Volunteer Trip Overseas

VOSO (Volunteer Ophthalmic Services Overseas) is a charitable trust administered by the NZAO, and provides donated eye exams, spectacles and surgery to the people of the Pacific Islands. Several trips of a fortnight each travel to various Pacific countries each year. The photos show some images of Annette's Voso trips to Labasa (Fiji) and Pago Pago (American Samoa). The queues of people wanting eye care are long, and all we can do is work as hard as we can. The hopsital staff in Labasa translated for us, and I was happy to have the aircon at the hospital. In American Samoa, I spent a week in a small health centre in the west of Tutuila then a few days a various sits in the east, including working out of the chief nurse's back bedroom (as the health centre had blown down some years before). So, when you donate your old spectacles, in good condition, to your local NZAO optometrist, be happy because you know they will go to a good home in the Pacific.

Cricket session with Daniel Vettori

3D

Have a read of this site - it explains 3D very well. There are some people who do not develop 3D vision (often because their eyes were slightly misaligned or had different prescriptions as young children) but most people have good 3D acuity. However, many of these do not see artifical 3D comfortably, mostly because there is a very slight misalignment or prescription difference between their eyes. I loved "Shrek Forever After" in 3D when I saw it last week, & my children are hassling for "Toy Story" for the school holiday treat. But my binocular system is pretty robust - all those years of practising Magic Eye pictures and awareness of my visual system from Optometry school....

www.crunchgear.com/2010/06/19

Take a break with Daniel Vettori

Optometrists

Every year, your New Zealand registered optometrist must do at least 20 hours of continuing education, at the standard of a post-graduate course. This ensures that your optometrist stays up to date with current knowledge of eye health, spectacle lens design, contact lens materials, best-practice patient care, eye surgery, etc, etc, etc. Most NZAO and Visique optometrists do many more hours of CE, as we are interested in the eyes and visual system (else we wouldn't have selected optometry as a career!) and want the very best for our patients.

Some of this CE is provided by reading peer-reviewed journals, in print and on the Web. Some is available in small-group seminars and workshops - learning new techniques in contact lens fitting or in minor "surgery" (syringing out blocked tear ducts, for example)is best done hands-on. Lectures or larger seminars, at conferences for example, are a great way to learn about new research and the chance is there to question the researchers after the lecture. And many of us take part in local discussions to share information about techniques or to improve our ability to diagnose - interesting case studies. Of course, any patient discussed is anonymous!

Sometimes when you visit your NZAO optometrist, she will be using similar tests to the ones you are familiar with. Sometimes the techniques or equipment is new. But in any case, you can be reassured that she will be able to provide you with the best and most current advice available.

Glaucoma - what is it?

In the "olden days", people accepted problems that occurred with old age (if you were lucky enough to live beyond seventy). "Granny was blind, but we never knew why" is a comment I used to hear frequently from older folk when asking about their family history of eye conditions. Now, we want solutions for our health problems, incluidng vision problmes and vision loss.

Granny might have been "blind" simply because she did not have the appropriate glasses, or due to a cataract (surgery for these before the early 1980's was more dramatic than it is to-day and cataracts had to be denser before the benefits of operating outweighed the risks). Or Granny could have had something more sinister - retinal detachment, retinal blood vessel haemorrhages or glaucoma. And glaucoma, if not treated early, can still cause blindness. A large part of a comprehensive eye exam in NZ and other western countries is to do with eye health and disease detection - early detection of problems means that they will be treated more easily and better.

Glaucoma can come in several forms - chronic or acute, simple or complex (self-explanatory), primary or secondary. Primary disease "just happens"; secondary happens after something else (eg glaucoma after taking a hit to the eye, maybe months or years after). Chronic disease occurs over years; acute can occur in hours. The most common type of glaucoma is chronic, simple (primary)glaucoma - so I shall discuss that here.

