Spring 2017 VOLUME 20 ISSUE 3 EYE2EYE 2the magazine of the leaders in collaborative eye care
IN THIS RANZCO Code Introducing RANZCO’s Social Media for RANZCO 49th Annual of Conduct first Dean of Education, doctors keeping it Scientific Congress ISSUE: page 10 Dr Catherine Green professional page 32 page18 page 30 When freedom becomes reality
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EYE2EYE 2the magazine of the leaders in collaborative eye care 32 43 Contents Message from the President 4
Censor-in-Chief’s Update 6
CEO’s Corner 8
RANZCO Code of Conduct 10
Membership Spotlight 18
Annual Scientific Congress 32
RANZCO Museum 47
Policy and Advocacy Matters 48
International Development 52 60 67 Branch Musings 55 Special Interest Groups 58
RANZCO Affiliates 59
Ophthal News 63
Obituaries 68
Classifieds 70
Calendar of Events 71 Front cover: Photos courtesy of Tourism Western Australia, full details of images on page 32
Eye2Eye is published by The Royal Australian and New Zealand College of Ophthalmologists as information for its members. The views expressed in the publication are those of the authors and not necessarily of the College. The inclusion of advertising in this publication does not constitute College endorsement of the products or services advertised. Editor: Maheen Imam Design and layout: Francine Dutton The Royal Australian and New Zealand College of Ophthalmologists A.C.N 000 644 404 94-98 Chalmers Street Surry Hills NSW 2010 Australia Ph: +61 2 9690 1001 Fax: +61 2 9690 1321 E-mail: [email protected] Website: www.ranzco.edu 4 Message from the President
Message from the President Professionalism and the Code of Conduct
At last year’s Council the interest of others. It is inherent meeting, the Council in the definition of a profession The College Oath that a code of ethics governs discussed a particularly the activities of each profession. In acknowledging the privilege severe and flagrant breach These codes require behaviour of practising medicine and of the Code of Conduct. It and practice beyond the personal ophthalmology, and in accepting became readily apparent that moral obligations of an individual. Fellowship of this College, I make this declaration sincerely in the the wording of the Code and They define and demand high standards of behaviour in respect to presence of my family, friends, our complaints procedures the services provided to the public colleagues and teachers. were inadequate if the and in dealing with professional Patients are my first concern and Council wished to sanction colleagues. Furthermore, these codes in caring for them I undertake to are enforced by the profession and use my knowledge and skill to the a Fellow. best of my ability. Calls were made to deal with are acknowledged and accepted by these types of breaches that display the community (Professions Australia, I will seek actively to maintain my skills and abilities throughout behaviour that is unacceptable to 1997). my professional life, to practise patients and other Fellows and fails to Professionalism is not only a skill within those abilities and to live up to our professional standards. set in a given occupation, it is an contribute wherever possible to To do this, we needed to change the ineffable something that the person the science of ophthalmology. wording of the Code and formalise the exudes in manner, dress, speech process for dealing with complaints to and standards of practice that is I will seek to enhance the quality ensure procedural fairness and natural palpably powerful. Standards such as of patients’ lives, maintain their justice and to allow the College to honesty, due diligence, perseverance, dignity, support their carers, and impose sanctions in severe cases. willingness to listen and learn, treat all people equitably. We are fortunate to work within a creative thinking within a framework I will strive at all times to be self-regulating profession. With that of training, and other qualities are worthy of my patients’ respect privilege comes some responsibilities. things that most people would be and never to abuse their trust or We must reassure the public that hard put to describe but they are confidence. My clinical decisions proper training has been given, that things that people expect in the will not be influenced by personal sufficient knowledge and skills have professionals with whom they engage. gain. I extend these commitments been attained, that standards have Another word for these standards beyond individuals to the health been met and that we will wield our is virtues and the hard-to-describe and wellbeing of the community. power in a fair and benevolent manner. something exuded is trustworthiness: I will treat with courtesy my A profession is a disciplined group the sum of these virtues. colleagues and all who contribute of individuals who adhere to ethical The College has articulated its to the wellbeing of my patients. standards and possess special professional responsibility through May these affirmations guide knowledge and skills derived from the College Oath. This is a condition and inspire me in practising the research, education and training at a of College membership that we all art and science of medicine as an high level, and who are prepared to accepted at the time of our graduation ophthalmologist. apply these knowledge and skills in as a Fellow. Eye2Eye Spring 2017 5
Dr Di Semmonds presents at the Council meeting held in June 2017 While this is a requirement • The Standard of Clinical the process. The complaints process of membership, it remains an Competence is now fair, transparent and robust. It aspirational statement, not a formal • The Standard of Collegiality fulfills our requirements of procedural set of standards that can be enforced. • The Standard of Commercial fairness and natural justice. The initial statement of the Code of Professionalism The updated Code of Conduct has Conduct produced by Richard Stawell • The Standard of Social been extensively edited, vetted and and the Board used the College Oath Responsibility now approved by the Board and the as its basis and expanded each of the • The Standard of Training and Council, as well as by numerous other sections in language that was more Research Fellows interested in this area. I urge specific. This became a requirement of These are not new standards; they you to read the new Code and provide fellowship of the College. However, reflect the expectations of the feedback on any issues that you feel this version was not sufficiently robust community and peers concerning should be addressed. (The new Code for the Council to sanction a Fellow the conduct of ophthalmology in of Conduct is printed in full on who had flagrantly and severely Australia and New Zealand. The Code pages 10 to 16.) breached the Code. We needed to complements the Medical Board Professional behaviour is important change the wording of the Code Code of Good Medical Practice. It for our patients, and for the regulatory and formalise the process for dealing also complements the criminal legal bodies in medicine including the with complaints to ensure procedural system in both countries. government. It is in our rational fairness and natural justice. The Board has also approved an self-interest to act ethically. Poor RANZCO Vice President, improved process for the handling of behaviour reflects on us all, creates Dr Di Semmonds, and the complaints complaints. The CEO will assess any unwelcome damage to our reputation committee have re-examined and complaint to RANZCO initially. If the and hence puts our profession at risk. re-written the code with the assistance complaint relates to an incident of By accepting the Code of Conduct of Brett Saunders, our in-house legal a criminal nature or a breach of the Fellows recognise and accept that counsel. They have retained the Medical Board Code, it will be referred membership of the College imposes structure based on the College’s Oath to the appropriate authorities. If additional obligations over and above and used the governing principle the complaint relates to a possible personal values to act honourably that the patient’s interests are always breach of the Code of Conduct, it and decently. An enforceable Code of paramount. This principle is supported will be referred to the committee Conduct helps to protect us all from by a series of guiding standards: and a fair and transparent process unacceptable behaviour. • The Standard of Patient Care will commence. Information will be • The Standard of Patient gathered with rights of appeal and A/Prof Mark Daniell Relations re-examination required as parts of President, RANZCO 6 Censor-in-Chief’s Update
Censor-in- Chief’s Update Working towards RANZCO’s 2017-2020 Strategic Plan
Much of this issue of Eye2Eye been proposed in RANZCO’s 2017 – We have planned the Train the Trainer focusses on the work that has 2020 Strategic Plan. Some of the notable session for Multi-Source Feedback developments we have embarked on been done over the last 12 (MSF) to allow our mentors to guide are: trainees in the reflective practices months to update RANZCO’s • revising the selection processes they need to interpret and act on their governance framework to (this has been reported in detail in feedback. This will be implemented in meet the new AMC standards. previous issues); 2018 for those completing basic and • aligning the Training Post advanced training. Specialty medical education Accreditation Standards to meet and training programs aim Finally, I am looking forward to the overarching requirements of working with Dr Catherine Green as trainee safety and wellbeing; and to establish the lifelong Dean of Education – Cathy brings with • establishing a Curriculum Review professional practices of her much knowledge of the existing Committee and launching a Vocational Training Program (VTP) doctors. The Professional workshop delivered by the as well as expertise in designing the Standards Council’s academic renowned medical education view is that “for a profession expert Professor David Prideaux. educational experiences for trainees that will ensure RANZCO is the most ‘capable to exist there must be a Our program of improvements for the year is ramping up. We will of entities’ for our trainees, for our capable entity to oversee and shortly have the curriculum review Fellows and for the patients we serve. administer professional entry, workshop mentioned above and the Dr Justin Mora professional standards and first meeting of the Selection Board. Censor-in-Chief, RANZCO compliance expectations on behalf of the public”. RANZCO has welcomed the opportunity to have an outside measure of our practices. While we were re-accredited for three years (2016 -2019), we were also set conditions (53 of them) to meet over that three-year period. The interim report was due on 18 August 2017 and it is pleasing to note that solid progress has been made as RANZCO continues to evolve its main strategic priority: Education, Training and Accreditation. From the conditions set out in the AMC Report and grouped under 10 standards, it was apparent that many requirements could be met by accelerating the work that had already Drs Catherine Green, Justin Mora and Ruth Ferraro 7
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CEO’s Corner RANZCO Support to Members
Many Fellows and other medical indemnity or other business is easy to think that we all need to be members are involved in insurances. However, RANZCO good at everything, or that someone insurance only works if committees else will pick up the problem later, RANZCO committees or or individuals are following RANZCO but unfortunately it has been shown training as supervisors or policy and abiding by RANZCO that this is usually not the case. clinical tutors. Terms of Reference. This ensures Support in many forms is available to that decisions are grounded in fact, supervisors and trainees, so please These are all important roles in the and follow processes that have been ask. training of future ophthalmologists, approved by the Board. If this is the In consideration of issues the ongoing education of Fellows, case, then disputes should not arise previously faced by supervisors and advocacy and the general smooth as the policies direct in a way that trainees, over the last 18 months running of the College. Committees, ensures appropriate consideration RANZCO has undergone a huge supervisors and tutors are supported and documentation of decisions, policy review. We have updated by College staff. We all know you allowing for communication of many policies and created new volunteer your valuable time, and decisions in a non-threatening and policies and policy procedure the last thing you want to be doing is supportive way, including having documents as required. This will be a non-clinically related administrative RANZCO staff or other third parties continual process as the business of work. Every staff member is actively present as necessary, and providing providing training and professional providing secretariat support, or natural justice to all involved. education evolves due to regulation working behind the scenes. All Treating everyone fairly and and community expectation. committees have a Terms of Reference providing honest and timely This process has not only been in that defines their purpose and feedback may sound obvious but, response to our Australian Medical operation. It outlines a reporting in the rush to complete tasks or Council and Medical Council of New structure for the committee finish meetings, this can easily be Zealand accreditation but because it and ensures regular turnover of overlooked. In particular, there is a was time. It does mean there is a lot membership so that knowledge risk that supervisors and tutors look more policy for Fellows and trainees can be widely shared and new ideas to take shortcuts or gloss over issues to understand and apply, but if done generated. Supervisors and tutors in the hope that someone else will correctly there should be no issues. have clear policies and procedures tackle the problem. This will not only The College staff are willing and able that guide their work. create a greater problem later, but to help. We will continue to work It is important to remind everyone it belittles the responsibility held with committees and consult widely on committees, in which I include by those in key training positions to make further improvements. Most Council, and all supervisors and to provide an environment of importantly, we will be providing tutors that RANZCO has in place excellence in training. It is important training and ongoing administrative insurance policies that cover that if an issue does arise people support, so please take advantage of individuals and the College in who may feel isolated, such as these. the unfortunate event of any supervisors, seek help from RANZCO action taken against a person or staff, Directors of Training or their Dr David Andrews committee working on behalf of local QEC. It is almost certain that, Chief Executive Officer, RANZCO RANZCO. These insurances are whatever the situation, it is not the not designed to replace your own first time it has been experienced. It 9 ADVERTORIAL - AVANT
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RANZCO’s Code of Conduct provides a framework to guide RANZCO Fellows in their obligations as members of the College. The importance of a Code Conduct, particularly in a partially self-regulated profession, cannot be understated. By holding RANZCO members to a high ethical standard, as befitting the purpose, mission and values of both the College and the profession, we ensure that health systems, government and the public can rely on ophthalmologists to act in patients’ best interests at all times. It is, therefore, essential that RANZCO’s Code of Conduct is robust, transparent and unequivocal. With this in mind, RANZCO’s CEO and legal counsel have worked with the RANZCO Board and Council to review and update the Code of Conduct to ensure that it is clear and fair and that the standards it sets remain relevant in the changing medico- political landscape. The revised Code sets a benchmark against which all activities Code of Conduct should be measured and equips the College with a clear set of rules with which to hold members to account. The new Code of Conduct, approved by the Board and Council this year, is printed in full on the following pages. We ask that you take the time to read it and consider all of the standards discussed and the implications of those standards. If you would like to download a copy of the Code of Conduct, it is available on the RANZCO website in PDF form – www.ranzco.edu/about-ranzco/our -organisation/code-of-conduct. Eye2Eye Spring 2017 11
