NOW
Deakin Optometry’s final year students commence 6-months of residential placements in November 2014 Make your mark on the future of our great profession TO FIND OUT MORE VISIT www.optomsupervisor.com
Deakin Optometry 11/04/2014 9:34 am
MAY 2014
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MANAGEMENT
Practice Dollars – By Karen Crouch*
Keeping in touch with your most valuable resource – humans New consultation terms in modern awards
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ractices employ staff, clinical and administrative, on a variable hours basis, often involving changes either to rosters or working hours. Based on employee and industry feedback, such changes, albeit reasonable and well intentioned, were not preceded by adequate consultation. On the back of our previous article which touched on familiarity and compliance with new legislation on Fair Work Act 2009, employers should be aware of requirements of the latest amendment. On 24 December 2013, a Full Bench of the Fair Work Commission (FWC) handed down its decision with regards to the proposed new “consultation clause” for all modern awards. As a result of a Fair Work Act 2009 amendment, introduced by Fair Work Amendment Act 2013,
all modern awards, and enterprise agreements made on or after 1 January 2014, are required to have “consultation terms” that require an employer to consult with employees about proposed changes to regular rosters or ordinary hours of work. Included in the decision, and the new model consultation clause inserted in modern awards, an employer must: • provide information about changes to employees and their representative, if any; • invite employees affected, and their representatives if any, to give their views about impact of the change (including any impact on family or caring responsibilities); and • give consideration to any views about the impact of the change/s from employees concerned, and/or their representative.
VIETNAM TO CAMBODIA TANDEM* BIKE RIDE 2014
The new consultation obligations do not apply where an employee has irregular, sporadic or unpredictable working hours. Employers are encouraged to review impact of the modern award amendment to their business, particularly the new consultation clause. Where an employer is likely to change an employee’s regular roster or ordinary hours of work it is important to consider that decision in light of new consultation obligations and any other clause already contained in the modern award that relates to work and roster arrangements. This new requirement of businesses can be viewed as: • either yet another legislative compliance burden; or • an opportunity to enrich employee relations by merging it with other staff-related programs. For example, the administrative burden may be quite simply complied with by a cut and paste of the new requirements into new
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Join our charity challenge and help raise $100,000 for Guide Dogs NSW/ACT. For further information call 1300 905 188 or visit www.inspiredadventures.com.au/guidedogs/vietnam2014
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Karen Crouch is managing director of Health Practice Creations Group, a company that assists with practice set ups, administrative, legal and financial management of practices. Contact Karen on (02) 0433 233 478 or email kcrouch@hpcnsw.com.au or www.hpcgroup.com.au
Alcon opens manufacturing plant in Singapore
O 11-22 OCTOBER 2014
employment agreements and the practice Policy & Procedure Manual. And, those practices who perform regular staff appraisals or occasional performance discussions should include these new provisions of the Act in such oneon-one discussions, seeking confirmation from staff that they are satisfied with the manner in which changes are affected. The ultimate result is that employees feel consulted, not just on changes, but on the broader aspect of business and practice management generally. In effect, a business burden may be converted into an employee relations enrichment exercise! ■
n 14 April, Alcon officially opened its new $200 million, 330,000-square-foot pharmaceutical manufacturing facility in the Tuas Biomedical Park in Singapore. Located to be closer to Alcon’s growing base of customers in Asia, the plant produces ophthalmic pharmaceutical products for eye conditions such as glaucoma, dry eye, allergies and bacterial infections. Alcon’s top five products produced at the facility are Systane, Travatan, Patanol, Tobradex and Vigamox, a company spokesperson
said. Currently, the facility employs 150 staff, and is expected to continue to grow as production increases. Alcon already operates another manufacturing facility in Tuas Biomedical Park, which opened in 2005 to produce ‘Dailies’ contact lenses. “The need for quality eye care is increasing rapidly across Asia, as the population grows and ages,” Mr Roy Acosta, area president, Alcon AsiaPacific, said. “With the opening of this new manufacturing facility, Alcon is making a strong investment in the future of our business in Asia. ■ www.insightnews.com.au
An online web-based programme for eye health professionals. Approved by the Optometry Board of Australia (OBA) for a maximum 28 CPD points with Therapeutic content.
Seven cases each comprising a series of seminars based on clinical case studies, linking academic knowledge with practice. • All cases have been produced by qualified glaucoma specialists. • Participation is available to any eye health professional. CPD points awarded are for optometrists.
