insight september 2014
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Luxottica losesDefence contract
Luxottica Retail Australia, which owns the OPSM brand, has lost a $33.5 million Australian Defence Force contract.
Qld court hearing now in December
The Supreme Court of Queensland hearing into the glaucoma decision by the OBA has been put back to December
Founder suing Vision Eye Institute for $2.8m
The founder of listed ophthalmology practices company Vision Eye Institute is suing the company for $2.8 million. 40
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All the ophthalmic news that matters!
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THE EYES AND EARS OF THE OPHTHALMIC WORLD – SINCE 1975 SEPTEMBER 2014
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5SEPTEMBER 2014www.insightnews.com.au
AUSTRALIA’S LEADING OPHTHALMIC NEWSPAPER – SINCE 1975
Luxottica’s $33.5m Defence contract axed over incorrect handling of data
Luxottica Retail Australia, which owns the OPSM brand, has lost a $33.5 million Australian
Defence Force contract after checks revealed the personal informa-tion of some Defence personnel were sent offshore by Luxottica. Medibank Health Solutions moved quickly to terminate its contract with sub-contractor Luxottica after a routine review early in July re-vealed that the personal details of Defence staff seeking optical ser-vices had been sent to an unnamed overseas location.
It was one of the first commer-cial contracts to be severed resulting from a data sovereignty issue in-volving a government department.
Luxottica operates more than 400 OPSM stores nation-ally, as well as Laubman & Pank in Queensland, South Australia and Western Australia.
A Medibank spokeswoman said an initial check by Luxottica revealed there had been a breach relating to the transfer of optical claims infor-mation overseas since 2012.
“We conduct rigorous reviews with our sub-contractors to ensure our contract obligations with Defence are met,” the spokeswoman said.
“Defence has strict data sover-eignty guidelines which state that all staff-related information must remain onshore.
Medibank said Luxottica has con-firmed it had taken steps to recover the optical records sent overseas.
According to Medibank, there was no evidence the informa-tion had been “passed on to any parties beyond those working for Luxottica”.
Medibank apologised for the breach and said other sub-contrac-tors had provided assurances that all customer data was held onshore.
A spokesperson for Luxottica said on 31 July that due to the com-mercial confidentiality of the com-pany’s contractual arrangements with Medibank Health Solutions, “we cannot comment on matters of this nature at this time”.
The Australian Medical Association has intensified pressure on the federal government and the Department of Defence to launch an official probe into the contract.
“The latest incident with op-tometry services just shows that the problems are not going away. An
audit is needed urgently,” AMA pres-ident, Assoc Prof Brian Owler said.
“The contract has been dogged by problems, particular-ly in terms of access to off-base medical services.”
Government departments are effectively prohibited from offshor-ing personal details they hold on ei-ther their staff or clients under strict policies surrounding data security and sovereignty.
However the combination of sensitivities surrounding health and military personnel data have compounded issue into what is shaping-up to be one of the most serious offshore data breaches yet to hit the government.
The AMA says that there have been ongoing issues with MHS it wants resolved.
“Many medical specialists have not signed up to the MHS ar-rangements due to unilateral fee cuts, new contract provisions, and the potential for MHS to interfere with the doctor/patient relation-ship, Assoc Prof Owler said.
“There has been the loss of choice of specialists and we know there are problems in accessing contracted specialists, particu-larly in areas where major bases are located including Darwin, Townsville, the South Coast and Canberra.”
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UK eye surgeon says optometrists could do much of femto surgery
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Luxottica losesDefence contractLuxottica Retail Australia, which owns the OPSM brand, has lost a $33.5 million Australian Defence Force contract.
Qld court hearing now in DecemberThe Supreme Court of Queensland hearing into the glaucoma decision by the OBA has been put back to December
Founder suing Vision Eye Institute for $2.8mThe founder of listed ophthalmology practices company Vision Eye Institute is suing the company for $2.8 million. 40
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THE EYES AND EARS OF THE OPHTHALMIC WORLD – SINCE 1975 SEPTEMBER 2014
CATARACT
Hot on the heels of the decision by the State of Louisiana in the United
States to permit optometrists to undertake ophthalmic surgery, an ophthalmologist in the United Kingdom says optometrists have a role to play in femto laser surgery for cataract, Optician reports.
Speaking on 9 June at a live surgery session at the British Contact Lens Association’s Clinical Conference, Dr Rajesh Aggarwal said that a significant part of fem-tosecond laser cataract surgery could be carried out by non-surgi-cal staff.
“Optometrists are the obvious choice,” Dr Aggarwal said. “The way we would set it up is we’d have the optometrists doing the femto-second part of the procedure – the technician part – which is 80 per cent of the workload. We’d be in the theatre next door sucking the lens out and putting an implant in, and we’d have a rotating system.
“If you want to bring femto-slaser cataract surgery into the National Health Service, that’s the only system that would work. You’ve got to have high volumes
because the cost of the machines is so high.”
Delegates to the BCLA watched Professor Sunil Shah perform a live femtosecond cataract procedure at his Birmingham clinic, where optometrist Ms Raquel Gil Cazoria was part of the operating team.
Dr Aggarwal, medical director at BMI Southend Hospital, said there is currently direct referral from optometrists to ophthalmol-ogists in his area but that medi-cal opinion on that is currently divided.
“Personally, I think that every optometrist should be able to refer directly. GPs are trying to put an end to that because they want to control the patient,” Dr Aggarwal said.
“You can see why they want to do that because financially it would make sense for everything to come through them.
“As far as the patient is con-cerned, that only extends the time to treatment. We fought a long, hard battle to get every optom-etrist on the books to be able to refer directly and GPs are trying to turn back the clock.” ■
On 1 July, a new law came into effect in Queensland, the Health Ombudsman
Act 2013.From that date, all complaints
about Queensland health prac-titioners will be received by the Office of the Health Ombudsman, which will either manage the mat-ters or refer them to the relevant national board to manage.
Complaints that were made to the Australian Health Practitioner Regulation Agency or national boards before 1 July will generally continue to be managed by AHPRA on behalf of national boards.
However, under the new law the Office of the Health Ombudsman can request that a matter be re-ferred to them to be managed.
If that were to happen, AHPRA will inform both the notifier and the practitioner who is the subject of the notification.
Anyone can make a complaint about any health service provided in Queensland.
A health practitioner can also make a complaint to the Office of the Health Ombudsman if he/she has a concern about the health, conduct or performance of anoth-er practitioner. ■
Queensland health ombudsman to deal initially with complaints
SEPTEMBER 2014
LEGAL
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Supreme Court of Qld hearing on glaucoma delayed until December
Assoc Prof Owler said that one result of the problems was that non-contracted specialists were being used and ADF personnel “transport-ed elsewhere to access care – even when it might be available locally.”
Luxottica Australia in June 2012 was awarded the contract valued at $33.5 million to provide optical services for the Australian Defence Force as an exclusive sub-contractor to prime contractor Medicare Health Services, part of the Medibank Private health fund.
The win was part of a larger mul-ti-million dollar contract awarded by the ADF to Medibank and its sub-contractors to provide a wide range of medical and allied health services both on and off base.
Luxottica’s contracts was to ex-clusively offer eye services to more than 80,000 ADF personnel each year, including eye examinations, frames and lenses, access to eye-health scans, and sunglasses.
Luxottica’s chief executive offic-er of Asia Pacific, Mr Chris Beer, said at the time the contract was award-ed: “Our agreement to provide optical services to the Australian Defence Force as a sub-contractor to Medibank is due to our proven track record with the ADF in Western Australia and South Australia, ex-tensive geographical reach, product offering and Australia’s largest team of optometrists.”
From 1 September 2012, Luxottica’s off-base optical services
was to be available to all ADF per-sonnel who would be able to select optical and sunglass frames from a wide range. They would also have the option to upgrade to an even wider selection of top brand frames at special rates, from Luxottica’s eyewear brands portfolio crossing sport, lifestyle and high-end fash-ion. Mr Beer said: “We are always looking for opportunities to fur-ther enhance our retail footprint for our national OPSM brand and for our Laubman & Pank brand in its traditional home states of South Australia, Western Australia and Queensland.”
Medibank’s managing drec-tor, Mr George Savvides, said at the time the tender process run
by the ADF was rigorous and far reaching and, through Medibank and its sub-contractors – inclu- ding Luxottica’s OPSM and Laubman & Pank brands – would deliver world-class health services to the entire ADF population.
“This contract is an exciting op-portunity for all parties involved. It will enable the delivery of quality care across a full range of health services including prevention, treatment and rehabilitation for both physi-cal and mental health. This service would not be possible without the expertise of our subcontractors and we are looking forward to working together to ensure better health outcomes for all ADF personnel,” Mr Savvides said. ■
There has been a delay in the hearing of a judicial review in the Supreme Court of
Queensland into the decision by the Optometry Board of Australia to extend the scope of practice for therapeutically-endorsed optom-etrists to diagnose and treat glau-coma without the need for oversight by ophthalmologists.
What was expected to be a four-five-day hearing was origi-nally scheduled to commence on 4 August, however a directions hear-ing held in the Supreme Court on 30 July under the direction of Justice Anthe Philippides was advised by lawyers for both the Australian Society of Ophthalmologists, The Royal Australian and New Zealand College of Ophthalmologists and the Optometry Board of Australia that at least seven to eight sitting days would be needed to hear the exceptional volume of material and witnesses to be examined in the matter.
It is understood the OBA’s deci-sion to produce 20 witnesses was the cause of \ abandonment of the 4-August start of proceedings.
Justice Philippides indicated she would be effectively unable to hear the matter in one sitting. There was a likelihood the matter could con-sequently be part heard this month
with subsequent sitting(s) to be scheduled in the new court calen-dar late in the first quarter of 2015..
In consequence it was decided to seek another, longer sitting block at the earliest opportunity. The only available one commences on 1 December and the available judge is Justice Alan Wilson.
Both parties have agreed to the new arrangement.
Legal standingThe claim by the OBA that ASO and RANZCO did not have legal standing in regard to the diagno-sis and treatment of glaucoma was thrown out by the Supreme Court of Queensland, with costs awarded against the OBA, by Justice James Douglas on 19 December 2103. Justice Douglas heard the matter on 30 August 2013.
At issue was the standing of ASO and RANZCO to challenge changes to the role and responsibilities of optometrists, initiated by the OBA in early 2013. Justice Douglas rejected the claim by the ABO that the ASO and RANZCO have no special inter-est in the matter of glaucoma diag-nosis and treatment beyond that of any other member of the public and that their position as professional bodies of ophthalmologists does not provide that standing.
ASO and RANZCO lodged a court challenge when the Australian Health Practitioner Regulation Agency (AHPRA) and the OBA would not resile from ex-tending the scope of practice allow-ing optometrists to diagnose and treat glaucoma without oversight by ophthalmologists, as had been the case for about ten years.
“A legal victory for ophthal-mologists in the Supreme Court of Queensland today has regrettably not alleviated concerns about pa-tient safety,” RANZCO commented after Justice Douglas’ decision was handed down.
“This [decision of the OBA and AHPRA] overturned tradi-tional medical practice in which ophthalmologists have overseen patient diagnosis and treatment for glaucoma.
“The concern is that optom-etrists have been approved to assess medical conditions that are beyond their learning and experience.
“By contrast, ophthalmologists study for seven years to become doctors and then spend another five years to become medical eye specialists. An ophthalmologist would acquire 12,000 hours of clini-cal training in treating eye disease before being authorised to respon-sibly initiate treatment for patients.”
Justice Douglas’ ruling of was welcomed by ASO president, Dr Arthur Karagiannis, and RANZCO president, Dr Stephen Best, how-ever, both stressed their concern at the delay occasioned by the OBA challenging standing. Sadly, they said, a court hearing date cannot now be secured until May or June 2014 “with thousands of Australians potentially at risk of defective diag-nosis in the interim”.
A spokesperson for the OBA said the board acknowledged the Supreme Court of Queensland’s rul-ing of 19 December 2013 in favour of ASO and RANZCO on the ques-tion of their standing to challenge changes to the role and responsi-bilities of optometrists under the board’s revised Guidelines for use of scheduled medicines which were re-leased in March 2013.
Also, that the board will de-fend its position when the ASO and RANZCO legal challenge is next before the courts and will make no further comment in the interim, the spokesperson said.
The ASO and RANZCO initiative is fully supported by the Australian Medical Association, which has de-scribed the optometrists’ move as out of step with expert opinion on best patient care for those suffer-ing glaucoma which is a serious
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LEGAL
Continued from page 7
eye disease affecting 300,000 Australians. The Medical Board, of Australia though, has taken no legal action to challenge the origi-nal decision.
The ASO-RANZCO legal chal-lenge seeks a return to the collab-orative co-management regime of treating glaucoma that was in place before OBA amended the optometrical scope of practice.
The applicants argued that that it is generally inappropriate to dismiss judicial review proceed-ings on the ground of standing, Justice Douglas said.
Furthermore, the focus of the applicants’ concerns was on the standards of professional care to be applied to patients rather than their individual members’ finan-cial interests.
In his view, Justice Douglas said, in this case it would have been preferable to deal with the [standing] issue at trial.
The Optometry Board of Australia’s case was that OSA and RANZCO have no special interest in the matter of glaucoma diag-nosis and treatment beyond that of any other member of the public and that their position as profes-sional bodies of ophthalmologists does not provide that standing.
Justice Douglas, in his judg-ment, said his conclusion was that the applicants [ASO and RANZCO] have shown that they have stand-ing to bring the application, with the result that the respondent’s [OBA’s] application should be dismissed.
Justice Douglas said that in determining standing, regard
must be had to the public interest in the observance by statutory au-thorities of the limitations upon their activities which the legisla-ture has imposed.
The code of conduct of RANZCO requires its 788 members to treat the interests of their pa-tients as paramount and RANZCO requires its members to enter an oath in which they must swear or affirm that patients are their first concern, Justice Douglas said.
Ophthalmology is the specialty of medicine concerned with the di-agnosis and management of disor-ders of the eye and visual systems and the diagnosis and treatment of glaucoma is within the specialty of ophthalmology, he said.
Furthermore, the guidelines approved by the board and min-isterial approval permit optom-etrists to treat glaucoma patients in circumstances without the su-pervision of the members of ASO to ensure that treatment is in the best interests of those patients.
Also, RANZCO is responsible for determining standards of care by its members in the practice of ophthalmology, however the
combined effects of the guidelines and ministerial approval is that it permits optometrists to treat glaucoma in circumstances where that treatment is not subject to the standards of RANZCO.
And Justice Douglas pointed out that no individual ophthal-mologist elected to be an appli-cant in the court proceedings, i.e. the focus of the applicants’ con-cerns was on the standards of professional care to be applied to
patients rather than to individual members’ financial interests.
Justice Douglas said the OBA’s “abandonment of the shared care arrangement” between ophthal-mologists and optometrists in issuing the guidelines deprive RANZCO its capacity to deter-mine the standards of care of the patients concerned and, accord-ingly, gives it a special interest in challenging.
Counsel for OBA and RANZCO had said that what they brought to the subject matter of the litigation was informed concern that went beyond that of general members of the public, with each organisa-tion having a special interest in
patient safety in that area of oph-thalmology greater than that of a member of the general public, Justice Douglas said.
However, counsel for the OBA maintained that responsibility for determination of standards of treat-ment by optometrists now rests with the Medical Board and there was no need for a role to be accorded to OBA and RANZCO to challenge the legality of the instruments.
In his conclusion and orders, Justice Douglas said the evidence established to his satisfaction that the OBA’s and RANZCO’s roles in setting and advocating standards of patient care for the treatment of glaucoma by ophthalmolo-gists over many years gave them standing to challenge the valid-ity if instruments which, although directed to the conduct of optom-etrists, have the effect of removing ophthalmologists from their previ-ous role in the process.
Also, that the applicants have an interest in the treatment of glau-coma which may be non-material but which is very different indeed from that of a diverse group of or-dinary Australians associated by some common opinion on a matter of social policy which might equal-ly concern any other Australian.
“Their functions as organisa-tions, historical roles in the regu-lation and advocacy for standards of patient care and the specialised knowledge derived from their membership set them quite apart from other members of the pub-lic,” Justice Douglas said.
“In my view, their standing is clear and certainly not so obviously untenable that their application should be dismissed at this stage.” ■
Clearly.com has launched a three-hour delivery ser-vice for contact lenses in
Sydney’s CBD – something the
company believes is a first for optical e-commerce in the world. Customers place their order to Clearly’s call centre and then the
order is sent via the company’s distribution centre in Alexandria.
The offer applies to all invento-ried contact lens product. ■
OBA’s response to court decision
A spokesperson for the Optometry Board of Australia said the board ac-knowledged the Supreme Court of Queensland ruling on 19 December 2013 in favour of ASO and RANZCO on the question of their standing to challenge changes to the role and responsibilities of optometrists under the board’s revised Guidelines for use of scheduled medicines which were released in March 2013. The board will defend its position when the ASO and RANZCO legal chal-lenge is next before the courts [now commencing 1 December] and will make no further comment in the interim, the spokesperson said.
Legal challenge seeks a return to the collaborative co-management regime
Three-hour delivery for contact lenses in Sydney central business district
All former serving Australian Defence Force personnel are now covered by Medicare
for GP health assessments. ■
ADF veterans eligible for MBS health assessments
VICE REGAL
Governor-General appointed patron of RANZCO Eye FoundationThe Governor-General of
Australia, Sir Peter Cosgrove, has been appointed pa-
tron of The RANZCO (Royal Australian and New Zealand College of Ophthalmologists) Eye Foundation as this year’s annual eye health community awareness JulEYE campaign draws to a close.
“We are delighted to have the Governor-General accept our in-vitation to be patron of RANZCO Eye Foundation”, its chief execu-tive officer, Ms Jacinta Spurrett, said on 29 July.
“His support will be invalu-able as we continue to shine the spotlight on the often-overlooked problem of eye health in Australia and surrounding regions,” Ms Spurrett said.
Now in its seventh year, the JulEYE campaign aims to encour-age all Australians to have their
eyes tested to assist with the early detection of eye disease. It is also the flagship fund-raising vehicle for the foundation which in con-junction with the Ophthalmic Research Institute of Australia has provided more than $12.5 mil-lion to medical research projects across Australia and New Zealand since its inception in 2002.
In 2013, the foundation dis-tributed more than $1.8 million in
grants to its domestic and interna-tional programs including more than $400,000 to seed-fund fun-damental medical research in the areas of glaucoma, macular de-generation, diabetic retinopathy, corneal diseases and rare diseases.
The funding included:• More than 11,000 surgical pro-
cedures to help disadvantaged patients and rectify cataract, pterygia and other serious eye-health issues across the foun-dation’s international patient delivery programs across five neighbouring countries.
• The six Myanmar clinics the foundation funds performed approximateky 600 sight-saving operations per month.
• In the Kimberley, the diabetic eye care program provided re-mote eye screening services to more than 800 patients, 100 of
whom underwent surgery to correct vision imperfections dis-covered during screenings.
• The foundation was able to continue funding a number of RANZCO initiatives, such as supporting teaching positions at the Pacific Eye Institute in Fiji and funding Retina Research Fellowships in 2015.
“Each year, one in four Australians are at risk of losing part or all of their vision to eye dis-ease despite 75 per cent of vision loss being preventable or treatable if detected early,” Ms Spurrett said.
“As Australians we need to stop our eye-health complacency and schedule regular eye checks.
“No one should take his or her eyesight for granted. Having an eye test is as simple as making an appointment and as serious as saving your sight.” ■
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Governor-General Peter Cosgrove
SEPTEMBER 2014
OPINION
Letter
(This letter was received in re-sponse to one published in the August issue:)
Catherine, sadly your situation is one which all optometrists con-front at some stage – to deliver news about adverse changes in the eye which cause visual impairment.
Suggestions I can offer:1. Support person comfort. Neighbour, driver, carer needs to accept role of short-term care. It is okay to tell the patient to return with a support person as you have to communicate a strategic de-tailed management plan. This can include referral options, including referral to Guide Dogs Australia and Macula Disease Foundation for resources. In this case, the neighbour would have been an ideal support assistant as they had committed to accompany this gentleman and would have a trusting established relationship.
2. Low vision patients can adapt to their home environment and learn new skills to keep their independ-ence. 6/40 binocular with learned use of peripheral remaining vision is workable for low-vision therapists and patients with good cognition. You painted a picture of “worst case scenario” after the long silence. Take caution with jumping the gun and not exploring treatment options.
3. Refer to an ophthalmologist and allow ophthalmologist to fa-cilitate communications if you are not up to the task.
It is understandable as a new graduate that this is difficult, con-fronting and takes you to your deepest soul search. If I tutored you at any stage at UNSW, we did some role playing exercises, where one student is the practitioner and one is the patient and we used simple English language to com-municate eye disease informa-tion. This was very challenging for the students, as it was more like a drama class with a highly-critical audience. Definitely, an idea that should be explored in fourth year with more emphasis on how to manage difficult prognoses.
