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HomemifeatureFocus on the Future: Looking to 2016

Focus on the Future: Looking to 2016

As 2015 draws to a close, mivision asked members of the eye care and eyewear profession about their expectations for the year ahead.

There’s no doubt that the Federal Government review, currently underway, of items included in the Medicare Benefits Schedule will impact the delivery of eye health in Australia. To what degree remains to be seen in the New Year, as several ophthalmologists and optometrists were keen to point out when mivision asked them what to expect in 2016. Additionally, the freeze on Medicare rebates for optometric services remains a concern. On the upside, new technologies and opportunities for optometrists to both focus on sub specialties and work more closely with ophthalmologists are expected enhance eye health services and provide exciting professional challenges in years to come. More specifically, here is what was said…

Dr. Bradley Horsburgh

President, RANZCO
“It is my greatest hope that the Federal Government will seek genuine advice and broad clinical input from the medical profession, in undertaking the current MBS review. The task is Herculean. The timelines are way too short. Medical practitioners are taxpayers too. We all realise and accept that the country needs a sustainable health care system. We know where the system inefficiencies reside. I just wish that government would give the profession a meaningful indication of the value of what needs to be excised and we can work together to deliver.”

Professor Mark Gillies

Macular Research Group, Save Sight Institute, Medical Foundation Fellow the University of Sydney
“My prediction for 2016 is that many eye research groups will go to the wall unless they find alternative sources of funding, such as industry or private philanthropy. The success rate for applications to the NHMRC, the government’s main funder of biomedical research, will fall from 20 per cent a few years ago to under 10 per cent because the duration of grants has been increased from three to five years without additional funding to cover it. This is something worth raising with your local MP. Expect to see OCT angiography used more frequently for the investigation of retinal vascular disease and sub retinal neovascularisation. OCT angio provides higher definition imaging of such things as occult choroidal neovascularisation without the need for a dye.”

Dr. Rick Wolfe

Vistaeyes, Peninsula Eye Centre
“My predictions for 2016 are… with more surgeons seeing the importance of astigmatism elimination following IOL surgery, over 0.50D will be a rarity. Astigmatism lowers quality of life and lessens efficacy of the new trifocal IOLs, which are gaining popularity. They have largely replaced bifocal IOls. With understanding of the contribution of the posterior corneal astigmatism and the introduction of IOLs correcting as little as 0.68D, the noise in outcomes has gone. Additionally, refractive surgery has failed to provide presbyopic emmetropes with a surgical solution. Corneal inlays are looking like they will grow in 2016 as a solution. And, the use of intracorneal ring segments, topographic-driven PRK and corneal cross linking (CXL) to increase best-corrected acuity in keratoconus will grow, as will CXL to stabilise progressive disease.”

Clinical Associate Professor Ivan Goldberg

University of Sydney Head, Glaucoma Unit, Sydney Eye Hospital Director, Eye Associates
“Nothing is more fraught with potential errors than attempting to predict the future! Having apologised in advance and qualified my comments accordingly, my predictions for ophthalmology for 2016 are a growing need to engage constructively with patients as they increasingly seek information about their eyes and condition(s) on the internet, a continuing squeeze of private practices’ resources as Medicare benefits remain frozen and all other costs continue to grow, along with ever-expanding scientific advances that inform and expand management options, allowing care to become ever more effective. Excitement and anticipation remain the names for the game.”

Dr. Simon Chen

Vision Eye Institute
“Optical coherence tomography angiography (OCT-A) will be introduced into clinical practice due to the recent availability of numerous commercial OCT-A devices. This is an exciting new non-invasive imaging technology that employs an OCT scanner to generate angiographic images of retinal and choroidal blood flow. It will eventually provide many new insights into our understanding of retinal disease and will transform how we assess and manage patients with common conditions including age related macular degeneration, diabetic retinopathy and retinal vein occlusion. There will be some pain in store for patients and eye care practitioners resulting from a planned major review and overhaul of the Medicare Benefits Schedule (MBS) by the Federal Government. Given the increasing costs of health care which are increasing at unsustainable rates, it seems likely that Medicare rebates for many ophthalmology related item numbers will be reduced or restricted. How this will impact upon patient care remains to be seen.”

Genevieve Quilty

CEO, Optometry Australia
“2016 will see a continuation of collaboration, across the profession, facilitated through Optometry Australia in relation to the cuts to patient rebates through Medicare. In October 2015, we presented 18,000 patient signatures calling on the government to reverse the Medicare cuts. With the Medicare review fully underway in 2016, Optometry Australia, along with the profession, will unite to demonstrate how cost effective a sustainable investment in Medicare is, both for preventative patient eye health outcomes and for the sustainability of the government’s health budget. With 80 per cent of eye health conditions either preventable or treatable if detected early, a sustained and fair increase in Medicare funding makes sense.”

Jess Chi

National President, Cornea and Contact Lens Society
“My prediction for 2016 is that more optometrists will differentiate themselves in an increasingly competitive market by embracing sub-specialties such as contact lenses, dry eye and paediatrics and by investing in new technology. I predict more optometrists will embrace myopia control, whether it be via contact lenses or other means, in an attempt to arrest this growing world-wide epidemic. At the beginning of 2015, the Medicare fee cap was lifted, and we witnessed many optometrists embracing the change by charging for their services rather than choosing to bulk bill. I predict that this trend will continue in 2016 with optometrists choosing to be remunerated more appropriately for their skills and expertise.”

Veronica Kypros

Executive Officer, Australian College of Behavioural Optometrists
2016 is the year that ACBO’s Practical Vision Therapy program will go global. With the first international licence agreement signed off, the program will run in the USA next year for the first time, and discussions are pending with other potential international partners. It will also be the year that strategic relationships come into their own as we explore exciting initiatives and opportunities for collaboration with other organisations, particularly in the realm of education. ACBO’s education events are selling out on a regular basis, and development of online education will remain a priority in 2016.