Case 1 - Pigment Dispersion Syndrome. This case covers the initial diagnosis, management and long term follow up in a patient with pigment dispersion syndrome. Case 2 -IIn this case we discuss the presentation, appearance and clinical features in a patient with optic nerve hypoplasia.
• The programme consists of 7 cases, each with a case history, questions and answers for self-directed learning, followed by an associated web-based assessment.
Case 3 - We look at a patient who presents with vague visual field loss, and discuss the diagnosis and follow up in patients with primary open angle glaucoma.
• The assessment associated with each case is made up of multiple choice and true/false questions.
Case 4 - We discuss a patient presenting with unusually high intraocular pressure, as well as the diagnosis, management and features of Posner Schlossman syndrome.
• Two attempts are available to achieve the 70% pass required by the OBA. • Each successfully passed course attracts 4 CPD points as approved by the OBA. • Successfully passing all 7 courses awards the maximum 28 CPD points. • The annual cost for the programme is $150 i.e. for up to 7 cases. • CPD points are only allocated to each case(s) completed prior to 30th November 2014.
Case 5 – Patients often present with vague symptoms. This case looks at a patient with unusual symptoms who is found to have glaucoma. Unfortunately the patient then develops a central retinal vein occlusion. Features and long term management of this condition are discussed. Case 6 – Patients can have multiple things that occur concurrently. We look at a patient with suspected glaucomatous changes, who has an associated intracranial tumour. Features differentiating these two entities are reviewed. Case 7 - Conditions don’t always present as you may expect. We review a case of bilaterally painful red eyes, found to be due to bilateral acute angle closure. Features of this condition are reviewed.
www.glaucomaeducation.com
DISPENSING
Selling diversity
New website launched at CFEH
We aren’t just talking colours and trends here. We are also talking price points. You might see yourself as a boutique specialising in higher-end products, a family-oriented shop with mid-range offerings or a business catering to the budgetconscious. But with the competition the way it is today, you may want and need to reach a wider customer base. To help you broaden your horizons, try these Insight Basics.
Have a plan
Analyse the demographics of your practice. See what price points are selling well or not so well. Check current inventory to determine price categories you could expand or minimise.
Offer options
In all categories. Eyewear is a family affair and it’s an everyday, every occasion affair. Provide a range of price options for everyone from kids, tweens and teens to Mum, Dad, Grandma and Grandpa in all product categories, including sun, sport and accessories.
(L-R) Helen Beange, who has AMD, Guide Dogs NSW/ACT web designer Rosalie Williams and CFEH director Michael Kalloniatis
New and noteworthy
When purchasing products in any price range, look for innovative design and technology – new hinges, premium materials and user-friendly mounting systems. Keep an eye out for that killer shape or amazing colour combination – sure to be the next must-have wardrobe addition. And always focus on quality.
Treat all products equally
Mix value, mid-price and high-end eyewear in your displays, including the windows. Present all products the same way whether they are inexpensive or expensive. Show trends, styles, colours and technology. You may not be able to deliver designer names at a lower price point, but you can deliver the look, such as colourful, retro-inspired acetates.
Essential extras
Always offer all the options: premium lens materials, anti-reflective and anti-scratch lens coatings, photochromic-lens technology and polarisation. Package all eyewear with the same respect used on higher-price products, with a good case, preferably a hard case, and a cleaning cloth.
Don’t pigeonhole customers
Never assume your patients are interested in one or the other: inexpensive or expensive eyewear. The same consumers can happily fill their shopping bags with a mix of both, just as they might buy a basic T-shirt or bangles to wear with an expensive suit, or lower-price but stylish weekend wear to complement their pricier weekday wardrobe. Show options at various price points. After spending significantly on a pair of eyeglasses, your customers might be more inclined to buy a second or even a third pair if the price is right. ‘Selling Diversity’ by Gloria Nicola was originally published in 20/20, a publication of Jobson Medical Information LLC.