4. Situation feels more difficult when there is an optometrist in the family, but they are distant.
Frustrating for the patient and for you, as they are ideal party for you to use to communicate information. Try and establish a link; ask to communicate to the relative and ask them personally if they can offer any support, par-ticularly with courtesy check-up telephone communication.
5. Do not underestimate your capac-ity to “learn to make a difference”. Explore every avenue you have within your means to make a dif-ference to this gentleman. Research with the local GP network support options and management plans. Keep a diary of what you did and said, so it helps you know workable approaches to problems and gives you the confidence to manage dif-ficult situations.
6. Eight children, yet no one around for dear old dad. Make sure this gentleman knows that he has a re-sponsibility to let his children know about his condition and they should understand that they have a respon-sibility to help in his care, in the case of his declining illness. As health professionals, we see the burden of isolation and neglect with the elder-ly. Social workers are another net-work of people you can resource for strategies within that community.
You say this gentleman is “not quite sure what is happening”. Train yourself to be that person, that can offer good counselling with assertiveness on follow-up and ensure your patient under-stands concerns for ongoing management particularly where intravitreal injections are vital.
7. Reach out. Congratulations on your courage for speaking out. Optometrists who are also educa-tors need to ensure graduates are equipped with skills to cope with challenging situations. Debriefing with a work colleague, or fellow optometrist is critical for you to help understand your reaction and particularly “feelings of de-spair and helplessness”. You have a strong sense of responsibility and social justice. Let this guide you, in working out management plans for your patients.
8. Be prepared for unusual presen-tations. Sometimes one appoint-ment can take two spots because of complexity. Learn to negotiate
through this with a protocol for your secretary. Some appoint-ments can be rescheduled for you to give full attention to emergen-cies /ocular crises.
9. One bad day at the office does not make for a career diversion. If you speak to “seasoned optometrists”, they will tell you their stories and then some more. Some days, you just have to do overtime. If you are locuming, ensure you have your number of patients quota specified or say ‘last appointment at 4.30pm’. You have a right to protect your mental stress and not take yourself to a breakdown/burnout.
10. We should have a Medicare item number for counselling ser-vices. Yes, counselling – it is a big part of our job. We all do it on a voluntary basis and allow ade-quate time for it.
Your extension of service in caring for an elderly relative gives the practice goodwill and the relatives are more than likely to commit to your practice for their eye-care needs.
Respect and gratitude to Catherine, “the lovely and helpful optometrist”. Think of it also, as personal growth as you will learn many life skills on your journey in the “small rural town”. ■
Esther Euripidou Optometrist, Sydney, NSW
This subject is now closed
Cruise seminarsI recently participated in an optometry con-ference run by a Chicago ophthalmologist, Mark Rosanova. He has been organising op-tometry cruise conferences around the world for over ten years and runs up to half a dozen cruise conferences each year to varied places from Alaska, Caribbean, Mediterranean and the Baltic.
The cruise seminars are sponsored by the Illinois Optometric Association and this par-ticular seminar was on the Mediterranean
from Athens to Venice and attended by 18 optometrists and ophthalmologists. The at-tendees included four other Australian optom-etrists: Steve Zantos, Penelope Zantos, Orlando Pezzimenti and Anne Pezzimenti.
The lectures given by an ophthalmologist and optometrist were scheduled for morn-ings at sea and were excellent in content and presentation.
The lecture topics included an update on keratoconus, paediatric contact lens fitting and
management, myopia control and femtosec-ond cataract surgery.
I thought this interesting mode of optom-etric continuing education might be of interest to your readers.
If they would like any further information on AEA Optometry cruises they could contact Dr Mark Rosanova at [email protected]. ■
David MallettOptometrist, Geelong, VIC
10 www.insightnews.com.au
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P: 02 9420 3200 F: 02 9420 3222 E: [email protected] www.healyoptical.com.au
12 www.insightnews.com.auSEPTEMBER 2014
HealthPACT
Femto laser surgery is not cost effective: Advisory Committee
Lions Ride for Sight participants raise $43,500 for CERA research
National registration boards seek comments on blood-borne viruses
Although the technology of femtosecond laser surgery has diffused in the private sec-
tor in Australia, based on the lack-ing of patient relevant outcomes and evidence of costeffectiveness, HealthPACT (a subcommittee of the Australian Health Ministers’ Advisory Council) will not be further pursuing research into that technology.
The news was conveyed in a let-ter to the president of the Australian Society of Ophthalmologists Dr Arthur Karagiannis, from the chair of HealthPACT, Professor Brendon Kearney on 16 July.
In his letter, Prof Kearney said The Health Policy Advisory Committee on Technology (Health-
PACT) recently developed a tech-nology brief update on femtosec-ond lasers for cataract surgery.
The technology brief update notes that further evaluation of the effects of femtosecond laser cataract surgery is required, Prof Kearney said in his letter.
Furthermore, that it is cur-rently not entirely clear whether the demonstrated benefits of the technology can fully translate to safer, more accurate outcomes for patients as a limited number of studies have evaluated visual and refractive outcomes.
In addition, at its current cost to the healthcare system and patients, femtosecond laser cataract surgery
is not considered to be cost-effec-tive over conventional surgery in the Australian context.
“HealthPACT has therefore ad-vised that although the technology has diffused in the private sector in Australia, based on the lacking of patient relevant outcomes and evidence of cost-effectiveness, HealthPACT will not be pursuing research into this technology fur-ther, Professor Kearney said.
“Aside from routine horizon scanning work, HealthPACT is in-terested in developing a dialogue with many of the speciality col-leges and societies in Australia.
“Therefore I would like to take this opportunity to seek
nominations from the Australian Society of Ophthalmologists on the top five issues facing the society at this point in time. Nominations may include either new and emerging technologies or proce-dures in ophthalmology, or those that the society has identified as possible targets for disinvestment.
“Your nominations will be collated and prioritised, and then placed on HealthPACT’s work plan for future research.”
Other technology briefs, up-dates and reports commissioned or written by HealthPACT are avail-able on the HealthPACT website at the following link: http://www.health.qld.gov.au/healthpact. ■
As the incidence of diabetes increases, more and more Australians are at risk of los-
ing their sight to diabetic eye dis-ease. Many of those people will be in the prime of their working life.
But thanks to the signifi-cant support received from the 2014 Lions Ride for Sight, the Centre for Eye Research Australia is working to save the sight of Australians with early-stage dia-betic retinopathy.
The $43,500 raised by riders and clubs throughout Gippsland will fund the ‘Personalised Eye Consultation’ trial, developed by Dr Gwyn Rees at CERA.
“The trial will involve eye-care professionals working with people who have early-stage diabetic retinopathy, and who are struggling to manage their blood glucose.
“Together, they will develop a tailored diet and exercise plan, aimed at improving the patient’s blood glucose control and there-by saving their sight,” explains Dr Rees.
The trial will commence in 2015 at the Royal Victorian Eye and Ear Hospital in Melbourne, and based on the results, Dr Rees hopes to see the program rolled out across Australia.
Now in its 21st year, the Ride for Sight raises essential funds for CERA.
“Each year the Lions put on a fantastic event, showcasing Gippsland’s countryside and rais-ing vital funds to fight vision loss and blindness,” CERA manag-ing director, Professor Jonathan Crowston, said.
The 2014 Ride took place over three-and-a-half days in April. Riders started and finished at Drouin, cycling through Phillip Island, Leongatha, Yinnar and Trafalgar.
If you’d like to ride in 2015, con-tact Bethan Hazell on 03 9929 8424 or [email protected]. ■
The 14 national boards, including the Medical Board of Australia and the
Optometry Board of Australia in the National Registration and Accreditation Scheme (the National Scheme) are releas-ing for public consultation draft guidelines on the regulatory
management of registered health practitioners and students infect-ed with blood-borne viruses.
The National Law requires the national boards to ensure there is wide-ranging consultation on the content of any proposed code or guideline.
The national boards are now
seeking feedback on the draft guidelines and are interested in comments from stakeholders.
The National Boards are seek-ing general feedback on the proposed guidelines for the regu-latory management of registered health practitioners and students infected with blood-borne viruses.
Written email submissions to the national boards should be marked ‘Consultation – Guidelines for the regulatory management of registered health practitioners and students infected with blood-borne viruses’ and sent to [email protected] by close of business 26 September. ■
CERA’s Dr Eva Fenwick, who rode in the 2014 Lions Ride for Sight event, with her strongest supporter, her son
P: 02 9420 3200 F: 02 9420 3222 E: [email protected] www.healyoptical.com.au
14 www.insightnews.com.auSEPTEMBER 2014
OPINION
Art & ScienceThe more years that go by the more I appreciate the art & sci-ence of optometry and the variety of personalities that we deal with. Of course the extremes often come to mind: The 4.98BC/-30.00D severe-cone with an ‘engineer’ personality. How about the apha-kic, familial cornea plana with a 9.54BC/+33.50D lenticulated RGP, mother. Then there’s the OCD lawyer or the psychotic sickness beneficiary, whose case histories take twenty minutes. A number of these cases have serious eye prob-lems. Very serious: Some of the worst cases I’ve seen in my thirty-five years in optometry and right at the limits.
They may have severe side ef-fects from the psychotropic meds they are prescribed. The Thorazine Shuffle is not just a cool song by alternative band Gov’t Mule. I deal with a manic-misogynist who buys his -11.00D specs online and then drives home drunk with dou-ble vision. He abuses a young lady optometrist – like it’s her fault. She promptly ejects him and phones me up. Before she puts the phone down he’s ranting away at the re-ception staff and more or less barges in to see me. The list of cases goes on and on.
A number of these medi-cated patients get dry eye, ac-commodative problems, and dilated/constricted pupils. Some- times a dilated pupil helps them ‘look around’ an apical or hydrops scar. At other times a constricted pupil will help reduce the aberra-tions of a forme fruste or an off-axis cone. We see many other side ef-fects to many other Rx meds, legal and illegal drugs of choice.
Sometimes when I tell a col-league I saw five cones in a day they freak out and say they don’t see five in a year, which is about right for the average demographic of say 1:2000 incidence of KC. Ten thousand peo-ple is said to be the demographic to sustain an optometrist. That’s why really small towns of three or seven thousand people usually only have a visiting optometrist or patients have to go to a bigger centre for care. There are even people who examine eyes on a bus or offer mobile opto-metric services. In South Africa they have the Phelophepa train. Literally translated from a combination of two regional languages, Tswana and Sotho, it means ‘good, clean health’ and consists of eighteen coaches that provide general medi-cal care, including optometry and ophthalmology.
Not all eyecare is provided on the high street or at a mall-based ‘store’.
Optometric practice in par-ticular is amazingly diverse and as practitioners we will in time come across many different races, cul-tures, creeds and personalities.
Rich and poor, sharp or dim, deaf, medically, genetically or
socially disadvantaged, we see them all. We do the best we can.
On the Road Again.This missive comes to you
from the East Coast of Australia. We’ve been enjoying some won-derful places on a ten-day road trip between a board meeting in Sydney and speaking at AUSCRS in Port Douglas. I’ve already fallen in love with Blueys Beach and Seal Rocks and am enjoying the balmy weather we’ve experienced. If this is winter, sign me up!
State of the NationSome of rural Australia is looking a bit tired and over-regulation is wide-ly evident. Optometrists I speak to all around Australia are somewhat negative. Many are frustrated by bureaucratic and commercial chal-lenges. What I do note however is that passionate practitioners always tend to land with their feet on the ground. Some are solidly booked up. Frankly I think that many could do with a refresh in attitude and image. One cannot complain about commercial threats if you don’t embrace every patient or provide an attractive proposition. To me it sounds like half of the population are either tight-as retirees or habitu-ally unemployed beneficiaries.
It will be interesting to see if the proposed freeing-up of some Medicare-related billing restric-tions in 2015 breathes some fresh air into the profession. Some prac-titioners are interested in some rebranding and refreshing. In the past I’ve created or been involved in a few award-winning practices
and together with my graphic artist, decorator wife, have trans-formed quite a few practices and professional images.
Just take a step back and look at your own practice, without your rose-tinted retrospecs. How does it look in an aberration free mir-ror? Tired? Cluttered? Is your eight-year-old website still relevant, up-to-date or appealing? Does it work across various platforms such as smart phones or tablets? How in-tegrated are your systems? Can you show a patient an OCT, slit lamp or retinal image, field or topogra-phy on a 32-inch flat screen HD TV? Do you have stylish retail dis-plays? Are your frames just boring stodge? Do you turn away patients because they don’t buy their con-tact lenses or spectacles from you, or abuse them because they own some ready-mades? On the other hand do you come across as a twit on Twitter or freaky on Facebook?
There is so much that can be done and over the years I’ve learned a trick or two from the experts, up-graded and sold old dinosaurs and new start-ups for record prices. I find it rather rewarding to see peo-ple I’ve helped thrive in their rein-vigorated professional and retail lives. I continue to advise and share some of these secrets for success.
I like new challenges and be-lieve there is yet much good in store for proactive practitioners.
Get in touch and lets see what we can do. I may just be swinging by your neck of the woods in the not-too-distant future. The open road and wide-open spaces of Australia beckon. ■
Ms Annette Estoe, co-owner and founder of Denmark’s FLEYE eyewear, has been awarded the ‘Innovative Entreprene-urship
Award’ by Womenomics, Denmark’s conference for female business leaders.
The Womenomics Committee praised her
“entrepreneurship ambition and design skills” as well as the “export success of her eyewear company”.
Three different awards were presented by the committee to business women who have accom-plished something extraordinary, with the entrepre-neur award going to Ms Estoe. ■
Alan P SaksMCOptom [UK] Dip.Optom [SA] FCLS [NZ] FAAO [USA]
Saks on Eyes
Award for FLEYE co-owner and founder
Annette Estoe EVERYBODY READS INSIGHT!
SEPTEMBER 2014
CONTACT LENSES
US Senate monitoring competition climate in contact-lens industry
15www.insightnews.com.au
The United States Senate’s Judiciary Antitrust Sub-committee held a hearing
on pricing and competition in the contact lens industry as Insight was going to press.
The title of the hearing ses-sion in Washington was ‘Pricing Policies and Competition in the Contact Lens Industry: Is What You See What You Get?’
The hearing was presided over by Senators Amy Klobuchar and Mike Lee, chairman and ranking member of the sub-com-mittee, respectively.
Certain contact lens manufac-turers have begun implementing ‘Unilateral Price Policies’ recently that require retailers to sell certain
contact lenses at or above a set price. The hearing began exam-ining whether those policies de-crease competition and lead to higher prices for consumers by eliminating the ability of retailers to discount.
Witnesses at the hearing includ-ed: R. Joe Zeidner, general counsel, 1-800 CONTACTS, Inc.; Millicent Knight, OD, head of professional affairs, Johnson & Johnson Vision Care, North America; David Cockrell, OD, president, American Optometric Association; and George Slover, senior policy coun-sel, Consumers Union.
After hearing testimony and asking questions about the cur-rent competitive climate among
independent eyecare profession-als, online retailers and optical chains in the contact lens busi-ness, Senator Klobuchar said the committee would “continue to ac-tively monitor the situation” in the coming months.
In opening up the discus-sion, Senator Klobuchar said: “As I understand it, the markets for contact lenses is different than other markets. The retailer of the product is a kind of essential gatekeeper. Without his involve-ment or Rx, [this] might impact the sale of the products.
“Three manufacturers have announced pricing [plans] where-by there are minimum price agree-ments ... in some instances, [such]
agreements can be justified. But in most cases the most immediate results is an increase in price, as the consumer can no longer seek the product at a lower price.
“This is intended as an explor-atory hearing. More than 35 mil-lion Americans use contact lenses. Tens of millions of consumers pay for contact lenses each year; price matters. Some consumers were lenses longer than they should. Price can [affect] this.”
VMail will continue to cover the hearing and related issues as further details become available, which will be reported initially online in Insight’s ‘News Now!’ and later in the print version of Insight. ■
Shamir Australia has been given approval to use the iconic green-and-gold
‘Australian Made’ logo on its range of Australian-made lenses, becoming the 2000th business currently registered to do so.
That means there are now 2000 businesses, with some 15,000 products that consumers can search for on the Australian Made Campaign’s online directory at www.australianmade.com.au.
“The Australian Made Campaign is a collective effort to brand genuine Aussie products in Australia and markets all over the world – the more businesses
involved, the stronger the impact, Australian Made Campaign chief executive, Ian Harrison, said.
“This milestone carries an im-portant message – being Aussie is good for business.”
Shamir Australia general manager, Paul Stacey, accepted a commemorative certificate from Australian Made on behalf of the organisation.
“We are proud to manufacture our lenses in Australia, using cut-ting-edge technology and high-ly-skilled technicians, for some of the largest optical retailers in Australia and New Zealand. We also have a strong emphasis on
supporting the smaller Australian independent businesses.” Mr Stacey said.
“The Australian Made logo is a symbol for excellence in manu-facturing, commitment to local jobs and local reinvestment, so it is a great fit for our brand.”
The AMAG logo has been help-ing businesses to clearly identify their products as Australian, and at the same time providing con-sumers with a highly recognised and trusted symbol for genuine Aussie products and produce, for nearly thirty years.
The green-and-gold Australian Made, Australian Grown (AMAG)
logo is the only registered coun-try-of-origin certification trade-mark for genuine Australian products and produce. ■
Certificate from Australian Made Campaign
2000th Australian-Made approval for Brisbane-based lens company
is registered with the Australian Made Campaign Ltd (AMCL) and is licensed to use the Australian Made, Australian Grown (AMAG) Logo on the products registered with AMCL in accordance with the AMAG Code of Practice, the
Trade Marks Act 1995 and the Australian Consumer Law.
CongratulationsShamir Australia is the
2000licensee of the Australian Made Campaign Ltd
th
This is to certify that
Australian Made Campaign Ltd
www.australianmade.com.au
Shamir Australia
Australian Made Campaign Ltd
Ian HarrisonChief Executive
David GrayChairperson
SEPTEMBER 2014
ALLEGED COLLUSION
France legislates to substitute cheaper AMD drug for more-expensive oneFrance has made its move to
knock the Novartis eye drug Lucentis out of drug cover-
age and move its cheaper cousin Avastin into its place.
It follows the news that an-ti-trust watchdogs in Italy are seeking €1.2 billion ($1.6 bil-lion) in damages from Roche and Novartis, while France and the European Union have launched separate investigations.
Novartis and its Lucentis part-ner Roche are fighting back.
French lawmakers sanctioned reimbursement for off-label use of prescription drugs by passing an amendment to the country’s social security budget.
The new law specifically names Roche’s cancer drug Avastin as a substitute for its more expensive counterpart, Lucentis, to treat age-related macular degeneration.
France’s move came after Italy’s government agreed to pay for Avastin in treating the eye disease.
Protests have been made by Roche, which makes Avastin and Lucentis, and Novartis, which markets Lucentis outside the United States. Both drugs have the same mechanism of action – they choke off harmful blood vessels.
But the companies say that by paying for the off-label use of Avastin in macular degenera-tion, European governments are endangering patients and may be violating European Union laws, according to The Wall Street Journal.
For France and Italy, it’s a mat-ter of economics. Mr Gerard Bapt, a French socialist legislator who proposed the off-label amend-ment, estimates that Avastin is 30 times less expensive than
Lucentis in his country, and that passing the measure would save France at least €200 million ($273 million) a year.
The prices of the two drugs vary by country, but on aver-age, one injection of Avastin sells for €40 ($53.76) in Europe, while Lucentis costs about €900 ($1,209.47) per injection, accord-ing to the WSJ.
Not everyone in Europe sup-ports legislation to promote off-label drug use. In May, the director of Europe’s top pharma-ceutical trade group, Mr Richard Bergstrom, wrote a letter to the European Commission opposing the promotion of off-label drug use by health care organizations, according to the WSJ. As leader of the European Federation of Pharmaceutical Industries and Associations, Mr Bergstrom is in
the process of scheduling a meet-ing with Ms Paola Testori Coggi, director general for health and consumers for the Commission, to discuss the matter further.
Roche said it supports EFPIA’s position that off-label prescrib-ing decisions should be based on medical need rather than eco-nomic pressures, according to the WSJ. Novartis told the WSJ that it’s exploring its legal op-tions for challenging the off-label decisions in France and Italy. Lucentis brought in $2.4 billion for Novartis last year, in markets outside the U.S.
Still, the two Swiss pharma-ceutical giants could be facing an uphill battle in Europe, where their reputations have been tar-nished by allegations that they colluded to protect sales of Lucentis. ■
The International Assoc-iation of Contact Lens Educators played a promi-
nent role in the British Contact Lens Association Clinical Confe- rence & Exhibition, held in Birmingham, UK recently.
The conference marked the first ‘IACLE Contact Lens Educator of the Year’ awards to recognise and reward achievements in con-tact-lens education worldwide. The program also included the first IACLE/International Session where researchers from the Netherlands, India, Saudi Arabia, Jordan, Greece and Italy presented their work.