for in this Code. In such circumstances, a Member’s RANZCO Code of Conduct priority must always be patient care. The Royal Australian and New Zealand College of RANZCO This Code is applicable to all RANZCO Members and is Code of Conduct Ophthalmologists (RANZCO) is the also intended to inform the public of the conduct they specialist medical college responsible for the training and are entitled to expect from RANZCO Members. professional development of ophthalmologists in Australia This Code does not create legal or other rights and New Zealand. between Members or with members of the wider Our mission is to drive improvements in eye health care in public. Australia, New Zealand and the Asia-Pacific region through collaborative development of standards and the continued 2. College Oath provision of exceptional training, education, research and The following oath is taken to be given by all Fellows as a advocacy. condition of College Fellowship: Underpinning all of our work is a commitment to: “In acknowledging the privilege of practising medicine • Best Patient Outcomes: aiming to ensure equitable and ophthalmology, and in accepting Fellowship of this access to the highest quality eye health for all. College, I make this declaration sincerely in the presence • Education and training: providing contemporary of my family, friends, colleagues and teachers. education, training and continuing professional Patients are my first concern and in caring for them I development. undertake to use my knowledge and skill to the best of • Evidence based decision making: using research to my ability. underpin improvements in education, training and eye I will seek actively to maintain my skills and abilities health care. throughout my professional life, to practise within those • Collaboration: working with others involved in abilities and to contribute wherever possible to the the delivery of eye health care nationally and science of ophthalmology. internationally. I will seek to enhance the quality of patients’ lives, • Collegiality: supporting trainees and Fellows through maintain their dignity, support their carers, and treat all all stages of their career. people equitably. I will strive at all times to be worthy of my patients’ RANZCO has adopted this Code of Conduct to specify the respect and never to abuse their trust or confidence. My standards of conduct required by all Members clinical decisions will not be influenced by personal gain. 1. Introduction I extend these commitments beyond individuals to the RANZCO’s Code of Conduct (the Code) reflects RANZCO’s health and wellbeing of the community. I will treat with values, the College Oath and prevailing community courtesy my colleagues and all who contribute to the expectations concerning the practice of ophthalmology. wellbeing of my patients. The Code commits all Members to the highest standards May these affirmations guide and inspire me in practising of ophthalmic practice and care as a condition of the art and science of medicine as an ophthalmologist.” RANZCO membership. 3. Collaborative Development The Code complements the Medical Board of Australia’s code Good Medical Practice: A Code of Conduct for This Code has been developed by the College in Doctors in Australia and the Medical Council of New consultation with non-ophthalmologists, the RANZCO Zealand’s Good Medical Practice with a focus on membership, RANZCO committees, RANZCO Council ophthalmic practice. and the RANZCO board. The scope of the consultation has strengthened the Code and assures individual Member compliance with this Code does not excuse a Members that the Code reflects the standards Member from compliance with other applicable codes. To expected of them by their peers and the wider the extent of any inconsistency, the highest professional community. standard shall always prevail. RANZCO commits to the ongoing collaborative This Code does not vary any obligation arising under the development of the Code to ensure that it continues to Law of Australia and New Zealand. Members must be keep pace with changing professional and community aware of all relevant jurisdictional requirements and must expectations. abide by all relevant Law. If any provision of the Code conflicts with the Law, the Law takes precedence. Where 4. Conduct Dilemmas the Code imposes an obligation that is greater than the This Code identifies the principles and standards of Law, Members must comply with the Code unless it acceptable conduct. All circumstances are different. This would cause a Member to breach the Law. Code does not seek to describe all relevant values of the This Code is not intended to be exhaustive. There will profession or to provide specific advice on ethical issues inevitably be situations that are not expressly provided and ethical decision-making. 12 RANZCO Code of Conduct
Members are reminded of the importance of consulting 7. The Standard of Patient Care with colleagues on professional and ethical matters. The Standard of Patient Care concerns the level of care When Members are faced with a conduct dilemma, they Members provide to their patients. are expected to seek timely direction and advice from Patients depend on you. A Member’s ability to deliver the senior colleagues, the College and professional advisors required Standard of Patient Care requires that all actions where necessary. are designed and implemented to ensure optimal patient 5. Application of the Code care outcomes. This Code has been adopted by RANZCO to ensure the To meet the required Standard of Patient Care, Members highest standards of ophthalmic practise and care by its must: Members. 1. always act in the best interests of the patient; As a condition of RANZCO membership, all Members 2. provide clinical care consistent with the prevailing must abide by this Code at all times irrespective of standards of the specialty, within the constraints of systems and resources available; whether they work in a paid or volunteer capacity in Australia, New Zealand or any other jurisdiction. 3. fulfill duties to patients without discriminating on the basis of age, gender, ethnicity, insurance status, All Members are responsible for their compliance with disability, religion, lifestyle, culture or other individual the Code. characteristic; 6. Governing Principle and Guiding Standards 4. address issues that compromise patient safety in a The governing principle of this Code is that patients’ timely manner and act to minimise risk; best interests are always paramount. This principle is 5. report all incidents or events that have resulted in or supported by the following guiding standards which may lead to patient harm in the future in accordance must be maintained at all times by all Members: with employer policy and relevant Law; • The Standard of Patient Care 6. take reasonable steps to ensure continuity of care • The Standard of Patient Relations for patients for whom a Member has responsibility • The Standard of Clinical Competence (this includes arranging appropriate cover when not available and handover to other surgeons, clinicians • The Standard of Collegiality or allied health professionals with competent and • The Standard of Commercial Professionalism timely referrals); • The Standard of Social Responsibility 7. manage or undertake procedures only on patients • The Standard of Training and Research whose clinical conditions are within the scope of a The guiding standards of this Code are not new Member’s competence having regard to training, standards. The guiding standards reflect the expectations experience, credentialing and current practice profile of the community and peers concerning the conduct of except in an emergency situation where alternatives ophthalmology in Australia and New Zealand. do not exist or where no other appropriately trained The guiding standards must inform all Member activities. health professional is available; These standards are the standards against which all 8. respond in a timely manner to requests from others Member conduct will be assessed. for advice or opinion and for surgeons, respond as a priority to requests for help from another surgeon in In order to comply with this Code, Members must be the operating theatre; able to demonstrate that any and all of their actions are consistent with the guiding standards of this Code. 9. take reasonable steps to facilitate on-going care in the event that a patient relationship is terminated; Any conduct falling short of or inconsistent with 10. offer assistance in an emergency situation subject to the guiding standards of this Code may constitute your assessment of your own safety, your skills, the Unsatisfactory Conduct or Misconduct and may be the availability of other options, the impact on any other subject of College sanction. patients under your care and continue to provide All Members should be aware that conduct falling short assistance until your services are no longer required; of or inconsistent with the guiding standards of this Code 11. ensure informed consent (including informed may also constitute a breach of the Law and expose financial consent) has been obtained from the offending Members to civil or criminal prosecution and patient (or guardian) before elective operations are penalties. undertaken and wherever reasonably possible in Ignorance of the guiding standards in this Code shall not emergency situations; excuse a Member. All Members are expected to read and 12. take reasonable steps to ensure a culture of operative understand this Code. Members must abide by this Code safety for patients exists, including implementing an at all times as a condition of their membership of the approved Surgical Safety Checklist; College. 13. ensure elective and scheduled urgent procedures are In addition to non-compliance with the guiding performed in an institution capable of providing the standards in this Code, Member conduct that damages appropriate level of pre and post-operative care; the professional standing and reputation of RANZCO shall 14. prioritise intervention on the basis of clinical need constitute a breach of this Code. when confronted with multiple demands; Eye2Eye Spring 2017 13
15. contribute to ensuring a safe environment for the 5. be sensitive and aware that different beliefs, care of patients; backgrounds, values and cultures may influence a 16. refer a patient when the best treatment for the patient‘s understanding, decisions and responses; patient is not within a Member’s scope of practice; 6. discuss the patient‘s diagnosis, investigations and with respect to patient records: treatment in a way the patient can understand; 17. maintain complete, legible, correct and 7. provide the patient with recommendations contemporaneous patient records; determined by clinical need; 18. ensure all patient records include sufficient detail 8. provide reasonable opportunities for patients and to allow another health professional to assume relatives to ask questions; immediate management of a patient in the event 9. be open and honest when the patient has suffered a that the Member is no longer available to continue complication or adverse event; management of the patient; 10. maintain the confidentiality of all information 19. ensure that clinical notes are dated and that the divulged by a patient or obtained from the patient author is identifiable; (e.g. radiology, photographs, pathology results etc.) 20. ensure operation notes outline the procedure unless otherwise required by Law or agreed to by the patient (this particularly applies to publications and performed, including any specific problems presentations where the patient’s identity must be encountered; concealed); 21. document a postoperative plan that includes 11. ensure Member contact details are available to treatment until the patient is next to be reviewed; hospitals and appropriate contact details are 22. comply with privacy legislation and ensure available to current patients in the event of an records are not subject to unauthorised access or emergency; distribution; 12. never engage in a sexual relationship with a patient 23. ensure the confidentiality of patient records and only or use a relationship with a patient as an opportunity disclose confidential information to a third party with to promote a sexual relationship in the future; the patient’s permission or as required by Law; 13. never abuse (physically, emotionally, financially, 24. ensure that patient records are not falsified, altered psychologically, verbally or sexually) or assault a after an adverse event, deliberately destroyed, lost or patient. hidden; 25. determine a process to ensure that in the event 9. The Standard of Clinical Competence of a Member’s retirement or incapacity, a smooth The Standard of Clinical Competence concerns the handover of patients currently under the Member’s acquisition and maintenance of a Member’s professional care and ensure that all medical records in archive skills and knowledge. or other storage facilities are either destroyed or Clinical competence is central to a Member’s ability to transferred according to requirements of the local deliver the required Standard of Patient Care. To meet the jurisdiction; required Standard of Clinical Competence, Members must: 26. ensure that the Member’s estate and legal guardian 1. ensure that they are and remain demonstrably are provided with appropriate instructions to ensure competent with regard to the prevailing standards hand over and appropriate management of all of the specialty; medical records in the event of a Member’s death 2. satisfy all registration requirements for Continuing or in cases of permanent incapacity that prevent a Professional Development; member from being able to practice 3. be appropriately credentialed by the employing authority and the relevant facility provider; 8. The Standard of Patient Relations 4. maintain appropriate medical indemnity The Standard of Patient Relations concerns the legitimate insurance; expectations of patients that their views are listened to 5. continually reflect on individual performance and that their dignity and autonomy are respected. The particularly with respect to results obtained by standard also reflects the expectation that Members will peers; communicate openly, honesty and empathetically with 6. participate in performance appraisals and audits; all patients. 7. facilitate and participate in peer reviews; To meet the required Standard of Patient Relations, 8. keep up to date with the relevant literature; Members must: 9. immediately report to a Member’s credentialing 1. communicate openly, honestly and empathetically authority and the RANZCO Chief Executive Officer with patients; any loss of hospital privileges, loss of or limitations 2. respect the wishes of the patient; or conditions placed on medical registration, 3. not bully, harass or pressure a patient into agreeing restricted rights of practice and any indemnity to a plan of action; restrictions arising from any Medical Board of 4. seek to communicate effectively with patients, Australia or Medical Council of New Zealand relatives, carers and legal guardians; disciplinary action against a Member; 14 RANZCO Code of Conduct
10. only claim to have undertaken or obtained training, 15. if providing the first opinion, facilitate a second experience or expertise that can be readily and opinion if requested by the patient; objectively substantiated; 16. if requested to provide a second opinion, ensure 11. not practise if impaired by drugs or alcohol; that the patient is made aware that the Member is 12. not practise if impaired by physical or mental contracted to provide a second opinion only; disability that could adversely affect patient 17. ensure that all second opinions are based solely on outcomes; the patient’s best interests. 13. arrange the involvement of a suitably qualified 11. The Standard of Commercial colleague in the management of a patient if a Professionalism Member becomes relevantly impaired. The Standard of Commercial Professionalism concerns a 10. The Standard of Collegiality Member’s conduct within the business of ophthalmology. The Standard of Collegiality concerns a Member’s It is a professional responsibility to ensure that the professional interaction with colleagues. Safe and patient’s best interests are paramount when providing effective patient care involves working in partnership advice, opinion or intervention. with other healthcare professionals. Respecting To meet the required Standard of Commercial the knowledge and views of others is an important Professionalism, Members must: component of teamwork and a central attribute of an 1. not exploit a patient’s vulnerability or fears; ophthalmic professional. 2. be honest in all financial and commercial matters; To meet the required Standard of Collegiality, Members 3. not directly or indirectly encourage indiscriminate or must: unnecessary interventions; 1. not engage in any conduct that would bring the 4. provide an accurate estimate of fees when obtaining practice of ophthalmology into disrepute; consent to treatment; 2. respect the training, knowledge and experience of 5. charge reasonable and commensurate fees for others; professional services; 3. not force a Member’s views or opinions on a 6. not take financial advantage of or exploit a patient; colleague in an inappropriate manner; 7. use accurate treatment codes and follow all rules 4. participate constructively in peer review; and regulations when seeking reimbursement 5. not engage in, facilitate or condone any from government and third party payer systems communication or actions which involve ensuring always that systems are not manipulated discrimination, bullying or harassment; for personal financial advantage; 6. not engage in communication that criticises 8. disclose to patients any relevant interest in or of a colleagues in an untruthful, misleading or deceptive relevant third party; way; 9. not participate in fee splitting for referrals or recommendations; 7. not engage in communication that denigrates another medical practitioner or healthcare 10. not recompense, either directly or indirectly, in return professional; for patient referrals; 8. observe the same levels of respect for others when 11. not participate in any programs or schemes that could be reasonably seen as either soliciting referrals using social media as a Member would in a public for reward or receiving a reward for referring forum; patients; 9. respond in a timely manner to requests from other 12. provide information about the likelihood, risks and clinicians for advice, opinion or assistance; costs of subsequent or revisional surgery should 10. take all reasonable steps to contribute to ensuring a either be required; safe working environment for all colleagues; 13. declare any and all conflicts of interest and ensure 11. never seek to enhance a Member’s practice by that the same are managed in accordance with actively damaging or inhibiting a colleague’s prevailing standards, ensuring always that a practice; Member’s interests do not conflict with the interests 12. not lodge a complaint alleging a breach of this Code of patients, colleagues, the College or the health by a fellow Member without a reasonable basis or for system; a vexatious or ulterior purpose; 14. not accept inducements; 13. not engage in conduct that represents a serious 15. comply with RANZCO’s policy on Ophthalmologists’ breach of RANZCO policy; and Trainees’ Interactions with the Medical Industry; with respect to second opinions: with respect to advertising: 14. if providing the first opinion, consider the benefit to 16. comply with all relevant Law including, but not the patient of seeking a second opinion including limited to, New Zealand’s Health Practitioners when the prospect of a second opinion is raised Competence Assurance Act and in Australia, the Health by the patient, the patient’s family or other health Practitioner Regulation National Law as it applies in professional; each state and territory Eye2Eye Spring 2017 15