Michael Jacobs

Business Consultant
“My prediction for 2016 is for reasonable stability in the retail optometry market in the face of likely instability and uncertainty in the national and global economies. Retail confidence has been improving but is fragile and a likely downturn in the Australian economy in 2016 will damage confidence. That said, the strong health component of optometry buffers it from major variations.The wholesale optometry supply industry may not be so fortunate. The continued slide in the Australian to US dollar exchange rate combined with the ease of sourcing product directly from China will not do any favours for local suppliers. Technology and regulatory risks are relatively minor for the 2016 period. In summary, a mixed bag; neither positive nor negative.”

Mark Overton

Ideology Consulting
“My prediction for 2016 is that the battle for market share and patients will continue and intensify as the franchises expand and independents defend their territories. The struggle as always is a local one and those practices, of whatever genre, that are not working hard to maintain patient relationships and actively meet needs and wants will find life hard. The national picture is important but any practice only has to be the best locally to be successful. The economy will play a large part in 2016, as it did last year, with a Federal election also looming, the older consumers are likely to be conservative. If you have been working on your practice for the last couple of years… well done! If you haven’t, flex the Extractus Digitorum muscle or prepare for a rocky 12 months.”

Jim Papas

Eye Clarity
“With a lowered outlook in Australia’s terms of trade due to lower commodities and Chinese demand, coupled with reduced family income growth, we will see steady or subdued household and consumer spending. This means that competitive pressures in the industry remain and consumers will be discerning on how they spend their money. For the profession it means competition will become greater, chasing growth and market share. This, in turn, will lead to more fragmentation. There is a real opportunity to provide greater integration of eyecare services between optometry and ophthalmology, which will benefit the Australian population in early detection, management and efficiency in services. This will free up time for ophthalmologists to do more surgery and procedures and to cope with the increased demands of an aging population. The two professions sitting together and mapping out a united road map would ensure better patient outcomes, which could be delivered as opposed to being forced into political imperatives of political parties.”

Simon Lewis

CEO, Eyecare Plus
“There is no doubt that Australian optometry has changed dramatically in the last 10 years. While the ‘clinical’ side is still important, there has been a definite move towards providing a more competitive ‘retail’ offering – this has simply been a necessity. Over the next few years we expect to see this trend continuing in the form of an improved and clearer offering for consumers. Some practices are already offering more consistent retail prices, where a feature like Transitions has a consistent price regardless of the lens type. This will continue, providing benefits like clearer staff explanations, better patient understanding and greater proportions of lens upgrades.”

Steven Johnston

CEO, Provision
“My prediction for 2016 is that successful independent practitioners will grasp the need to differentiate themselves via the total client experience that they offer. This will include embracing contemporary diagnostic equipment to deliver the most comprehensive clinical experience as well as motivated, enthusiastic front of house staff who deliver an outstanding dispensing experience, in a practice environment that is unique. Being ‘Vanilla’ won’t be good enough anymore.”

Dr. Abi Tenen

Vision Eye Institute
“My predictions for 2016, albeit I do not possess (sadly) a crystal ball are:“Laser assisted cataract surgery will become the preferred technique as a technophilic society accepts that precise computerised laser cutting is more reliable than the manual version. I also predict ongoing fierce arguments to the contrary. I also predict that trifocal multifocal IOLs will be the ‘new black’. And, despite the exciting and unprecedented opportunities we now have to treat our patients with phenomenal technology, it will become more (not less) difficult to do so as rebate reforms are likely to make it more costly for patients to access optimal care in future. We need a culture shift in terms of attitude and costs relating to modern medical service, in my opinion.”

Peter Larsen

Director Professional Services, Specsavers
“My prediction for 2016 is that increasingly both ophthalmology and government will lean on optometry to deliver primary eye care. This requires unprecedented trust between the two professions, utilising enhanced communication and driven not by legislation but by sustained activity by the industry for the benefit of our patients.”

Simon Ponnusamy

AM Eyewear
“You’ll see a lot more labels using a larger combination of different materials in the production of their frames. In the ever changing and competitive eyewear market, labels are pushing the boundaries to give their product a point of difference from their competitors. Advanced techniques are using acetate, stainless steel, titanium and variety of different organic materials to make frames both strong and lightweight, and to give them unique details so they stand out from mainstream designs. Flatter lenses in sun is also a trend that’s been making more of an appearance at the recent international trade shows.”

Dave Allison

Sunday Somewhere
“2016 is all about round, bold and playful frames. Yes, round is still ‘en vogue’ though the colours and sizes are more experimental. The 1960s–70s hippy / boho trend maybe the reason for this. “The aviator is making a come-back! Flat (zero base) lenses are in. Colour-wise we’ll see more interesting transparent and tortoise-shell acetate options with an overload of combination (metal / acetate) frames flooding the market. Mirror lenses are still relevant, both subtle and bold options will be key here.”

Jonathan Hennessy Sceats

Jono Hennessy
“The demand for independently designed, unique eyewear will increase in 2016. This trend is very good for independent optometrists and should be the direction for buying groups so the independents can compete differently to the chain stores and increase their personal and professional connection with their patients.
Metal temple details will increase in appeal as will unique but wearable looks and colours. Tone-on-tone acetates in strong colours will continue. Wood looks, like dyed or half-coloured wood, will continue but may be taken over by the big fashion brands. Unique fabric laminations will increase but the construction must be correct and high quality or delamination may occur (so be careful which company you buy them from).”