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ith the incidence of vision loss increasing, a new website, www.visionloss.com.au, was launched on 1 April at the Centre for Eye Health, located at the University of NSW, to enable people affected to know how and where to access services as quickly as possible. Designed by Guide Dogs NSW/ACT the website is believed to be the first of its kind in Australia dedicated to the issue of vision loss. Featuring sections on different vision conditions, information on local services, links to support groups and industry bodies, and an interactive discussion forum, it aims to provide eye-care professionals, people experiencing vision loss and the public with a single portal of information about eye health and the range of expert services available from optometrists through to the free specialist services provided by organisations like Guide Dogs. “After many years working with the eye-health industry and people who are blind or vision impaired, we realised there was an opportunity to create a central online site about vision
loss,” Mr Charles Ulm, marketing and communications manager of Guide Dogs NSW/ACT, said “We strongly encourage people experiencing trouble getting around because of vision loss to seek help early but were concerned they, their families and their eye-health professionals may not know how to quickly and easily find that help. www. visionloss.com.au is designed to be that solution.” Professor Michael Kalloniatis, director at the Centre for Eye Health in Sydney where the website was launched, congratulated Guide Dogs on taking the initiative to develop a tool that would fill a gap in the industry. “Learning you are losing your vision can have a huge impact on your life, so it’s vital people in that situation know there are services and supports to help them maintain or regain quality of life,” Professor Kallionatis said The website is accessible for people who are blind or vision impaired with features including options for text to be read by a screen reader, enlarged or even the contrast changed to make it easier to read. ■ www.insightnews.com.au
CLASSIFIEDS
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Optometrists, Optical Dispensers & Assistants Full-time and Part-time roles available across Australia Queensland Western Australia New South Wales Victoria South Australia Bupa Optical is a unique and growing division of the global BUPA organization. At BUPA we are dedicated to being a health and care partner to millions of people around the globe. Through ensuring that our patients receive the very best eye health care and eye wear solutions. Each practice is supported by a practice manager, experienced optical dispensers and assistants, so every customer is provided with the continuity of care that we expect. The products we have will surprise and delight even the most discerning of customers with lenses available from some of the best laboratories in the world and frames from a large portfolio of fashion houses around the globe. In recognition of your commitment, professional care and commercial contribution you; • Will be rewarded with a competitive package • Have the opportunity to participate in a lucrative commission scheme • Have access to a broad range of unique benefits that only an organization like BUPA can offer. If you are serious about eye health and making a difference then please click http://www.bupa.com.au/about-us/ careers/careers or call 1300 072 311 for a confidential discussion.
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January 24-30, 2015 Rusutsu Ski Resort, Hokkaido, Japan Website: www.skiconf.com Email: info@skiconf.com
SALES REPRESENTATIVES NSW & VIC Mondottica Australia currently has positions available in both NSW and VIC for experienced and energetic Sales Representatives with proven sales records. Working alongside the State Area Manager, your primary responsibility is to service our existing clients and further develop the territory and distribution of our brands. Wholesale experience within the optical/ sunglass industry would certainly be advantageous but should not discourage successful candidates working outside the industry. Primarily, you will be customer service focused, results driven and adept at building and maintaining long term relationships with clients. If you wish to be part of a progressive company that enjoys a reputation for high quality and service then please forward your resume electronically to amyhoole@ mondottica.com.au . All enquiries will be treated confidentially. The remuneration package will include a competitive retainer, commission and car allowance
4 out of 5 ophthalmic practitioners rely on Insight to keep up-to-date with the ophthalmic professions MAY 2014
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Revisit all the moments that have defined the ophthalmic professions and industry in the past 38 years!
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Over 38 years we’ve seen many changes in the ophthalmic professions and industry; ophthalmic professionals’ stars rise and fade, restructuring of the industry, clinical studies that have led to revolutionised eye-care, the struggles and triumphs of eye-care practitioners, new companies emerge as leaders, existing companies merge, established companies fold, and old technologies made redundant by new technologies.
INSIGHT’S 400th Issue Online Special After a record 38 years and 400 issues, we’re proud that INSIGHT is the highest circulated ophthalmic publication in Australia. To mark this milestone, INSIGHT has produced a special online 400th issue that revisits all the significant and industry changing news over the past 38 years. Take a journey down memory lane by reliving all the industry-altering moments that have defined our professions and industry and makes it what it is today by visiting the INSIGHT website to read this special online edition.
Visit www.insightnews.com.au INSIGHT statistics Published for 38 years, readers rely on INSIGHT for hard-hitting news supplying the facts that are reliable, accurate, independent and unbiased. Ophthalmic professionals respect INSIGHT because we identify the issues that need to be covered and challenge our readers through intelligent reporting and analysis.
88%
74%
INSIGHT is the most-read ophthalmic publication with 88% of practitioners regularly reading it.
If ophthalmic practitioners were to read only one publication, 74% would choose to read INSIGHT only.
78%
85%
78% of ophthalmic practitioners rely on INSIGHT to keep up-to-date with the ophthalmic professions.