17. comply with the Medical Board of Australia To meet the required Standard of Training and Research, Guidelines for Advertising Regulated Health Service Members must; and the Medical Council of New Zealand Statement on with respect of supervision: Advertising; 1. Continue to develop and maintain competence as a 18. provide only clear, factually correct and verifiable teacher and supervisor; information; 2. not engage in, facilitate or condone any 19. not advertise in a manner that misleads any patient communication or actions which involve or the public in any way; discrimination, bullying or harassment; 20. not advertise in a manner that promotes the 3. maintain full responsibility for patient welfare when perception that a Member’s services are better than delegating responsibility for surgical management to those provided by peers; a trainee or junior doctor; 21. not include any inducement for referrals; 4. ensure clear and well-defined arrangements for both 22. not directly or indirectly attempt to reduce the supervision and the resumption of direct control of reputation or standing of colleagues, particularly by the surgical intervention; attempting to elevate a Member with comparative 5. provide appropriate supervision that minimises risks claims of superior experience, techniques or to the patient; outcomes; 6. raise performance concerns with trainees at the 23. not use testimonials or before and after photographs earliest possible opportunity; that could be perceived to create an unrealistic 7. give accurate, candid and non-biased feedback on expectation of patient outcomes; progress and performance of trainees including 24. be responsible for any advertising issued on a assisting in remediation programs where necessary; Member’s behalf e.g. by an employer or associated 8. not fail to come to the assistance of or arrange practice. assistance for anyone to whom patient care has been 12. The Standard of Social Responsibility delegated, without good reason; 9. be honest, factual and objective and, as far as Ophthalmologists play a key role in the health system possible, constructive when providing an assessment and a leading role with respect to eye health. With this and feedback to a trainee; responsibility comes a range of obligations. 10. include accurate and verifiable information when The Standard of Social Responsibility concerns your public conducting assessments and providing feedback to conduct and how you interact with the wider community. a trainee; To meet the required Standard of Social Responsibility, 11. ensure all assessments are conducted honestly and Members must: fairly; 1. not be found guilty of breaching any criminal Laws; 12. not provide an unsatisfactory assessment or 2. not be found guilty of any professional misconduct; feedback to a trainee when it is not justified; 3. ensure that all actions are consistent with all relevant 13. not provide a satisfactory assessment or feedback to and applicable Laws; a trainee when it is not justified; 4. ensure that services provided by or arranged by a with respect of surgical demonstrations: Member are necessary in order to obtain benefit for 14. inform and obtain specific consent from the patient the patient; prior to any surgical demonstration; 5. not use public resources (including Medicare) principally for financial gain or for career or academic 15. abide by RANZCO’s policy on Live Transmission of advancement; Surgery; 6. inform relevant authorities of an infection that 16. always place the patient’s best interests ahead of all could be transmitted through medical practice other interests including a Member’s interests and (this applies to all Members and their colleagues); the educational value of the session; 7. volunteer to be tested if there is a possibility of 17. declare any financial or non-financial benefit, direct infection by an infectious agent that could be or indirect, that may accrue to a Member from a transferred to a patient. demonstration prior to the demonstration being undertaken; 13. The Standard of Training and Research with respect of research: Training and research is central to the practice of 18. comply with the Guidelines for the conduct of ophthalmology. Where mandatory, training and Research published by the Australian National research provides the foundation for the acquisition of relevant professional skills and knowledge. Where Health and Medical Research Council, and the Health voluntary, training and research provides a context for Research Council of New Zealand; the acquisition of advanced skills and knowledge and with respect of new intervention, technology, the opportunity to provide leadership and professional techniques or prostheses: guidance to colleagues. The Standard of Training and 19. possess all relevant training; Research concerns your conduct when undertaking 20. not proceed without at least a reasonable belief that training and research. there is a theoretical patient benefit to be achieved; 16 RANZCO Code of Conduct
21. prior to proceeding, fully inform the patient and (i) where the conduct of a Member involves a serious obtain informed written patient consent, obtain all breach of RANZCO policy (including this Code) or relevant approvals from relevant ethics committees, damages the professional standing and reputation new technology committees and relevant of RANZCO; and jurisdictional oversight authorities; (ii) where the conduct of a Member occurring in 22. comply with all relevant credentialing authority, connection with the practice of ophthalmology The perfect capsulotomy hospital and legal requirements; or occurring otherwise than in connection with 23. participate in a properly constructed clinical trial the practice of ophthalmology is inconsistent with where appropriate; the Member being a fit and proper person to be a Precise, visually centred, and stronger 24. maintain a personal register of experience (an audit); Member of the College. capsulotomies in milliseconds 25. participate in peer review. “Unsatisfactory Conduct” means conduct of a Member occurring in connection with the practice ™ 14. Member Health and Wellbeing of ophthalmology that is a breach of RANZCO policy ZEPTO is a new capsulotomy device with a disposable handpiece and tip Members are encouraged to maintain good physical, (including this Code) or falls short of the standard of that produces a quick, elegant, round capsulotomy in milliseconds. psychological and emotional health and seek help if and competence and diligence that RANZCO expects of its The tip consists of a miniature, transparent, soft silicone suction cup that when required, rather than self-diagnosing and treating. Members. houses a circular nitinol capsulotomy element, which has been refined at Members are encouraged to develop insight and in 17. Information and Assistance the micron scale to enable uniform 360-degree capsule cutting. appropriate cases, to seek guidance from a suitably Additional information to assist you to understand the qualified physician in order to identify whether any Code can be found on the RANZCO website. impairment, temporary or permanent, has the potential Members seeking conduct guidance are encouraged to to affect the ability to provide optimal care to patients. lodge timely requests for guidance with the College by Members are encouraged to develop insight regarding emailing [email protected] the effects of ageing and the signs of illness, including SMILE Instrument Set Members should note that seeking guidance from mental illness and dependency, in fellow practitioners. the College does not excuse a breach of the Code. All Members are encouraged to be vigilant when it comes Members are ultimately responsible for ensuring their The ReLEx™ SMILE is a refractive correction procedure which is carried out 2-839 Chan SMILE Dissecting Forceps to the health and wellbeing of fellow practitioners and to ongoing compliance with this Code. in a single step with a femtosecond laser, without the need to cut a flap. intervene appropriately when the health and wellbeing of fellow practitioners is at risk. 18. Related Documents Discrimination, harassment and bullying threatens Health Practitioner Regulation National Law Act 2009 New 6-835 SMILE Double Ended Dissector 2-837 SMILE Lenticule Removal Forceps, 23 Gauge Member health and wellbeing and is specifically Zealand precluded by this Code. Health Practitioners Competence Assurance Act (2003) 15. Alleged Breaches of the Code Medical Board of Australia Good Medical Practice: A Code 6-836 SMILE Double Ended Dissector with Spoon Tip 2-836 SMILE Lenticule Removal Forceps of Conduct for Doctors in Australia Alleged beaches of this Code are brought to the attention Medical Council of New Zealand Good Medical Practice of RANZCO by lodging a complaint. Medical Board of Australia Guidelines for Advertising Complaints are lodged and managed in accordance with 6-837 SMILE Lenticule Hook 2-114 Castroviejo Suturing Forceps (0.12mm) Regulated Health Services the Complaints Resolution Policy. A copy of that policy can Medical Council of New Zealand Statement on Advertising be found on the RANZCO website https://ranzco.edu/ about-ranzco/our-organisation/policies Australian National Health and Medical Research Council Guidelines for the conduct of Research The Form for lodging a complaint can be found on the RANZCO website https://ranzco.edu/about-ranzco/ Health Research Council of New Zealand Implementing our-organisation/policies. Research : a guideline for health researchers NEW from Rayner: RANZCO Conflict of Interest Policy ® Complaints in which an alleged Code of Conduct breach arises are referred to the Code of Conduct Committee RANZCO Complaints Resolution Policy RayOne Preloaded IOL RANZCO Discrimination, Harassment and Bullying Policy and are determined in accordance with the Code of Introducing RayOne® with patented Lock & Roll™technology Conduct Procedure Policy. A copy of that policy can be RANZCO Reconsideration, Review and Appeals Policy for the smallest fully preloaded IOL incision found on the RANZCO website https://ranzco.edu/ RANZCO Live Transmission of Surgery Policy about-ranzco/our-organisation/policies. RANZCO Ophthalmologists’ and Trainees’ Interactions with It is a breach of this Code to lodge a complaint alleging the Medical Industry Policy Patented Lock & Roll™ technology a breach of this Code by a fellow Member without a 19. Further Review for a smoother, more consistent rolling and delivery reasonable basis or for a vexatious or ulterior purpose. of the lens via micro incision This Code shall be reviewed as and when directed by the 16. Understanding the Code Board and in any event, not greater than five (5) years • Rolls the lens to under half its size before injection • Fully enclosed cartridge with no lens handling In this Code the following words have the following from the date of adoption. • Easy to use, true 2-step system meaning unless otherwise specified: 20. Version Control • 1.65 mm RayOne® nozzle - Smallest fully preloaded injector nozzle “College” means RANZCO. • Full power range, from -10.0 to +34.0 Dioptres Version: CC2017 “Law” means all common law, statute and regulation in - Largest fully preloaded power range available Date of Adoption by the Board: 19 August 2017 force in Australia and New Zealand. DV892-0817 “Member” means a Fellow or Associate of the College. “Misconduct” means: 1800 225 307 dfv.com.au
The perfect capsulotomy
Precise, visually centred, and stronger capsulotomies in milliseconds
ZEPTO™ is a new capsulotomy device with a disposable handpiece and tip that produces a quick, elegant, round capsulotomy in milliseconds. The tip consists of a miniature, transparent, soft silicone suction cup that houses a circular nitinol capsulotomy element, which has been refined at the micron scale to enable uniform 360-degree capsule cutting.
SMILE Instrument Set
The ReLEx™ SMILE is a refractive correction procedure which is carried out 2-839 Chan SMILE Dissecting Forceps in a single step with a femtosecond laser, without the need to cut a flap.
6-835 SMILE Double Ended Dissector 2-837 SMILE Lenticule Removal Forceps, 23 Gauge
6-836 SMILE Double Ended Dissector with Spoon Tip 2-836 SMILE Lenticule Removal Forceps
6-837 SMILE Lenticule Hook 2-114 Castroviejo Suturing Forceps (0.12mm)
NEW from Rayner: RayOne® Preloaded IOL Introducing RayOne® with patented Lock & Roll™technology for the smallest fully preloaded IOL incision
Patented Lock & Roll™ technology for a smoother, more consistent rolling and delivery of the lens via micro incision • Rolls the lens to under half its size before injection • Fully enclosed cartridge with no lens handling • Easy to use, true 2-step system • 1.65 mm RayOne® nozzle - Smallest fully preloaded injector nozzle • Full power range, from -10.0 to +34.0 Dioptres - Largest fully preloaded power range available
DV892-0817
1800 225 307 dfv.com.au 18 Membership Spotlight
Membership Spotlight Introducing RANZCO’s first Dean of Education, Dr Catherine Green it was very interesting to be involved I have done with RANZCO and so I in the process. I was involved in the enrolled in a Master’s. It has been an curriculum review and, after serving as absolutely wonderful and eye-opening subject leader for Clinical Ophthalmic experience, in some ways like entering Pharmacology & Emergency Medicine a completely different world, or at least (COPEM), I became Chair of the OS another country! I have had to grapple Board of Examiners. The Ophthalmic with new and sometimes difficult Basic Clinical Competencies and concepts and learn a new vocabulary. Knowledge (OBCK) exam was also It has been very exciting to be able to relatively new and needed quite a bit of immediately apply what I have been work to ensure it was valid and reliable, learning to the RANZCO context. This so I became Chair of OBCK as well. In role combines the two worlds. I hope addition, I joined the Victoria Branch to facilitate exchanges across the two Committee, initially as Treasurer, then as domains so we can continue to improve Dr Catherine Green Chair. This led to a Council position and, ophthalmology training in Australia and In early June, RANZCO after a while, I became a Board Director. New Zealand and within our region. In 2009, I was nominated by RANZCO You’ve done quite a bit of work appointed our first Dean of to join the first APAO Leadership Q delivering eye health care programs Education, Dr Catherine Green Development Program (LDP). in the Asia Pacific region, can you tell Participants were invited to the AAO AO, who will work alongside us about some of the challenges you LDP as guests in 2010, and I found faced and how you overcome these? Censor-in-Chief, Dr Justin the program inspiring and valuable. Mora, and Deputy CEO and I thought RANZCO should have its A Australia is very fortunate in that Head of Education, Dr Ruth own program, so I worked with the our health system is well resourced. Ferraro. Dr Green will play an CEO and Board to get the RANZCO In less developed countries, the lack LDP established. Attending the AAO of resources (including equipment, important role in guiding the program also inspired me to work access to medication, number of trained College’s work in improving with the APAO to further develop their staff, funding etc.) is a constant battle. the educational services that program, which has gone from strength Measures to address gaps in eye care we provide to trainees and to strength over the years and is one in the past have tended to focus on of the most enjoyable aspects of my service delivery, but I believe investing in the continuous professional current professional activities. sustainable teaching and training is the development opportunities we only way to achieve lasting results. This is How do you feel about being Q more challenging in many ways because provide to ophthalmologists. appointed as the first RANZCO Dean it takes time to set up and there is lag For this issue of Eye2Eye, we of Education and what do you hope to time in achieving results. Obviously, achieve in your new role? interviewed Dr Green on her clinical teaching involves service delivery new role and what she hopes A The Dean position is a dream job as well, so the key is to try to encourage to achieve as RANZCO’s first for me. I spend a lot of time thinking engagement of all stakeholders, which Dean of Education. and reading about surgical education can be complex. and ways to improve what RANZCO You’ve done a lot of work in does. The position means I can create Q Q Can you tell us a bit about your the gender space; what are the key dedicated time for this, instead of work with the College over the years? takeaways for progressing gender having to find time in between other equality in your point of view? A I have always been interested commitments. in education and teaching. After I strongly believe in gender What drew you to the role? A returning from my overseas fellowship, Q equity and promoting diversity in all I responded to an invitation to become A Ophthalmology has a proud history workplaces and society in general. It’s an examiner for what was then Ocular of dedicated teachers and trainers complex, but the first steps include Pharmacology. The Ophthalmic and a culture where this is valued. A acknowledging the imbalances, trying Sciences exams were undergoing couple of years ago, I decided to explore to understand the reasons for them and quite a lot of change at the time, and surgical education to further the work then addressing these in a systematic Eye2Eye Spring 2017 19