New research is occuring all the time, but my understanding at present (mid-2010) is that, as we age, the amount of fluid produced in the eye (to feed the back of the cornea and keep the eye' optics clear) is constant, but the drainage to remove this often becomes poorer. Sometimes this is due to an obvious blockage (secondary to...something?) and sometimes it "just happens". Our understanding is that this might be caused by microcellular changes in the tissue in the drainage system, so the cells stiffen up and do not work as well.

The upshot is that the drain works less well, and the pressure inside the eye rises. This can happen over years, and is why your optometrist monitors your eye pressures (routinely from around the age of 40; younger due to family history or from findings during the examination). The most important sign of glaucoma is a change to the appearance of the optic nerve inside the eye, which is why your optometrist will make a detailed effort to see the nerves well, and compare what is seen from one visit to the next. If these results are suspicious, a test of peripheral vision can be done, and measurements of the thickness of the nerve fibres can also be done. Changes in these readings are monitored, or the person is referred to an ophthalmologist for treatment for glaucoma, if these changes are severe enough. Any sight lost cannot be regained, because the nerve cells have died due to the pressure rise, so the aim is to detect changes before they are bad, and to prevent any more sight loss. Glaucoma that is more established is harder to treat. Some times the standard treatment of daily eye drops will not control the disease, and drainage surgery is needed in the eye. In some unfortunate people, the disease is so severe that even this will not control the disease, as the optic nerve is so damaged that any remaining cells just give up and die.

Primary simple glauocma develops over years, so it is important to have regular eye health checks (as recommended by your optometrist depending on the outcome of the exam and your family history), even if your vision is clear. If the disease is caught early enough, driving is still possible. Central vision is only affected in late-stage glaucoma, and one eye gets the disease before the second. This means that , without a regular eye health exam, you could develop glaucoma with no symptoms. And the risk increases with age, especially over 80. So make sure your older family memebers don't neglect their eyes.

So, in short, the most common type of glaucoma takes years to develop, has no symptoms, tends to occur more frequently as we age (earlier if there is a family history as there are some genes linked with some types of glaucoma) and can be treated but not cured. Catch it early, and the nastiness can be avoided. So have regular eye exams with your optometrist, even if you can see clearly.

Click on the title to go to the home page of Glaucoma NZ - you can learn more about glaucoma and sign up to receive "Eyelights", a free publication for glaucoma patients and their families.

Lenses

A lens is a lens is a lens, right? Sorry, no. Most of the world's lens companies spend millions of dollars in research and development in devising the best lens for each prescription. Why?

Before the mid-1980's, the choices of lenses involved choices of material - glass or plastic. Polycarbonate, lighter to wear and more impact resistant than plastic (which is more impact resistant than glass), was not used often as the surface scratched quickly and it required different machines to cut it. Glass came in clear or photochromatic, and could be hardened to make it more impact resistant, which could be used for safety lenses.

High index glass, which gave a thinner lens for the same prescription, started to become popular in the 1980's, but it could not be hardened or made photochromatic.

The next development was photochromatic plastic lenses (late 1980's). Rodenstock produced aqua, blue and pink, but it wasn't until Transitions released their first generation product that the market really took off. Transitions is selling Generation 6 now.

Polycarbonate lenses have been improved so they scratch less, and they also can be produced in photochromatic materials now. As a thinner, harder, lighter lens option, they are the only lens we recommend for children and rimless frames, but are a great choice for everyone.


The first bifocal lens was devised by Benjamin Franklin in the 18th century. He simply cut his reading script and his distance script in half horizontally, and cemented them together. Later designs had smaller reading areas, often a circle or a half circle, which were less obvious to the wearer as well as people looking at her.

In 1959, Essilor produced Varilux, and Varilux 2 followed in 1964. Progressive addition lenses had arrived! The distance script blended into the reading script, but the reading area was quite small, and there was considerable distortion that the wearer would notice when she moved her head, or even as she scanned a page of text.

Research and development dollars have been poured into improving progessives - increasing the size of the near portion, making the distortions less and making the vertical distance between the distance and reading scripts closer (to use in smaller frames. Not all progressives are created the same!

