New technology, greater access to better treatments, a stronger retail environment, more collaborative practice, these are just some of the developments Australian experts in eye care expect to occur in the coming year. Let’s hear it from them…
Dr. Simon Skalicky
I hope that Minimally Invasive Glaucoma Surgery (MIGS) will become more readily available for glaucoma patients.
Many MIGS devices have restricted availability until review by the Medical Services Advisory Committee (MSAC) is complete. It would be great if these devices were approved by MSAC, especially as initial evidence for MIGS seems promising.
I see flourishing evidence of collaboration between
optometry, ophthalmology and technology… and patients are clearly benefiting from this approach.
There is no Medicare item number for stand-alone MIGS procedures: the few MIGS devices available today are restricted to insertion at the time of cataract surgery. Yet MIGS might be more suitable than traditional glaucoma surgery in some patients who do not need or have already had cataract surgery, who are currently ineligible for MIGS.
The ideal is a less restrictive MIGS item number and more MIGS devices to choose from: this would allow more options for glaucoma patients, ultimately leading to better health outcomes and more satisfied individuals.
Dr. Nicole Carnt
I am looking forward to releasing data from two case control studies on how the ocular surface fights infection. The first study, at Moorfields Eye Hospital, London, collected cheek swabs and sputum samples to look for small variations in inflammation pathway genes in 146 acanthamoeba keratitis patients and 250 contact lens wearing controls. This information could help predict which patients are predisposed to more severe outcomes and uncover novel treatment targets that could preserve vision. In the other study, at Westmead Institute for Medical Research and UNSW, Sydney, we are collecting corneal, conjunctival and tear samples to look for cellular pathways and proteins important in microbial keratitis. This field, known as ‘OMICs’, is of great interest in developing biomarkers, and techniques have expanded to work with very small samples that we collect from the eye, so this is an exciting time in clinical research.
2018 is looking more and more like a tipping point for the profession from an independent perspective. Consolidators are emerging and one can only think this will lead to increased commoditisation of optometric practice as there will be reduced diversity and genuine freedom to make clinical decisions. At the same time, diversity of supply will be negatively impacted as the corporates increasingly focus on rationalising suppliers. In this environment, ProVision will be working doubly hard to ensure our members continue to grow at a faster rate than the overall market so that we sustain a healthy independent sector.
When we look at winning projects, like Clinical Assoc/Prof. Andrew White’s Agency for Clinical Innovation program, which promotes collaborative glaucoma care by optometrists and ophthalmologists, it is clear we are now optimising our capacity to work together by using our complementary skills to eradicate unnecessary loss of vision.
By putting patients first, we use our skill set as optometrists to help to our fullest potential, facilitating appropriate glaucoma triaging and care to reach those who are the most vulnerable – the one in every two Australians who do not realise they have glaucoma.
Everywhere I look, I see flourishing evidence of collaboration between optometry, ophthalmology and technology… and patients are clearly benefiting from this approach.
CEO, Optometry Australia
The Medicare Benefits Schedule (MBS) Review Task Force is working its way through the entire schedule and we are hopeful that optometry items will be on the agenda early in 2018. We have met with the Chair of the review, Professor Bruce Robinson, and we believe the process provides an opportunity for MBS rebates to more appropriately reflect the practice and service that optometrists provide to the Australian community. We have been lobbying persistently in Canberra for all 40 – 64 year olds to be able to access a rebate every two years for a comprehensive initial eye examination. The change from two years to three years was an unexpected move in the 2015 budget and out of step with best practice, and we are working hard for this to be amended. We are hopeful of change, either through the review or in the 2018 budget. We understand how critical our advocacy efforts are to our members and they can be assured of our continued focus in this area.
The world’s population is set to reach 7.95 billion in 2018 and China’s economy is set to overtake the US for the first time, yet here in Australia all the talk is of a Chicken Little “the sky is falling in” retail apocalypse with the arrival of Amazon to our shores. There is no doubt Amazon is going to shake up retail markets and department stores in particular but the optical retail market has a few advantages not shared by pure commodity markets in that most eye wear purchases are related to health care and quality of life. Eye care practitioners have had so many disrupters affect the market over the past 10 years, I am hoping that they have become more agile in dealing with competition. Differentiating practices will become essential and I hope to see practices make the retail space more sensory and experiential in 2018.