way. This requires cultural change, which takes time, but this should not Dr Brad Horsburgh on his career, dissuade us from trying. Governance structures and policies need to be College experience and life after formulated in such a way that certain RANZCO Presidency groups of people are not disadvantaged. Decisions need to be made with input from representative groups. We need to Personal history: be aware of unconscious bias and how it I was born and raised in country can affect our own and others’ thinking. Queensland. In my hometown, Although the concept of targets is the term ‘multiculturalism’ was a controversial, it really is the most 16-letter word of great value on effective way of bringing about change. the Scrabble board but little else. It is surprising that in ophthalmology Country Queensland in the 70s we do not have 50-50 gender balance, was a sociological monoculture – but this should be our aim. This means suspicious of any cultures other than looking at ophthalmology right from the dominant Anglo Celtic view the recruitment and selection process, of the world. It was difficult to be through to training and specialist different. I do remember repeatedly practice, which should be underpinned defending a childhood friend who by excellent governance that promotes was seen as different. My parents, equality. Dr Brad Horsburgh recognising that education was key to maximising the chance of Q You’re a member of the RANZCO One year since the their children’s success, sent us to Diversity and Inclusion Committee; RANZCO Diversity and boarding school. Boarding school what do you see as the main role Inclusion Committee was was in many ways the formative for this Committee and why is it period of my life, shaping my views necessary? established, we interviewed on ethics, respect and collaboration A The Committee reports to the RANZCO Past President with others. RANZCO Board and is evidence that and Chair of the Diversity Professional life: the Board is committed to equity and and Inclusion Committee, diversity to meet our obligations to the I have greatly enjoyed my community. The Committee provides Dr Brad Horsburgh, to professional involvement with a forum for discussion and debate to discuss everything from his RANZCO. Perhaps because I was the inform strategic planning decisions Presidential past, College first in my family to study medicine and some aspects of College life that address these issues, as well as experience, personal implementing change where it is reminded me of growing up in needed. Diversity and Inclusion covers highlights and professional country Queensland. One of my so much more than gender, although victories to his role in first professional observations was gender is important. Organisations such chairing three of RANZCO’s that many of the men (as there were very few women) went to the as RANZCO are not only expected to be committees – the Diversity socially accountable; they should also same schools as myself. It was also play a role in leading cultural change in & Inclusion Committee, evident that many Fellows held our society. the Workforce Committee the same worldview. This is not an intrinsic criticism but rather, I think, You recently made the 2017 and the Medicare Advisory Q a reasonably accurate observation. Queen’s Birthday Honours List for Committee. Over the years I have noted that all the incredible work you’ve done some Fellows have found it difficult in ophthalmology, how did you On his early career to be different. As the years have celebrate? highlights: passed, my respect for the College A It’s such a huge honour to receive Being accepted into the and the ethics of the Fellows has the award. I’ve celebrated with family ophthalmology training program, only continued to grow. At all times and friends both here in Australia and senior registrar training in the United the interests of our patients and the greater good of the profession of overseas. The most enjoyable aspect of Kingdom and being invited to join it has been the many, many messages medicine have remained paramount. the late Dr Frank Sullivan’s practice of congratulations I have received. One example is the way Dr Bill were highlights of my early career. When it was announced, I had no idea Glasson and Dr Russell Bach led the that so many people read the paper on My term as RANZCO President has cataract campaign in 2009, which the Queen’s Birthday! The investiture been the pinnacle of my midcareer was inspirational. Dr Peter Sumich’s ceremony is in October so there will be and nobody knows how one's career strategic insights were key. The another opportunity to celebrate then. will ultimately be book ended! Fellowship was united in opposing 20 Membership Spotlight
the inequity of the government’s Australian and New Zealand national officers are now a reality. Recent budgetary proposals. Ultimately, governments, as well as the general government communications include we were successful because of the public, that the medical profession an admission that there is both a correctness of our cause. will face additional public scrutiny. structural oversupply of domestic RANZCO’s governance procedures medical students as well as an His Presidential need to demonstrate diversity and oversupply of SIMGs. highlights: inclusion. The College is making the The College will face constant The most satisfying achievements requisite policy changes. pressure from the government to during my tenure as President were: Change is very difficult. In making provide additional ophthalmology establishing RANZCO’s 35% female policy changes we must make every training positions in the face of an leadership target; the introduction attempt to take people with us. The overwhelming stream of medical of the RANZCO referral guidelines Diversity & Inclusion Committee must students seeking training positions. for Glaucoma Management, advocate for change. The Committee The challenge will be to increase Age-related Macular Degeneration will need to be as persistent as the training positions appropriately, (AMD) Management and Diabetic Workforce Committee has been over without lowering the standard Retinopathy Management; and the the past few years in prosecuting of our training. In respect to the inclusion and upholding of a Code of the case for change. As an example acknowledged oversupply of SIMGs, Conduct clause in the new RANZCO of this, the Diversity and Inclusion the College will continue to struggle Constitution. Committee, in conjunction with the in discriminating between genuine CPD committee, are promoting the ‘area of need’ SIMG applications On being a ‘feather use of practice visits, particularly versus disingenuous ‘practice in need’ dusted’ President: between recent graduates and senior applications. There is a cadence to life. As previous Fellows, not only as a way of obtaining The Fellowship should take comfort presidents will report, finishing one’s Level II CPD points but also to foster in the fact that, at a meeting in June term leaves a hole in one’s professional inclusion and collegiality. Some of 2017, the government accepted life. I do miss the contact with other the planned Diversity and Inclusion RANZCO’s position that the aggregate Board members and the College Committee changes will involve production of ophthalmologists is executive. I do not, however, miss the registrar appointment and training broadly in line with demand. There is an email correspondence associated with roles of the QEC. Dr Justin Mora acknowledgement by all that RANZCO the role. and the QEC are working to make will seek to increase the number of His views on some of the changes, whilst consulting with the regional training positions. teaching consultants and the broader Legislative risks challenges the College Fellowship, to ensure the reasons for The MBS Review continues to grind faces: making these changes are understood onwards. Whilst ophthalmology is and accepted. Some of the decisions The greatest challenges facing the yet to be reviewed, there are soon to are straightforward whilst others will College are governance, workforce be referral and billing changes that require the Wisdom of Solomon. and legislative risk. will impact upon private practice. Diversity and Inclusion Workforce challenges Government insiders are actively External threats being faced by For the first time in Australia's history, mooting legislative changes to move the College will require internal the medical workforce has been the MBS closer to the Canadian health changes in policies and procedures. successfully forced into structural care model. We live in interesting There is an expectation by both the oversupply. Unemployed junior house times.
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Representing the community’s Feedback from a lay view on eye representative: health and I was very impressed at the care with which you discussed the trainees at the various levels. I trust the trainees know (and training appreciate!) that they have this level of oversight and stewardship from the College members who sit on the QEC Committee. Since 2014, RANZCO’s It was good to know that the College has a degree of flexibility Lay Reference Group has within its training programme and is able to consider applications been acting to represent for part-time, time off, and maternity leave to cope with the trainees’ life events that inevitably will occur. I wonder, from listening to your community opinion to the discussions about this with respect to several of the trainees, if the College on a variety of issues importance of communication between the trainees and the College supporting the advancement is made clear, and that encouraging a conversation at the earliest of the science and practice of opportunity will likely lead to a more satisfactory outcome for all parties. ophthalmology. I assume that each trainee is given clear directions about the Initially formed in 2015, Lay communication line(s) to the College (and more importantly, to Reference Group representatives someone within the College) and that they are encouraged to use ensure community engagement this/these. I hope that the trainees fully understand that the College and community perspectives are is made up of real people (and from what I heard yesterday, clearly considered. The Group is a mechanism extremely wise and experienced people!), not just an institution. that allows for ad hoc input as may I was interested in the variety of training offered within the different be needed from lay individuals DHBs - how one can effectively get lost as a trainee within a big (community representatives of hospital, get little cataract experience in another area, and so on. non-medical background) to support The QEC committee obviously acknowledges the relative pluses and RANZCO’s objectives and operations. minuses offered by the various training hospitals throughout the In the past, representatives have country. As a lay person, it is comforting to know that you work hard predominantly participated in OBCK, to ensure that all trainees are moved around during their training, OSCE and RACE exams, with the aim so they can experience a range of the richness of ophthalmological to conduct their observations in a diversity around New Zealand. If I was required to be seen by an manner that ensures no disadvantage ophthalmologist, I would be grateful for one who had had a full and occurs to candidates, patients or rounded education. I acknowledge that this must be a very hard one examiners engaged in the exams for the QEC to balance, taking into account the personal situations of undertaken. However, as the College the trainees. Thank you for your work in this area. evolves, there has been a shift to incorporate lay representation in committee participation. For example, having permanent representation on RANZCO is seeking interest from instruments or ophthalmic the Diversity and Inclusion Committee, individuals who are interested in pharmaceutical items. and representation in QEC meetings joining the Lay Reference Group for If you know of anyone who would (following the QEC revised Terms of 2018-2020, and who have the capacity fit this description and may be Reference) whereby membership shall to reflect on, identify and represent interested in sitting on the RANZCO include a community representative of community issues. Representatives Lay Reference Group please encourage non-medical background. would ideally be based in either them to get in touch by sending an Lay Reference Group representatives email to [email protected]. remain in the position for a term of Sydney, Melbourne, Brisbane, three years, with the option of up Auckland or Wellington. Some travel to three further one-year terms at may be required and out-of-pocket the discretion of the RANZCO Board. expenses will be reimbursed. Finally, RANZCO would like to With the current Lay Reference Lay individuals are not and have take this opportunity to extend Group term coming to a close and never been an ophthalmologist, appreciation to the 2014-2017 due to the increase in the number optometrist or someone who is/ Lay Reference Group for their of engagements needed from lay has been working in eye health. input and participation to date persons, RANZCO is looking to engage Neither are they currently employed and to thank those who will additional members of the community in an allied ophthalmic profession, continue on the group. to join the group for the next three- in ophthalmic research or in a year term. company that produces ophthalmic 22 Membership Spotlight
Ensuring best patient care through the NUCLEUS Program The NUCLEUS Program Standard 1: Governance preventable, effective infection control has been developed to for Safety and Quality in requires a range of strategies across all levels of the healthcare system assist RANZCO members Health Service and a collaborative approach for in improving the safety Good governance is fundamental successful implementation. Standard and quality provided within for improving the safety and quality 3 aims to assist in the development ophthalmic practices using of health care services provided. and implementation of evidence- Despite health care in Australia based strategies to prevent patients the National Safety and being largely associated with good acquiring preventable healthcare Quality Health Service clinical outcomes, aspects of best associated infections and to effectively (NSQHS) standards as a patient care can at times be omitted, manage infections when they occur. framework. One of the key causing preventable adverse events to continue to occur. The aim of Standard Standard 4 – Medication applications of the NUCLEUS 1 is to create integrated governance Safety Program is as a quality systems that maintain and improve Many adverse medicine events are improvement tool for all the reliability and quality of patient preventable through standardisation care as well as improving patient aspects of ophthalmology and systemisation. Additional outcomes. Standard 1 provides a solutions for reducing medication (including both medical framework for safety and quality by errors, including improving and non-medical), which outlining the expected governance communication between clinicians involves continually raising structures and processes of a safe and between clinicians and patients, organisation. the quality of care provided using technology to support recording Standard 2: Partnering and transferring information, and to patients, resulting in providing patient information and healthcare that is safe, with Consumers clinical decision support at the point effective, patient-centred, It is essential for patients to be the of care. Standard 4 assists in ensuring centre of their own care. Patient-centred clinicians safely prescribe, dispense timely, efficient and care is recognised as an element and administer appropriate medicines equitable. of high quality healthcare that can to patients who are informed about The NSQHS standards were lead to improvements in healthcare their medicines. developed by the Australian quality and outcomes by increasing Standard 5 – Patient Commission on Safety and Quality safety; cost effectiveness; and patient, in Health Care (ACSQHS). These family and staff satisfaction. Standard Identification and standards provide a nationally 2 aims to ensure health services Procedure Matching consistent statement pertaining are responsive to patient, carer and Patient identification and the consumer input and needs. to the level of care consumers matching of a patient to an intended can expect to receive from health Standard 3 – Preventing treatment is an activity that is services. The following NSQHS and Controlling performed routinely and can often standards are the basic principles be perceived as an insignificant task. of the NUCLUES Program and have Healthcare Associated Tools including the World Health been developed and implemented to Infections Organization’s Surgical Safety Checklist ensure best patient care is provided With at least half of healthcare and the Ensuring Correct Patient, to patients. associated infections being Correct Site, Correct Procedure Protocols Eye2Eye Spring 2017 23
provide a basis for the development of safety routines for common tasks Impact Factor success for Clinical and providing defence against simple mistakes that can progress and and Experimental Ophthalmology cause harm to patients. Standard 5 The editorial team at Clinical and Experimental aims to ensure the health workforce correctly identifies patients where Ophthalmology (CEO) is delighted to announce the new care is provided and correctly matches Impact Factor (IF) of 3.00, up from 2.55 last year. The patients with their intended treatment. IF is a measure of citation frequency that reflects the Standard 6 – Clinical average annual number of citations made to recently Handover published articles, and is the premier metric used to A lack of or breakdown in compare journals within a field or specialty. Use of the IF communication and transfer of as an evaluation tool is based upon the commonly held information has been identified as a assumption that citations are a measure of the ‘‘impact’’ of crucial contributing factor towards serious adverse events and is a major a paper on fellow researchers in the field, and therefore an preventable cause of patient harm. indicator of quality. An IF of 3 shows that articles published The use of a standard process for in CEO in 2014 and 2015 were cited on average 3 times in clinical handover has been shown 2016. to improve the safety of patient care as critical information is more Based on the new IF, CEO is now #13 of the 59 ophthalmology journals likely to be transferred and acted listed in the Journal Citation Reports. This is an improvement from the 2015 upon. Information being transferred tables where CEO was ranked #16 of 56 journals, and moves CEO into the top between healthcare providers should 25%. This reflects the excellent reputation that CEO has now achieved within include all relevant data, be accurate the international ophthalmic community. Top quality research from around and unambiguous and occur in a the world is submitted for consideration, and CEO is able to select the best timely manner. Standard 6 aims to papers for publication. ensure that there is a standard process As the RANZCO scientific journal, CEO also continues to provide an essential in place to ensure timely, relevant platform for the dissemination of Australasian ophthalmic research, with half and structured clinical handover that of the published papers emanating from research teams within Australia and supports safe patient care. New Zealand. The increase in IF is also therefore an indication of the increase in quality and impact of the research being undertaken by RANZCO Fellows. Standard 10 – Preventing The editors, Professor Bob Casson and A/Professor Salmaan Al-Qureshi, Falls and Harm from would like to extend their thanks to Fellows for supporting the CEO with their Falls contributions as Editorial Board members, authors and reviewers. We look forward to further success in 2017 as the journal continues to strengthen and Whilst the risk of falls is well grow. documented for the elderly, falls can occur in all age groups, with an increased risk of falls when entering healthcare facilities. The risk of falls CEO Impact Factor 2012-2016 and harm from falls is higher for people with impaired vision, poor 3.1 balance or muscle weakness and those 3 who are taking some medications. 2.9 Policies, procedures and protocols for 2.8 all age groups need to be based on the available evidence and best practice. 2.7 The aim of Standard 10 is to reduce the 2.6 incidence or number of patients’ falls 2.5 and minimise harm from falls when they occur. 2.4