Three ‘IACLE Contact Lens Educator of the Year’ awards were presented, one for each of IACLE’s global regions. The awards were supported by the BCLA and sponsored by CooperVision.
Certificates were presented by outgoing BCLA president Andy Yorke and senior vice-president, global professional and clinical affairs at CooperVision, Dr Juan Carlos Aragón. This year’s recipi-ents were:• Asia Pacific Region: Dr Rajeswari
Mahadevan of Sankara Nethralaya Medical Research Foundation, Chennai, India.
• Americas Region: Dr Sergio Garcia of University of La Salle, Bogotá and the University Santo Tomás, Bucaramanga, Colombia.
• Europe/Africa – Middle East Region: Dr Eef van der Worp, affiliated with the University of Maastricht, the Netherlands Dr van der Worp thanked IACLE for the award, which he said was an “enormous honour”. The ‘IACLE Travel Award’, sup-ported by BCLA, went to Wang
Ling of the Jinling Institute of Technology, Nanjing, China.Among many other highlights of the conference for IACLE:
• Vice-president Professor Philip Morgan was awarded the BCLA Medal;
President Dr Shehzad Naroo was awarded honorary life mem-bership of the BCLA “in recogni-tion of outstanding contributions to the association”;
IACLE members and FIACLEs among those receiving BCLA fellowship were Dr Rajeswari Mahadevan (India), Prasad Sawant (India), Dr Ali Masmali (Saudi Arabia), Dr Raquel Gil Cazorla (Spain), Professor Lyndon Jones (Canada), Caroline Christie (UK), and Robert Conway (UK)
Delegates from 51 countries attended the BCLA 2014 confer-ence. The largest contingents from
outside the UK were from the USA (57) followed by Denmark (50), Italy (34), Japan (32) and Germany (31).
IACLE’s education day and annual general meeting, held at Aston University in Birmingham on 5 June to coincide with the conference, attracted 40 del-egates. The program of lect- ures and workshops was jointly or-ganised by the British Universities Committee of Contact Lens Educators (BUCCLE).
Next year, IACLE will hold the Third IACLE World Congress on Contact Lens Education in Manchester, UK on 23-27 May. The congress is timed to pre-cede the British Contact Lens Association’s 2015 Clinical Confe- rence & Exhibition in Liverpool (29 May-1 June). The theme for the congress is ‘Be the best in contact lens education’. ■
16 www.insightnews.com.au
Global educators honoured at BCLA meeting
EVERYBODY READS INISGHT!
17SEPTEMBER 2014www.insightnews.com.au
SAFETY
Warning on blinding injuries when cleaning beer lines in pubs and clubs
A professor at Sydney-Sydney Eye Hospital has warned that people who clean beer
lines in pubs and clubs need to wear eye and face protection when handling alkaline chemi-cals, after seeing a continuing trend of serious injuries.
Clinical Professor Stephanie Watson is concerned by the se-verity of alkali burns to the eyes and face which could easily be prevented.
“We see a new alkali-related eye injury about once a month. The most serious are associ-ated with beer line cleaners,” Professor Watson said.
“The combination of an al-kaline solution, high pressure and lack of eye protection when cleaning beer lines results in dev-astating injuries.”
Professor Watson stressed the need for eye and face protection to be goggles that are sealed on the face right around the gog-gles when worn so that the al-kaline solution cannot enter the goggles.
A 25 year old man from Port Macquarie is one year into recovery following alkali related eye burns.
Macleay Borger lost all vision in his left eye and has limited vi-sion in his right after a beer line
cleaner was ejected into his eyes and face.
He has undergone more than 10 bouts of surgery including dermabrasion, skin grafts and amniotic stem cell membrane transplants however is still un-able to drive or return to work.
Mr Borger said he didn’t re-alise the danger associated with using potassium hydroxide when working at a bar.
“People understand the im-portance of being careful when lifting something heavy but often don’t take the same approach when handling dangerous chem-icals,” he said.
“I’ve spent months recovering at Sydney Eye Hospital since the injury but life has changed dras-tically since the injury.”
Using wraparound eye and face protection in those cases would prevent the extensive damage caused by cleaning solutions.
Professor Watson published a letter to the editor in the latest edition of the Medical Journal of Australia where she has called for the introduction of mandatory safety guidelines.
“I strongly advise people cleaning beer lines to wear full face and eye protection.” ■
SEH Admission 1 month post admission Stephanie Watson stresses that the goggle in her left hand should be worn because it can be sealed, whereas the one in her right hand cannot
Examining Macleay Borger at Sydney Eye Hospital this month
When first admitted to Sydney Eye Hospital One month after first admission As he is at present
SEPTEMBER 2014
DATA COLLECTION
Save Sight Institute launching National Keratoconus RegistrySave Sight Institute, a research
centre of The University of Sydney, is preparing to launch
a National Keratoconus Registry to collect high-quality data and out-comes from emerging therapies and surgical techniques relating to the management of keratoconus.
It is expected that the registry will be expanded internationally.
Led by Save Sight Institute’s Clinical Professor Stephanie Watson, in collaboration with the Centre for Eye Research Australia in Melbourne, the project involves the development of a software plat-form to enable the mass collection of anonymous patient data in real-life clinical settings.
The project is a clear example of how research can be embed-ded within health-care delivery, a key recommendation of the 2013 McKeon Strategic Review of Health and Medical Research.
According to Prof Watson: “Many therapies, devices and sur-gical procedures have been devel-oped to treat keratoconus, but few have been evaluated using post-market surveillance, and there is no system in place to collect such data nationally.
“Keratoconus tends to affect young adults and has a significant public health impact”.
The first treatment to be evalu-ated via the registry is cross-link-ing, a relatively-new approach to halting keratoconus progression.
Following evaluation of cross-linking treatment protocols, the
registry will obtain long-term data on cross-linking, as well as emerg-ing treatments such as the combi-nation of cross-linking with laser and the use of rings.
Once established, the registry will evaluate the clinical and pa-tient-reported outcomes of emerg-ing therapies.
Seed funding for the Australian Keratoconus Registry was made pos-sible because of the generosity of patient Mr Larry Kornhauser, who made a $50,000 donation in memory of his late mother, Bettie Kornhauser.
TestimonialAccording to Mr Kornhauser “I was diagnosed with keratoconus when I was 12 and my mother accom-panied me to every eye appoint-ment throughout my adolescence and beyond, including my corneal transplant operation. She would be honoured to be a part of this project which will hopefully lead to better treatments for adoles-cents with keratoconus.
“Bettie was a committed phi-lanthropist, past president of the Victorian Citizens Advice Bureau, founder of Wear for Success Melbourne and a supporter of nu-merous not-for-profits and awards to assist disadvantaged young people succeed in their lives.”
Keratoconus reduces vision by altering the biomechanical properties of the cornea. It affects 50-200 people per 100,000 of the general population (1).
Severe visual deterioration af-fects 20% of keratoconics and usu-ally occurs in the second and third decades of life due to astigmatism, corneal scarring or both. As it af-fects young adults, it has a signifi-cant public health impact (2).
If vision loss from Keratoconus cannot be corrected by spectacles or contact lenses, corneal grafting may be needed, which involves a life-long risk of graft rejection and weakening of the structural integ-rity of the eye (3).
The Australian Keratoconus Registry is based on the highly suc-cessful ‘Fight Retinal Blindness! (FRB!) project, led by Professor Mark Gillies, also from the Save Sight Institute. T
he FRB!’s innovative free soft-ware platform – now in its sixth release – has expanded rapidly and collects real-world clinical data on macular degeneration patient outcomes from ophthalmolo-gists throughout Australia, China, Europe and New Zealand.
According to Prof Gillies: “There is no other system quite so easy to use. Collecting baseline data on a patient takes just 30 seconds to enter, with follow-up appoint-ments involving just 15 seconds of data-entry.”
Through the FRB! system, the visual outcomes of 3,500 pa-tients, 4,500 eyes, 65,000 visits and almost 80,000 treatments are currently being tracked in a com-pletely anonymous way. That pro-vides valuable insights regarding
different treatment approaches and enables more clinicians to benchmark and continuously im-prove their own patient outcomes.
Added to that, the program has real benefits for people living with macular degeneration. Says Prof Gillies: “For patients, the simplified graphical outputs of their treatment journey helps them to understand the consequences of various treat-ment approaches, and is thought to be improving compliance”.
The FRB! project is a joint ini-tiative by the Save Sight Institute in Sydney, the Centre for Eye Research Australia in Melbourne and the Lions Eye Institute in Perth.
For more information on the Australian Keratoconus Registry please contact Gayani Gunasekara on [email protected].
For more information on the Fight Retinal Blindness! project please contact Amparo Herrera-Bond on [email protected]. ■
References: (1) Kennedy RH, Bourne WM, Dyer JA. A 48-year
clinical and epidemiologic study of keratoconus. Am J Ophthalmol. 1986
Mar 15; 101 (3) 267-73. (2) Kymes SM, Walline JJ, Zadnik K, Gordon MO. Quality of life in keratoconus.
Am J Ophthalmol. 2004 Oct; 138 (4): 527-35. (3) Kelly T-L, Williams KA,
Coster DJ, Australian Corneal Graft Registry. Corneal transplantation for keratoconus: a registry study. Arch
Ophthalmol. 2011 June; 129 (6): 691-7.
18 www.insightnews.com.au
Researchers at the University of Oxford in England have found that lights, which de-
pict an image of a cyclist, may go some way to improve the safety of cyclist by enabling drivers to recognise them more quickly, Optician reports
Brainy Bike Lights have been developed by behaviour expert,
Crawford Hollingworth, to pick up on the fact that universally-understood symbols are identified more quickly and accurately than simple lights.
Professor Charles Spence at the experimental psychology labo-ratory at the University of Oxford, where the tests were carried out, said the symbol could make a
difference to road safety as they allowed motorists to discriminate cyclists more quickly. ’
“Our brains interpret sym-bols very rapidly, within .001 of a second of seeing something our brains have made a decision about what it is and how to respond,” Professor Spence said. “The re-search demonstrated that since
drivers will be able to identify cy-clists on the road more quickly, they would also be able stop sig-nificantly more quickly – should they need to.”
Research already demon-strates the power of symbols in communication and that they can be quickly identified at distance even in adverse conditions. ■
New design of bicycle light helps motorists see faster: University of Oxford research finding
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SEPTEMBER 2014
EDUCATION
Graduation of UNSW’s School of Optometry class of 2013
A total of 43 (one posthu-mous, see below) optom-etrists graduated from the
University of NSW’s School of Optometry and Vision Science on 16 June 2014. As well, four PhDs, three MOptoms, and 30 GradCertOcTher were also con-ferred at the same ceremony making a total of 80 who had their degree/certificate conferred either in propria persona or in absentia.
The graduation ceremony was followed by a Graduation
Afternoon Tea in the courtyard of the Rupert Myers Building where the SOVS is located. The program was introduced by SOVS’ head of school, Prof Fiona Stapleton, who welcomed the new graduates, their parents, and other guests in attendance.
After congratulating the new graduates, she handed the floor to Prof Merlin Crossley, dean of the Faculty of Science, UNSW, who gave a brief occasional ad-dress. Subsequently, he presented prizes to award winners each of
whom was introduced by Prof Stapleton after she detailed the prize itself.
In his address Prof Crossley complimented optometry for being a comprehensive clini-cal profession with very high academic and research track re-cords, for its expanding scope of practice, and for being a profes-sion supplying a service that is in increasing demand because of Australia’s ageing population.
It was obvious that while SOVS may not be the largest academic
unit under his authority, it was one that he took considerable pride in.
Once again an optom-etry graduate was awarded a University Medal, an award that does not come optometry’s way every year because the SOVS can-didates are up against students from all UNSW faculties.
The University Medal was presented to Ms Amy Moreland for outstanding academic achievement. Not surprisingly, she was also the recipient of the Luxottica Prize for Clinical Ocular Therapeutics (Year 5), the ACBO Prize for best overall performance in binocular and children’s vision, and the Optometrists Association Australia Prize for outstanding academic performance in the BOptom/BSc double-degree.
Another significant prize win-ner (WA Opticians Associates Prize for Clinical Optometry (year 5), the Transitions Optical Prize for best overall performance in Clinical Optometry throughout the BOptom/BSc double degree, and the Designs for Vision Prize for best overall performance in Primary Care Optometry
The 14 national boards in the National Registration and Accreditation Scheme
(the National Scheme) are re-leasing for public consultation draft guidelines on the regulatory management of registered health practitioners and students infect-ed with blood-borne viruses.
The National Law requires the national boards to ensure there is
wide-ranging consultation on the content of any proposed code or guideline.
The national boards are now seeking feedback on the draft guidelines and are interested in comments from stakeholders.
They are seeking general feed-back on the proposed guidelines for the regulatory management of registered health practitioners
and students infected with blood-borne viruses, as well as on the following questions: 1. Is a guideline necessary? 2. Is the content of the guideline
helpful, clear and relevant? 3. Is there any content that
needs to be changed, added or deleted in the guideline?
4. Do you agree with the pro-posal that boards expect
registered health practition-ers to comply with CDNA guidelines for the manage-ment of health practitioners infected with a blood-borne virus? That includes follow-ing advice on their scope of practice based on the CDNA guidelines.
5. Do you believe that there is any conflict between these
Following its July 17 meet-ing, the board of directors of the Council of Fashion
Designers of America ratified the addition of 30 new members,
including Barbara McReynolds and Gai Gherardi, the co-design-ers, co-founders, and co-owners of l.a.Eyeworks, based in Los Angeles, California, and distributed in
Australia by Eye Candy Optics.“McReynolds and Gherardi’s ad-
mission to the CFDA is remarkable because it reinforces how influential West Coast designers are to the big
picture of American fashion,” Brent Zerger, director of communications for l.a.Eyeworks, said.
l.a.Eyeworks will celebrate its 35th anniversary on 9 September. ■
20 www.insightnews.com.au
Merlin Crossley, Amy Moreland Dianne Pyliotis Fiona Stapleton
National boards seek feedback on proposed guidelines for blood-borne viral infections
CFDA membership ratified for l.a.Eyeworks co-founders
21SEPTEMBER 2014www.insightnews.com.au
EDUCATION
throughout the BOptom/BSc double-degree), was Ms Rebecca Pyne.
Her optometric ‘pedigree’ is noteworthy as her father is also a UNSW optometry graduate who went on to study medicine subsequently and ultimately dermatology, the specialty in which he now practices.
Ms Pyne shared the WA Opticians Associates Prize for Clinical Optometry (year 5) with Ms Rebecca Cox who also received the Susan Larter Vision Trust Prize for best clinical performance in children’s vision, vision therapy, and learning difficulties during her course.
The tragic accidental death just before graduation of Ms Catrin Tran, a popular and widely respected member of the class of 2013, was acknowledged at the event. She was also scheduled to receive the BOC Ophthalmic Instrument Prize for best overall performance in colour vision throughout the BOptom/BSc double-degree.
As a representative of the graduating class, Ms Dianne Pyliotis, at the afternoon tea, thanked the presenters at the celebration, the SOVS staff, and the prize donors for their contributions over the duration of their course. It was a confi-dent and competent performance that was well received by the large crowd in attendance.
Prof Stapleton closed the formal part of the ceremony which was followed by a group pho-tograph and light refreshments. Needless to say, the atmosphere was very up-beat and a fitting end to five years of student life. ■
Graduation of UNSW’s School of Optometry class of 2013
Dutch contact lens manu-facturer Oté has a re-leased a new contact
lens case with integrated patient
reminder system. The i-case features two rings
on each side of the case which patients turn and set when using
lenses for the first time, creat-ing a reminder for changing and cleaning. The manufacturer said the case, which can also be
branded with company logos, had received the support of the Dutch association of contact lens specialists, ANVC. ■
guidelines and any other guidelines for the manage-ment of practitioners infect-ed with a blood-borne virus? Is there any conflict with any obligations that may arise in the workplace?
6. Is it reasonable and appro-priate for the board to take regulatory action only if a practitioner who is infected
with a blood-borne virus is placing the public at risk?
7. Do you have any other com-ments on the guideline?
Written submissions are to be provided by email, marked ‘Consultation – Guidelines for the regulatory management of regis-tered health practitioners and stu-dents infected with blood-borne viruses’ to guidelinesconsultation@
ahpra.gov.au by close of business 26 September 2014.
Submissions must be in Word format so that they can conform to W3C’s Web Content Accessibility Guidelines (WCAG) 2.0 when published.
The boards and the Australian Health Practitioner Regulation Agency publish submissions on their websites to encourage
discussion and inform the com-munity and stakeholders. They will not place on their websites, or make available to the public, submissions that contain offen-sive or defamatory comments or which are outside the scope of the consultation. Before publica-tion, they may remove personal-ly-identifying information from submissions. ■
35 of the Class of 2013
Merlin Crossley, Rebecca Pyne, Rebecca Cox The Pynes
National boards seek feedback on proposed guidelines for blood-borne viral infections
New contact lens case offers patient reminders
22 www.insightnews.com.auSEPTEMBER 2014
CERA
$1.126 million funding for National Eye Health SurveyIn what is a first for Australia, a
National Eye Health Survey has been given a $1.126 million fund-
ing injection by the federal govern-ment, it was announced on 17 July.
The national survey, to be conducted by the Centre for Eye Research Australia, has been needed for a long time and will provide an accurate, evidenced-based picture of nationwide eye health, the chief executive officer of Vision 2020 Australia, Ms Jennifer Gersbeck, said.
“This is a huge boost for Australia’s eye health and will give us the evidence we need to tackle blindness and vision impairment more effectively,” Ms Gersbeck said.
Ms Gersbeck said Australians’ eye health is at-risk as the popula-tion ages.
It is estimated that almost 85 per cent of all vision impairment will be among those aged 50 years and over and that the growing di-abetes epidemic is also expected to dramatically impact Australian eye health.
“We know that as Australia’s population ages we will see an increase in the number of people with age-related eye diseases and conditions, and being armed with accurate data will help us tackle those conditions efficiently and effectively,” Ms Gersbeck said.
The managing director of CERA, Professor Jonathan Crowston, said: “At the moment we use decade-old data. There is a clear need for an evidenced-based picture of eye health in Australia.
“The survey will give us clear evidence of what the eye health issues are, the extent of the prob-lem and where our efforts need to be directed. Importantly, having hard evidence means we can di-rect frontline eye health services to where we need them most,” Professor Crowston said.
“The collection of data on blinding conditions such as tra-choma has enabled us to reduce its prevalence in remote indig-enous communities from 14 to 4 per cent over the past eight years.”
The new funding from the fed-eral government in conjunction with the nearly $1 million already raised through cash and in-kind contributions from the non-gov-ernment and private sectors will
enable the survey to get underway in the coming months.
Vision 2020 Australia member contributors are the Centre for Eye Research Australia, Optometry Australia and the Brien Holden Vision Institute
Private sector contributors are Luxottica, Novartis, Zeiss and Designs For Vision. ■
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Jennifer Gersbeck
SEPTEMBER 2014
EDUCATION
More support needed for teaching in general medical practice: AMAThe future for family medical practition-
ers living in and serving local commu-nities in sufficient numbers depends
very much on the capacity to attract medi-cal students to pursue general practice, and to be able provide quality training experi-ences within general practice, according to Associate Professor Brian Owler, president of the Australian Medical Association.
Assoc Prof Owler said that, despite a range of initiatives being in place to support GPs and practices to be involved in teaching and train-ing, the number of practices teaching medical students, pre-vocational doctors, and GP regis-trars remains relatively low.
“Only 10 to 20 per cent of vocationally regis-tered GPs are teaching or are being accredited to teach,” A/Prof Owler said.
“The growing number of medical students and graduates is placing enormous pressure on existing teachers and practices to take on more students and trainees.
“The AMA has welcomed the May budget decisions to provide $119 million to double the Practice Incentive Program Teaching Incentive for teaching medical students, and the $52.5 million in GP Infrastructure Grants, but that is not enough to build a long-term sustainable training program.
“A recent AMA survey shows that more needs to be done to address the barriers that discour-age GPs and practices from being involved in teaching.
“Teaching students and GP registrars puts pressure on GPs to keep up with appointments, and this additional work goes largely unpaid and unrecognised.”
A third of the AMA survey respondents high-lighted the following impediments to providing GP teaching:• lack of up-skilling opportunities; • lack of administrative support to manage
placements and funding arrangements; • lack of non-financial recognition from train-
ing bodies;
• lack of space; • teaching accreditation requirements; \• additional effort not recognised; and • lack of time to up-skill. • “Despite the recognition of those barriers, the
overall survey results suggest that GPs want to teach,” Assoc Prof Owler said.
• “Improved support and recognition would encourage greater participation in teaching.
• “We need more teachers if we are to produce the future medical workforce the community needs.”