Chief Business Development Officer, EyeQ Optometrists
2018 will bring continuing opportunities and challenges for the optical industry, making it even more important to be innovative and responsive to patient needs. The business of optometry is about building relationships and we hope to see that further emphasised as patients value the eye care along with the eyewear they receive. EyeQ Optometrists’ expansion will continue to be based on delivering this to local communities across Australia by providing all aspects of support to independently owned optometry practices.
Managing Director, VSP Australia
In 2018, we remain focused on providing opportunities that support the success of independent optometrists. One exciting product that we’ll be introducing that offers a differentiated opportunity for ECPs and their patients is Unity Via, our advanced progressive lens. With Unity Via, we have delivered a big leap forward in lens design and innovation, without a complicated dispensing process for the ECP. In the end, it provides effortless vision for the patient. In fact, in an independent, double-masked randomised crossover study, Unity Via was rated two to one over the leading progressive lens.
Optometry Director, Specsavers Aus/NZ
I believe 2018 is going to be a landmark year for all in our profession. Practices of all shapes and sizes now have OCT, many of us are using the Oculo referral platform and more and more optometrists are using the RANZCO glaucoma referral pathway. The most significant change however, will be the focus on patient outcomes. At Specsavers, one of the things we will be doing this year is measuring glaucoma detection rates and collating the data from all our stores to determine exactly how well we are tracking in closing the gap on the undiagnosed cohort in our society. This is an exciting time to be an optometrist because all the available equipment, IT, software and systems are converging as enablers, helping us as primary carers to provide better patient outcomes.
This is the start of outcome-led optometry and will change the way eye care is delivered, not just in Australia and New Zealand, but around the world.
A/Prof Mark Daniell
2017 was a year of change for RANZCO, with significant updates made to many processes and policies, and great strides made in how we deliver education and training in modern and effective ways to ensure we continue to produce some of the best ophthalmologists in the world. This focus on providing the best possible education and training services will continue in 2018.
2018 will also see an increased focus on Indigenous and regional eye care for the College. We are working with the Minister of Health and his team to produce a model to help eradicate avoidable blindness in Indigenous communities. Working towards this will be a key priority for RANZCO.
We will also be updating and modernising the RANZCO Referral Pathway for Diabetes Management, making it more useful and relevant for both optometrists and ophthalmologists, and helping them to work collaboratively to deliver effective and efficient eye care.
Dr. Smita Agarwal
Ophthalmology is such a fast moving field with constant innovation always striving for better results. I am really looking forward to newer and longer lasting drugs/treatments for retinal vascular and degenerative diseases. Newer, better lenses are in the pipeline to customise each patient’s visual needs following lens replacement surgery and to better match the natural human lens. Ophthalmology is one of the first branches where convergence of humans and robotics was possible and it is going to get better. I am also looking forward to innovations in genetic engineering and stem cell research for various diseases and the beauty is that we have the equipment to actually visualise the results.
In the end, I do hope that humankind does not let technology rule our decision making and that ethics and professionalism continue to be maintained.
OPSM Eyecare Director
OPSM’s growth for 2018 will be supported by a fantastic and growing team of optometrists, with our graduate intake in this month being our biggest ever.
We predict the optical industry will continue to embrace newer eye care technologies (including OCT and intense pulsed light treatments), which will result in a greater diversity of services and encourage a higher standard of clinical care to patients.
OPSM hopes for increased support from Medicare, with funding for a full initial comprehensive consultation being reverted to once every 24 months (for those in the age range 40 to 64) instead of once every 36 months.
Designs for Vision
The prevalence of dry eye means many ophthalmologists and optometrists are differentiating their focus by upskilling on dry eye diagnosis and treatment. We are fortunate to have been in the box seat for many years now with the keratograph, blephasteam, punctal plugs and a full suite of dedicated products, but there are other excellent products on the market; the BlephEx being one I would love to have an equivalent of.
IPL is emerging as a pinnacle product for treating meibomian gland dysfunction, with three versions available that essentially do the same thing. This is already a crowded space, and there is more on the horizon. There is likely to be at least one advertisement in mivision to promote a conference dedicated to DED. I certainly have a few in the diary for 2018, and look forward to catching up with you at some of them.