Impact Factor 2.3 Simon Janda, Manager, Professional Development 2.2 2 1.9 1.8 2012 2013 2014 2015 2016 Year 24 Membership Spotlight
ensuring researchers acknowledge the An update from requirements of the HREA. Similar to the NEAF, the HREA requires the following the Human information from investigators in an Research Ethics easy to navigate online form: • Project overview Committee • Project team and team member details As highlighted in previous • Disclosure of any financial or issues of Eye2Eye, as part of non-financial interest pertaining to Meet A/Prof Lyndell Lim, their strategy to streamline the research RANZCO HREC member • Restrictions of publication or A/Prof Lim is an ophthalmologist with ethics approval, the NHMRC dissemination of research has now ceased the use of the dual subspecialty training in the areas • Questions regarding the evaluation of ocular inflammatory diseases and National Ethics Application of the study/research proposal medical retina. She has authored over Form (NEAF) which has been • Location/sites of the project 60 peer-reviewed published articles and • Research methods being used replaced with the Human six book chapters. She has also been (depending on your method, Research Ethics Application the recipient of an NHMRC Early Career you may be required to provide Fellowship in support of her research (HREA). specified details) work, in addition to competitive The aim of this new application form • Participants of the study – with grant funding from the Ramaciotti is to provide a refined and concise whom or with what will the Foundation, Diabetes Research Trust application process to facilitate research be conducted (depending and the Ophthalmic Research Institute efficient and effective review of on the type of participants needed, Australia (ORIA). ethics for research involving humans. you may be required to provide She is currently a Principal Research HREA principally focuses on assisting specified details) Fellow at the Centre for Eye Research researchers to take into consideration • Project details – you will need Australia, University of Melbourne, the ethical principles of the National to provide a reflection of your where she also heads the Clinical Statement on Ethical Conduct in research project as a whole, Trials Research Unit. A/Prof Lim is Human Research (2007) in relation to including the methods used and also a consultant ophthalmologist the research being conducted rather participants involved subspecialising in the fields of medical than focusing solely on meeting the • Describe any risks and burdens retina and ocular inflammatory disease requirements for approval. associated with this research as at both the Royal Victorian Eye and For researchers required to complete well as outlining how these risks Ear Hospital (RVEEH) and the Royal the HREA for RANZCO HREC review, will be mitigated and managed Melbourne Hospital, and is Head of the the application can be easily accessed • Outline any benefits associated Ocular Immunology Clinic at RVEEH. via the Human Research Ethics with your research Although she has served on a number Committee (HREC) webpage on the • Outline the type of information/ of committees in the past, the RANZCO RANZCO website or, alternatively, data and sources of information HREC is the only ethics committee directly through the NHMRC website. that will be collected and any that she has served on thus far - and There are numerous support options ethical considerations relating she (quietly) finds working on this provided on the HREA help support to the collection and use of this committee a lot more interesting than page including FAQs, user manuals information some of the other committees she has and ‘how to’ guides. Applicants are not Once the information listed above is worked on. required to have an existing NHMRC entered, researchers are then able to Her contribution to the RANZCO account and have the options of generate the HREA document. Any HREC is to help evaluate proposed signing up or accessing resources as a separate project descriptions, protocols research projects for scientific quality, guest user. Existing applications can be or additional documentation can be particularly in her subspecialty fields uploaded or a new application can be attached to the HREA as well. of interest. In turn, she has also learned created directly through the website. Researchers are then required to a lot from her fellow HREC members, We thought it would be beneficial select the organisation that hosts particularly in regard to how proposed to review and complete an HREA the HREC (RANZCO) and the review research projects may be viewed by ourselves to examine the process pathway through which they intend non-ophthalmologists. and ensure that our Fellows can to submit the application. Once Her main passion is in clinical research, easily navigate through the process. each researcher has signed a digital particularly in the areas of ocular For the purpose of this test, we declaration form agreeing to the inflammatory disease and diabetic signed in as a guest. After navigating terms and conditions, the HREA retinopathy, where she is continually through several basic questions, an can be generated and printed, and searching for better treatments for these introduction page appears prior to the sent to the HREC to commence the diseases - but these are a distant second commencement of the application, application review process. to being a mum of two young sons. Eye2Eye Spring 2017 25
was engaged to William Dalton Wormald, an Englishman who lived in Sydney. As a young patient of Temple Smith’s, orthoptist Lyn (Lipman) Brent recalls Mrs Wormald being his secretary in the late 1940s. In 1997 Dr Reuben Hertzberg, who had been head of the Ophthalmology Department at the RAHC, wrote an unpublished article in response to Dr Bill Gillies, who had asked for more details about the history of orthoptics in Sydney. In this paper, Hertzberg states that “Mrs Wormald attended the outpatient clinic and assisted the honoraries by taking visual acuities and instructing parents whose children had an eye occluded.” Hertzberg’s comments provide some insight into Audrey’s likely role as Temple Smith’s secretary. Like the British ophthalmologists before him, it is probable that Temple Smith taught Audrey how to assess a child’s visual acuity and give advice to parents whose children required occlusion therapy. Essentially, he was following the apprenticeship training model which had been in place before Mary Maddox established the formal Audrey (Roberts) Wormald orthoptic training course in England in 1928. As has been well documented, the first orthoptist was Mary Maddox in London. She was taught by her In search of the first ophthalmologist father, Dr Ernest Maddox, to examine and treat patients with ocular motility defects. In some female orthoptist in ways Audrey’s experience mirrored that of Mary Maddox. Sydney Like Audrey, Mary first worked as a secretary and then went on to take a great interest in the science of ocular To New South Wales (NSW) orthoptists, motility function. The difference between them was Emmie Russell is considered the doyen of the path each of them followed. Mary continued along a professional route while Audrey chose to remain a orthoptics, the first in the state, one of the secretary and to leave the orthoptic work to the formally first in Australia and a founding member of trained orthoptist, Emmie Russell. Whether Audrey ever the Orthoptic Association of Australia (now contemplated orthoptic training is unknown but being Orthoptics Australia). newly married, and considering that the only orthoptic In the few historical accounts of Australian orthoptics, training course in Australia was held in Melbourne, it is that is how she is described. But was she really the first? likely that she simply chose to remain in Sydney. Certainly she was the first qualified orthoptist but she Nevertheless, under Temple Smith’s guidance she was not the first to undertake some basic orthoptics assisted him by assessing children’s vision and gave tasks. That honour goes to Audrey (Roberts) Wormald advice to parents whose children required patching. who worked under the supervision of Sydney paediatric However, while Audrey Wormald may have performed ophthalmologist, Dr Ernest Temple Smith. some clinical tasks, it is true that Emmie Russell was In the early 1930s Drs Norman (later Sir Norman) indeed the first official orthoptist in Sydney. Gregg, Frederick Gregory Roberts and Edwin Temple Shayne Brown Smith were Honorary Surgeons at the Department of Ophthalmology at Royal Alexandra Hospital for Children MAppSc, BA, DipAppSc, DOBA, FOAA (RAHC). Dr Temple Smith’s secretary, Audrey (Roberts) Wormald, accompanied him to RAHC where she assisted in some clinical tasks. Audrey Roberts was born circa 1908. She spent her early childhood in Hobart and her family moved to Sydney after her father’s untimely death. Audrey attended Ascham School in the eastern suburbs of Sydney and in 1923 gained her Intermediate Certificate. Note: This article draws on a number of sources. After school, she completed a business college course Please contact Shayne Brown at and worked as a medical secretary for a family friend, [email protected] for a full list of references. ophthalmologist Dr Edwin Temple Smith, who practiced in Macquarie Street in Sydney. By February 1926, Audrey 26 Membership Spotlight
resources. It also reinforced the long- term potential of Choosing Wisely to significantly change the mindsets and behaviours of health professionals and patients – to successfully challenge the notion that ‘more is better’ when it comes to managing a person’s health.” Health profession leading the way Two years of Choosing An update on Engagement with Australia’s peak Wisely medical bodies is critical to the Choosing Wisely Engagement in Choosing Wisely success of Choosing Wisely in Australia is growing, with encouraging growing awareness of the initiative, Australia results emerging from the disseminating new recommendations, implementation of a range of Choosing Choosing Wisely Australia and emphasising the important role Wisely projects. Thirty-two member the health profession plays in effecting is driving a culture shift in organisations (80% of medical colleges) change – not only among health how we deliver healthcare have published 133 recommendations providers, but with people who regularly by promoting a national covering themes like imaging (21% of request unnecessary tests. recommendations), medicine use (20%), conversation about what care The first Choosing Wisely in Australia pathology (11%), antibiotic use (8%) and report, published in December 2016, is really needed. Momentum end-of-life and palliative care (6%). highlighted a disconnect between GPs continues to build since the Several Australian health services and other healthcare professionals, initiative launched in April are leading the charge to implement and among consumers, as to why these recommendations within the 2015. Thirty-two member unnecessary tests and interventions hospital setting. This includes projects to were occurring. Surveys undertaken organisations, including improve pathology ordering practices, by NPS MedicineWise revealed 41% RANZCO, and 10 health the use of local anaesthetic infiltration, of general practitioners and 21% of services are working together and deprescribing of proton-pump specialists said they were asked for inhibitors. Results of these projects were unnecessary tests several times a week, to improve conversations presented at the first Choosing Wisely whereas 79% of consumers said they Australia National Meeting held in May about necessary care had tests at their healthcare provider’s 2017. All have been wrapped in multi- and reduce the number recommendation. Table 1 highlights the faceted behavioural change programs to most common drivers of unnecessary of unnecessary tests, ensure buy-in across departments and care with patient expectations the treatments and procedures service areas. strongest driver. recommended and delivered Some health services are embedding to patients. Choosing Wisely in broader aspects Table 1. Four most common drivers of their organisation, including job of unnecessary care Australia and New Zealand are advertisements, staff inductions and among 20 countries that have adopted inpatient information packs. Austin Choosing Wisely to challenge and Health and Royal Brisbane and Women’s Reasons GPs Specialists change a culture of over-testing and Hospital will shortly pilot consumer Patient over-treating patients. The initiative 60% 44% resources empowering patients to be Expectations originated in the United States in more proactively involved in healthcare Potential for 2012, and promotes new evidence- decision making. 58% 41% medical litigation based recommendations developed NPS MedicineWise Client Relations by specialty colleges and affiliated Manager - Health Technologies, Uncertainty societies on practices that should be Dr Robyn Lindner said “The local regarding the 54% 46% diagnosis questioned. implementation of recommendations Led by the medical profession, across the health sector and the Difficulities Choosing Wisely encourages community is key to achieving change. in accessing information health professionals to have better “Our National Meeting was attended 50% 55% from doctors in conversations with people about what by more than 200 delegates from other settings, healthcare is truly needed. At the same across the health sector all committed including results time, Choosing Wisely is working to to improving the safety and quality of help the community understand that healthcare in Australia. The surveys also revealed 79% of more care is not always better care. “The event demonstrated the impact general practitioners and 85% of The Australian initiative is facilitated of Choosing Wisely Australia on patient specialists agreed there was a problem by NPS MedicineWise. care and more appropriate use of health with the use of tests, treatments Eye2Eye Spring 2017 27
and procedures, and they rated their The recommendations have been making are all part of the national responsibility to reduce inappropriate widely promoted across RANZCO’s effort to drive change. use by 90% and 95% respectively. membership and among consumers A key resource is the ‘5 Questions With the impetus of Choosing Wisely through pre and post release surveys, to ask your doctor before you get Australia to improve the quality and the Choosing Wisely Australia any test, treatment or procedure’ safety of Australia’s healthcare system, and RANZCO websites, member resource – developed by Consumer it creates real opportunity for health publications, general news and trade Reports in the United States and professional colleges, societies and media, and social media platforms. widely adopted internationally — to associations to enhance training of There is now an opportunity to support conversations between health health professionals by embedding explore avenues for measuring professionals and consumers. The Choosing Wisely principles and the implementation of RANZCO’s questions are: recommendations into core activities. recommendations in the hospital This could include incorporation into setting where health services are member education, training and championing Choosing Wisely. examinations, and through regular communications to its members. Consumer awareness QUESTIONS New recommendations and engagement Do I really need for ophthalmologists Engaging consumers in the concept of ‘more is not always better’ when it 1 this test, treatment Following consultation with members, comes to healthcare is central to the or procedure? in March 2016 RANZCO released five success of Choosing Wisely. What are the risks? recommendations for ophthalmologists Consumer survey results published and other health professionals designed in the 2016 report highlighted 2 to improve eye health practices based contradictory attitudes among Are there simpler, on current best-practice evidence: consumers around medical testing, 3 safer options? despite consumers aware of Choosing In the absence of relevant Wisely Australia agreeing some What happens if history, symptoms and signs, 1 tests could be harmful, or produce ‘routine’ automated visual 4 I don’t do anything? fields and optical coherence misleading results and needless tomography are not indicated. treatments. The survey found 71% What are the costs? of people agreed with reducing 5 AREDS-based vitamin unnecessary care; however, 74% 2 supplements only have a indicated that if they were sick, their proven benefit for patients with doctor should conduct all available In Australia, this resource has certain subtypes of age-related medical tests related to their condition. been translated into 10 additional macular degeneration. There is Dr Lindner said there was a languages to support broader no evidence to prescribe these considerable body of work being uptake in the community. It is hoped supplements for other retinal undertaken to raise awareness among general practitioners and other conditions, or for patients with consumers of Choosing Wisely and health providers use this as the basis no retinal disease. to encourage consumers to be for improving conversations with Don't prescribe tamsulosin more proactive in discussing testing consumers and when recommending 3 or other alpha-1 adrenergic and treatment options with health particular courses of action. blockers without first asking professionals, including questioning A glimpse into the future the patient about a history of necessity. cataract or impending cataract “Some people don’t feel as There is no doubt Australia is surgery. though they have permission to ask embracing Choosing Wisely. NPS Intravitreal injections may questions about the course of action MedicineWise will continue to work 4 be safely performed on an being recommended to them,” she with members to deliver the latest outpatient basis. Don't perform said. “That’s why it’s important that evidence-based advice around routine intravitreal injections in health professionals help create an tests, treatments and procedures a hospital or day surgery setting environment where people can feel for the benefit of the Australian unless there is a valid clinical comfortable to do so and be more community. Reducing the incidence of indication. active participants in their own unnecessary or inappropriate medical In general there is no indication healthcare. This can help reduce care is in the best interests of all 5 to perform prophylactic or eliminate unnecessary tests or Australians. retinal laser or cryotherapy to interventions.” asymptomatic conditions such Partnerships with consumer as lattice degeneration (with advocacy organisations, media or without atrophic holes), for and public relations activities and which there is no proven benefit. the development of resources for consumers to assist in shared decision 28 Membership Spotlight
