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Ophthalmoscopy for All

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Ophthalmoscopy for All MAY 2017 # 09 Upfront In My View In Practice Sitting Down With The hidden tolls of AMD How to free yourself Using OCT for treatment Aqueous angiography from third parties decisions in glaucoma advocate, Alex Huang 12 18 35 – 37 50 Ophthalmoscopy For All Transforming eyecare for millions with a six-dollar device 20 – 29 NORTH AMERICA www.theophthalmologist.com B:216 mm T:210 mm S:200 mm B:272 mm S:256 mm T:266 mm CLIENT APPROVAL: INSERTION NOTES: IMAGES: PUB: THE OPTHALMOLOGY Vyzulta _concept_wait_ CLOSE DATE: NONE Coming_Soon_CMYK_Flat_ The_Opthalmology_R01.tif (CMYK; 300 ppi; 100%) VERSION NONE ECD NONE NOTES: INSERTION DATE: NONE The Opthalmology UNIT NONE GCD NONE IMAGES: Vyzulta _concept_wait_Coming_Soon_ BLEED 216 mm x 272 mm CSM NONE CMYK_Flat_The_Opthalmology_R01.tif (CMYK; 300 ppi; 100%) TRIM 210 mm x 266 mm AD BEN A. LIVE 200 MM X 256 MM CW NONE VIEWING 210 mm x 266 mm ACCT JANINE FONTS: None GUTTER None PM JULIE G. SCALE 25.4 MM : 25.4 MM PROD. ART. MARK NICHOLSON DPI NONE PROOF NONE INKS: 210 MM X 266 MM NONE ACTUAL PROD. MGR. Cyan, Magenta, Yellow, Black BAU6001_THE_OPTHALMOLOGY_M01.INDD DOCUMENT PRINTED AT: NONE 3-20-2017 3:58 PM Image of the Month Lizard Eye Suren Manvelyan is a professional photographer with a wide range of photographic interests. This image is a close-up of a Basiliscus lizard’s eye and is part of one of his latest popular series which features close-ups of human and animal eyes. Suren says “It is much more difficult to photograph animal eyes – you can’t tell them to stay calm! I also need to be very close to the animal, which is why I have fewer eye photos from dangerous animals!” As well as photography, Suren also teaches physics, mathematics, projective geometry and astronomy, and can play five musical instruments. Image courtesy of Suren Manvelyan, http://www.facebook.com/SurenManvelyan Do you have an image you’d like to see featured in The Ophthalmologist? Contact [email protected] www.theophthalmologist.com Contents 10 In My View 16 When is the best time to remove retained lens fragments after cataract surgery? Caroline Baumal believes that later rather than sooner might be the best approach for some patients. 17 Michael Stewart makes the alternative case that the timing of vitrectomy for retained lens material is important – but not in the way you might think… 18 You don’t have to be beholden 20 to third parties – it is possible to regain control and enjoyment of your practice, argues Jane Lindell Hughes. 03 Image of The Month Upfront 10 Turning the Tables Feature 09 Editorial It’s in Our Nature 11 Near, Not Far 20 Ophthalmoscopy For All by Mark Hillen Andrew Blaikie, John Sandford- 12 “A” is for Anxiety Smith and William J Williams tell their story of developing On The Cover 13 Body Clock Control and producing a low cost MAY 2017 # 09 ophthalmoscope to increase Upfront In My View In Practice Sitting Down With The hidden tolls of AMD How to free yourself Using OCT for treatment Aqueous angiography from third parties decisions in glaucoma advocate, Alex Huang 12 18 35 – 37 50 A health worker using the Arclight 14 Looking at Listening accessibility and improve care in Ophthalmoscopy For All Transforming eyecare for millions with a six-dollar device 20 – 29 on a patient in Rwanda. Credit: low income countries – and it all Clare Morton. 15 Business in Brief started with a popsicle stick, an NORTH AMERICA www.theophthalmologist.com LED, and a cat… OPD-Scan III TRS Total Refraction EPIC Refraction ARK Autorefraction ion Anterior Wavefront Automation Workstation Systems Segment Imaging Refractive SOLUTIONS Marco Refraction Systems – Advanced automated instrumentation includes the OPD-Scan III Integrated Wavefront Aberrometer, the TRS-3100/TRS-5100 and EPIC Digital Refraction Workstation, Autorefractors/Keratometers (with VA measurement, Subjective Sphere Refi nement, Tonometry, Glare testing on certain models) and Lensmeters–all with EMR integration. And introducing ion IMAGINGSM System– a highly sophisticated slit lamp integrated anterior segment imaging system that emphasizes image quality, simplicity and effi ciency. TRS-5100 Product/Model name: The Difference is Marco. REFRACTOR RT-5100 Designed and Manufactured by NIDEK - Represented by Marco 800-874-5274 • marco.com 598 RefSol-ion-TheOPHM.indd 1 4/6/17 3:00 PM MEET PAM’S SISTER The LAMBDA 100 Retinometer is the only Potential Acuity Meter still in production today. Investing in the LAMBDA will allow you to increase your revenue