• Based on the survey findings, the AMA be-lieves further policy initiatives to better sup-port teaching and training in general practice should be targeted in the following areas:
• continued funding for GP practice infrastruc-ture projects that enhance training capacity;
• encouraging and supporting GPs to up-skill to enhance their teaching;
• streamlined accreditation requirements for teaching. ■
23www.insightnews.com.au
www.eyesright .com.auAU 1800 637 654
SEPTEMBER 2014
MANPOWER
Optometry student numbers: are there too many or too few?
The question of whether there are too few or too many optometrists in Australia re-mains largely unanswered.
In short, it depends on whether any study and consequent report on the subject was sponsored or commissioned by an interested party, such as a professional association or a corporation, and whether the researcher(s) had a connection with any such body.
Optometrists Association Australia com-missioned or sponsored optometry manpower studies and reports over many years. Access Economics produced a report in 2006 that was sponsored by Luxottica, followed by one in 2011 that was sponsored by Specsavers.
Over many years articles and reports about optometry’s manpower needs have been pub-lished (e.g. Johnston et al, 1988, Horton, 1992, Australian Institute of Health and Welfare, 2009, Kiely et al, 2010, Deloitte Access Economics, 2012, ACIL Allen Consulting, 2014) or submit-ted to commissioning entities.
They focus on practitioner/population data, number of practising optometrists, and population data. While they have to deal with student numbers as part of the ‘input’ to their analyses, the latter seems to have featured less in subsequent discussions.
Estimates of the Australian primary-eye-care market share held by optometry are around 75%. Australia is also now in an anomalous situation regarding course dura-tion whereby the optometry courses on offer range from 7 years: UMelb offers a 4-year post-graduate OD [a relevant 3-year, undergraduate degree is a pre-requisite] to an intensive and extended 3.3 year course (Deakin University). The other schools offer 5-year double-degree courses. Regardless, once registered with the national Optometry Board of Australia, gradu-ates of all courses are equal under the law.
Optometry Australia commissioned a team at Monash University to carry out a study Optometric demand and supply 2011 to 2036 (reported in Australian Optometry, May 2014) which has been delivered. While the report was for OA, it is reasonable to assume that all or much of the report will become available more widely in due course.
Dr Patricia Kiely, OA’s standards and re-search adviser who has been a co-author on a number of similar exercises in the past, was involved in the report’s commissioning and creation.
The Monash report’s end year of 2036 is brave given the 22-year interim, the ad-vances being made in consulting room tech-nology (see Insight, June 2012, page 30) and
ophthalmology, social changes that can occur (e.g. the feminisation of the profession), con-sumer spending patterns, etc.
In the OA (May 2014) teaser, Dr Kiely noted that with Flinders and Deakin Universities’ graduate output coming on stream, Australia’s optometrist output will shift from around 140 from the three original schools (UNSW, UMelb, QUT) to around 300 in total.
To pursue the student number issue further, Insight contacted the five Australian schools with a request for student numbers. The mas-ters of such data were Flinders University in Adelaide. Not only did they supply the basic numbers requested they also provided item-ised data on which states the students came from (expectedly, South Australia dominated), and categorised numbers generally by whether they were metropolitan or rural/remote candi-dates (Flinders has a targeted sub-quota sys-tem: 20 places reserved for rural/remote entry candidates and up to 5 for indigenous candi-dates. That figure of 25 is to be ramped-up to 35-40 over time). Other institutions provided breakdowns by sex and while they show a pre-dominance of females, female numbers are not overwhelming – yet.
Rational assumptionsThe successor institute to one of my almae martres (QIT-QUT) did not respond by our deadline despite a repeated request. In the ab-sence of actual figures, some rational assump-tions have been applied to their double-degree (BVis Sci, MOptom) instead.
At least one OA division is known to have considered the issue, e.g. the Qld/NT Division’s Strategic Plan 2013/2014 states ‘Graduate quan-tity – reasonable distribution of graduate place-ments, appropriate number’. Appended to that statement was a rider ‘encourage rural position uptake’ which suggests that the practitioner maldistribution issue is also acknowledged.
Based on real figures from four schools and assumptions for the fifth, it would appear that there are about 120 students in their final year in Australia in 2014 and about 960 students in all years in Australian schools and departments of optometry. Further, the 2015 year output should rise to around 265, i.e. more than a dou-bling of 2014 figures. That alone is interesting because that is exactly the same number re-corded as ‘course completions’ (from the three older institutions only: UNSW: 91, UMelb: 104, QUT: 70) in 2006 according to a report (August 2009) by the Australian Government’s Australian Institute of Health and Welfare on Eye health labour force in Australia. At the time
that represented 8.6% of ‘employed’ (practis-ing) optometrist in the country.
The numbers projected here beyond 2015 differ little, e.g. 2016: 270 and 2017: 290 gradu-ates. Those figures match closely those at-tributed to Dr Kiely in AO in relation to OA’s unpublished 2014 report by Monash University.
Number of optometristsOlder data puts the number of full-time equiva-lent optometrists at 3,329 (ABS 2006 census data 4,414 in total) which represented an 11% increase in the 5 years up to 2006. However, practitioners registered with Medicare and claiming at least one optometrical service under Medicare totalled just 2,003 at that time. With increased student output and probably traditional retirement rates that should mean more than 4,000 optometrists (FTE) now in the workforce. Importantly, the dis-tribution of FTE optometrists in 2006 was 18 per 100,000 in major cities and as few as 3 per 100,000 in remote/very remote areas. Those figures do not match data from other studies (see next) nor are they even close.
More recent figures (July 2009) from Kiely et al. (2010) put the number at 4,255 optometrists registered and 3,719 of those were actually practising. (87.4%). Their FTE figure of 3,664 practitioners was derived using an ‘hours-worked’ model.
The overall ratio of FTE optometrist to pop-ulation figure was 1:5,944. The highest was South Australia (1:8,631) although the Northern Territory, classified as remote/lightly populated, actually reached 1:9,367.
The lowest was New South Wales (1:5,247) which probably goes a long way towards ex-plaining the ‘underutilisation’ experienced by some or even many practices. Importantly, their conclusion at the time was that the number of Australian optometrists ‘was more than adequate to meet the needs of the community’. Even earli-er, Johnston et al. (1988) predicted that, based on 1987 data, unless there was a 1.7% increase in uti-lisation of optometrical services before 2000, the predicted case loads of optometrists would fall.
Furthermore, they predicted that a 1:10,000 practitioner to population ratio would be achieved by 1994 a figure that has long been passed given the Kiely et al., 2010 data above.
Another report (Horton, 1992) suggests that such a ratio was reached circa 1992 (1:10,821). Again the conclusion was reached that the work force was ‘sufficient’.
The actual number of active practitioners in 2014 is probably in excess of 4,000 given a figure of 3,719 in mid-2009 and an assumed annual graduate output in excess of 100 p.a.
24 www.insightnews.com.au
– By Lewis Williams, PhD
SEPTEMBER 2014
MANPOWER
Optometrist to population ratioThe foregoing gives O:Pop ratios ranging from 1:18,000 (ABS 2006) to as few as 1:5,247 (July 2009) suggesting at least a declining workload and, probably, practice viability over the last decade. That data will be used later.
Overall, 2,978 optometrical practices were identified in the ACIL Allen Consulting re-port commissioned by The Commonwealth Government Department of Health (dated 22 April 2014) but deriving meaningful data on optometrist numbers and/or their utilization from that is fraught with difficulty, e.g. some are satellite/part-time ventures while others host several practitioners.
Australian populationCurrently, Australia’s population is growing at about 1.7% per annum (Australian Bureau of Statistics data, December 2013). What is more critical to optometric manpower re-quirements are those factors that affect the demand for optometrical services, especially presbyopia, AMD (probably a greater effect on ophthalmology manpower needs than optom-etry), glaucoma, etc. Other factors that could affect the demand are significant changes in Ortho-K utilisation, the advent of new anti-my-opia techniques, the onward progression of the prevalence of myopia in Australia’s population, etc. While those are possible, some are unlikely and overall the effects will probably be mini-mal. All other factors driving the demand for services are assumed to remain at about cur-rent levels.
The presbyopic populationThe factors of presbyopia and AMD relate largely to the 40-and-over age group. A study of ABS data was made to predict the population 40 years and older for 2014, 2019, and 2024, i.e. up to 10 years from 2014. Anyone think-ing that a presbyopic bonanza awaits them in ‘the future’ is bound to be disappointed be-cause the ‘presbyopic’ population (aged 40 and older) expressed as a percentage of the total population varies from 46.47% in 2014, 46.65% in 2019, to 47.54% in 2024 (ABS predictions, see interactive age profile in: http://www.smh.com.au/federal-politics/political-news/squeeze-is-on-as-australias-populations-boom-20131126-2y83k.html), i.e. Australia’s population age profile will change little with respect to its ‘presbyopic’ population in the foreseeable future. That increase of about 1%, combined with predicted population growths of about 1.7% p.a. (was just 1.5% p.a. for the decade to June 2012) means that there is no
bonanza to be had. Furthermore, any pro-jected population expansions are expected to come overwhelmingly from migration and the majority of that expansion is likely to be pre-presbyopic in age so again no bonanza until much later. ABS projections follow three mod-els each with their own expansion rate. They range from about 1% to 1.9% well into the first half of the current century.
Taking best (worst if you are against popula-tion expansion) case scenario figures the popula-tion will increase by say 2% p.a. and the presbyopic population will increase by only about 1% of the total population over the next 10 years.
Australia’s predicted population:Population % Presbyopic # Presbyopic2014: 23,524,055 46.47 10,931,6282019: 25,619,895 46.65 11,951,6812024: 27,690,209 47.54 13,163,925
Those figures translate to an additional 2,232,300 presbyopes over the next 10 years. However, many of these (see next) will also be myopes, hyperopes, astigmats, etc. and will al-ready be under optometric or ophthalmologi-cal care and require no additional practitioner, rather just an additional factor, a near addition, in their optical appliance (contact lenses, specta-cles). A higher population estimate of 28,319,525 (assuming high fertility, high life expectancy and high nominal immigration) appears at: http://stat.abs.gov.au//Index.aspx?QueryId=714 but the differences amount to about 2.25% and make lit-tle differences to the general thrust of the thesis being presented here.
The myopic populationThe figures for myopia are a little more dif-
ficult to pin down as the figures depend on the numerical definition of myopia used, e.g. >0.25, >0.75 D, etc., the ethnicity of the popu-lation studied, especially if myopia-prone groups are included, the age at which deter-minations are made, etc. Various Australian studies (1999–2005) have given the myopia prevalence as being between 8.4% and 17%. Assuming there has been some increase in prevalence, a figure of 20% for myopia would probably overestimate the numbers to 2024 al-though at least one study has implied that the figures have been relatively stable, and lower, in Australia over an extended period (Junghans and Crewther, 2005).
The hyperopic populationFigures for hyperopia are the most difficult to ascertain because some studies only record
significant error, e.g. >+2.75 D at 5.8% (Kempen et al., 2004). This is probably done because many lower hyperopes, especially when young, do not seek a correction for their measurable but not vision-decreasing refractive error un-less they are symptomatic as well. Given a like-ly distribution curve (higher errors are the least common) it is probable that the prevalence is much higher than that 5.8% figure. However, a figure of about 5% at age 12 (>+1.75 D) was reported by Ip et al. (2008). That figure rose to 6.8% when only Caucasians were considered. Overall, attributing hard numbers to the over-lapping and age-dependent refractive errors is neigh on impossible short of doing a study that seeks such data specifically.
Analysis: RetirementThe cover story of the June 2012 edition of Insight detailed a 2012 manpower report com-missioned by Specsavers Pty Ltd in 2011 and authored by respected group Deloitte Access Economics which has authored optometric manpower studies in the past, e.g. in 2006.
That report stated that only 6% of Australian optometrists were over 60 years of age. As of July 2009 45% (1,915) of optometrist (4,255 – 1,928 female, 2,327 male) were under 40 years of age suggesting that they had at least another 20 to 25 years of working life ahead of them (i.e. until 2029 to 2034, well past the 2024 forward projection canvassed here).
Allowing for early retirement, departures from the profession, motherhood, practitioners joining partners (male or female) in family com-panies, untimely deaths, emigration, and im-migration, the data would probably support an assumption that say 1,500 of those are ‘stayers’ to at least 2024. However, an unknown number of older practitioners, i.e. older than 40 in 2009) will still be active until at least 2024 as well.
Australia’s changing retail and optometric ‘retail’ landscapes may see more rather than fewer of those potential ‘retirable’ practition-ers ‘staying on’. For modelling purposes that number has been put at 500 but it could eas-ily be higher and is unlikely to be lower. Those numbers mean that at least about 2,000 of the optometrist required out to 2024 are already in the profession and practising in 2014.
Analysis: Predicting needs:Scenarios used:O:Pop ratio: 1:5,000 to 1:20,000 in increments of 2,500.Australia’s population (ABS data): 2014: 23,524,055, 2019: 25,619,895, 2024: 27,690,209
Continued on page 26
25www.insightnews.com.au
Optometry student numbers: are there too many or too few?
SEPTEMBER 2014
Continued from page 25
The following spreadsheet results.
Taking a worst-case scenario of just 200 (250 or more is more likely) new graduates who re-main in the profession each year for the next 10 years, means an additional 2,000 making a total of at least 4,000 practitioners by 2024 without tak-ing into account practitioners who choose to stay longer and other factors that are more likely to in-crease practitioner numbers than decrease them.
These data (table above) suggest that the ‘truth’ lies somewhere between:
A significant surplus already (2,000 ‘stayers’ and ongoing graduations and a need for between 1,176 [2014] and 1,385 [2024]); and
A mixture ranging from a ‘current’ unmet need and a surplus ‘later’ (between 4,705 (2014) and 5,538 (2024) with around 4,000 already ‘in the system’ in 2014 (a deficit) and another 2,000 plus to graduate by 2024 (a surplus).
The manpower ‘room’ is playing host to two ‘elephants. Firstly, there is the pervasive under-utilisation/underemployment of optometrists already in practice involving a significant and possibly even a majority of practices.
Certainly, there are many practices that are operating at or near capacity, especially in heav-ily-marketed city practices and in country and more remote areas (the maldistribution issue) but equally there are many practices that are operating well below capacity sometimes being capable of a doubling or even a tripling of cur-rent ’throughput’.
The second issue is the under ‘production’ of ophthalmologists and the generally older age of current fellows (generally, they graduate as fellows in their mid to late 30s). Given the expense, time, and resources needed to train an ophthalmologist to the level desired (re-quired?/necessary?) it makes sense from many angles to utilise optometrists more gainfully in general eye care so that ophthalmologists can do what they alone are qualified to do, i.e. surgery, complex therapeutics including AMD anti-VIGF therapy and whatever might replace it, etc.
Ultimately, the reality of health care, the grey-ing of Australia and all that that entails, and the costs involved in producing an ophthalmologist may force the devolution of some traditional
ophthalmological tasks to allied health profes-sional including optometrist and orthoptists.
Is an O:Pop ratio of 1:5,000 viable? Most would probably say not although the 2009 NSW figure passes perilously close and is a partial ex-planation at least, of the underutilisation many experience. If the 1:5,000 scenario is discarded as non-viable then the predictions (1:7,500 or more) all show that we already have too many optom-etrists and that situation is bound to worsen pos-sibly by up to 2,000 practitioners by 2024 (3,692 vs. up to 6,000).
Predicting a downturn in the standard of student entering the professionMuch of the foregoing is based on the assump-tion that current work practices will continue largely unchanged. While the scope of optom-etry is expanding, the likelihood that technology changes may reduce the need for professional time and input is also significant. No such crystal ball gazing is attempted here.
Should a surplus, especially a significant sur-plus, transpire, it is reasonable to assume that graduate salaries will decline, especially for those wedded to the idea that they will only seek em-ployment or start a practice in a major city or very nearby. Once such information is fed back to high-school students at the career-decision stage (say years 10 to 12) the demand for a place in an optometry course will also decline and with it the currently very high entry standards for optom-etry students.
Ultimately, the standard of the practising professional will reflect those standards and there is a real possibility that the profession will go into decline. Some have already discussed that scenario and put a time frame of 15 to 30 years while others put it at as little as 15 years. The deciding factor may be the rate of ‘washout’ of existing practitioners most of whom met high to very high standards to enter the profession in the first place.
Disenchantment and/or dissatisfaction with their rôle could accelerate the decline while in-creasing satisfaction may slow any such decline.
The numbers aired here, assumptions and all, suggest that some serious thinking is required sooner rather than later before the die of the fu-ture is cast and foreseeable problems are avoided.
A contrary take on the situationThe 2012 DAE report to Specsavers Pty Ltd, which followed on from a report sponsored by OPSM in 2006 and which drew from DAE’s extensive collec-tions of health-care data, concluded that by 2030 (a more ambitious end date than canvassed here) some 6,500 FTE optometrists would be required based on their methodology which amounted to a shortage of 1,500 optometrists by 2030.
Using a crude linear model (start 2009: 3,105, end 2030: 6,500 FTEs needed – based on that 2012 report) that suggests that by 2024
(predicting 2014: 3,910 [actual figure nearer to 4,000+ according to estimates above], 2019: 4,720, 2024: 5,530.
A comparison with the prediction table above shows a near perfect match for 2024 figures (in-terpolation of DAE 2012 report data: 5,530, table above: 5,538) FOR A RATIO OF 1:5,000, a figure that most would agree is either not viable or borderline at best (the maldistribution issue is ignored here because it is too complex to deal with and is unlikely to be solved even in the long term unless there is a radical shift in the outlook of young people in general).
Regardless of the interpretation applied to these data, the situation does not bode well for the profession of optometry as over-produc-tion and its sequelae, including underutiliza-tion, look likely.
Only time will tell how close or how far off these estimates/predictions are but from afar (2014) the possibility of a significant over-pro-duction (unemployed or employed but underu-tilised) of optometrists looks a safer bet.
Postscript: In attempting the analyses appearing above a greater appreciation is gained of those (mostly specialised professionals) who have de-livered reports successfully in which assump-tions were not or could not be swept under the carpet and hard numbers instead of conjecture were the only acceptable form of data. Their task is monumental when the number of influential aspects/variables and the ‘rubberiness’ of that data have to be addressed. Sometimes the dearth of data or survey results, or the proprietary nature of some previous analogous reports adds to the overall frustration. ■
ACIL Allen Consulting, 2014. Optometry Market Analysis (a report to The Commonwealth
Government Department of Health).Australian Institute of Health and Welfare, 2009. Eye
health labour force in Australia.Deloitte Access Economics, 2012. Optometry
Workforce Report: 2009 to 2030 (a report to Specsavers Australia Pty Ltd).
Ip JM et al., 2008. Prevalence of hyperopia and associations with eye findings in 6 and 12 year olds.
Ophthalmology 115(4): 678 – 685.Johnston A et al., 1988. Projections of optometric
manpower in Australia 1987 to 2000. Clin Exp Optom. 71(4): 126 – 38.
Horton P, 1992. The Australian Optometric Workforce. Clin Exp Optom. 75(1): 1 – 9.
Junghans BM, Crewther SG, 2005. Little evidence for an epidemic of myopia in Australian primary
school children over the last 30 years.BMC Ophthalmol. 5: 1 doi:10.1186/1471-2415-5-1.
Kempen JH et al., 2004. The prevalence of refractive errors among adults in the United States,
Western Europe, and Australia. Arch. Ophthalmol. 122 (4): 495–505.
Kiely PM et al., 2010. The Australian optometric workforce 2009. Clin Exp Optom. 93(5): 330 – 340.
26 www.insightnews.com.au
Predicted number of optometrists required
MANPOWER
SEPTEMBER 2014
AHPRA
OBA advertising guidelines for optometrists ‘updated for clarity’
27www.insightnews.com.au
National Boards have acted on the feedback they received about the
Guidelines for advertising regu-lated health services (Advertising guidelines) that were released in March and have now published an update.
Anyone who advertises a reg-ulated health service must meet the requirements of the National Law. That includes registered health practitioners, individuals who are not health practitioners and businesses.
No requirements have been added from the previous version, and the update has now come into effect.
The updated Advertising guide-lines were edited to make them clearer, particularly about that:• Under the National Law, testimo-
nials are not allowed when adver-tising a regulated health service
• The obligations of the National Law about advertising only apply when a regulated health service is being advertised, and
• The National Law is not
intended to stop members of the community and patients from discussing their experi-ences online or in person.
Much of the feedback received was about the ban on using testi-monials in advertising a regulated health service. That is a require-ment of the National Law, which is something National Boards are required to implement.
The terms of reference for a scheduled review of the National Registration and Accreditation Scheme (the scheme regulating
registered health practitioners in Australia) include a point relat-ing to advertising, and interested members of the public and health practitioners are able to provide feedback about the legislation.
More information is available on the AHMAC website. ■
Further information: Section 133 of the Health Practitioner Regulation National
Law, as in force in each state and territory, which relates to advertising.
A fact sheet on advertising is published on the AHPRA website.
Amcal and Guardian phar-macies across Australia are spearheading an important
health awareness campaign in partnership with the Centre for Eye Research Australia.