conditions will also have an impact on • Are their work habits changing? Mental health the medical workforce. In 2004, The When people’s motivation, Royal Australian College of General concentration levels or in the medical Practitioners released a report titled productivity levels are dropping it profession The Conspiracy of Silence: Emotional may be due to an episode of poor Health Among Medical Practitioners, mental health. and RANZCO’s which was an early look at mental • Do they seem to be taking less health stresses and impacts on general care with their appearance at Employee practitioners. Key findings of the work? report pointed to low job satisfaction • Are they absent from work, or Assistance rates, heightened risk of emotional ill late into work, more often than health and an increased risk of suicide. normal? Program (EAP) Many of the findings were linked • Do they seem to lack control to stress, burnout and workaholic of their emotions or are they In recent years, high profile tendencies among ‘high achievers’, campaigns and public figures displaying sudden and dramatic a common trait among medical changes in their mood? have worked hard to raise professionals. • Are they avoiding social awareness around the impact In 2013, a National Mental interactions, appearing unwilling of mental health conditions Health Survey of Doctors and to communicate or seeking Medical Students was conducted in the community. But, how isolation? by Beyondblue, an Australian prevalent are mental health organisation that works to raise Managing mental health conditions in Australia? awareness of depression, anxiety at work; the RANZCO According to Medicare Benefits and suicide prevention. The survey Support Program Schedule data for 2015 - 2016, looked at the mental health of an estimated 2.3 million patients medical practitioners from a range Our work and personal lives are accessed a Medicare-subsidised of specialities (ophthalmology was intertwined, so it makes sense that mental health-related service in not included in the study). The mental health challenges will impact that year. Over that time the rate specialities included in the study on both. At work, you have the added of patients accessing Medicare- were general practice; anaesthetics; support of being able to access the subsidised mental health-related mental health; emergency medicine; RANZCO Support Program, delivered services was highest for those aged paediatrics; surgery; rural, remote, by Converge International. All College 35 - 44 (129.9 per 1000 population). Aboriginal health; oncology; employees, Fellows and trainees have In addition to the MBS data, statistics obstetrics and gynaecology; imaging access to this confidential service and from the Black Dog Institute, which is and pathology. can obtain counselling, coaching and focused on understanding, preventing The 2013 survey found that the support for workplace, emotional and treating mental illness, show that doctors most likely to experience a and personal issues. You can get in one in five Australians aged 16 - 85 minor psychiatric disorder were aged touch with the expert counsellors at experience a mental illness in any year. up to 40, they were more likely to Converge International at any time
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Curiosity and tolerance are really really are tolerance and Curiosity With greater diversity in the the in diversity greater With Eye2Eye Spring 2017 29
Australia was one of the seven by IOA partners including the International countries that helped found the International Pediatric and Strabismus IOA. From the IOA’s foundation Council (IPOSC), the International Orthoptic until now, Australia has remained Strabismological Association (ISA) Association (IOA) an active member, sharing and the World Society of Pediatric knowledge and experiences with th Ophthalmology and Strabismus. Six 50 Anniversary our global colleagues. The IOA is Australian orthoptists were selected now supported by 22 member to present their work in the fields of The 50th Anniversary of the countries and represents more than education, refractive error, low vision, International Orthoptic 12,000 orthoptists worldwide. The age related macular degeneration, Association (IOA) was IOA organises a well developed optic disc examination in glaucoma, celebrated in Lisbon, and managed global exchange and strabismus risk factors. The and volunteer program. This often Portugal in June 2017. Past next IOA Congress will be held in involves screening and teaching Liverpool, UK in 2020. Australian representatives community health workers in – Marion Rivers, Dr Kerry developing countries in basic Fitzmaurice and Shayne detection of vision impairment and Brown – attended a blinding eye conditions. The IOA also symposium that celebrated supports international exchange visits by orthoptists from developing 50 years of global orthoptics, countries to travel internationally. with this year’s theme being: The IOA congresses are well 50 years of Orthoptics: attended by Australian orthoptists, Past, Present and Future. and the previous congress held in Sue Silveira, the current Rotterdam had the theme of Bridging Australian representative, Worlds, reflecting the science that connects dynamic, culturally and presented on behalf of linguistically diverse orthoptists (L-R) David and Marion Rivers and Shayne Orthoptics Australia during from around the world. The congress Brown attending the celebrations for the IOA the symposium. was supported by symposia offered 50th Anniversary
suggest that eye exercises, behavioural have a responsibility to help families Ophthalmologists vision therapy, or special tinted filters make the best use of limited resources. or lenses improve the long-term We should steer families away condemn educational performance of people from unproven interventions that Channel 7 report affected by dyslexia or other learning consume resources and thus interfere disabilities,” said RANZCO President A/ with the implementation of proven on behavioural Prof Mark Daniell. methodologies such as educational and “It is irresponsible to promote language based therapy.” optometry behavioural optometry to treat these RANZCO supports and concurs conditions without letting people know with the joint statement on learning Channel 7 News recently ran a that it is an unproven practice. Parents of disabilities, dyslexia, and vision by the report promoting behavioural children with dyslexia and other learning American Academy of Ophthalmology disabilities want to do what’s best for optometry to treat learning (AAO), the American Academy of their children and it is unfair to give Pediatrics (AAP) and the American difficulties, and a number of them false hope in expensive treatments Association for Pediatric Ophthalmology Fellows flagged this to the and aids for which there is no evidence.” and Strabismus (AAPOS). Joint In an Eye2Eye article last year, College. In response to this, Statement: Learning Disabilities, RANZCO issued a strongly Prof Frank Martin et al examined the role of ophthalmologists in the Dyslexia, and Vision is a comprehensive worded media release management of dyslexia. The article policy document and states that “It is condemning the coverage for highlighted the need for management important that any therapy for learning failing to acknowledge the lack of dyslexia and learning disability to disabilities be scientifically established to be valid before it can be recommended of research and evidence to be based on science, “not on arbitrary and capricious dogma” and pointed out for treatment.” and goes on to say that support the practice. that there is no credible evidence to “…the evidence does not support the “Primary dyslexia and learning support claims for treatment that is not concept that vision therapy or tinted disabilities are complex neurocognitive based on appropriate remedial reading lenses or filters are effective, directly or conditions and are not caused by vision intervention. The article concluded indirectly, in the treatment of learning problems. There is no evidence to that that “As doctors, ophthalmologists disabilities.” 30 Membership Spotlight
Social media for doctors: keeping it professional Social media platforms can be a fantastic mechanism to Australia’s Good Medical Practice: a legislation imposes further obligations develop your professional code of conduct for doctors in Australia. on practitioners and practices in presence, share information The Social Media Policy released relation to health information. and network with your by AHPRA and the National Boards Sharing information, particularly colleagues. Bearing in in March 2014 confirms that the with international colleagues, can be professional obligations outlined in helpful in allowing a ‘virtual corridor mind some important the Code of Conduct apply when consultation’ with an expert or as a considerations will ensure using social media. second opinion to aid in diagnosis. you can make the most Privacy settings All patient information should be of social media and also de-identified unless you have the It is vital to understand your security specific consent of the patient. If you comply with your legal and settings and review them regularly do have consent, make sure this is professional obligations. for each different site or platform you clearly documented. With images, it General considerations use, particularly as the default settings is best to always seek and document change periodically and new functions permission, even if you believe the when using social media are added. image has been de-identified. Getting engaged in social media now Some platforms are completely If you are planning to post involves choosing from hundreds of public and should be used cautiously. de-identified information, you should different platforms, from professional Even on those platforms with privacy carefully consider whether it can networking sites such as LinkedIn, settings, certain parts of your profile, be sufficiently de-identified. For social networking platforms like such as your name, profile photo, list example, if it concerned a particularly Facebook, blogs, microblogs such as of friends or connections, gender, rare condition, the image itself or Twitter, and content-sharing platforms geographic location and pages or basic demographic information may such as YouTube and Instagram. networks to which you belong may enable the patient to be identified. Referral tools such as WOMO and True be considered ‘publicly available’ There have been instances of patients Local, discussion forums and message and cannot be protected by privacy identifying themselves, or being boards and messaging platforms such settings on all sites. identified by friends or family, from the as WhatsApp also fall within the broad Be aware that even if you remove information or image posted about category of social media. content from some platforms, copies of them. If re-identification does occur, The key issues to consider are: that information may remain viewable and appropriate consent had not been 1. How your professional and legal elsewhere if it has been shared with obtained, de-identification does not obligations affect your use of others. Assume that if you post cure the breach. social media. something online it could become Inadvertent breaches of privacy 2. The different privacy settings and public and you may be unable to delete and confidentiality can also occur if defaults of each platform you use. it. If ever in doubt, don’t post it. personal information about a patient, 3. How posts, even those you think It is becoming increasingly common or staff member, is accidentally are private, could reflect on your to be able to use your details for one disclosed, for example, in the professional reputation if seen by platform to log in to other platforms, background of a photograph. Some a patient, colleague or potential applications or websites. This means real life examples include patient employer. that information held by the one records being open on a computer 4. Your obligations to comply platform may be shared between screen, a patient’s name being shown with policies covering your platforms and may become more on imaging and a patient’s face employment. widely available. It would be wise being seen in the background of an 5. Your rights and obligations in to create individual profiles for each employee’s selfie. relation to comments made about different platform or application so you you online. do not unwittingly give access to your Professional behaviour Professional and legal information. Your social media profile will often Privacy and connect your professional and private obligations personas. Your private actions may Doctors are required to meet confidentiality be seen as a reflection on your public particular standards of professional Confidentiality remains a fundamental persona. It is therefore safest to behaviour, which are primarily requirement of the doctor-patient assume that at some stage a patient contained in the Medical Board of relationship. In addition, privacy or colleague may be able to see your Eye2Eye Spring 2017 31
social media activity - consider whether familiarise yourself with and follow any you are comfortable with that before such policies, particularly in relation to posting. the use of patient information. Policies Some key tips Consider who you ‘friend’ or share will generally prohibit using social information with on social channels. media in a way that would breach any Always be sure of the identity of people law (for example privacy, defamation, whose friend requests you accept. Do confidentiality, discrimination or not accept friend requests from patients harassment, intellectual property, and do not seek to ‘friend’ patients. competition and consumer laws), Bear in mind that the AHPRA and or that would bring your employer the National Boards’ code of conduct into disrepute, and may prevent you also includes professional obligations commenting on workplace matters. such as your responsibility to promote If you are intending to use the health of the community through any patient information, even health education, disease prevention de-identified, you should be aware Understand the privacy and health promotion (clause 5.4). that such patient information may be settings of all your social Arguably, posting images or comments the property of the practice or hospital media accounts and that could be seen to endorse activities where you work and should not be review these regularly and behaviour such as excessive alcohol used without the entity’s consent, as consumption, drug use, violence or well as any relevant patient consent. anti-social behaviours, could not only If you own the practice where you damage your professional reputation, work, consider your online presence but could be in breach of your in the context of what you would be professional obligations. willing to accept from any employed Advertising or contracted doctors working in your AHPRA’s Guidelines for advertising practice. Obtain and document regulated health services (the Guidelines) Contact arising from any includes social media in the definition patient consent to use any of advertising. When using social media online presence patient information, even to promote your practice, you need You may be contacted by people who if apparently de-identified to be particularly aware of restrictions wish to seek further information or on patient testimonials, use of images advice from you in response to your including photographs, and discounts social media presence. Develop a and incentives. strategy for responding to this - for The Guidelines prohibit testimonials example, referring them to their own in advertising regulated health services treating doctor for any clinical advice including on doctors’ own social media in the first instance. If they wish to pages. Doctors are not responsible commence seeing you as their treating ! for controlling the content on pages doctor, you should ensure that a Be aware of your outside their control, and patients can formal doctor/patient relationship is professional, legal and still share views through consumer and established in the normal course. employment obligations patient information sharing websites when using social media Ruanne Brell, Medico-legal Advisor, that invite public feedback or reviews If in doubt, don’t post about experience of a practitioner or Avant practice. Importantly, you should not re-post any testimonials from third party websites on your own social media If you would like to hear more on this topic and ask pages and if someone posts an questions, Avant will be presenting two social media inappropriate comment or image you sessions at the upcoming RANZCO Conference in Perth. are responsible for removing it from your page. It is generally advisable to disable Saturday 28 October the comments function on pages you Professional development pre-conference workshop control and you should regularly review ‘Social Media and Advertising’ the content on your accounts to ensure it is all appropriate. Monday 30 October Employment obligations 9:30 – 10:00am A session at the Practice Managers’ Conference Many workplaces, such as hospitals, have policies in place regarding use ‘Social Media for Practice Managers’ of social media. It is important you 32 Annual Scientific Congress
The countdown is on - RANZCO’s 49th Annual Scientific Congress! With just two months remaining, final preparations for RANZCO’s 49th Annual Scientific Congress are in full swing. The event will be held at the Perth Convention and Exhibition Centre (PCEC) situated on the beautiful Swan River in the heart of Perth. This year’s Congress promises to deliver another exciting program packed with a range of exceptional symposia, workshops, presentations, and keynote addresses from local experts and internationally renowned speakers. In this issue of Eye2Eye we cover everything you need to know about one of the most exciting eye care events in the region. Things to do in Perth, all photographs below are courtesy of Tourism Western Australia.