stream. Give your cataract patients tangible evidence that having surgery can improve their vision, even if they are suffering from AMD. Contact us today to schedule a demonstration with your HEINE Representative: www.heine-na.com/ret100 10 Innovation Way • Dover, NH 03820 • [email protected] © 2017 HEINE USA Ltd. All rights reserved. www.heine.com ISSUE 09 - MAY 2017 Editor - Mark Hillen [email protected] Associate Editor - Ruth Steer [email protected] Associate Editor - Roisin McGuigan roisin [email protected] Editorial Director - Fedra Pavlou [email protected] Content Director - Rich Whitworth [email protected] Publishing Director - Neil Hanley [email protected] Sales Manager - Abigail Mackrill [email protected] VP Sales North America - Scott Schmidt [email protected] Head of Design - Marc Bird [email protected] Designer - Emily Strefford-Johnson [email protected] 50 Junior Designer - Hannah Ennis [email protected] Digital Team Lead - David Roberts [email protected] Digital Producer Web/Email - Peter Bartley [email protected] Digital Producer Web/App - Abygail Bradley NextGen [email protected] Digital Content Assistant - Lauren Torr [email protected] 40 Small(er) Sequence, Audience Insight Manager - Tracey Nicholls Big(ger) Promise [email protected] Audience Project Associate - Nina Duffissey CRISPR/Cas9 gene editing [email protected] holds huge promise, but it also Traffic and Audience Associate - Lindsey Vickers [email protected] has limitations. Seokjoong Kim Traffic and Audience Associate - Jody Fryett and Sung Wook Park discuss [email protected] Social Media / Analytics Associate - Ben Holah developing an alternative Cas9 [email protected] orthologue to help bypass some Events Manager - Alice Daniels-Wright [email protected] of the current issues. Marketing Manager - Katy Pearson [email protected] Financial Controller - Phil Dale [email protected] Accounts Assistant - Kerri Benson [email protected] 40 Profession Chief Executive Officer - Andy Davies [email protected] Chief Operating Officer - Tracey Peers 46 There’s Doing Good, [email protected] Then There’s Doing Good Change of address Providing care in developing [email protected] Nina Duffissey, The Pathologist, In Practice countries is a worthy endeavor Texere Publishing Ltd, Haig House, Haig Road, – but there’s a right and wrong Knutsford, Cheshire, WA16 8DX, UK 32 PDEK in 15 Steps way to go about it, says Kevin General enquiries www.texerepublishing.com PDEK provides many benefits Waltz, who provides seven [email protected] +44 (0) 1565 745 200 as an option for keratoplasty, lessons for being a responsible [email protected] including the ability to use “medical tourist.” Distribution younger corneas – an important The Ophthalmologist (ISSN 2051-4093) and The Ophthalmologist North America consideration when donor (ISSN 2398-9270), is published monthly, by Texere Publishing Ltd and is distributed in the corneas are in short supply, says USA by UKP Worldwide, 1637 Stelton Road B2, Amar Agarwal. Piscataway, NJ 08854. Periodicals Postage Paid at Sitting Down With Piscataway, NJ and additional mailing offices POSTMASTER: Send US address changes to The Ophthalmologist, Texere Publishing Ltd, 35 Window of Opportunity 50 Alex Huang, Assistant c/o 1637 Stelton Road B2, Piscataway NJ 08854 Single copy sales £15 (plus postage, cost available OCT offers unprecedented Professor, Doheny and Stein on request [email protected]) information about the eye, and Eye Institutes, Department of Annual subscription for non-qualified recipients £110 Felipe Medeiros explains why it Ophthalmology, David Geffen Reprints & Permissions – [email protected] can, and should, be used to support School of Medicine, UCLA, The opinions presented within this publication are those of the authors and do not reflect the opinions of The treatment decisions in glaucoma. California, USA. Ophthalmologist or its publishers, Texere Publishing. Authors are required to disclose any relevant financial arrangements, which are presented at the end of each article, where relevant. What are we missing? See more, treat more with optomap® optomap plus Courtesy of SriniVas Sadda, MD optomap af Courtesy of SriniVas Sadda, MD optomap fa Courtesy of Paulo Stanga, MD optomap icg Courtesy of SriniVas Sadda, MD “Seeing more of the retina provides greater insight, improves diagnosis and management. Without seeing, we cannot treat. Ultra-widefieldopto map imaging has set the standard of care, it is difficult to imagine going back to standard fundus photography”. Prof Paulo E. Stanga, Manchester Royal Eye Hospital,
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