Research increasingly emerges about the growing epidemic of myopia, an area in which I will continue to focus. According to a CooperVision survey of optometrists, approximately half are not doing any form of myopia control. I predict (and hope) that this number will fall dramatically.
I believe we will also continue to see the development of our future leaders. Over the past few years I have been impressed by the dedication and enthusiasm of younger practitioners, seen through organisations such as Early Career Optometrists and Young Optometrists.
With continued technological advances and developments, the future is exciting.
Managing Director, Quantum RLV
For low vision and blindness technology in 2018, we are going to see the move to wearable technology gather pace.
In 2017 we witnessed the spectacle mounted OrCam reading system create news worldwide, and it will soon be joined by a range of vision enhancement systems that magnify text on a virtual screen via a head mounted device. We are also going to see some new refreshable Braille technology that will provide a tactile screen small enough to be carried in a pocket and costing a fraction of traditional devices. In the low tech area the really big news for 2018 is hand held magnifying glasses that do not require batteries. This sounds like a small step but it will make a huge difference to the thousands of seniors who struggle to change batteries due to their vision loss.
National Business Development Manager, Eyecare Plus
‘Generational change’… during 2018, Eyecare Plus sees a continuing transformation of our industry.
With independent practices, there will be a slow generational change as younger owners take over the reins.
Being tech savvy, the younger generation will see the importance of up to date equipment in the practice and the role that digital marketing has in the annual marketing plan.
To be successful, independent practices need to demonstrate a clear point of difference and embrace extra services that are marketable. Optometrists will have special interests in dry eye, myopia control and ortho-k, etc. Backing up a strong clinical foundation with quality lens and frame choices is the key.
With the increasing popularity of online retailers, providing personalised service and well trained staff are paramount to a successful business.
Managing Director, France Medical
2018 is going to be an excited year for France Medical with the introduction of two new optometry devices for macular degeneration and glaucoma screening.
France Medical is also going to launch new applications for vision therapy using Virtual Reality technologies.
Following its ongoing success with the E-Eye and Antares combo for dry eye, the company will continue to grow and establish new partnerships with optometrists. More exciting innovations will come to Australian shores towards mid-2018, stay tuned…
CEO, George and Matilda
We know the optical industry is changing at a rapid rate, and in 2018, I have no reason to believe that it won’t become even more competitive and challenging.
Practices that can provide a unique, personalised in-store customer experience will be best placed to thrive. The one thing that we hear time and time again from our partners, team and patients is that a onesize fits all approach does not work.
At George and Matilda Eyecare we are on a mission to improve the quality of eye care and positively impact the lives of Australians. To achieve this, we are partnering with the best independent optometrists in Australia and investing heavily in platforms, technology and training. This is allowing us to be more flexible on how we bring our unique, patient and customer focused proposition to life across all of our community and we are excited for what 2018 will hold.
I see 2018 as the year in which myopia control becomes more mainstream. CooperVision is leading the charge. Their recent acquisition of Paragon further cements their reach in myopia control. The RGP polymer scene is becoming more interesting: We have more choices with newly formed Acuity Polymers now posing a challenge to B+L/Boston and Contamac, as will Cooper/Paragon and other providers.
2018 will see consolidation of the various groups and chains. It will be interesting to see how they go about marketing and getting bums on seats. Independents should stay strong, continue to carve their niche and offer the specialised services that the chains struggle to provide: there are still many who prefer the more personalised, independent touch and will actively seek out such providers. Make sure they know you’re out there by harnessing the power of social media.
Dr. Simon Chen
My prediction is that the introduction of free optical coherence tomography (OCT) scanning and retinal photography during routine eye examinations at Specsavers stores will lead to the detection of many patients with previously undiagnosed eye disease.
Due to their large optometric market share, OCT and retinal photography based screening has the potential to detect numerous important sight threatening conditions such as glaucoma, exudative age related macular degeneration, diabetic macular oedema, retinal vein occlusions, epiretinal membranes, vitreomacular traction, and macular holes amongst others. As with any screening programme there will also be false positive results, when tests may suggest the presence of disease such as glaucoma in patients that do not have the condition. It will be interesting to see the impact on patient care.