The Crawley Edge Boatshed The Basin, Rottnest Island Photo: Simon Burrows Photo: Carly Donohue Lancelin sand dunes
Perth City Skyline at dawn Scuba diver inspecting red sponge, Thrombolites, in the Yalgorup National Park Photo: Simon Burrows off Rottnest Island
View from Kings Park Araluen Botanic Park Fremantle Markets Photo: Daniel Paletz Eye2Eye Spring 2017 33
About the Congress convenors With RANZCO’s 49th Annual Scientific Congress just around the corner, we interviewed this year’s course convenors, A/Prof Angus Turner and Dr Fred Chen, on some of the highlights to look forward to at this year’s event. A/Prof Angus Turner and Dr Fred Chen A/Prof Angus Turner Hospital, his young family moved to Q As one of the convenors, can you London for him to pursue advanced A/Prof Angus Turner completed tell us a bit about the work that goes training in medical and surgical retina medical training at The University into preparing for Congress? at Moorfields Eye Hospital. During the of Western Australia (UWA), before five years he spent in the UK, he also studying at Oxford University and A The conference is organised completed a Doctorate of Philosophy completing a Masters of Evidence professionally by Think Business Events (PhD) in surgical techniques of retinal Based Medicine. He undertook his and we are grateful for their expertise. In addition, showcasing what the host pigment epithelium transplantation ophthalmology training in Melbourne, for treatment of dry and wet macular followed by post-graduate training at city has to offer and considering how to make the journey special requires degenerations at the UCL (University the University of Sydney in refractive College London) Institute of surgical procedures. careful preparation to cater to the varying tastes of attendees. Ophthalmology. Dr Chen returned to As McCusker Director of Lions Perth in 2010 as a Senior Lecturer at the Outback Vision, A/Prof Turner is Q How would you recommend UWA Centre for Ophthalmology and actively involved in the delivery of those attending the RANZCO Visual Science. He is also a consultant specialist outreach services to remote Congress for the first time make the vitreoretinal surgeon at Royal Perth and Indigenous communities in the most of their experience? Hospital. He and his team are funded by Kimberley, Pilbara, Goldfields Great the NHMRC and philanthropic grants I would suggest staying in Western Southern and South West regions. A and donations, helping them work A/Prof Turner holds an academic Australia a bit longer and making your on high resolution retinal imaging, post and is a Professor at UWA, where way down to Margaret River for the WA phenotyping of inherited retinal he is engaged in a number of research Branch meeting hosted the following diseases and macular degeneration, projects at the Lions Eye Institute, Saturday in the famous surfing and application of stem cell technology in focusing on service delivery for remote wine-growing region. personalised medicine and phase II/III and Indigenous people. A/Prof Turner is As a local, what are some of your clinical trials of novel retinal therapies. also a consultant at Fremantle Hospital Q favourite things to do and see in and an ophthalmology teacher for the Q What can we expect from this Perth? Rural Clinical School. year’s Congress? The water is a highlight – both the What can we expect from this A A Five days of inspiring lectures, Q graceful Swan River and the spectacular year’s Congress in Perth? comprehensive courses, invaluable coast, which features one of my opportunities to network and catch-up A This year RANZCO’s Annual Scientific favourite beaches, Cottesloe. There is with colleagues from all around Australia Congress is in the heart of the city with a burgeoning gastronomic scene and and New Zealand. Perth is remote and a stimulating academic program as well a visit to the restored State Treasury beautiful. The Congress is a perfect as some wonderful events in striking Buildings is well worth it for many of excuse to see the west coast of this venues. the restaurants. Perth has changed a lot country. since the last RANZCO Congress here! Q What are you looking forward to Q What are some of the most about this year’s Congress? Dr Fred Chen responsibilities/challenges of a RANZCO Congress co-convenor? A As always, the collegiality of RANZCO Dr Fred K Chen studied medicine is a highlight with opportunities to in Perth at The University of Western A The many responsibilities of a connect with friends passionate about Australia (UWA). After completing his co-convenor include recommending the same vocation. ophthalmology training at Royal Perth social venues and a lot of email 34 Annual Scientific Congress
correspondence with Denise and Dani work of the RANZCO Scientific you to Fremantle where you can visit from Think Business Events and Alex Program Committee. The social the only World Heritage Listed Building and Sarah from the College. We also program organised by Think Business in WA, the Fremantle Prison, and the attend several teleconferences with the Events brings delightful WA cuisine historic Fremantle Market. For those RANZCO scientific program committee. accompanied by a beautiful city view who love the ocean, Rottnest Island It is a fantastic experience and a great at Fraser’s Kings Park, location of the is easily accessible as a day trip from privilege to be a co-convenor for the Congress Dinner. The Perth Convention Fremantle port. For a more leisurely walk Congress. and Exhibition Centre, situated in the from the Convention Centre, the Kings City of Perth, is easily accessible and Park and Botanic Garden will reward you Q What are you excited about most has modern facilities for speakers and with a breath-taking view of Perth city at this year’s Congress? attendees. It has been 10 years since the centre and the Swan River after a steep last congress was in Perth. The city has 300-step climb up Jacob’s Ladder (starts I am most excited about the A expanded significantly in population at Mounts Bay Road and finishes at Cliff opportunity at this year’s Congress during this period with large investment Street in Kings Park). If you want to see for Western Australians to show our into new developments on the river. It is a one tonne pure gold coin and learn eastern states colleagues what we do definitely worth the trip across Australia all about the Australian gold rush, the well in the west. There will be many to experience the culture, art, food and Perth Mint is only a 10 minute bus ride WA ophthalmologists, researchers and hospitality of Western Australia. from the convention centre. Cottesloe allied health workers attending this beach is a favourite for travellers as this is As a local, what are some of your conference to share their experiences, Q the one of the best places in Australia to favourite things to do and see in and learn from, attendees from across see the beautiful sunset over the Indian Perth? the country, as well as from further Ocean. For a great shopping experience, afield. A For families with children, the Subiaco, Claremont, Northbridge and Q Why would you encourage others Perth zoo is a short ferry trip from the King Street in the City offer a range to attend? convention centre. A slighter longer trip of local and international brands. For on river cruise from the Elizabeth Quay foodies, Perth has a wide range of A The scientific program in 2017 at the city (right next to the convention delicious modern cuisines scattered all is outstanding thanks to the great centre) down the Swan River will take over the city and surrounding suburbs.
Social Program
Congress Welcome for Graduation and Awards Congress Dinner Delegates and Industry Ceremony and President’s Date: Tuesday 31 October 2017 Date: Saturday 28 October 2017 Reception Time: 19:00 – 22:00 Time: 18:00 – 19:30 Date: Sunday 29 October 2017 Venue: Fraser’s Kings Park Venue: The Summer Gardens Time: 18:30 (for a 19:00 start) – 22:00 Taking in a spectacular 180-degree Perth Convention and Exhibition Centre Venue: Winthrop Hall vista of Perth, in the surrounds of Enjoy the beautiful ambiance of the Celebrate the successes of our Fellows Kings Park, Fraser’s will be a magical Summer Gardens at the convention and welcome our newest Graduands setting for the Congress Dinner. Enjoy centre, taking in the sensational at this special ceremony taking place a fabulous meal with friends as we Perth skyline to meet with friends at the majestic Winthrop Hall at The congratulate our invited speakers and and colleagues. We will be having University of Western Australia. The scholarship winners. Guests are invited a traditional Welcome to Country reception onsite afterwards in the to add ‘a touch of Bond’ to your dress performed by Indigenous singer- stunning grounds of the university will for the night. songwriter Phil Walley-Stack. There make this a memorable night. will be delicious canapés and wine, celebrating the best of Western Australian produce. Eye2Eye Spring 2017 35
Non-scientific sessions: This year, we are pleased to present a number of activities, courses and opportunities for you Sessions not to be missed: to make the most of your time in Perth. Once Sunday 29 October again there will be a number of non-scientific Contemporary Cataract Issues: Pause, courses and symposia taking place including Stop or Rewind? Ethics and Professionalism; Crossing the Monday 30 October Line and Stepping up to the Challenge of Plenary Session: ORIA update the Future, an important session covering Tuesday 31 October workforce survey results, area of need, the Plenary Symposium: Minimally Invasive changing face of medical records, CPD, audit, Glaucoma Surgery revalidation and more. Wednesday 1 November We have also brought together a number of facilitators to present the RANZCO Professional Development Workshop Plenary Symposium: Clinical on Saturday afternoon. This CPD accredited session will Controversies include updates and information from experts exploring a broad range of topics including practice and personal *Schedule taken from the preliminary program investment strategies, working collaboratively with allied and dates are subject to change. Please visit the health, social media and advertising and more. Congress website for updated information. Full program details are available on the Other Meetings page of the congress website: http://ranzco2017.com/other-meetings/
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Moorfields Eye Hospital, London drugs work by inducing cell death in and was awarded a PhD for work the scar forming cells. I then went to Invited on ocular fibrosis at the Institute the US to learn to work on models of of Ophthalmology, University glaucoma in San Diego with Robert Speakers College London. He subsequently Weinreb. The work I did there was to completed glaucoma fellowships examine how some of the drugs that Named Lectures at the University of Sydney and UC we use in glaucoma actually work – San Diego where he then joined the When I came to Melbourne ten years Council Lecture glaucoma faculty, prior to moving to ago, I became very interested in the Prof Jonathan Crowston Australia in 2006. ageing process and finding out why Sir Norman Gregg Lecture Prof Crowston’s research is there’s an exponential increase in rates Dr Noel Alpins AM focussed on understanding why of glaucoma as we get older. Dame Ida Mann Lecture ageing predisposes to optic Prof Trevor Sherwin nerve disease, particularly on Q What do you see as your most eminent accomplishment in your Fred Hollows Lecture neuroplasticity and the potential for career? Dr Geoffrey Cohn OAM retinal ganglion cell recovery. Q Tell us a little bit about the A I’m most proud of bringing Update Lectures work/research you’re involved in. young researchers into the field of Glaucoma glaucoma and I’m also proud of the Dr Anne Coleman A My research is in the field of way that I look after my patients. glaucoma and I work with both a Retina basic laboratory group and a clinical Q You’re presenting the Council Prof Lyndon da Cruz th group and what we’re trying to do Lecture at RANZCO’s 49 Annual Cataract is find ways of protecting the optic Scientific Congress, can you Dr Bonnie Henderson nerve from the vulnerabilities that give us a sneak peek of your Oculoplastic occur as our nerves get older. We presentation? Prof Don Kikkawa have two approaches—one is trying One of the things I’ll be talking to understand why our optic nerves A Paediatrics about in this lecture, or asking the become more vulnerable as we age Prof Michael Brodsky question really, is if it’s possible and the second is to develop clinical to improve vision in people with methods for testing interventions glaucoma – can we actually make that reverse the effects of ageing. the cells that are there and still Q What prompted you to surviving work better, and might specialise in glaucoma and what it be possible to regrow an optic are some recent, interesting nerve? discoveries in this area? Q What will the audience be A I got into glaucoma through able to take away from your some interesting wound healing. I presentation? was lucky enough to go and hear a lecture from Professor Sir Peng Tee A I’d like the audience to Khaw in London. He had done some understand the key challenges we very interesting work on new drugs face as clinicians and researchers that prevented scar formation in the in glaucoma. Can we measure the eye. It was an excellent and inspiring impact of an intervention on making Prof Jonathan Crowston lecture so I promptly decided that that nerve healthier, and can we do I was going to do a PHD with him. I it in a matter of a few months rather Named Lectures spent three years working with him than the one or two years that it looking at scarring in the eye after currently takes us. Council Lecture glaucoma surgery. Prof Jonathan Crowston Q Tell us an interesting fact How has your work about yourself that most people Prof Jonathan Crowston is the Q contributed to the surgical don’t know. Ringland Anderson Professor of and medical management of Ophthalmology, University of I grew up in Austria and I’m a glaucoma? A Melbourne and Managing Director of qualified ski instructor. I spent much the Centre for Eye Research Australia. A The initial work that I did with of my early life teaching people He is a practicing glaucoma specialist Peng was trying to understand how who had broken their spinal cords clinician at the Royal Victorian Eye these drugs, which are very powerful to ski, including paraplegics and and Ear Hospital, Melbourne. agents in stopping excess in scar tetraplegics, and I’ve taken a lot of Prof Crowston gained his formation, actually work. We did groups of people with spinal injuries ophthalmology training at some early work showing that these to the mountains to ski. Eye2Eye Spring 2017 37
recognised contributions to the This phenomenon of ocular residual advancement of refractive surgery astigmatism (ORA) provided the basis over his career. In 2010, he was for Vector Planning that resolved the invited Council Lecturer at the the prevailing differences between RANZCO Annual Scientific Congress. corneal and refractive values and Q You’re presenting the Sir resulted in less astigmatism remaining Norman Gregg Lecture at RANZCO’s overall. The transition from incisional 49th Annual Scientific Congress, surgery to excimer laser refractive can you give us a preview of your surgery resulted in two conflicting presentation? approaches that were paradoxal and confusing to me and was the driving Astigmatism management has A force to developing a single consistent become a more important parameter paradigm for astigmatism treatment to treat over recent years along with Dr Noel Alpins AM overall. other refinements of small incision Sir Norman Gregg Lecture cataract surgery and laser refractive Q What advice would you give to Dr Noel Alpins AM surgery. young ophthalmologists looking to Both corneal and refractive Dr Noel Alpins AM, of Melbourne, specialise in cataract and refractive parameters have played a part is a widely recognised clinician, surgery? individually but the development of investigator, and speaker, and the vector planning has enabled both to A Develop your skills in obtaining developer of a comprehensive be included in the surgical plan. emmetropia on cataract surgery and approach to astigmatism analysis Analysis of outcomes has become introduce toric implants to achieve called the Alpins Method. He was an more effective using vectors so that this. Once you have gained the early adopter of small incision cataract satisfaction of success in this activity, surgery, and incisional as well as laser modern techniques developed have then move into laser refractive surgery refractive surgical techniques. been adopted by the cataract and Dr Alpins published the basis of refractive journals and the FDA. and ICLs. the Alpins Method in a 1993 paper New parameters of measuring such Remember to analyse your results and expanded the approach over as CorT have also been developed in an ongoing systematic manner the succeeding two decades. Several for corneal astigmatism for greater to refine nomograms and keep peer-reviewed journals, as well as accuracy in toric implant surgery as improving visual outcomes. well as laser vision correction. the American National Standards Q What are some changes you Institute, have adopted the method as Q What would you like the hope to see in the next five to ten a standard for reporting astigmatism audience to take away from your years in this field? results. The method is incorporated presentation? in a surgical planning and outcomes A Over the next five to ten years I analysis program called ASSORT. A The audience will benefit from the hope to see adoption of CorT as an As an honorary senior fellow, Dr innovations in astigmatic reduction astigmatism parameter becoming Alpins is a clinical senior lecturer at surgery that will give improved more wide spread with a general shift outcomes and reduced dissatisfaction the University of Melbourne. He serves to vector planning from refractive rates. on the editorial board of many peer- based treatment. reviewed publications and ophthalmic You pioneered the Alpins Q Earlier this year you were periodicals, including the Journal of Method for astigmatism analysis, Q presented with a prestigious Cataract & Refractive Surgery, Ocular can you tell us a bit about this and Order of Australia Medal for Surgery News, EuroTimes, Cataract and how it all came about? Refractive Surgery Today and others. He your significant contributions to has published more than 150 articles A While developing outcomes refractive surgery innovation, how and 20 book chapters, receiving more analysis programs, to be able to do did you celebrate? than 1100 peer-review citations. this with both spectacle values for In 2015 he received the Certificate astigmatism as well as from corneal A Receiving the award has been a for Outstanding Contribution in topographers, I recognised that the privilege for which I am very grateful. Reviewing, awarded by Elsevier. difference between the two was as a On Australia Day I drove to Newbridge Dr Alpins is a recipient of the result of targets that were actually not in Victoria to give a speech as an Lans Distinguished Award from the zero even though maximum reduction Ambassador to hopefully inspire International Society of Refractive was the goal. Once this facet was the locals at the Australia Day flag Surgery (ISRS) and American Academy introduced with analysis, then parallel raising celebrations. When I got back of Ophthalmology (AAO) (2012); the corneal and refractive analysis were to Melbourne, my daughter had had AAO Achievement Award (2013); possible using the intended common a baby boy, so we celebrated both and the ISRS Lifetime Achievement astigmatic treatment (the TIA – target events with much champagne at Award (2014) for his internationally induced astigmatism vector). dinner. 38 Annual Scientific Congress