Launched in July, the ongoing campaign encourages people with diabetes to have more-regular eye tests and to consider a range of health checks to prevent eye dis-ease that can lead to blindness.
The involvement of pharma-cies is expected to lead to more people seeking eye examinations as they visit pharmacies much more frequently than ophthalmol-ogists’ and optometrists’ practices. Also, dispensing prescriptions for people with diabetes would alert pharmacists that they (the people
with diabetes) have the disease and, therefore, will benefit from being encouraged to have more-regular eye examinations.
“Currently, over one million Australians have diabetes and that number is expected to double in the next 10 years, posing major public health and economic is-sues,” Dr Peter van Wijngaarden, principal investigator at CERA, said on 23 July.
“We are committed to devel-oping an efficient, cost-effective and sustainable nation-wide diabetic eye screening system for all Australians to detect the early changes of eye disease and start treatment before signifi-cant vision loss occurs,” Dr van Wijngaarden said.
Pharmacists in the two groups commenced acting as front-line health partners during the month of July following Diabetes Awareness Week (July 13-19) to provide information to people with diabetes about lowering their risk of diabetic eye disease, with the hope that they will con-tinue to do so.
“Up to 50 per cent of Australians with diabetes don’t undergo regu-lar eye checks. That’s a staggering figure given that we know regular diabetic eye check-ups and timely treatment can prevent most vision loss from that condition,’’ Mr Gary Dunne, Sigma’s chief operating of-ficer, said.
“Pharmacists know they can reach out to their patients in a
trusting and professional man-ner with information provided by CERA about the importance of eye tests to prevent eye disease and ensuring they also look after their general health,’’ Mr Dunne said.
Amcal and Guardian phar-macists presented patients with a structured plan to help prevent diabetes related vision loss by helping them understand: the importance of healthy eating; the need for regular exercising; the critical role played by blood-pressure control; the need for everyone with diabetes to keep track of their glucose levels; and the critical need to have regular eye checks and timely treatment to prevent sight-threatening dia-betic eye disease. ■
Two pharmacy groups spearheaddiabetes-awareness campaign
SEPTEMBER 2014
RETAILING
Australian Retail Awards recognise Specsavers for second year running
Specsavers has followed up on last year’s success at the Australian Retailers
Association awards by being named the Retail Innovator of the Year and Multichannel Retailer of the Year at the 2014 awards.
The Retail Innovator of the Year award acknowledges ‘a retail business constantly pushing the boundaries of convention, dis-playing a talent for finding new opportunities and adapting to the ever-changing economic and social climate’.
Specsavers won the Retail Innovation award for the
implementation of ‘Precision Care’, a full dispensing toolbox in Australia and New Zealand. Launched to consumers last year, Precision Care helps customers make a genuinely-informed de-cision on the right lens; ensures there is an accurate measurement of the pupil in relation to the lens they will wear; and helps custom-ers properly assess their preferred frames through the use of digital magic mirrors.
The Multichannel Retailer of the Year award ‘showcases cutting-edge retailers who have developed and implemented a multichannel
business strategy that has en-hanced their business and em-braced the internet, social media, blogs and mobile phones to con-nect with consumers’.
Specsavers’ submission for the Multichannel Retailer of the Year Award laid out the company’s con-tact lens multichannel strategy, which has taken Specsavers’ mar-ket share in contact lenses from 11% to 33% in under two years. It highlighted the move from a traditional in-store approach, supported by TV and radio, to a multichannel strategy that com-peted with online operators and
provided customers with the best prices in contact lenses, in-store af-tercare and home delivery without compromising on customer service.
“Multichannel retailing is becoming more important in Australia, as it combines the power of bricks and clicks,” commercial director Paul Bott, who accepted the award, said.
“We launched our e-com-merce business to deliver great value to our customers, the con-venience of home delivery, in-store aftercare support from any of our 300 stores and this has given rise to a trebling of our mar-ket share in this growing area.”
Specsavers’ general manager Derek Dyson, who was also key-note speaker at the event, com-mented: “Last year, Specsavers won Australian Retailer of the Year and Australian Employer of the Year, so we are thrilled to win two more prestigious awards for our business.
“It is incredible to think that, within only six years of opera-tion, we have opened almost 300 stores, created more than 3,000 current jobs for Australians in our stores and support office, intro-duced a manufacturing base into Australia, and are now market leaders for both eye tests and pre-scription eye wear.” ■
The board of the Optometry Council of Australia and New Zealand Board is interested
in receiving applications from suitably-qualified optometrists for the role of Director of the OCANZ Board that is nominated by the board. The members of OCANZ ap-point the OCANZ board of directors at their annual general meeting.
Interested optometrists are able to forward a current CV and
supporting statement address-ing the following selection crite-ria electronically to the board at [email protected] by Friday 22 August 2014.
Selection criteria: • holds current registration
with the Optometry Board of Australia with good standing;
• an experienced optometrist who possesses attributes that dis-plays integrity, thinks critically,
applies expertise, can commu-nicate constructively and has the ability to focus strategically;
• demonstrates an understanding of the objectives of the National Registration and Accreditation Scheme;
• previous experience as a mem-ber of an optometry regulatory authority or accreditation team would be an advantage;
• not a current Optometry Board of
Australia member or a member of a board committee or advisory group that deals with matters re-lating to accreditation; and
• has not been an employee of OCANZ within the past two years. ■
Further information on OCANZ, including a copy of the organisation’s
constitution, can be found at www.ocanz.org.
28 www.insightnews.com.au
Paul Bott and Jack Silloray (Specsavers) at the ARA Awards
Russell Zimmerman (ARA), Derek Dyson and Richard Couch (Specsavers) and Roger Gillespie (Bakers Delight) at the ARA Awards
Call for applications for board nominee for director of Optometry Council ANZ
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SEPTEMBER 2014
LENSES
Young Optometrists CPD event: Don’t forget the dispensingThe New South Wales Young
Optometrists group held another successful and
well-attended CPD evening re-cently in Sydney.
Unlike the usual topics present-ed at optometrical CPD events, the evening’s focus was all about mod-ern lens prescribing and dispensing.
Co-MCs for the evening were Ms Carina Trinh, YO treasurer and Ms Rebecca Li, YO’s social director.
Presenters were Mr Tim Thurn from Essilor, Mr Ulli Hentschel from Rodenstock and well-known optical dispenser and educator Mr Grant Hannaford from Hannaford Eyewear, Bowral, NSW, who was also representing Australian Dispensing Opticians Association (NSW). Mr Hannaford also supervises regular dispensing session within the op-tometry clinic at UNSW.
It could be argued that the even-ing’s topic, dispensing, is under-represented in optometrical CPD presentations given that it is an ac-tivity so central to a successful op-tometrical practice, if not in time, certainly in outcome.
Miscellaneous dispensing issuesMr Hannaford was the first pre-senter, opening with the topic of progressive-power lenses (PPLs) and their marketing on the basis of budget, average, and premium designs. He argued that despite the actual marketing strategy used by the lens supplier and/or the supply-ing practice, the ‘real’ premium lens is actually the one that is most ap-propriate for the patient. He added that price alone cannot be a driver of spectacle lens choice. Although many factors are involved in lens selection he advised the audience to take careful note of previous, successful, lenses/wearing patterns and be guided by them where pos-sible (if it ain’t broke …).
When patients simply don’t like their new spectacles, the changes in-duced by the move to their new lens-es, especially any Rx change, change in lens design/philosophy, and/or any ‘different’ aberrations inherent in the new lenses, warrant further in-vestigation and analysis. His general advice was to question everything.
He then asserted that, in prac-tice, prism is the enemy, espe-cially when it is of the unwanted or unprescribed variety such as is induced by errors in PD, near-segment heights, cylinder-axis er-rors, and corridor length in PPLs. He also suggested that records and the patient need to be interrogated about previous prism experience, prescribed and otherwise.
Mr Hannaford also warned about complacency when prescrib-ing single-vision lenses and ignoring vertical prism issues, especially in high ametropia and most especially in cases of anisometropia (includ-ing antimetropia). When the source of dissatisfaction involves prob-lems with acceptance of prescribed prism, he warned that dispensing errors can decrease or exaggerate the intended effect.
While he noted that most prac-titioners accept the need for mo-nocular PD measurement and use in the context of PPLs and aspheric lenses, his advice was to consider monocular measures in all situa-tions as a simple way to increase wearer satisfaction.
In anisometropia cases due to monocular cataract surgery he ad-vised the audience to wait until the other eye is also operated on if at all possible. When anisometropia and its effects have to be dealt with his advice was to consider customising lens-centre thickness (he provided some of the maths behind calcu-lating spectacle magnification), using aspheric lenses, modifying the form of the lens, or as a last resort (he described the move as ‘naughty’ in jest), mix lens refractive indices, a practice he was against philosophically.
He mentioned iseikonic and afocal iseikonic lenses but between the measuring the aniseikonia and computational, cosmetic, and man-ufacturing issues, he urged caution, an approach supported by the low market figures for such lenses. Not mentioned was the other factor at play, Australia has little or no capa-bility to manufacture such lenses given the decline in specialist opti-cal laboratories locally.
From his perspective he sees the labs and suppliers as making a
wide range of lenses available but it is up to the practitioner to locate and apply the appropriate designs. Suitability of lenses to the patient is not a lab responsibility, it rests squarely with the practitioner.
Tips and traps of successful dispensingRodenstock’s Mr Ulli Hentschel de-livered a point-form presentation detailing each as he went.
Decide the lens before the frame having due regard for lifestyle, visual demands, and other behaviours.
If it ain’t broke don’t fix it, im-prove it! Investigate what has been worn successfully in the past and for how long. It is probably erro-neous to give an old design again, especially as there is the strong like-lihood that it will be discontinued eventually. Amounts spent on previ-ous Rxs is also a good guide to future behaviours. Note lens material, cor-ridor length, head posture, extent of the useful visual fields offered by existing lenses, current add, etc.
Make sure it all fits into the frame as just getting a PPL into a frame is not ideal. If necessary, choose a dif-ferent frame, not a less suitable lens.
One pair is rarely enough. Don’t promise one pair can do it all be-cause no PPL does everything opti-mally. Seed the idea that more than one pair might be required ‘up front’, i.e. early in the dealings with the pa-tient. The patient will soon learn the limitations of what they wear but to avoid disappointment those out-comes need to be explained before they arise, not after. To do otherwise risks eroding their confidence in the prescribing practitioner.
The (high) cost of managing optometric grief casesMr Tim Thurn presented an over-view of Australian data relating to the cost of trouble shooting, re-makes, and credits related to dis-pensing misadventures. Overall, the cost is estimated to be almost $8.5 million ($8.46 million was given but such accuracy is probably unjustified given the ‘wooly’ nature of costing and the vagaries in the re-porting systems). The smaller figure is probably close to a ‘seen’ figure,
the ‘unseens’, especially those un-accounted for in practices, would probably increase the amount sig-nificantly. The ‘seen’ figure based on industry data, translates to $1.20 for every lens dispensed (success-fully or otherwise) in Australia is a little disturbing. According to in-dustry figures spectacle lenses ac-count for between 45% and 55% of practice sales.
AsphericsAs a rule-of-thumb, drop the lens’ optical centre 1 mm for every 2 ° of pantoscopic tilt. Every single vision Rx, whether aspheric or not, should be dispensed using centre heights determined on the wearer with the frame to be dispensed. Errors lead to a loss of confidence in the ‘dispens-er’ and by association, the practice. After two remakes, most confidence is gone. No centre heights and no tilt compensation are common ways to court problems at or after delivery.
Paths to successSuccess is an amalgam of prac-titioner knowledge, ability, and communications skills mixed with patient expectations relating to their practitioner and the product selected/chosen.
Maximum vision is the expec-tation and to ascertain just what that entails Mr Thurn advised practitioners to ask, listen, and ob-serve. He then quoted the results of a Sydney survey of practices. In order of patient priority: appropri-ate advice, proximity of practice to work/home (i.e. ease of access from a relevant base), the choice available, courteous staff and good service in the practice, practice reputation, costs. That order is not necessarily the way some practi-tioners would see it and often the last point is assumed to be the main issue – erroneously.
Communications featured high-ly in his overview of the root causes of problems. Miscommunications, misinformation including a lack of information (not given, not heard, too busy), conflicting infor-mation about the technology on offer. His summary was that there was a need for clear and accurate communications.
30 www.insightnews.com.au
SEPTEMBER 2014
LENSES
31www.insightnews.com.au
Young Optometrists CPD event: Don’t forget the dispensingHis parting comment, pre-
sumably based on his many years working on many levels and in several countries for a leading PPL manufacturer/supplier/lab was: avoid using the dotting-up method (sometimes referred to disparag-ingly as the dartboard approach) of PPL marking up to reduce problems at or after appliance dispensing.
Q&AAn enthusiastic Q&A session with the presenters fielding questions followed. One question was about the use of double-headed monitors on desktop computers by PPL wear-ers. The advice was careful monitor placement, the use of occupational PPLs (extended focus lenses), care-ful prescribing, and in some cases curbing enthusiasm for very large monitors as head movement will be required and the practical flexibil-ity of PPL working distances can be
exceeded. The monitors should be located at eye level and the wearer’s expectations about just what their spectacles can do for them may need to be made more realistic rather than idealistic – patient counselling may be required. Importantly, the patient expectation should be ascertained before an appliance is made.
Questions were raised about ‘de-ciphering’ the in-house PPLs used by some of the larger optical chains. The audience was directed to interrogate the internet (e.g. optiboard) or their more-experienced colleagues.
Alternatively, in some cases, a description of the lens and/or its characteristics to a PPL company may lead to being offered an equiv-alent (in some cases they may even be the actual manufacturer of the in-house product).
On the subject of problems with prism, one not-so-obvious sugges-tion was to ascertain whether or not
the patient still used their previous Rx (assuming it too had prism) – the alternation between two different amounts of prism (old and new) is a known problem. Questioning the application (working distance) that is problematic may also reveal a di-chotomy of problems, e.g. old were better at near, new better at dis-tance, or vice versa). Being clear on what distances are involved when terms like television, reading, com-puter, tablet computer, etc. are used can also be helpful.
Identifying lens materials, es-pecially premium materials can be a problem and the only solution offered is probably inaccurate in average hands – use a lens gauge (‘Geneva’) to measure front and back curves, measure lens BVPs ac-curately, and measure lens centre thickness. Using the thick lens for-mula and those measures, an esti-mate of the refractive index can be
made. The latter might identify the lens and/or the manufacturer.
One questioner sought advice on handling PPL remakes and dif-fusing the situation that creates. The advice was: if a previous PPL wearer, investigate differences in lenses, if dispensed correctly, check heights, PDs, etc. Ask the wearer about their use of their lenses, how much of the reading area is actually used, their opinion of the distance VA, etc.
The panel advised having a standard procedure (implying a process sorted out prior to the prob-lem arising) in place in the practice. Likewise, one to deal with difficult patients in general. Their advice was to try to fix the problem completely and/or successfully (not necessar-ily one and the same thing) because success leads to a ‘faithful’ patient who has confidence in the ability of the practice to solve their problems should they arise. ■
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SEPTEMBER 2014
PEOPLE
Former senator is new chair of Vision 2020 Australia
Second full-time teacher appointed to Randwick College’s dispensing course
Former senator Ms Amanda Vanstone has been elect-ed chair of Vision 2020
Australia, succeeding former MP Dr Barry Jones in the position.
Ms Vanstone was elected at a board meeting in Melbourne on 18 June following Dr Jones step-ping down from the position after holding it since 2002.
Vision 2020 Australia chief executive officer, Ms Jennifer Gersbeck, said the new chair would bring extensive experience to the role.
“Vision 2020 Australia has al-ways been able to attract high-cal-ibre board members with a wealth of knowledge and experience and Ms Vanstone will complement the suite of talent on the Vision 2020 Australia board,” Ms Gersbeck said.
Ms Vanstone was a Liberal Party senator from South Australia in the Howard government, where she held a number of ministe-rial appointments before retiring from the senate and becoming Ambassador to Italy.
She is currently chair of the Royal Flying Doctor Service, board member at Port Adelaide Football Club, a columnist for The Age newspaper and the presenter of ‘Counterpoint’ on ABC Radio National.
“I look forward to working with Amanda towards our goal of eliminating avoidable blindness, and based on her contribution since becoming a board member,
she will provide valuable support to our cause,” Ms Gersbeck said.
“Ms Vanstone joined the Vision 2020 Australia board in March at a critical time when work on developing the new strategic plan, which will guide the direction of the organisation over the next three years, had just commenced.
“This organisation has such a strong reputation not only in the
eye-health and vision-care sector, but also among parliamentarians, and Amanda’s wealth of experi-ence will continue to build on this,” she said.
Ms Gersbeck thanked Dr Jones for his outstanding commit-ment to the organisation: “Barry has been remarkable in steering Vision 2020 Australia in the right direction during his time in the role. On a personal note, he has not only been a colleague and confidante but a real friend and I thank him enormously for his commitment,” she said.
Dr Jones, who has resigned as chair after 12 years, said he stepped down from the role with strong confidence in Vision 2020 Australia’s future.
“It is time for fresh leadership and Amanda will certainly pro-vide that,” Dr Jones said.
“You haven’t seen the back of me yet though. I will still be around, on the board until November and flying the flag for Vision 2020 Australia.” ■
Randwick College has ap-pointed Ms Keleigh Walsh as its second full-time
teacher for its Certificate IV: Optical Dispensing course. The other full-time position is held by Mr James Gibbins.
Ms Walsh had filled a part-time rôle on the course since May and commenced her full-time rôle on 14 July. She brings extensive experience to her new position having been a part-time teacher on the OTEN Distance Education Certificate IV: Optical Dispensing course for more than five years.
In the current tertiary educa-tion climate of lean funding, the appointment of a ‘new’ full-time
teacher is an uncommon event and can be taken as a sign that Randwick College has confidence in the re-vamped course it accepted from Sydney Institute’s Ultimo campus.
Ms Walsh’s industry experience is extensive and covers wholesale, retail, laboratory, and practices.
After extensive retail experi-ence including exposure to the ‘one-hour’ era of optical retailing including management rôles, Ms Walsh joined Gerber Coburn (as it was then). She followed that company’s evolution that culmi-nated in a long-term association with one of their agencies, Hilco, the ophthalmic spare-parts, small equipment, and special tools
company. Along the way she also gained retail and wholesale experi-ence in the optical machinery and spectacle lens tinting technologies used in ophthalmic practices.
When asked what her areas of special interest were she nomi-nated lens edging and fitting and, perhaps most important of all, spectacle frame adjustment. ■
David Evian on 28 July received a Presidents Award from Paul Levi
of The Australasian College of Behavioural Optometry.
The award honours his long service as the New South Wales regional director of ACBO and be-havioural optometry in general. ■
32 www.insightnews.com.au
TIME TO CHANGE YOUR COLOURS.
FCA Excellence inMarketing Award Winner
2013
FCA EstablishedFranchisor of the Year
2013
Australian Retailer of the Year
2013
Australian RetailEmployer of the Year
2013
Asia-Pacific Best Retail Training Organisation
2013
Roy Morgan ResearchNo. 1 for eye tests
2013
At Specsavers we are looking to grow our store network substantially over the coming 12 months - opening a significant
number of brand new stores while expanding an even greater number of stores as they out-grow their current premises.
With such a big growth plan comes a similarly large opportunity for optical professionals at all levels: we have partnership roles all over
the country as well as employed positions. So, whether you are an optometrist, a dispenser or an optical retailer we want to talk to you.
If you feel it’s time for a change - or if you feel uncertain of the future in your current role - our recruitment team can tell you how you
can fast-track your career and partnership prospects with us - the Australian optical store network that has grown from start-up to
$600 million annual sales in just six years.
To see how you can join one of our teams, call Carly Parkinson on 0478 201 057
or email [email protected]
WHY SPECSAVERS OFFERS THE CHANGE YOU MAY BE LOOKING FOR…
Barry Jones, Jennifer Gersbeck and Amanda Vanstone
Keleigh Walsh
ACBO award winner
David Evian (left) and Paul Levi
TIME TO CHANGE YOUR COLOURS.
FCA Excellence inMarketing Award Winner
2013
FCA EstablishedFranchisor of the Year
2013
Australian Retailer of the Year
2013
Australian RetailEmployer of the Year
2013
Asia-Pacific Best Retail Training Organisation
2013
Roy Morgan ResearchNo. 1 for eye tests
2013
At Specsavers we are looking to grow our store network substantially over the coming 12 months - opening a significant
number of brand new stores while expanding an even greater number of stores as they out-grow their current premises.
With such a big growth plan comes a similarly large opportunity for optical professionals at all levels: we have partnership roles all over
the country as well as employed positions. So, whether you are an optometrist, a dispenser or an optical retailer we want to talk to you.
If you feel it’s time for a change - or if you feel uncertain of the future in your current role - our recruitment team can tell you how you
can fast-track your career and partnership prospects with us - the Australian optical store network that has grown from start-up to
$600 million annual sales in just six years.