85% of practitioners believe INSIGHT provides balanced and independent reporting.
Research conducted at ODMA2013 in Brisbane.
I
T’S intriguing to hear so many whine and whinge about online dispensing, whether it’s contact lenses or prescription glasses or sunglasses. Most (perhaps all) of them would have bought goods online – books, DVDs, travel and accommodation, clothing, shoes, leather goods, electronic games and just about everything else that you can bring to mind. But isn’t it odd that they don’t want anyone buying optical goods online. “Ah, that’s different,” is the usual cry!
T
HE recent Optrafair London trade exhibition attracted an attendance of 4,616 visitors, which left for dead the 3,000-plus attracted to a rival exhibition held in London a few months prior. Given that the population of the United Kingdom is about three times that of Australia, that’s the equivalent of only about 1,538 attendees if it was ODMA’s biennial exhibition, when in fact there were 4,934 attendees in Brisbane in 2013. Game, set and match for any knockers of the ODMA exhibition.
H
EALTH minister Peter ‘Plod’ Dutton is trying his hardest to appear on top of his extensive portfolio, but he has an annoying habit of harking back to the previous government and putting in the boot whenever he has the opportunity – whenever asked in Question Time, he constantly refers to “cleaning up Labor’s mess”, or words to that effect.
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He’s becoming tiresome and it adds nothing to his efforts to cope with what is a challenging portfolio. Perhaps he should grow up a little and move on; to no longer bore everyone silly. Fortunately for the nation, the head of the federal health bureaucracy is a tough, no-nonsense operator who would be able to run rings around her nominal boss, if required to do so. Yes, the lady concerned has some baggage in the form of her role in ‘A Certain Maritime Incident’ – i.e. the Tampa episode that helped ‘Honest John’ Howard win the 2004 federal election. And she is said to be waiting to take over as permanent head of the Department of Prime Minister and Cabinet in the Credilin, Murdoch, Abbott government when the present head of PM&C retires. Let’s hope she stays on at health for a good while – in the interests of ensuring there remains a good health system despite the efforts of knockers like Plod.
A
S the federal government tries to soften up the electorate for whatever Joe (The treasurer who can’t count) Hockey has in store for us in the federal budget for 2014-15, health-care providers can probably relax. After all, Prime Minister Tony Abbott, the evening before the September 2013 election, said a government he headed would not touch pensions, health, education and a few other areas of concern. But was it a case of elect me and my mates at any cost and we’ll look after you – no surprises,
honest as the day is long, blah, blah? Well, we’re dealing with a man who can be economical with the truth when it suits him, who already thought he could get away with changing pension entitlements, until the pensioners made it clear that was not on, and he backed down, hastily confirming that pensions would not be touched. However, that’s the only one of his pre-voting-day, no-touch promises that he’s thought wise to confirm. So we probably shouldn’t be surprised if Joe Hockey ignores what Tony Abbott promised and cuts into health, one way or another, with the agreement of the PM.
T
HE ‘Publication Whose Name We Do Not Utter’ keeps on telling porkies about its relevance to the Australian and New Zealand ophthalmic markets, the latest being that it is a “leading communicator in every optical media in Australia and New Zealand”. How can that be when, for example, Insight has 22 per cent more circulation than it has in Australia and when New Zealand Optics has almost four times more circulation? It can’t.
F
IGURES just released by the Australia Bureau of Statistics show wages rose by 2.5 per cent in the year to December 2013, while in the same period, gross corporate profits were up 9.5 per cent. So what are the captains of industry complaining about?
www.insightnews.com.au
T
HE goings on concerning federal assistant health minister Senator Fiona Nash, her former chief of staff and of late the special minister of state grow murkier and murkier as time goes on. As reported last issue, now it turns out that an outfit called the government staffing committee, which vets and approves staffing appointments to ministerial offices, is in it up to its neck. That august body is chaired by social services minister Kevin ‘Rug’ Andrews and includes special minister of state Michael Ronaldson, Prime Minister Tony Abbott’s chief of staff Peta Credlin and Andrew Hirst, as well as Deputy Prime Minister Warren Truss’s chief of staff, David Whitrow. And from time to time, Ms Credlin’s husband, Brian Loughnane sits in on its meetings. It’s bad enough that Peta Credlin and David Whitrow are unelected public servants who can wield such power, but worse is that Brian Loughnane is not even that, being an employee (i.e. director) of the Liberal Party. Just how is all that in the best interests of the nation?
enforcinging the Therapeutic Goods Authority’s insistence that new products and procedures be trialled here before being released onto the market, despite similar trialling having been satisfactorily carried out in overseas markets. Countries such as the United States and Japan have Food and Drug Administrations that handle new products and are renown for being tough on companies. The TGA (the equivalent of the FDAs) insists on local trials as well, causing huge collective expense for drug and medical-equipment companies for what is largely duplication. Wasteful, to put it mildly, with the consumer eventually ending up paying for it all.
