As a born and bred optometrist, running my family business – Vision Eye Health – on the Gold Coast, I remain just as passionate as ever about eye care and furthering my knowledge in this space. This year, having attended my 13th Australian Vision Convention (AVC), I can confirm that I definitely prefer face-to-face experiences as opposed to virtual.
To me this makes sense. After all, we should be practising what we preach… we should be reducing our near vision work.
AVC 2022 was a great opportunity to catch up with colleagues and have a tangible experience with new equipment and medication.
Appropriately, this year’s topics covered further developments in dry eye technology and myopia management, just to name a few. The information provided was particularly pertinent given that these are key conditions I have seen increase during COVID.
For those of you who missed out on another great event, delivered by Optometry Queensland / Northern Territory (OQ/NT), here are some highlights.
NATURALVUE CONTACT LENSES
Originally designed for presbyopia, these lenses use the extended depth of focus (EDOF)/pinhole concept to allow vision at a range of distances. They are also reported as being able to mask up to 2.00 dioptres of astigmatism. As these lenses generate peripheral blur, they work for myopia control, too. While NaturalVue contact lenses are already approved for myopia control in the United States, I’m looking forward to the next random controlled trial, which should produce results in the next year or so. This will enable a comparison against MiSight contact lenses. A great bonus for these lenses is their exclusivity to independent optometrists. You’ll need to get in touch with VTI Vision to become accredited to prescribe them using the appropriate fitting guide.
The importance of axial length measurements to ensure myopia progression is truly being halted is something that has really been drummed into us in recent years. With this in mind, it might be time to start investing in Lenstar Myopia – a new technology from Hoya. Perhaps it was Dr David Stephenson’s excitement when discussing this device – I’m not sure – but it certainly rubbed off on me. The Lenstar Myopia is effectively a three-dimensional optical coherence tomographer (OCT), that measures keratometry and biometry and has very neat software to track progression of axial length and refraction against reference data in a graph format; something I’m particularly happy with as a visual learner. In conjunction with this are MiyoSmart lenses, which reportedly reduce progression by 59%. Hoya seems to be developing into a one stop myopia management shop. Similar to NaturalVue contact lenses, you also need to be accredited to prescribe/ purchase MiyoSmart lenses.
Dr John Hogden helped us revise the different types of corneal grafts and what conditions are most suitable for this type of treatment, e.g., Fuch’s endothelial corneal dystrophy, keratoconus (when good vision is not achievable with spectacles or contacts), trauma and infections and their resulting scarring. It’s the clinical pearls that these conferences reveal that I always find most beneficial, such as tips on how to distinguish between graft rejection and graft failure, even if just to be reassured that I’m practising in the same way as my colleagues.
OptiLight is the latest version in intense pulsed light (IPL) technology from Lumenis. For those of you who must have been living under a rock and don’t know, IPL targets the eyelids with intense pulsed light to treat dry eye by improving meibomian gland function and reducing inflammation. It was pleasantly surprising to hear OptiLight is more comfortable than previous versions and interesting to note this technology treats/kills demodex. I’ll be sure to start recommending this treatment more now.
OCULAR SURFACE DISEASE
What a relief to finally have some clear information on what’s what with cyclosporine and how to handle it in terms of the Pharmaceutical Benefits Scheme (PBS). Thank you, Dr David Gunn. To summarise, Ikervis is currently the main option for cyclosporine as Restasis is not approved by the Therapeutic Goods Administration, and Cequa has availability issues. PBS requirements for Ikervis (authority required) are an ocular surface disease index score of more than 23, an Oxford score of four, inadequate relief with preservative free lubricants, and patients must continue using their preservative free lubricants. It was refreshing to hear honest feedback on these products, such as how they sting and take about three months to get maximum effect. With this knowledge, we can more effectively prepare our patients and coach them through this journey.
While my introverted nature has always had me sitting at the back of the class or lecture and avoiding these workshops for fear of being put in the spotlight, given the new interactive CPD requirements, I succumbed to participation. Turns out they’re not so bad after all, more like a tutorial. Jason Holland is always entertaining, with plenty of useful information to impart. Like, did you know that an easy way to tell an EDOF intraocular lens (IOL) from a single vision IOL is with retro-illumination? This lets you see the slightly elevated transition element in the centre of the lens. I used this clinical pearl within a week of attending AVC. It was reassuring to hear other colleagues had also found patients can take up to four months to fully adapt to EDOF/multifocal lenses, particularly for intermediate vision. I wonder if this will lead to further adjustments with follow-up and refraction check time frames.
AVC wouldn’t be complete without mention of the lively exhibition hall where optometrists, speakers, exhibitors, and other industry colleagues gathered to share information and network. Every break between lectures and workshops allowed us to continue the nerd-fest and marvel at the latest and greatest technologies on the market. This included everything from the new OptiLight IPL for dry eye, to myopia management lenses, equipment and software suites, and finance providers who help us facilitate the purchase of these exciting devices. The food was good, too.
Thank you to the sponsors, exhibitors and especially Optometry Queensland/ Northern Territory, without whom these high quality educational events would not be possible. Needless to say, for those of you who didn’t attend this year, you missed out on a great one. See you at the next AVC!
Hero image: Andy McKie from Lumenis with OptiLight ambassador and TV presenter Melissa Doyle.
Rebekah Bormann graduated from Queensland University of Technology in 2017 with a Master of Optometry with Distinction. She is the principal of her family business, Vision Eye Health, on the Gold Coast.