To see how you can join one of our teams, call Carly Parkinson on 0478 201 057
or email [email protected]
WHY SPECSAVERS OFFERS THE CHANGE YOU MAY BE LOOKING FOR…
SEPTEMBER 2014
COMMENT
Editorial
Coming Up
Court courtesy
The hearing in the Supreme Court of Queensland scheduled for the week commencing 4 August has had to be transferred to the week commencing 1 December be-cause the Optometry Board of Australia just three days before the 4-August commencement date informed the Australian
Society of Ophthalmologists and The Royal Australian College of Ophthalmologists that it will pro-duce 20 expert witnesses when the matter is heard by the court.
That threw a spanner in the works, as the court had set aside four-to-five days of the week com-mencing 4 August, but that had to be abandoned because hear-ing each of those 20 witnesses plus
those for the other side would ne-cessitate extending the hearing to seven-to-eight days.
Fortunately, a judge is able to hear the matter and hopefully that will be the case.
Meanwhile, the costs for both parties continue to rise, as the mat-ter has already been once before the court for a hearing, which ruled in favour of the ASO-RANZCO in
regard to them having ‘standing’. Now further costs will be incurred by instructing solicitors for both sides and their barristers, as well as more than 20 expert witnesses, at least one of whom is coming from the United States.
And to cap it all, there is the question of inconvenience for all concerned.
So, courtesy to the court? Hardly. ■
Australian College of Optometry National Conference in OctoberThe Australian College of Optometry has announced its keynote speakers for this year’s National Conference, to be held on 18-19 October.
According to the ACO, the conference will feature a series of highly-educational and engaging presentations by some of region’s leading experts in optometry.
The full conference program is now available at www.aco.org.au, with the following keynote speak-ers at the conference. • Ophthalmologist Assoc Prof
Jamie Craig has established the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG) – a repository of over 1300 cases of glaucoma-induced blindness and 1100 secondary glaucoma cases. His laboratory conducts genome-wide associa-tion studies and gene discovery projects in monogenic traits and he has identified at least two genes which are associated with open angle glaucoma and that can cause blindness.
His keynote presentations will analyse demographic variations of glaucoma and the public health challenge of glaucoma in Australia and abroad. He will look at genetic screening methods for identifying patients who are at risk of develop-ing glaucoma, surgical procedures
and their selection criteria and surgical complications. • Prof Robyn Guymer is the head
of the Macular Research Unit at the Centre for Eye Research Australia (CERA) and is the lead investigator on the bionic eye project. She will present the session ‘Laser Intervention in Early Age-related Macular Degeneration’ covering the use of laser to halt and potentially reverse age-related macular de-generation and identifying pa-tients who may benefit.
• Dr Peter Hadden is the tertiary referral specialist for all adult intraocular tumours in New Zealand. He will present the session ‘Anterior Eye Neoplasia: Differentiating Between the Benign and the Malignant’. The topic will cover the use of optical coherence tomography (OCT) in diagnosing anterior segment neoplasia and explain which anterior segment tu-mours pose the most serious threats to vision and lives of pa-tients and their treatment.
The ACO national conference will be held on 18-19 October at the Melbourne Cricket Ground. For more information and to register see the ACO website www.aco.org.au or phone (03) 9349 7477. ■
SA Blue Sky Congress in November
The 9th SA Blue Sky Congress will be held at the Adelaide Convention Centre on 6-8 November, this year extending its welcome to include all optical dispensers and front-line staff across Australia by adding an ad-ditional education stream for op-tical dispensing and throwing the trade exhibit open to all.
Optometry South Australia says it recognises that a thriv-ing optometry practice is reliant upon the effective collaboration and coordination of expertise between optometrists, optical dispensers and all the practice team to ensure that each patient receives the continuum of care and positive purchasing experi-ence that will keep them coming back.
“The optometry sector is ex-periencing significant changes as the scope of practice of optom-etrists expands into therapeutics and new players enter the market place,” OSA says.
“Governments across Australia are looking for optome-try to step up and lighten the load for GPs and ophthalmologists so that essential eye care can be provided in a more timely and cost effective way to Australian communities.
“Those changes have resulted in a need for practitioners to be
innovative in order to remain relevant and competitive. In a thriving optometry practice now more than ever there is a need for optometrists and optical dis-pensing teams to work together seamlessly and professionally.
‘Whilst the process of selling glasses is an integral and vital part of any successful optometry business and is primarily a retail experience, it’s important to re-member that what we’re selling is unique and precious: good vision for life. Together, we should take pride in this.”
In addition to the usual two-day education program provided for optometrists, there will also be a separate, parallel education stream tailored for optical dis-pensers and their staff. The con-tent and speakers will be decided by a specially-convened optical dispensing advisory committee made up of a variety of experi-enced optical dispensers from across the sector.
Whilst the education streams will be tailored and tot- ally separate, optometrists, opt- ical dispensers and optical sta- ff will have the opportunity to network and sha re in the Blue Sky trade exhibit on 7-8 Nove- mber and the Blue Sky Play Time social event on the evening of the 7 November. ■
34 www.insightnews.com.au
SEPTEMBER 2014
LEGAL
Founder sues Vision Eye Institute for $2.8m over alleged deception
35www.insightnews.com.au
The founder of listed oph-thalmology practices group Vision Eye Institute, Dr Harry
Unger, is suing the company for claims of up to $2.8 million on the basis it breached disclosure obliga-tions and acted deceptively almost six years ago, The Age newspaper in Melboune reported on 6 August.
Two separate claims lodged in the Supreme Court of Victoria date back to 2008, when the market value of the laser-eye-surgery provider slumped from $237 million to $86 million over the calendar year.
Dr Unger, who started the com-pany in 2001 and was chief execu-tive until 2007, alleges the company engaged in misleading or deceptive conduct by asking that he repay an outstanding $632,000 loan used to buy shares, despite forgiving loans provided to other employees.
In a separate claim, he alleges the company, which was previ-ously called Vision Group, did not keep the market fully informed of
the terms of the chief executive’s employment and its entertainment of bids from potential private eq-uity buyers.
At the time, Dr Unger was the company’s executive director, strategy and development, hav-ing passed the chief executive of-ficer role to his successor, Mr Neil Rodaway, in 2007.
Dr Unger claims he suffered a loss of $2.8 million, related to a fall in the share price from $1.90 on 11 August to 68¢ on 29 October. He claims the loss on the basis that he possessed information about the sacking of Mr Rodaway and bids from potential private equity buyers but would have breached insider-trading laws if he sold his shares.
The claim alleges that Mr Rodaway’s position as chief execu-tive officer was terminated in a con-versation that occurred at a board meeting on 9 August. However, two days later, on the Monday, Mr Rodaway presented the company’s
full-year results and the company announced his termination on 18 September.
According to the claim, Dr Unger, who controlled 2.3 million shares at the time, said he was told by Mr Rodaway of the sacking be-fore the Monday but was unable to act on the information until the market was informed more than a month later.
The claim also alleges that, on 2 September, Vision received a bid from Affinity Private Equity for $2.42 per share in cash.
In addition, the claim alleges Vision chairman Mr Shane Tanner, who remains in the role today, told ophthalmologist employees on 24 September that the company in-tended to engage with several bids from private equity firms in the coming weeks.
At the company’s annual meet-ing on 29 October, Mr Tanner dis-closed to the market that Vision was exploring the opportunity for a
private equity transaction.The value of Dr Unger’s stake fell
from $4.4 million on 11 August to $1.6 million on 29 October.
Today the company has a mar-ket capitalisation of about $130 mil-lion and its share price closed at 77¢ on 4 August.
Due to limitations on the abil-ity of shareholders to bring claims against companies, which expire six years after a share purchase, any investors who bought shares during the period in question could lose the ability to take their own action as early as 11 August.
Vision’s chief financial officer, Anne McGrath, is reported as saying to The Age that the company denies the allegations and is preparing a defence to them, which will be filed before 18 August, and that there will be no further comment at present.
Vision Eye Institute has had varied results since floating. At one stage, for a short period, its shares were worth $5.50. ■
The Cooper Companies Inc announced on 6 August that it has completed its acquisi-
tion of Sauflon Pharmaceuticals Limited, the manufacturer and dis-tributor of soft contact lenses and solutions. The transaction is valued at approximately $US1.2 billion.
According to CooperVision, the transaction gives it the ability to offer the most extensive range of daily disposable contact lens options to eye care practitioners and wearers worldwide.
“We’re approaching the daily
disposables category with a new, multi-tier model. By adding the Sauflon portfolio to our already-strong MyDay and Proclear brand choices, we’re bringing forward multiple contact lens families designed and marketed for distinct wearer segments,” Mr Daniel McBride, president of CooperVision, said.
“This approach to the market provides practitioners the abil-ity to offer a daily disposable lens for every eye and every budget, which should further accelerate
both practice growth and category momentum.”
The global daily disposable market has been growing at 10 per cent – the fastest-expanding segment among soft contact lenses. Clariti – now part of the CooperVision range – is the only brand of daily disposable silicone hydrogel lenses that spans the entire vision correction spectrum (sphere, toric and multifocal), of-fering strong performance and cost benefits.
The line complements Cooper-
Vision’s premium MyDay lens – which is now being launched in markets beyond Europe – as well as its Proclear 1 day lens with one-of-a-kind PC Technology.
CooperVision is now working to combine both companies’ people, processes and pipelines to build customer and wearer experience.
The company says custom-ers should continue working with their current CooperVision and Sauflon representatives, support resources and ordering mecha-nisms until advised otherwise. ■
Cooper completes acquisition of Sauflon
SEPTEMBER 2014
RETAILING
Essilor closing its Clearly.com bricks-and-mortar store in Sydney
Allergan lawsuit alleges insider trading by hostile-takeover bidder; lawsuit filed
Essilor on 16 July announced it is closing its rece- ntly-acquired Clearly.com.
au bricks-and-mortar store in George Street, Sydney.
Despite what the company de-scribes as “excellent results since launching in March and April respec-tively”, the news comes following the recent acquisition of Coastal Contacts Inc, Clearly’s parent company in Canada, by Essilor International, for $C430 million in April.
Essilor has moved quickly to begin the process of integrating Coastal and Clearly into its global network of eyewear companies, with its acquisition of Coastal as-sisting in significantly expanding its online presence and the com-pany’s multichannel capabilities.
However, with prescription lens-es at the core of its business, Essilor has a long-standing relationship
with eye-care practitioners in Australia, leading to the decision to close the Sydney retail store, par-ticularly as it has been a concern of some of its practitioner clients.
Clearly says its commitment “to making optical shopping a fun and engaging experience for custom-ers across Australia” is still strong. Outside of its retail success, Clearly has seen strong online results. The primary business of Clearly is online retailing of optical products and this continues to grow in the region.
Clearly will continue to acceler-ate its leadership in online optical in Australia through extra resources being directed to its online channels.
Mr Geoff Henshaw, manag-ing director of Clearly ANZ, said: “This was a very hard decision and made in respect to Essilor’s long-standing relationship with eye-care practitioners in Australia. If
there is a silver lining it is that this will allow us to focus our resources on our online business, where we are seeing great results. With this in mind we like our future growth prospects in Australia.”
Coastal Contacts Inc is the larg-est online optical retailer in the world. With every pair of glasses purchased, Clearly donates a pair to someone in need through its ‘Change the View’ project.
Founded in 2000, Coastal Contacts Inc. designs, produces and distributes a large selection of glasses and contact lenses on the internet, including a unique combination of designer glasses, contact lenses, sunglasses and vi-sion-care accessories.
The company services cus-tomers in more than 150 countries through the Coastal Contacts Inc family of websites. ■
Allergan’s defence against a $51 billion hostile takeover bid by Valeant Pharmaceuticals
and Pershing Square Capital Management’s has taken a new turn with Allergan’s announcement that it filed a lawsuit on 1 August in the United States District Court for the Central District of California.
The lawsuit alleges that Valeant, Pershing Square and its principal, Mr William Ackman, violated feder-al securities laws prohibiting insider trading, engaged in other fraudu-lent practices, and failed to disclose legally-required information.
In its complaint, Allergan is seeking, among other remedies, a declaration from the court that Valeant and Pershing Square vio-lated insider trading and disclo-sure laws, and an order rescinding Pershing Square’s purchase of the Allergan shares that Allergan claims were acquired illegally.
The complaint alleges, among
other things, that Valeant always directed the unsolicited transac-tion to acquire Allergan toward a tender offer. In addition, the complaint alleges that debt-laden Valeant did not have the resources to acquire Allergan, and therefore sought third-party financing as-sistance from Mr Ackman and his hedge fund, Pershing Square.
By the time Valeant and Pershing Square entered into their financing agreement, Valeant had hired finan-cial and legal advisors, held multi-ple board and committee meetings, and negotiated the respective finan-cial commitments of the parties.
Valeant, Pershing Square and Mr Ackman had not responded to the lawsuit at the time of going to press.
Wall Street bankers are said to be lining up to fund the potential $54 billion deal with more than $20 billion of junk debt.
Banks, including Barclays and RBC have raised loan commitments
to $8 billion and vowed to arrange $12.4 billion of high-yield bonds to fund the hostile bid.
Demand for high-yield, high-risk debt has made it simple for junk-rated borrower Valeant to finance the merger, by far the Canadian pharmaceutical com-pany’s biggest in its long string of buyouts, including Bausch + Lomb.
Allergan’s board of directors, in consultation with its financial and legal advisors, have unanimously twice rejected unsolicited proposals from Valeant and Pershing Square, concluding “that each substantially undervalues Allergan, creates sig-nificant risks and uncertainties for the stockholders of Allergan, and is not in the best interests of the com-pany and its stockholders.”
For the full year of 2014, Allergan said it expects total product net sales between $6,900 million and $7,050 million, excluding any future antici-pated revenue from the transition
services agreements related to the sale of a obesity intervention busi-ness. It remains to be seen whether unconventional mergers and acqui-sitions tactics from Valeant’s takeo-ver partner, Mr Ackman, will help the pair get a deal for Allergan done. But in the meanwhile, one lawmaker is putting heat on the Securities and Exchange Commission to consider revising the rules that allowed them.
Representative Edward Royce is taking issue with the conditions that allowed Mr Ackman to delay publicly reporting the 9.7% stake his company massed in Allergan earlier this year, which put him in position to team up with Valeant in the bid for Allergan.
Neither the SEC nor the courts has determined whether the two parties getting together constitutes insider trading. But Edward Royce is said to be prepared to take legis-lative action on his own if the com-mission doesn’t act. ■
36 www.insightnews.com.au
Closing: Clearly.com’s George Street, Sydney, bricks-and-mortar store
SEPTEMBER 2014
BUSINESS
Specsavers reports 14.5% increase in sales to $611 million in 2013-14Specsavers has reported a
14.5-per-cent increase in retail sales revenue from
$533 million in 2012-13 to $611 million in 2013-14.
Discussing its operations in Australia and New Zealand in 2013-14 in its annual report, the company said it had surpassed $A15 million in sales in one week in Australia and $NZ2 million in New Zealand, as well as topping $134,000 in online sales in just one day.
It had doubled the number of $A39 frames on offer, lowered the price of kids’ glasses to below $100 (2 for 1) for the first time and launched “our best ever designer sale with a range of single pair de-signers from $A99.”
The company’s market share among health-fund customershas risen to almost 35% and the volume share of the contact lens market had increased from 12% to 33%, and a new distribution centre in Singapore has been opened to support quicker delivery and further growth.
The company had become the number one choice for eye
tests and prescription eyewear in Australia and New Zealand, des-patching a record 3.2 million or-ders from its Melbourne Glazing Services laboratory.
A number of awards were won, including Australian Retailer of the Year, Australian Retail Employer of the Year and the Franchise Council of Australia’s Franchisor of the Year.
In Australia and New Zealand, the company has raised almost $A300,000 for local and na-tional charities, including the Fred Hollows Foundation, the Queensland State Emergency Service, the Women’s and Children’s Hospital Foundation, Starlight Children’s Foundation, the RSPCA, the Royal Children’s Hospital and Friends of Autism.
In Australia and New Zealand, the company is now offering free polarising lenses with prescrip-tion sunglasses, offering cus-tomers 100% UV protection and eliminating glare.
Worldwide the company achieved a 7.8% increase in group revenue and reaching record
customer numbers with almost 29million people now registered with it.
There were around 17 million visitors to company websites – about 25% more than the previous year
Carl Zeiss three-star ratings were attained in all of the company’s manufacturing and distribution sites and outperforming industry standards in terms of service and quality with store returns due to error or quality issues less than 0.2%
In a pilot study in the United Kingdom, staff use iPads to greet and register customers and to talk them through the different stages of their visit.
Precision Care, its three-step process which is live in Australia, New Zealand and the
Nordics, uses technology to help customers choose frames, select the best lens options for them and be measured accurately before the glasses are fitted. That includes the Digital Mirror, which can take multiple photos of a cus-tomer wearing different frames to help them see how the frames look
in profile and from other angles. In addition, a new virtual dis-
pensing tool helps staff explain the different parts of the eye and advise customers on the impact their prescription might have on their choice of lens.
Research has helped improve the overall layout and design of the site across all markets, includ-ing the addition of new CGI frame photography, a ‘Request an ap-pointment’ feature and enhanced content for local store pages.
The new look offers a more in-tuitive experience with a focus on fashion trends, offers, eye test and eye-care information, and has sig-nificantly improved click-through rates from the home page.
The online contact lens or-dering system, first launched in Australia and New Zealand in 2012, is now available to custom-ers in Sweden. The system has driven growth in Australasia, in-creasing market share from 12 to 33 per cent. Orders have already surpassed 30,000 in Sweden since it was introduced last June. ■
An ultrathin light detector that can sense wavelengths our eyes can’t see has the po-
tential to put heat-vision technolo-gy into a contact lens, according to University of Michigan reseachers.
Heat or thermal vision, one variety of night vision, illuminates the heat being emitted by animals, humans, cars, electronic devices and more.
The researchers have built the first room-temperature light
detector that can sense the full infrared spectrum. Infrared light starts at wavelengths just longer than those of visible red light and stretches to wavelengths up to a millimeter long.
Infrared vision is perhaps the best-known variety of night vision. It can also help visualise heat leaks in houses, help medical practitioners monitor blood flow, identify chemi-cals in the environment and allow art historians to see Paul Gauguin’s
sketches under layers of paint. Unlike comparable mid- and
far-infrared detectors currently on the market, the new detector doesn’t need bulky cooling equip-ment to work.
To make the device, the re-searchers put an insulating bar-rier layer between two graphene sheets. The bottom layer had a cur-rent running through it. When light hit the top layer, it freed electrons, creating ‘holes’ – gaps between
electrons that act as positive charges. Then, the electrons used a quantum mechanical trick to slip through the barrier and into the bottom layer of graphene.
The positively-charged holes, left behind in the top layer, pro-duced an electric field that affected the flow of electricity through the bottom layer. By measuring the change in current, the team could deduce the brightness of the light hitting the graphene. ■
An animation campaign called ‘I might not see you’ was launched on 23 July
to help make roads and foot-paths safer for people with vision impairment.
Vision Australia and Guide Dogs Victoria have used animat-ed ‘heroes’ walking the streets and encountering different road safety situations to illustrate the issues and daily challenges faced
by people who are blind or have low vision.
Ms Maryanne Diamond, gen-eral manager of advocacy and en-gagement at Vision Australia and Ms Karen Hayes, chief executive
officer of Guide Dogs Victoria said the road safety campaign aimed to lift the public’s understanding of what they can do to help make roads and footpaths safer for peo-ple with vision impairment. ■
37www.insightnews.com.au
Night-vision contact lenses coming soon?
‘I might not see you’ road and pedestrian campaign launched
SEPTEMBER 201438 www.insightnews.com.au
CORPORATIONS
Alcon to license technology for smart contact lenses and IOLs from GoogleAlcon, the eye-care division of Novartis, has entered into an agreement with a division of Google Inc to license its ‘smart lens’ technology for all ocular medical uses, a move that could bring significant vision and health benefits to contact-lens and intraocular-lens wearers.
In a statement released on 16 July, Alcon said the agreement with Google[x], a team within Google that is devoted to finding new solutions to big global problems, provides “the opportuni-ty to develop and commercialise Google’s ‘smart lens’ technology with the potential to transform eye care and further enhance Alcon’s pipeline and global leadership in contact lenses and in-traocular lenses.”
The transaction remains subject to anti-trust approvals.
Under the agreement, Google[x] and Alcon will collaborate to develop a ‘smart lens’ that has the potential to address ocular conditions. The smart lens technology involves non-inva-sive sensors, microchips and other miniatur-ised electronics which are embedded within contact lenses.
Novartis’ interest in this technology is cur-rently focused in two areas: • Helping diabetic patients manage their disease
by providing a continuous, minimally-invasive measurement of the body’s glucose levels via a ‘smart contact lens’ which is designed to meas-ure tear fluid in the eye and connects wirelessly with a mobile device;
• For people living with presbyopia who can no longer read without glasses, the ‘smart lens’ has the potential to provide accommodative vision correction to help restore the eye’s natural au-tofocus on near objects in the form of an ac-commodative contact lens or intraocular lens as part of the refractive cataract treatment.
