UPFRONT

Just as Insight went to print,

SPECSAVERS

unveiled the winners of the respective Doug Perkins and Dame Mary Perkins medals. The company’s store in Hervey Bay Pialba, Queensland, and the Queenstown practice in New Zealand claimed the Doug Perkins Medal, an annual award recognising consistently high standards of clinical excellence and patient care. The Dame Mary Perkins Medal, introduced this year for exceptional acts of patient care, went to Ms Mariella Coluccio, of Specsavers Bankstown, with her life-saving story of a 3-year-old after being turned away from hospital multiple times. The Kiwi recipient was Ms Celeste Raisbeck, from Specsavers Rotoura, for her outreach work with the Maori community. IN OTHER NEWS, The Australian College of Optometry (ACO) is opening its eighth clinic, Knox Eye Care, in Melbourne’s east. Located in Bayswater, the practice was set to open last month, with Ms Iris Huang appointed the role of site manager and optometrist. It comes after Wyndham Eye Care, located in Hoppers Crossing, opened in June to help meet unmet demand for accessible and affordable eyecare in Melbourne’s west. FINALLY, with cancelled conferences and travel restrictions, four Australian ophthalmic equipment suppliers are hoping to provide an alternative local opportunity to showcase their range of devices and equipment. The event, O=PEN HOUSE, has brought together BOC Instruments, Device Technologies, Designs For Vision and OptiMed who will offer special sale and showcase events at each of their showrooms in Melbourne during 8-9 October, and in Brisbane 15-16 October. A NSW event will be scheduled when COVID-19 restrictions allow. Due to lockdown requirements, bookings are essential and dates may change.

n WEIRD

NSW Minister for Customer Service Mr Victor Dominello has been diagnosed with Bell’s palsy. He only sought medical attention after members of the public raised concerns over his “droopy eye” during a recent media conference. The politician felt pain in his skull, behind his right ear, about 48 hours earlier, before waking up with pins and needles on the right side of his tongue.

n WONDERFUL

Vision Australia has thanked the Illawarra community in NSW for its support in helping to raise $851,153 during this year's Seeing Eye Dogs Appeal. The donations collected at Petbarn stores around Australia were enough to fund 17 guide dogs. But the Illawarra community went beyond expectations by contributing $204,539.

n WACKY

High profile Brit Piers Morgan has revealed a long list of symptoms after catching COVID-19 at the Euro 2020 finals, including headaches, fatigue and an inability to taste wine. But coughing fits have also caused a posterior vitreous detachment, which has meant he is now seeing floaters.

STAT

DEALING WITH DRY EYE

It’s estimated around 85% of dry eye sufferers have the evaporative form of the disease. Full report page 23.

WHAT’S ON

THIS MONTH AUSCRS 2021

23 OCTOBER

The Australasian Society of Cataract and Refractive Surgeons' annual conference is going digital due to COVID-19 restrictions. The face-to-face event will return in Noosa next year. office@auscrs.org.au

Complete calendar page 65

NEXT MONTH RANZCO

19 – 23 NOVEMBER

The 52nd congress is expected to be an opportunity to look towards the next 50 years of science, ophthalmology and the college. ranzco@thinkbusinessevents.com.au insightnews.com.au

Published by:

11-15 Buckhurst Street South Melbourne VIC 3205 T: 03 9690 8766 www.primecreative.com.au Publisher Christine Clancy christine.clancy@primecreative.com.au Editor Myles Hume myles.hume@primecreative.com.au Journalist Rhiannon Bowman rhiannon.bowman@primecreative.com.au Business Development Manager Alex Mackelden alex.mackelden@primecreative.com.au Client Success Manager Justine Nardone justine.nardone@primecreative.com.au Design Production Manager Michelle Weston michelle.weston@primecreative.com.au Art Director Blake Storey Graphic Design Michelle Weston, Madeline McCarty Kerry Pert Subscriptions T: 03 9690 8766 subscriptions@primecreative.com.au

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

ADDRESSING PRIORITISATION AND EFFICIENCY

continued from page 3

resisted parts of the standards being used in isolation by hospitals or private health insurers to determine funding for cataract patients.

“We remain disappointed the ACSQHC have not listened to the experts when making a final decision about the standards, as apart from these issues, they are very robust,” Verma said.

ASO vice president Dr Peter Sumich said the standard was “a poke in the eye” to ophthalmologists from RANZCO and the ASO who have “universally denounced it”.