Essilor has invested over $10million NZ into its technology centre in Auckland, so it can produce state-of-the-art lenses "Kiwi-made". It is world-class, and can grind and coat most prescriptions without the spectacles having to go off-shore.

Visique Kapiti Eyecare is proud to use Essilor lenses as they are made in NZ, and made by a company that has a track record of innovations and provising the very best designs. Physio 360 lenses involved 7 new patents, the design was that innovative.

As a patient, you will just see "better", "more comfortably", "like with my own eyes again".

Some other comapnies are using generic lenses or older designs - many still work well, but most of us prefer to drive a car with airbags and ABS if we can afford it. Lenses are the same - the technology costs a lot initially. Unfortunatley, economic reality means that as new designs become available, older designs and materials become scare or not available at all. Glass, for example, is not fitted by Essilor in NZ or Australia at all, and its delivery times have become unacceptable, so we do not supply it to our patients any more. If a low-cost option is more appropriate for you, don't hesitate to tell us, but I'm sure you would like to know what is on offer before choosing 19th or 20th centtury technology in 2010 or later!

Diabetes and the Eyes

Unfortunately, the most common cause of blindness in working-age people is diabetic eye disease. If you are diabetic, and the evidence is that only half the number of NZers with the condition have been diagnosed, the longer you have had the condition and the poorer the control of your blood glucose increase your risks of diabetic eye disease.

Diabetes is a disease where too much glucose in the blood damages the tiny capillaries all throughout the body, and they leak. Capillary damage in the kidneys leads to renal failure, and in the eyes leads to blindness, from damage due to bleeding, the lack of good supply to the seeing cells and from scarring and fibrosis from the bleeds.

In many regions in NZ, once a person has been diagnosed with diabetes, she is referred to an optometrist who has a contract from the local DHB for a diabetic fundus examination. (The fundus is the back of the eye). The pupils are dilated with eye drops, and either photographs are taken or the clinician looks with special lenses to check for signs of diabetic eye disease. These changes are some typical-looking bleeds or leaks of fluid.

If there are any changes, the person will be monitored or referred for laser treatment (to stop the leaks). In many cases, the eyes look healthy and the person is monitored - usually at 2-yearly intervals.

These diabetic exams are separate from your normal exam with your local optometrist. They do not check the prescription, and might detect other eye conditions (like cataracts) but do not always detect these. For example, often the photographs taken have to over-expose the optic nerves so any vessel leaks can be detected, but this means that glaucoma damage cannot be always be seen. So it is important to continue to have your "normal" examinations.

Diabetes is a nasty disease. Don't let it blind you or your loved ones.

What an optometrist does?

When you can get cheap glasses or contact lenses on the net, why do people choose to pay extra to receive professional service from their optometrists?

Optometrists in New Zealand are university educated health professionals, with five years undergraduate training and compulsory continuing education requirements each year. Keeping up with current knowledge of eye health, treatments and visual correction means that your optometrist can give you clear advice to help you see clearly with comfortable, healthy eyes.

The optometric exam involves taking a thorough history of both your eyes and that of your family, then tests to check your vision, health of the front and back of the eyes, how the eyes co-ordinate and any additional tests required depending on the results found. So, a pair of glasses has a lot of thought put into them - not just your choice of colour of the frame, but a shape to fit your face, lenses to suit your eye prescription and lifestyle and advice on their use and care.

Optometrists also give advice on lifetsyle and vision - sunglasses vary in lens materials as well as tints depending on whether they are used in alpine sports, water sports, driving or "general purpose". Some lenses are more inmpact resistant than others, so safer for children or in situations where the lenses could crack and the eyes damaged.

So, optometrists are the "GPs of the eye". And, like with your doctor, you pay for the advice given.

Old Skool or Uber Cool?

Looking for retro-inspired frames with styling from the '70s and early '80s, which ironically look fashion-forward right now.

Chunky plastic frame , full or half frame, with few colors to choose from.