The agreement represents an important step for Novartis, across all of its divisions, to lever-age technology to manage human diseases and conditions. Google’s key advances in the minia-turization of electronics complement Novartis’ deep pharmaceuticals and medical device ex-pertise. Novartis aims to enhance the ways in which diseases are mapped within the body and ultimately prevented.
“We are looking forward to working with Google to bring together their advanced tech-nology and our extensive knowledge of biol-ogy to meet unmet medical needs,” Novartis’ chief executive officer Mr Joseph Jimenez said. “This is a key step for us to go beyond the
confines of traditional disease management, starting with the eye.”
Mr Sergey Brin, co-founder of Google, com-mented: “Our dream is to use the latest technol-ogy in the miniaturisation of electronics to help improve the quality of life for millions of people. We are very excited to work with Novartis to make this dream come true.”
The agreement marries Google’s expertise in miniaturised electronics, low-power-chip design and microfabrication with Alcon’s ex-pertise in physiology and visual performance of the eye, clinical development and evaluation, as well as commercialisation of contact lenses and intraocular lenses. Through the collaboration, Alcon seeks to accelerate product innovation based on Google’s ‘smart-lens’ technology.
Amy Adams is new face for Max Mara sunglasses
Max Mara has chosen actress Amy Adams as the face for its collection of sunglasses and accessories. An internationally acclaimed ac-tress, Amy Adams has been nominated for sev-eral major awards include five Academy Award nominations, four BAFTA nominations and five Golden Globe nominations. She will be seen later this year in the new feature film by Tim Burton titled ‘Big Eyes’.
The sunglass collection – distributed by Safilo Group – includes new Max Mara Tribute sunglasses which combine a ‘crocodile’ ef-fect texture on the temples. The colour palette
incorporates the classic shades of Max Mara accessories: black with gradient grey lenses, havana with gradient brown lenses and opal brown with mirrored brown lenses.
The advertising campaign will be published in leading online and off-line international titles from October.
Pfizer buying specialist sterile-ilnjectables company Following its unsuccessful $US100 million bid for AstraZeneca, Pfizer may have fallen on its face when buying specialist in generic sterile inject-able drugs company InnoPharma in a deal that, at most, will hit $360 million.
Pfizer said on 23 July that it would buy New Jersey-based InnoPharma, for $225 million in cash and up to $135 million in contingent mile-stone payments.
“Today’s announcement is an important milestone as we continue to look for innovative growth opportunities for our sterile injectables portfolio, which will increase to 73 products with this acquisition,” Mr John Young, group president of Pfizer Global Established Pharma (GEP), said in an announcement.
The purchase should be completed in the current quarter.
InnoPharma has 10 drugs already approved by the Food and Drug Administration in the United States, 19 more filed with the agency and more than 30 injectable and ophthalmic products under development.
Pfizer said that the nine-year-old company “specialises in the really tricky products”, in such treatment areas as cancer and central nervous disorders, that need complex manu-facturing capabilities or have particularly chal-lenging bio-equivalency requirements.
Also, Pfizer pointed out that its own port-folio of established sterile injectable drugs is extensive. It has 44 products with over 190 pres-entations in the US.
Pfizer’s deal to bolster its generics business does nothing to alleviate its bigger problem: the need to expand its portfolio of novel, potential blockbuster drugs. That is what it hoped to get from AstraZeneca and why it bid up to $118 billion to buy it. But heavy resistance from AstraZeneca, bolstered by the United Kingdom’s tough anti-takeover laws, along with sideline support from politicians loath to lose one of the UK’s few large drug-makers, finally squelched that effort. There have been musings that Pfizer might find a way to reignite it, but for now it is buying a generic sterile injectable company instead.
Continued on page 40
Business BriefsEye-Point Technology III ®
As-Worn Quadro ™
Natural Posture ™
IntelliCorridor ™
Allows Autograph III to provide four times better visual benefits than previously available in other progressive lenses.
A new ergonomic design concept that minimises discomfort when viewing objects in the near and intermediate viewing zones.
ReCreating Perfect Vision®
AUTOGRAPH III
A revolutionary new progressive design concept utilising reverse engineering. Starting by defining the size of the object, Shamir has achieved remarkable real world image definition.
New IntelliCorridor technology utilised a unique power profile which provides clearer vision in the intermediate focus at any position.
A Revolutionary new concept in lens design
Auto III .indd 1 4/04/2014 8:25:56 AM
Eye-Point Technology III ®
As-Worn Quadro ™
Natural Posture ™
IntelliCorridor ™
Allows Autograph III to provide four times better visual benefits than previously available in other progressive lenses.
A new ergonomic design concept that minimises discomfort when viewing objects in the near and intermediate viewing zones.
ReCreating Perfect Vision®
AUTOGRAPH III
A revolutionary new progressive design concept utilising reverse engineering. Starting by defining the size of the object, Shamir has achieved remarkable real world image definition.
New IntelliCorridor technology utilised a unique power profile which provides clearer vision in the intermediate focus at any position.
A Revolutionary new concept in lens design
Auto III .indd 1 4/04/2014 8:25:56 AM
40 www.insightnews.com.auSEPTEMBER 2014
RESEARCH
Alzheimer’s not forgotten by CSIRO, despite reduced funding
Continued from page 38
Tommy Hilfiger renews with SafiloTommy Hilfiger Group and eyewear manufacturer Safilo Group on 4 August announced a five-year renewal of their global eyewear licensing agreement for the exclusive design, development, production and distribution of the Tommy Hilfiger ophthalmic and sun-glass collections.
The agreement will run until 31 December 2020, with an optional five-year extension thereafter.
Since establishing the global eye-wear licensing agreement in 2010, Safilo and the Tommy Hilfiger Group have grown Hilfiger brand’s global eyewear distribution business. In the forthcoming five-year term, the part-nership will focus on expanding distri-bution in Asia and Latin America – key markets with significant potential for expansion and category growth. ■
– By Lewis Williams, PhD
It’s ironic that at a time the present federal government is trying to downplay the im-portance of the CSIRO by reducing its fund-
ing, the organisation is announcing research findings that might make many Australians very glad the organisation has neither lost its way nor its research ethos, especially as Australia’s aged population grows.
In Copenhagen, Denmark, in mid-July, CSIRO’s Dr Shaun Frost presented the find-ings from four major Alzheimer’s disease stud-ies at the Alzheimer’s Association International Conference (www.alz.org/aaic/), a world forum for information on the cause, diagnosis, treat-ment, and prevention of AD and related disorders.
The studies examined changes in a patient’s ability to detect odours as well as changes de-tectable in the crystalline lens and retina. The research suggests that eyes and noses offer potentially simpler and less-invasive paths to early detection of AD, the most common form of dementia.
Dr Frost reported promising results from a major Australian study based on fundus
photography as an inexpensive, practical early detection method for AD. His paper, Retinal amyloid fluorescence imaging predicts cer-ebral amyloid burden and Alzheimer’s disease, describes how retinal imaging using a US-developed instrument can detect the tell-tale amyloid plaques made assessable by eating a disclosing dye. Beta-amyloid protein is the major component found in the brain ‘plaques’ characteristic of AD that is known to accumu-late in the brain many years before AD symp-toms are diagnosed.
Dr Frost’s team collaborated with Prof Ralph Martin’s team at Edith Cowan University (Perth) and Dr Steve Verdooner’s team from NeuroVision Imaging LLC (Sacramento, California) to conduct a clinical trial with the McCusker Alzheimer’s Research Foundation (Perth). Other collabora-tors include: Austin Health (Melbourne), the Florey Institute of Neurosciences and Mental Health (Melbourne), and the National Aging Research Institute (Melbourne).
The longitudinal study, known as the Australian Imaging and Biomarkers Lifestyle
Study of Aging (www.aibl.csiro.au), is supported by the Science and Industry Endowment Fund (www.sief.org.au).
Two hundred Perth volun-teers have been or are being recruited from three catego-ries of people: healthy, mildly cognitively impaired, and AD sufferers.
The retinal biomarker aspect of the trial involves two visits by volunteers for retinal fluores-cence imaging using hardware developed by NVI using tech-nology licensed by the Cedars-Sinai Medical Center in Los Angeles (the hardware is based
on a Nidek F-10 Confocal Scanning Laser Ophthalmoscope.
The F-10 uses four separate wavelengths of light spanning 490 nm [blue] to 790 nm [near IR]) to image various retinal layers. Importantly, the F-10 also has an auto-fluorescence imaging feature).
Between visits, volunteers are asked to consume a dietary supplement containing curcumin (the yellow component of turmer-ic). Curcumin binds strongly to beta-amyloid plaques and fluoresces, making the plaques visible as bright spots in the retina at the sec-ond of the two eye scans.
Measurements of the number, size, and distri-bution of the plaques are used to calculate a reti-nal amyloid index (RAI). NVI is also working on a proprietary high-bioavailability curcumin for-mulation to enhance the visibility of the plaques.
Preliminary results indicate a strong corre-lation between retinal and brain plaque level, suggesting that retinal imaging may be a prac-tical test for early detection of AD. Retinal im-aging can disclose much smaller plaques than is possible with traditional PET brain scans and the hope is that AD changes can be detected up to 20 years earlier. Furthermore, imaging may allow an individual’s response to any AD treat-ment to be tracked more accurately.
The spokesman for CSIRO’s health research endeavours is Perth-based teleophthalmology expert Dr Yogi Kanagasingham.
As Australia’s population expands, any de-velopments that can assist the problem of AD will increase in importance. Stunting CSIRO’s funding, and the flow-on effects funding cuts inevitably have, is a strange way of dealing with a growing problem.
One unanswered question remains: What happens if AD can be detected 20 years ahead of a serious decline in cognitive function but no treatment is available? ■
* Subject to the terms and conditions available on the competition website
www.meyephotocomp.com.au
AN INITIATIVE OF
An initiative of the Macular Disease Foundation AustraliaAn initiative of the Macular Disease Foundation Australia
CATEGORIES
Open - General Public Healthcare Professionals
Macular Disease Community Junior - Under 18
You can have macular disease without knowing. An eye test is essential - early detection can save sight.
Visit www.meyephotocomp.com.au to enter
Winners announced 9 December 2014.
Macular disease is Australia’s leading cause of blindness and severe vision loss.
Macular diseases include diabetic eye disease and macular degeneration, and they have one thing in common - they rob sight - from the very young right through to older Australians.
Macular Disease Foundation Australia invites you to enter the 4th annual mEYE World Photographic Competition and in doing so, help raise awareness of macular disease. Simply submit your photograph with a written description explaining how your entry captures ‘a sight worth saving’. Your unique interpretation is what this competition is all about - celebrating the world through your eyes.
Competition period: 2 September to 12 November
JUDGES
Ita Buttrose - Foundation Patron & media identity
Ken Done - Australian artist
Rex Dupain - Australian photographer
Alan Pryke - Australian photographer
Revisit all the moments that have defined the ophthalmic professions and industry in the past 38 years!
This issue marks a major milestone for INSIGHT – it is the 400th issueOver 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.
DISTRIBUTED BY HEALY OPTICAL PTY LTD
www.healyoptical.com.au
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Queensland Supreme Court in
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WA Coroner’s finding re
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the death of a women after she
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Court action is about safety: RANZCOLegal action launched by RANZCO and ASO against OBA is about patient safety: president
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$2000 CPD limit scrappedThe $2,000 limit on claims for CPD self-education is to be scrapped by the federal government
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treatment of ocular inflammatory
conditions
Hospitals rowA row has broken out over
claims that there is a waiting list
of up to four years for elective
eye surgery in public hospitals
$10m research pledge to SSIA patient has pledged to donate
$10 million to the Sydney-based
Save Sight Institute to support
its research
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AUSTRALIA’S LEADING OPHTHALMIC NEWSPAPER – SINCE 1975
All the ophthalmic news that matters!
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04
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JULY 2013
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INSIGHT’S 400th Issue SpecialAfter 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 statisticsPublished 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.
78% of ophthalmic practitioners rely on INSIGHT to keep up-to-date with
the ophthalmic professions.
88%INSIGHT is the most-read
ophthalmic publication with 88% of practitioners regularly reading it.
74%If ophthalmic practitioners were
to read only one publication, 74% would choose to read INSIGHT only.
85%85% of practitioners believe
INSIGHT provides balanced and independent reporting.
78%
Research conducted at ODMA2013 in Brisbane.
400th Issue dps.indd All Pages 17/01/14 11:44 AM
Revisit all the moments that have defined the ophthalmic professions and industry in the past 38 years!
This issue marks a major milestone for INSIGHT – it is the 400th issueOver 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.
DISTRIBUTED BY HEALY OPTICAL PTY LTD
www.healyoptical.com.au
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Zeiss closing SA Rx
surfacing laboratory
Zeiss is to close its surfacing
prescription laboratory at
Lonsdale, South Australia, with
a net loss of 75 jobs
No decision by Qld
Supreme Court
No decision has yet been
handed down by the
Queensland Supreme Court in
the ‘standing’ determination
WA Coroner’s finding re
post-cataract death
The WA Coroner has found that
the death of a women after she
had undergone cataract surgery
was by ‘misadventure’
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Published for 37 years!
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All the ophthalmic news that matters!
Court action is about safety: RANZCOLegal action launched by RANZCO and ASO against OBA is about patient safety: president
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03 New head for UniMel schoolAssociate Professor Allison McKendrick has been appointed head of UMel’s optometry department
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AUSTRALIA’S LEADING OPHTHALMIC NEWSPAPER – SINCE 1975DECEMBER 2013
$2000 CPD limit scrappedThe $2,000 limit on claims for CPD self-education is to be scrapped by the federal government
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C A 6 6 0 3THE NEW CARRERA COLLECTION CAN BE DISCOVERED AT ODMA ON STAND E8
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AMA broadens attack
on OBAThe Australian Medical Association
has broadened its attack on the
Optometry Board of Australia over
treatment of ocular inflammatory
conditions
Hospitals rowA row has broken out over
claims that there is a waiting list
of up to four years for elective
eye surgery in public hospitals
$10m research pledge to SSIA patient has pledged to donate
$10 million to the Sydney-based
Save Sight Institute to support
its research
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ISSUE
JULY
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AUSTRALIA’S LEADING OPHTHALMIC NEWSPAPER – SINCE 1975
All the ophthalmic news that matters!
01
04
09
JULY 2013
Book1-84.indb 1
13/06/13 1:31 PM
INSIGHT’S 400th Issue SpecialAfter 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 statisticsPublished 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.
78% of ophthalmic practitioners rely on INSIGHT to keep up-to-date with
the ophthalmic professions.
88%INSIGHT is the most-read
ophthalmic publication with 88% of practitioners regularly reading it.
74%If ophthalmic practitioners were
to read only one publication, 74% would choose to read INSIGHT only.
85%85% of practitioners believe
INSIGHT provides balanced and independent reporting.
78%
Research conducted at ODMA2013 in Brisbane.
400th Issue dps.indd All Pages 17/01/14 11:44 AM
Online
T H E I N T E R N AT I O N A L E X H I B I T I O N F O R O P T I C S A N D E Y E W E A R I N D U S T R Y PA R I S 2 0 1 4
visitors silmo 2013pr
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W W W . S I L M O P A R I S . C O M
45SEPTEMBER 2014www.insightnews.com.au
The most important thing in communication is to hear what isn’t being said
Every practice and business man-ager/owner appreciates the value of friendly, effective communica-tion with all levels of staff to ensure job satisfaction, create a friendly work environment in which em-ployees can be most productive, foster loyalty and promote a social element in the business.
In the daily hum-drum of practice life, sometimes we tend to undervalue the importance of communicating with fellow work-ers, too often assuming it’s all part of the daily grind. More relevantly, we often overlook the opportunity to pause and say ‘well done’ or ‘thank you’ as most attention fo-cuses on service excellence to cli-ents – appropriately so.
Understandably, possible op-tions for effective communica-tions need to be pre-planned and
interwoven into the normal run of practice life as much as possible although certain actions should be factored in as regular events e.g. annual Staff Appraisals.
Meetings: Regular meetings of various craft groups (e.g. recep-tion/practice management), oc-casionally attended by an owner, provide opportunities to ex-change ideas and improve rela-tionships. Naturally, this social aspect must be supported by a business need to justify the time and effort. A meaningful agenda is essential to avoid meetings for the sake of meetings.
Individual input/projects/as-signments: An extension of the periodical meetings where staff are assigned a topic to speak on. This simple step builds confi-dence while welcoming and valu-ing views of staff members. Good leaders encourage employees to operate as a team and pro-mote innovation through group
interaction, not to mention vastly improved staff relations.
Work smarter, not harder: Yet another initiative that should be continuously encouraged in group meetings, with some form of rec-ognition for suggestions of merit that enhance practice productivity or efficiency.
One-on-ones: This form of com-munication is best restricted to consultation with team leaders as too much time will be required to engage each staff member.
Staff Appraisals: While these are invariably viewed as a forum for performance assessment and sala-ry reviews, they should also be em-ployed as a very effective tool for relationship building, particularly with well performed employees, as they present an opportunity to offer a well deserved ‘thank you’. Social events: It never fails to amaze me how relaxing and inter-active a simple pizza and drinks
lunch or post-work meal can be in fostering closer friendships between employees as personal, community events and current affairs usually dominate over practice/business related discus-sion topics.
In larger practices, similar communications may also be em-ployed at board level to ensure meaningful, deeper relationships between principals which could occasionally include staff par-ticipation to ensure an effective connection between executive management and employees.
Always remember, communi-cation is a two-way street. ■
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 0433 233 478,
email [email protected] or www.hpcgroup.com.au.
The British Contact Lens Association has elected Ms Susan Bowers as its presi-
dent for 2014-15, with Mr Brian Tompkins the new president elect is Brian Tompkins.
Outgoing president, Mr Andy Yorke, presented the new president with the BCLA presi-dential chain of office at the as-sociation’s gala dinner, held on 7 June at Coventry in England, her home-town.
“It is a great honour to become BCLA president at this exciting time. I plan to use my term to support members in encouraging many more patients to try contact lenses during their eye examina-tion. I would also like to help raise the profile of fitting children and young people with contact lenses,
as the benefits can be truly life changing,” Ms Bowers said.
“The BCLA works hard to ed-ucate its members but I believe the public needs educating too about the value of professional eye care. It is incumbent upon us all to address this however and whenever we can, whether through social media, marketing or face-to-face in practice. I look forward to challenges and activi-ties of the year ahead.”
The BCLA has appointed two new optometric representa-tives to its council – Dr Christine Purslow and Mr Andrew Elder Smith.
The new line-up will see Shelly Bansal leave the BCLA council after 10 years’ service. Also leaving the Council are Jonathon Bench,
who was co-opted onto the coun-cil for one year, and Dr Ursula
Vogt, who served four years as medical representative. ■
MANAGEMENT
Practice Dollars– By Karen Crouch*
Effective Communication
T H E I N T E R N AT I O N A L E X H I B I T I O N F O R O P T I C S A N D E Y E W E A R I N D U S T R Y PA R I S 2 0 1 4
visitors silmo 2013
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W W W . S I L M O P A R I S . C O M
New president and council for BCLABCLA council composition:The composition of the 2014-15 BCLA council is: • Susan Bowers, President• Andy Yorke, Immediate Past President• Dr Catharine Chisholm, Past President• Brian Tompkins, President Elect • Karl Aberdeen, Technical Representative • Maxine Green, Technical Representative • Iain May, Contact Lens Optician Representative • Katherine Reed, Lay Member • Keith Tempany, Contact Lens Optician Representative • Andrew Elder-Smith, Optometric Representative• Dr Christine Purslow, Optometric Representative • Siobhan Wren, Medical RepresentativeA vacancy currently exists for a medical representative and BCLA student representative. BCLA student members will be invited to nominate can-didates in September.
www.glaucomaeducation.com
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.
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. 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.
Case 4 - We discuss a patient presenting with unusually high intraocular pressure, as well as the diagnosis, management and features of Posner Schlossman syndrome. 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.
• All cases have been produced by qualified glaucoma specialists.
• Participation is available to any eye health professional. CPD points awarded are for optometrists.
• 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.
• The assessment associated with each case is made up of multiple choice and true/false questions.
• 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.
Seven cases each comprising a series of seminars based on clinical case studies, linking academic knowledge with practice.
SEPTEMBER 2014
BASICS
47www.insightnews.com.au
Read on…
Want to help your customers spruce up their style and build an optical wardrobe without breaking the bank? Like to introduce them to the world of colour? Hope to stand apart from the competition and combat the raging power of online dispensing? Think … and then rethink readers – a must-have in any optical dispensary. To get the latest read on this essential accessory, check out these Insight Basics.
Rethinking readers Let patients know there is an alternative to humdrum dollar store readers. Show them what they are missing. Reinforce that readers purchased from you will be of higher quality and have the benefit of your expertise.