J
IDE temples on frames and sunglasses have been the rage for some years, although lighter-weight, slimmer styles are now making a comeback. The wide temples have suited some designers, who have loaded them up with logos, stripes, stars, stones and anything else they can think of. Some look good, others look cheap and nasty, but they sell like hot cakes; seemingly the more bling, the better. One problem is that they interfere with side vision when driving, so much so that in the event of an accident, a smart lawyer might be able to successfully put up a case that wearing wide-temple frames contributed so much to the accident and was in fact the reason it happened. So it could be a way to expand eyewear sales on safety grounds – one pair for ordinary wear and one for driving (probably a lightweight frame incorporating Drivewear photochromic lenses would be ideal). Worth a try.
UST what is it about the word ‘optician’ that bamboozles many, using it when the words ‘optical dispenser’ are the correct ones to use to describe what they are. The latest offender is one of the larger drug companies, which should know better. It offers its products to ‘opticians’ as if they are different to ‘optometrists’, which they aren’t in jurisdictions, particularly New South Wales. Perhaps it’s all to do with the dog-in-themanger attitude of the leaders of optometry in NSW, who simply won’t let go of the exclusive use of ‘optician’ granted to optometrists under the former Optometrists Act 1930 even though it’s hardly, if ever, used today. Members of the Australian Dispensing Opticians Association for years have pined to use ‘optician’, as is the case all over the world, but NSW OAA has successfully fought that off. Until the late 1970s, optometrists in NSW (and other jurisdictions) used both ‘optometrist’ and ‘optician’ titles as fits-alls to cover any likely incursions by those who are now called ‘optical dispensers’, particularly OPSM when it was a dispensing company in bed with ophthalmologists versus now being one of the two biggest employers of optometrists nationwide. But use of such dual-titles has now almost died off completely, as hardly anybody regards optometrists as ‘opticians’, particularly optometrists themselves. Maybe the offending drug company could lead a push for a more-descriptive name for optical dispensers. Then its offerings would make more sense.
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HE day that piles of legislation that is no longer of use to the community were to be scrapped by the federal parliament has been and gone. One piece of legislation that was missed is that
www.insightnews.com.au
ID you know that by 2040 there will be 55,000 Australians who are over 100, and 5000 of them will be 110. The largest segment of our population will be those between 85 and 100. More immediately, the number
of 65-year-olds will double within the next decade. Based on the above facts and figures and other demographics, the outlook for optical retailing in total has to be positive, however just who gets the benefits will have to be decided on a practice-to-practice basis, sort of like houseto- house fighting in wartime.
I
’VE just read an earnest (and serious) proposal by a group of no-doubt-well-meaning optometrists in England who are concerned about marketing activities by what they call ‘scandalous behavior’ by ‘the chains’, such as offers of ‘free sight tests’, ‘free glasses’, ‘free contact lenses’ and so on, while claiming the full tax-payer-funded fee for a sight test. They propose that those who make such offers in their advertising should not be able to claim one penny more for their sight-testing than their advertised lowest price – i.e. in many instances nothing. The sad part of it all is that, crazy and unrealistic as it is, they expect their proposal to be taken seriously. If that’s what the supposed ‘thinkers’ can come up with, it’s little wonder that ‘the chains’ are doing so well over there.
T
HE various chat-lines for optometrists and optical dispensers from time to time become alive with discussion on the pros and cons of doing adjustments of frames bought at other practices or bought online. There’s talk of legal aspects (onerous) versus risk (always present) versus creating goodwill (desirable) versus practice-building (also desirable). The reality is that consumers/clients/patients are now largely accustomed to no-charge adjustments. Isn’t it too late now try to charge for them for the privilege? Yes, most likely. And the same most likely also applies to charging for measuring PDs, axes, etc.
D
ID you know that disputes between customers and banks have fallen for the first time since the global financial crisis? According to the Financial Ombudsman, the number of disputes fell 11 per cent during 2012-13, backing a steady downward trend since 2008-09. Very impressive? Not when you consider the number of disputes – 32,307 for the year!
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