“Whilst falsely claiming to be consultative, it became clear it was a bureaucratic creation designed to allow manipulation of public hospital waiting lists to suit administrators,” Sumich said.

“It is beyond embarrassing for the ACSQHC that their document purporting to represent current standards is out of step with contemporary Australian clinical practice from day one.”

PRIORITISATION AND EFFICIENCY Professor Konrad Pesudovs, formerly foundation chair of Optometry and Vision Science at Flinders University, now SHARP Professor at UNSW, supports the standard.

He was part of the ACSQHC committee who developed the standard and said it was the work of a group of stakeholders involved in the cataract patient pathway, not only surgeons.

“Surgeons have a very important role in performing operations, but they don’t have a role in public health, primary care or in the community,” he said.

“This is important because this is where Australia’s problem with cataract exists. We have 10 times as many people in the age groups that get cataract today than we had 30 years ago, but we don’t do any more public cataract surgery than we did then.”

He said three things were required: more public cataract surgery; ensuring the right people – most disabled – get surgery first; and greater efficiencies in service delivery. The standard helps address the final two points – prioritisation and efficiency. Pesudovs, whose opinions are his own and don’t represent any organisation, suggested objections to a visual acuity criterion of 6/12 may be misplaced.

He said it was not a recommended criterion. It reads: ”Visual acuity of 6/12 or worse may provide a useful objective measure of visual impairment but may significantly underestimate function – for example in conditions of high or low light. Glare or contrast sensitivity may be disabling without an impact on visual acuity. Some patients will have higher visual needs, such as occupational activities.” Pesudovs said this was a wholly appropriate position.

“The problem of the right people not getting cataract surgery remains. Therefore, the standard includes a section on the prioritisation for cataract surgery.”

It includes Pesudovs’ Cataract Impact Model of prioritisation, on page 28.

“We take clinical measures of vision, cataract grades and vision-related activity limitation questionnaire data and combine it in a model that ranks people in terms of need for surgery. This type of sophisticated prioritisation model can ensure the right people are directed to hospitals where RANZCO surgeons can do their job and take cataracts out,” Pesudovs said.

Regarding bilateral sequential cataract surgery, he said the standard proposed it be used more widely.

“This is a safe approach in the era of intracameral antibiotics that eliminates the issue of increased falls, and its associated mortality and morbidity, that occurs between first eye and second eye cataract surgery,” Pesudovs said.

“Bilateral sequential cataract surgery also offers significant efficiencies in terms of public hospital process in clinical appointments and admissions. This would help us to get more surgery done.” n

"WE REMAIN DISAPPOINTED THE ACSQHC HAVE NOT LISTENED TO THE EXPERTS WHEN MAKING A FINAL DECISION"

NITIN VERMA, RANZCO

PATIENTS URGED TO KEEP CRUCIAL APPOINTMENTS

continued from page 3

communicate to its fellows and trainees about the importance of being specific when applying for travel exemptions across Australia.

RANZCO CEO Dr David Andrews subsequently sent an alert to Australian fellows, which said the issue may have arisen due to authorities not being aware that some services, such as intravitreal injections, were urgent and essential and cannot be provided by a local health professional such as a GP.

“We advise making this clear on any applications. Unfortunately, RANZCO cannot intervene for you in this process,” he said to fellows.

Meanwhile, the NSW restrictions has re-ignited concerns about apprehensive patients missing vital anti-VEGF appointments. The issue was a feature of lockdowns in 2020, when MDFA national research advisor Professor Paul Mitchell grew concerned that thousands of Australians were gambling with their vision.

This was exacerbated in July when, in a press conference, NSW chief health officer Dr Kerry Chant used eye checks as an example of something that could be put off during lockdown, if people weren’t experiencing “pain or other issues”.

At the time, the MDFA stepped in to clarify the matter and warn patients that any sudden changes in vision – even without pain – could be an eye emergency. It said deferring an eye

Dee Hopkins, MDFA. appointment in those circumstances could cause irreversible vision loss.

However, the MDFA remained concerned about anecdotal reports of people cancelling eye injection appointments. At one busy Sydney clinic on a particular day in July, only 23 of 43 scheduled patients attended their appointments.

“If this is a barometer of what is happening more broadly, the implications are quite concerning,” Hopkins said at the time. “Specialist eye treatments need to continue as scheduled as they are considered to be medically essential.

“If you require injections for wet AMD or DMO or other macular conditions, it is essential that you attend your specialist appointment or discuss your treatment options with your ophthalmologist.” n