Not grandma’s readerMake your customers aware readers are no longer just small, half-rimmed styles that perch on the end of the nose. They are now readily available in full-frame designs in all those hot retro styles – clubmen, cat-eyes, bold rectangles, rounds.
The more the merrier Stock a varied inventory in multiple col-ours and shapes. Multiple choices encour-age multiple sales. Remember readers are one category where everyone needs more than one pair so they can be readily avail-able throughout the house, in the car, at the office, on the boat. And it’s an area where consumers are willing to take more chanc-es with vibrant colours because they don’t wear them all day, every day.
New and novel Just as with other accessories, consumers are drawn to the new and unusual. A vari-ety of novelty readers are available, rang-ing from those that fold into a pen-shaped
case for easy carrying to stylish jewel-en-crusted frames for that night at the theatre. And they make a perfect stocking stuffer or Mother’s or Father’s Day gift.
Finishing touches Don’t forget readers have their own array of equally stylish accessories – elegant chains and striking cases. Help your customers build a wardrobe of fashion fused with function that can truly pull a look together – and definitely round out a sale.
‘Read on…’ by Gloria Nicola was originally published in 20/20, a publication of Jobson Medical
Information LLC.
For the second year running, Guide Dogs has been voted Australia’s ‘Most Trusted Charity’ in the annual Australian
Reader’s Digest ‘Most Trusted Brand’ poll.Based on a survey of 2,400 respondents
nationally, Guide Dogs was recognised for its services, including providing guide dogs to Australians who are blind or vision impaired for over 60 years.
On behalf of Guide Dogs, Dr Graeme White, chief executive officer of Guide Dogs NSW/ACT, thanked members of the public for their ongoing support and trust.
“We’re humbled by and grateful for this level of public recognition in our vital work, which enables Australians who are blind or vision impaired to be more independent,” Dr White said.
“Vision loss is a challenging disability but our services, including guide dogs and long canes, allow people to realise it doesn’t have to be limiting.
“The award is a reflection of the support from the charity’s donors and volunteers.
“We wouldn’t be in a position to receive this award without the assistance and contin-ued trust of our loyal supporters.
“Over the next 10 years it’s predicted that more than 2,000 guide dogs will need to be trained to keep up with growing demand from Australians who are blind or vision impaired, at a staggering cost of over $60 million – it’s the public’s generosity that will make that possible.”
Dr White accepted the ‘Most Trusted Charity’ award on behalf of Guide Dogs at a ceremony in Sydney on 24 July. ■
Guide Dogs voted ‘Most Trusted Charity’
Leila Davis and trusted friend
Vision-impaired seniors prefer ‘talking therapy’: CERA research
Google Glass goes on sale in UK for $A1,700
TREATMENT OPTIONS
Elderly adults with low vision who show signs of depression prefer ‘talk-ing therapy’ rather than anti-depres-
sants, according to new research by Centre for Eye Research Australia .
The study, published in the Australasian Journal of Ageing and led by Dr Gwyn Rees, screened 124 adults over the age of 60 for depressive symptoms when they visited low vision rehabilitation services. Thirty-seven per cent screened positive for signs of depression and took part in a follow-up telephone interview to determine which treatment options were most acceptable from a patient’s perspective.
The preferred treatment options were ‘talking therapy’ from a counsellor or psy-chologist (29%) and talking therapy in com-bination with medication (33%). Only 20% preferred medication alone and 18% chose no treatment. The most popular settings for talking therapy were in the patient’s own home (73%) or over the phone (67%). Around half reported they would be happy to receive sessions in a therapist’s office (56%) or a Vision Australia centre (46%).
PhD student Ms Edith Holloway said on 24 June: “Research has shown that older
adults may be reluctant to seek professional help for depression, especially from men-tal health professionals. That is due to their own reservations (self-stigma) about seek-ing help for a mental health condition, as well as their perceptions of others’ negative responses (perceived stigma).”
The researchers believe that this may be why therapy in the privacy of a client’s own home was a popular choice.
“Older adults have also reported a lack of accessible services, transportation prob-lems and cost as barriers to seeking psycho-logical support,” Ms Holloway said.
Only 7% of participants were in fa-vour of therapy sessions over the Internet. “Although internet usage has increased among older adults in the last decade, con-cerns around privacy and security, a prefer-ence for personal contact and fear of being unable to correctly navigate and use the web remain barriers,” she said.
The study also found that characteristics including severe vision loss, a history of de-pression, previous treatment for depression and having a perceived need for emotional support were all associated with a positive screening result for depression. ■
Smartglasses have finally gone on general sale for anyone in the United Kingdom over 18 with a credit card
and address.They are priced at £1,000 ($A1,700)
two years after they were extravagant-ly launched by skydivers in the United States.
The smartglasses have been praised by adherents who describe them as the evolution of wearable computing, while Google co-founder Sergey Brin has called them a way to “free your eyes””, and de-scribed smartphones as “emasculating”.
But they have also been the object of privacy objections, ridicule and even muggings in the US.
Google Glass consists of a pair of glass-es with a small prism-based translucent
screen mounted above the right eye. It can take pictures or video from a front-facing camera, controlled by a voice command or a swipe on the right-hand armature, and is designed to display at-a-glance in-formation on its screen which is visible only to the user.
It runs a variant of Google’s Android mobile software, and relies on a smart-phone for its data connectivity. Google says it offers about a day’s battery life, or 45 minutes of continuous video recording.
Google says it knows there’s a pent-up demand for Glass from all over the world and it picked the UK first because the company has a history of embracing tech-nology, design and fashion, and there’s a resurgence happening in technology in the UK. ■
www.insightnews.com.au
ACO’s Visiting Optometrists Scheme extended in Vic and SAThe Australian College
of Optometry’s Visiting Optometrists
Scheme contract with the federal health department has been extended to in-clude some additional sites through to June 2014.
Some of the new sites were identified by the de-partment as areas where more services were required for Aboriginal communities. As a result the ACO applied for, and was granted addi-tional funding.
The new sites are: Aboriginal Health Services at Kerang, Morwell and Bendigo in Victoria and at Mt Gambier and the Riverland region in South Australia.
Additional sites were added to increase the focus on residential aged care cli-ents, elderly clients and cli-ents with diabetes. Those sites are: Boort and Birchip in central Victoria and Minyip, Jeparit, Rainbow and Edenhope in the Horsham region.
The ACO provides care of communities experienc-ing disadvantage through the provision of compre-hensive public health eye care.
ACO staff also contrib-ute as locum optometrists in the Brien Holden Vision Institute program in the Northern Territory.
Further information: Dr Genevieve Napper, lead optometrist at Aboriginal Services (03) 9349 7476 or [email protected]. ■
The Melbourne Focus Conference is being held in the Victoria
capital on 25 May, which pro-vides an opportunity for del-egates to explore the delights of that city in mid-Autumn.
Where to stay?Melbourne Exhibition and Convention Centre (MCEC) is located within walking
distance from a range of hotels to suit any budget. Focus Conference’s accom-modation partner, Hilton Melbourne South Wharf, is ideally placed with direct ac-cess to MCEC. This modern and stylish hotel in located on the banks of the Yarra River with rooms offering city or bay views. Focus Conference delegates can take advantage
of the discounted rate of $295 for a King Room. Book directly through www.focus-melbourne.com.au
What to do? Melbourne is renowned for fine dining establishments – many of which are located within Melbourne’s CBD. Why not treat yourself on
INDIGENOUS SERVICES
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Contact us at:Email: [email protected]: www.intelligentstyling.com.auPhone: +61 2 96340121
Individual Shop PlanningWith IntelligentStyling & Concept-S-Design
Our optical practice designs and fit-outs are predicated on modular fittings and elements which offer the advantage of shorter planning and execution times, cost-savings and price transparency. Modular elements also offer the ability for a practice to be “refreshed” simply by re-positioning fittings within a practice, or they can easily be transported and reinstalled in new premises
FlexibilityCustomization to every demand and each budget
Sales increaseShop fittings provide the best environment for sales promotion
IndividualityRealizing a unique shop concept that only you have
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The Melbourne Exhibition and Convention Centre
Focus Conference: Melbourne in May
Continued on page 28
24-30.indd 24 7/04/14 10:09 AM
SEPTEMBER 2014 49www.insightnews.com.au
CLASSIFIEDS
MarketPlacePhone: 0425 532 888Email: [email protected]
POSITIONS VACANTOptical Dispenser/Retail Assistant - Melbourne Eastern SuburbsThis is a permanent part-time Optical dispensing position in an Independent Eastern suburbs practice. Work Thursday, Fridays and some Saturdays. Located 20 minutes from the CBD. Occasional full weeks - September/October 2014. SKILLS REQUIRED: Optical retail/dispensing experience essential; excellent customer service skills, retail optical sales, basic admin-istration, computer literacy, the ability to work independently and without super-vision & be reliable and highly motivat-ed. THE PACKAGE: Competitive hourly rate, Bonus incentive package, training & staff optical discounts.Contact Ruth on 0407 331 483 for fur-ther discussion.
Optometrist- Maternity Position- LensPro Booval QueenslandA full time maternity position is avail-able from the 7th of October for 6 months for an experienced optom-etrist. Positioned within the Booval Fair Shopping Centre at Ipswich, this fully equipped practice consists of a full equipped consulting room, a genuine 1 hour fitting lab, generous frame dis-play space and a large loyal customer base. This position would suit some-one who values full clinical freedom, enjoys working with experienced opti-cal dispensers and thrives on the abil-ity to act local whilst also be part of a larger group.
For further details please call Melanie Sutherland on 07 3281 8400 or email: [email protected]
Optical Dispenser/Manager MelbourneWe are seeking a vibrant, committed full-time dispenser to manage a new independent practice in inner city Melbourne. Experience is preferred, along with a drive to help build a high quality, successful practice. If you like to work hard, and be in control of your work environment, please email your interest and resume to Sue [email protected]
EQUIPMENT FOR SALE
Vintage but Usable Opthalmic Equipment For Sale
• B&L - Phoropter - perfect work-ing order (blue colour)
• Manual Vertometer (TOC brand). Perfect working order.
• Upright Maddox tester• B&L vintage contact lens hand
crimperTOTAL PACKAGE: $990 or nearest offer. Contact Ruth on 0407 331 483
Complete Testing Room & Dispensing Equipment For SaleLocated in Sydney . Including Topcon IS 600 chair, Digital slit lamp, TRC-NW8 Non-Mydriatic Retinal Camera, Auto Kerato-Refracto Tonometer TRK-2P, Octopus 600 perimeter & Wall columns. And all the associated parts to go along with testing room. Disp. Equipment. Basic tools set, B&S
countersink frame heater , CL-300 lens meter. Ultrasonic bath. For more information contact Stefan [email protected] or 0411 174 070
PRACTICE FOR SALENorth Perth - WAWant to walk into an established prac-tice in North Perth ? Suits new gradu-ate, dispenser or optometrist looking for inexpensive purchase. Located in busy and up and coming Fitzgerald St in North Perth. We have negotiated lease terms that are very low and have a database of over 7,600 patients. Established for over 20 years, this cur-rently part-time practice has solid po-tential for further growth. Has lots of potential and little cost to run. The shop is located near a post office , medical / dental centre , North Perth Plaza, hair salons and busy cafes and restaurants. We don’t have enough time to run this shop so that is why we are putting it up for sale . It is currently only open 4.5 days a week. Originally asking $165 000 but we have dropped the price for a URGENT SALE to $120 00. Phone 0422 344 561.
Established Business For Sale in Whitfords City Shopping CentreModern and big shop with a great design. Well established and located in Hillarys in the whitfords city shop-ping center. Its a nice size with testing room + lab/ lunch room. For more info call Lena 0422 344 561
WORK WANTEDQueensland - within 10-20 km of Brisbane CBD• Do you believe that patient care is
much more than just patient care?• Do you believe that optometry is
much more than just refracting people?
• Are you interested in having new blood joining your busy practice?
If your answer is ‘yes’ to the above ques-tions, perhaps I am the optometrist that you are looking for. I will also be thera-peutically endorsed. Ideally if you are the owner/manager of an independent/semi-independent practice (Others welcome too, as long as the condition fits), who are looking for a full-time/part-time optom-etrist, starting from the beginning 2015. Please e-mail me on snowmemory123 @gmail.com for more info.
FLEYE Frame Agents NSW, QLD, WA and SAHouse of Brands is seeking Agents to represent FLEYE – a Colourful and trendy Danish Eyewear Brand.
We are looking for Agents in NSW, QLD, WA and SA.
Please contact our Sales Brand Manager Kylie Nguyen on 0402 879 676
SEPTEMBER 201450 www.insightnews.com.au
AUGUST 4, 1914 was the start of the World War I, and all of the horrific, senseless car-
nage it brought to the warring countries.By coincidence, August 4, 2014 was to be
the start what was to be four to five days of the long-awaited Supreme Court of Queensland battle between The Royal Australian and New Zealand College of Ophthalmologists and the Australian Society of Ophthalmologists ver-sus the Optometry Board of Australia over the latter’s decision to grant diagnostic and man-agement rights to optometrists without any in-volvement of ophthalmologists.
The August 4 start date had to be put off until 1 December, when the OBA, just three working days before the hearing was due to commence, announced it was going to have 20 expert witnesses, which has blown out the hearing to seven to eight days.
So it will be at least four-five months before the legal guns are silenced, with every chance of a further delay into 2015 before judgment is handed down.
And either side could appeal the decision, whatever that may be.
By then, the costs to both sides, including lead-up work and the actual hearings, will be eye-watering, no matter who wins or loses. And it will be a winner take all.
By then, it will be at least two years since the OBA decided those it controls could do without the need for involvement of the senior profession of ophthalmology when it comes to glaucoma.
Will the community and the two profes-sions involved have been best served by it all?
THE loss of its $33.5-million contract with Medibank Health Services to supply op-
tometry and dispensing services to Defence personnel no doubt is causing grief at Luxottica and its OPSM operation.
At first glance, it may seem a bit tough to axe the contract because the names and mili-tary units of those personnel who have availed themselves of OPSM’s services under the con-tract have been forwarded overseas.
But it was a clear requirement under the contract that such data not be sent overseas, as it turns out has been going on since the com-mencement of the contract in 2012.
Perhaps senior management at OPSM should have been provided with a copy of British Interrogation Techniques in the Second World War by Sophie Jackson, which sets out very clearly how the slightest piece of informa-tion, when pieced together with other seem-ingly unimportant scraps of information, can often lead to the truth coming out and the breaking of those being interrogated.
OK, the Defence-contract is not necessarily in that league, but imagine the value of the data in the event of war between Australia and another coun-try which managed to get hold of the data, wheth-er it be on a plate in this era of electronic wizardry or by other means. It could be calamitous.
And that is probably what most angered the Defence brass hats.
AUSOPTOM chat line participants are spending a lot of time and energy seeking
an analogy for what optometrists do, particu-larly in the light of the trend for more and more people to take their prescriptions elsewhere from where they were generated.
There have been all sorts of attempts to find a suitable analogy, ranging from tailors to dentists, architects, medicos and just about anyone else.
But isn’t it really all about convincing a patient/client/customer that the practition-er/prescriber knows what he/she is doing and whatever that may be represents value for money.
There are any number of successful ‘inde-pendent’ practitioners who manage to do that, with very few patrons being ‘lost’ to someone else.
As one put it to me: “You usually have them in the chair for something like 30 minutes or so, and if you can’t convince them – be subtle – that they should have you dispense their prescrip-tion, then you should consider seeking another occupation. And the universities should spend more time on situations in practice like that.”
Sound words.
WHICH brings up the question of what is the emphasis of the universities in regard
to teaching of clinical work versus retail-man-agement during their undergraduate courses in optometry?
It’s no secret that they have a distinct prefer-ence for teaching clinical matters, with retail-management a poor second.
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That’s despite the retail side of an opto-metrical practice usually bringing in as much as 80 per cent of gross revenue, with fees for professional services and the like bringing in a lowly 20 per cent.
Perhaps the imbalance in undergraduate-content teaching is one of the main reasons why much of the retail war – about 65 per cent at a guess – is being won by corporation-ful-ly-owned or partially-owned practices rather than individual-owned practices.
Perhaps it’s why so many are taking a hard look at their futures.
AT the same time, there seems to be con-cern about what Optometry Australia
is up to, or rather what it was up to until re-cently, with its new claim of representing “all” optometrists.
Ah, so that’s why it was content to invest funds of all its members in such activities as ProVision – for the benefits of about 10 per cent of the floor membership only of the Australian Optometrical Association, later Optometrists Association Australia (as it was at the time and which is now Optometry Australia) – as it made no claim to represent “all optometrists”.
FOLLOWING on the news from Louisiana in the USA that optometrists there with mini-
mal training will be permitted to perform eye surgery, comes the news that a surgeon in the United Kingdom says optometrists have a role to play in femto laser surgery for cataract.
The gentleman concerned says that a sig-nificant part of femtosecond laser cataract surgery could be carried out by non-surgical staff and that optometrists are the obvious choice.
“The way we would set it up is we’d have the optometrists doing the femtosecond part of the procedure – the technician part – which is 80 per cent of the workload. We’d be in the theatre next door sucking the lens out and putting an implant in, and we’d have a rotat-ing system.”
Presumably he’s serious – or nuts.
THIS year marks the 50th anniversary of the completion of the final year of the BOptom
degree course at the University of New South Wales by the first undergraduates, who for-mally graduated in 1965.
The students concerned commenced their studies in 1960 in the diploma course con-ducted at Sydney Technical College but when
the university agreed to offer the degree course they were quietly convinced by the then head of the department and later head of the School of Optometry, Josef Lederer, that it would be best for them if they transferred to the degree course, which they all did.
Most have ceased practice by now, with a remarkable exception – Perth-based Ian Sim, who has just celebrated 30 years in his own contact-lens practice after originally decid-ing to become an actuary but then, after a chat with a well-known, highly-successful optometrist, opted to study optometry in-stead – on graduation practising in Sydney initially and later Perth, before opening City Contact Lens Clinic.
SO you thought removal of the carbon tax would reduce your work-place and domes-
tic energy bills back to what they used to be.Well sorry to tell you that we’ve all been
suckered by the politicians, because the huge increases in electricity prices have not been due to the carbon tax, which is just a blip in that regard, but due to energy companies get-ting away with scandalous, out-and-out price gouging since the ‘poles-and-wires’ privatisa-tions of recent times.
The much-vaunted carbon tax removal is of little consequence, despite the blatherings of the pale-blue-ties brigade in the Credlin-Murdoch-Abbott government.
What will be interesting to see is how the electorate at large reacts when it realises it has been dudded big time.
ONE of the most useless organisations in Australia, the Advertising Standards
Board, recently received a number of com-plaints about a television commercial it had produced extolling the organisation’s virtues.
Like good little boys and girls, the mem-bers of the ASB considered the complaints and, guess what, they found their own com-mercial did not breach its code of ethics; sur-prise, surprise.
The ASB is an organisation without teeth, wasting people’s times with stupid demands/requests that it can’t enforce – it just doesn’t have the power to do so.
Years ago, they tried to have a go at Insight over a small advertisement headed ‘How Are Your Nuts?’, which was all about a wholesaler having available screws and nuts for frame and sunglass hinges; it was dobbed in by an optometric luminary of the time.
When confronted by the ASB, we politely
and firmly suggested they go and have a fizzy drink – or words to that effect.
Never heard from them again.
AT last, Transport for NSW’s buses have ex-ternal destination signage that you can ac-
tually read!Instead of having hard-to-read yellow let-
tering and numbers, the new ones now have big white lettering on a dark background, which can be read a good distance away.
So congrats to NSW transport minister Gladys ‘Our Glad’ Berijiklian for finally getting some-thing right – it’s only taken going on for four years!
FEDERAL health minister Peter Dutton, at the drop of a hat, will rabbit on about the
former government’s “waste” and “the need to clean up its mess” and so on.
So it will be interesting to see how he re-sponds to the news just leaked out that a few months into his government’s term of office, he ran up a bill of $15,600 for the RAAF to carry him and two people from Canberra to Hobart and Hobart to Sydney, and Sydney to Canberra for one person.
Didn’t Treasurer Joe Hockey say the age of entitlement was at an end?
HEALTHSCOPE, the private hospital oper-ator, has floated for 21 times times earn-
ings, yes 21 times earnings.Are the ‘Mugs This Way’ signs thrown in as
part of the price?
THERE are all sorts of ‘weeks’ during each year, particularly health-care ones cover-
ing a wide range of conditions that we should all be aware of and should see someone about having them checked some way or other. All noble causes.
You’ll be pleased to know that the United States has not lost its sense of humour, having just celebrated National Clown Week! ■
LATE NEWS Specsavers awarded Defence contractSpecsavers has been awarded the contract to provide optometrical and dispensing ser-vices to Australian Defence Force personnel following the contract with ADF/Medibank Health Services held by OPSM being axed over personal details of Defence staff seek-ing such services being sent to an unnamed overseas location since 2012.