heal the sick or prevent disease if the Some of us will teach or operate in the skills and modest funding are made field. Others train and inspire guests available to the proponents. from other countries with our skills Hans Rosling shared a key insight: and perspectives in our Australian We, the experts on eye and vision facilities. No less important is the problems, must be advocates for the person who donates equipment or blind and needy. The political and support, the colleague who prepares economic barriers to sight restoration lectures and tutorials for others will often be more vulnerable to to deliver, the lateral thinker who assault by the solemn and well- explores ways in which angle-closure substantiated advice of visiting glaucoma can be acknowledged as a foreigners than they will be to the principle problem and strategies for pleas of our local colleagues. In many early detection and treatment. Dr Geoffrey Cohn ways, we are in a privileged position One area where such contributions that enables us to empower our peer can make a difference is in detection Fred Hollows Lecture group. and management of angle-closure Dr Geoffrey Cohn We will need considerable powers glaucoma, a blight afflicting rapidly of persuasion. Health care provision increasing numbers in South East Dr Cohn has a lifelong concern seems, in many countries, to be rigid Asia and presenting tragically late. with community medical care and and dysfunctional. An ophthalmologist We have noted up to one in eight of improved modes of service delivery. in Myanmar, Cambodia or Indonesia our profoundly blind outpatients in From the former “homelands” of who accords each patient 30 minute Myanmar who had been hoping for South Africa to Australia’s own consultations may be noble in his or cataract surgery only to be irreversibly neighbourhood – Indonesia, her commitment to the individual, blinded by glaucoma. Cambodia, Papua New Guinea and but does this serve the needs of the What inspired you to become an Myanmar – he has worked with broader society? Q ophthalmologist? local colleagues on empowering The Myanmar and Cambodia Eye communities to deliver and improve Care Projects anticipate committing A An extraordinary undergraduate their eye care. about 30 seconds to confirming the education fuelled by the most Coming from the intrinsically diagnosis and treatment proposals committed of teachers prepared generous nation of Australia, he penned by a well-trained auxiliary. me for many scenarios. Working as has been able to draw upon many Our results are numerous and a generalist in a remote “mission resources, such as equipment donated demonstrably excellent and our hospital” in the Kalahari Desert was by colleagues, hospitals and the coverage broad. We contend that constantly challenging. I could cope ophthalmological support industry. our approach is compassionate and with the trauma, the emergency In addition, many Australian eye effective. surgery, the obstetric complications, surgeons have contributed their And appropriate to the the burr holes; with entering a chest clinical, surgical and teaching skills. circumstances. or an abdomen. Vision problems Lay individuals and groups have My hero is Counsellor Wang Anshi, and headaches were ubiquitous and provided funding. who guided the Song Dynasty almost proved a locked vault resistant to my Dr Cohn has been able to confirm a thousand years ago toward the novel every attempt to find an entry point. his conviction that much of the concept that the state should serve We had a huge TB section, from blindness afflicting the developing the needs of the people. At a time which every patient required sputum world can readily be addressed by when the wealthy were concentrating stained weekly. This posed an education, appropriate technology financial power and influence in few impossible burden, which was taken and generosity of spirit. hands and regarding taxation as on willingly by a graduate of the optional, he urged the emperor to You’re speaking at the Fred village school. Gabriel went on from Q strengthen social institutions. Hollows Lecture at RANZCO’s 49th expertise at Ziehl-Neelsen staining Australia has been a model of what Annual Scientific Congress, can to examining the slides and thence society can and should achieve. you give us a sneak peak of your to other technical expertise. He was It is incumbent upon us as good presentation? grateful for the work, accepted a neighbours to protect and propagate modest salary and a small house and A Despite the remoteness of the model. mastered every skill we taught him. good news from the headlines, This seemed to me to be a model What would you like the many positive developments can Q for health care: devolve every task audience to take away from your be recognised in the fight against to an appropriate auxiliary, allowing presentation? blindness. The late Swedish Professor the clinicians to commit more time of International Health, Hans Rosling, A Any of us can contribute to health to consultation and management. I contended decades ago that there and social wellbeing in our own and look back on my internship in which is, in the developing world, no limit neighbouring countries. Little of the we had spent the early morning to what expertise can be applied to work is glamorous. All of it is fulfilling. hours taking blood, and note that Eye2Eye Spring 2017 39
phlebotomists have long taken over Raj Devasahayam, working with the that role. The compelling logic of this incomparable Dr Sai Win, have given can constructively be extended in Mandalay an eye bank which will many ways. restore sight to innumerable people I came to Australia to train in over the years to come. ophthalmology, returning to that It is a privilege to work with part of Africa as the community colleagues such as Richard Rawson, ophthalmologist four years later, who is willing to maintain a service able to create a pyramid of auxiliaries while I am dragged away to deal with and clinicians who could address the crises, and Sister Barbara Roberts, myriad eye problems. whose nursing students continue Q You’ve done quite a bit of aid to train other scrub nurses with the work in developing countries over precision that Barbara introduced. That the years, can you tell us about is a legacy of which one can be proud. Dr Anne Coleman some of the challenges you faced My friend and colleague Kwon and how you overcome these? Kang has provided the equipment Update Lectures and teaching needed to introduce The principal challenge is not Glaucoma A vitreoretinal surgery to Upper to appear challenged. When my Dr Anne Coleman Myanmar. Kwon rejects the notion of Australian team was invited to teach altruism, contending that we all gain Anne L. Coleman, MD, PhD is the Fran in Cambodia during the post-Khmer and Ray Stark Foundation Professor of Rouge recovery, we became aware something from this work. I concur, but do perceive a mindset in Myanmar Ophthalmology at the Stein Eye Institute of how readily one could collapse of the David Geffen School of Medicine in despair: the infrastructure was in and Cambodia that I would define as weaponised altruism: a perception at UCLA; Vice Chair for Academic disarray. Mortar shells had destroyed Affairs in the UCLA Department of the upper floor of the operating that although the government may do Ophthalmology, and Professor of theatres, so that rain leaked through nothing for the people, we will provide Epidemiology in the UCLA Jonathan and constantly. Power was unreliable, care and services with unbounded Karin Fielding School of Public Health. reticulated water worse. Roads love. She is Director of the Stein Eye Institute resembled river beds. Landmine What is one thing you have Centre for Community Outreach and injuries were so common that Q learned over the course of your Policy, which encompasses the Centre farmers could not safely enter their career that you’d like to share with for Eye Epidemiology, a research centre fields. that has supported numerous projects Our Khmer doctors and nurses us? at the interface of eye care and public proved to be the most positive, A We have long recognised the resilient and inspiring of people. They health, as well as the UCLA Mobile Eye imperative of applying appropriate Clinic, an outreach program founded acknowledged that they had reached technology. The rise of industrial a nadir and that only they could lift in 1975 that has screened thousands power in the developing world of individuals, focusing on children in themselves out of it. They thanked us has dramatically improved the profusely for assisting them to do so. schools located in underserved areas. affordability of such high technology. Dr Coleman received her medical Q What sparked your interest It is of little merit unless there is a degree from the Medical College of in foreign aid work and why corresponding cohort of experts Virginia, completed her ophthalmology would you encourage other able to spread the benefits of this residency at the University of Illinois, ophthalmologists to work in technology to those who need its obtained fellowship training in developing countries? What are help and, critically, to where they glaucoma at the Wilmer Eye Institute at some of the rewards of providing need it. The ideal will be to train, Johns Hopkins University, and earned eye care in developing countries? motivate and deploy workers a PhD in Epidemiology from UCLA. who have our skill and depth of A My mentor when I entered Dr Coleman’s research ranges across the field in Indonesia was Peter knowledge. areas including the etiology, diagnosis, Graham, a Perth eye surgeon who If we are unable to do so, it is treatment, and societal impact of has committed his life to helping incumbent upon us to ensure that an glaucoma, cataracts, and age-related the needy. Peter is a most effective alternative solution is conjured up in macular degeneration (AMD), including teacher and propagator of the concert with our local colleagues and quality-of-life research for patients positive self-help message. their communities. I have observed impacted by these eye diseases. Her If we are able to attain the key goal repeatedly that buildings and high work has appeared in high impact of making ourselves redundant, we technology acquisitions provide no journals such as JAMA, i, Ophthalmology, will have succeeded. We have not service. People can and do. and American Journal of Ophthalmology yet done so. There is much teaching Appropriate technology has zero including a compendium on “Big yet to do and much infrastructure to impact without appropriate service Data” in ophthalmic research that she build and support. Gerard Sutton and delivery strategies and personnel. presented as the 72nd Edward Jackson 40 Annual Scientific Congress
Memorial Lecture at the 2015 annual of glaucoma through their direct patients and for at-risk populations meeting of the American Academy of influence on IOP and/or through other around the world. I have devoted Ophthalmology (AAO). mechanisms of glaucomatous optic substantial effort to reviewing the work Dr Coleman has also been actively neuropathy, which will be discussed in of other researchers and scientists involved in national programs in my presentation. for the sake of advancing evidence- ophthalmology, as the prior Chair of a based knowledge and strengthening What would you like the audience 14-member committee of eye health Q the scientific foundation of care for to take away from your presentation? experts overseeing the National Eye glaucoma and other eye diseases. I was Will you be sharing any new Health Educational Program’s education recently a member of the Institute of techniques, methods or treatments programs, as a consultant to the Medicine (IOM) Committee on Public for glaucoma management? If so, U.S. Food and Drug Administration Health Approaches to Reduce Vision could you please provide further Ophthalmic Devices Panel, and as the Impairment and Promote Eye Health details? prior Secretary of Quality of Care for the to help address the current state and AAO. She is the founding Director of A Today, patients take it upon burden of vision loss and poor eye the AAO H. Dunbar Hoskins Centre for themselves to become informed health in the United States along with Quality of Care, Chair of the Council of about the potential relationships the creation of recommendations to the American Ophthalmological Society, between lifestyle choices and their improve the population’s eye health. My and a member of the Board of Trustees health. They seek information about personal research has focused on the of both Helen Keller International and things they can do to help minimise public health impact, risk factors, and the St John of Jerusalem Eye Hospital. the risk of losing vision, beyond treatments of the main causes of vision She is a former president of Women in drugs and surgery. However, it is loss and blindness in the developed and Ophthalmology and at-large member common for glaucoma patients and developing world: cataracts, glaucoma, of the AAO’s Board of Trustees. She is their families to be confused by all age-related macular degeneration, and a Member of the Institute of Medicine the information and misinformation uncorrected refractive error. Additionally, Committee on Public Health Approaches they find on the internet, and perhaps I have served as a faculty member in the to Reduce Vision Impairment and their misinterpretation. Therefore, it UCLA Department of Ophthalmology Promote Eye Health and a Scientific is essential for care providers to have for 27 years and have been a provider Advisory Panel (SAP) Member for knowledge of the available evidence so for many patients who inspire me to Research to Prevent Blindness. She that they can address patients’ questions continue my work to assist in their has received the Academy’s Life and concerns and effectively motivate care. Having the opportunity to help Achievement and Secretariat Awards. lifestyle changes. improve individuals’ lives, whether it be Since 2003, she has also served as through individual patient care, research Executive Editor of Glaucoma for the What do you see as the most Q or quality advancement, inspires and American Journal of Ophthalmology. eminent accomplishment in your encourages me to continue my work in career? Q You’re presenting the Glaucoma this field. Update Lecture at RANZCO’s 49th The most eminent accomplishment A You were the President of Women Annual Scientific Congress, can in my career so far has been the Q in Ophthalmology from 2003 to you give us a preview of your honour of presenting the 72nd Jackson 2006, what do you see as some of the presentation? Memorial Lecturer at the 2015 American biggest challenges that women in Academy of Ophthalmology annual A In my presentation for the Glaucoma ophthalmology face and what do you meeting. Using data from the largest Update Lecture I will use evidence in the think needs to be done to address ophthalmic clinical registry, the AAO current literature to review glaucoma these? risk factors beyond the traditional Intelligent Research in Sight (IRIS) ones. Glaucoma is believed to be a registry, my lecture sought to introduce A One of the biggest challenges multifactorial disease characterised by ophthalmologists and vision researchers that women in ophthalmology face optic nerve fibre atrophy and damage to the concept of “Big Data” with an is balancing their personal life and to the optic nerve head. Currently, IOP illustration of how a very large sample work. We can address this issue by is the primary and only evidence-based size can provide information about rare providing lectures and courses on how treatable risk factor for glaucoma. complications that would remain elusive to approach this balance. In addition, Traditional risk factors for glaucoma in smaller data sets. This lecture, and its support groups should be established include family history and ethnicity. counterpart manuscript, is the first study and opportunities should be provided However, there is growing evidence using data from the IRIS registry, which for them to interact with positive supporting the roles of other factors currently has eye examinations and women role models and mentors. that predispose a person to glaucoma clinical information on over 32 million Another challenge women face in damage. These “non-traditional” risk patients. ophthalmology is having a voice in organised medicine. This issue can be factors include low blood pressure or What inspires you to continue to Q addressed by having more women perfusion pressure and other vascular work in this field? factors that can influence the circulation in leadership roles, including at least to the eye and optic nerve. There are A I have dedicated myself to three women on boards, and by also a number of lifestyle factors that preserving and, where possible, providing speaker education doctor may contribute to the development improving vision both for individual training. Eye2Eye Spring 2017 41
tumours, and acquired disorders. I first became interested in the specialty Q What will the audience be during residency when we staffed a able to take away from your county hospital trauma centre where presentation? I took care of patients with major A Hopefully some pearls to improve eye and facial injuries. I was amazed their own surgical techniques and back then, as I still am today, that the results. improvement and final results for patients even with the most severe Q Tell us an interesting fact about injuries is astounding. It is one of yourself. the few fields in medicine where the I am married to a twin and I am the preservation and restoration of vision, father of twin girls. facial function and appearance are all Prof Don Kikkawa intimately interwoven. Breakthroughs include a great shift Oculoplastic towards personalised medicine. For Prof Don Kikkawa example, we recently had a patient Don O. Kikkawa is Professor and who had undergone numerous Chief of the Division of Ophthalmic procedures elsewhere to repair an Plastic and Reconstructive Surgery, orbital fracture, but his eye was and Vice Chairman at the University still displaced. We removed his old of California at San Diego (UCSD) implant and implanted a customised Department of Ophthalmology and 3D printed orbital implant. Now Shiley Eye Institute in La Jolla. He holds he is as good as new! Similarly, at a joint appointment as Professor in the the molecular level, we are able to characterise the markers on tumours UCSD Division of Plastic Surgery. He Prof Michael Brodsky is a Fellow of the American Academy and recommend specifically targeted of Ophthalmology and the American therapy based on a patient’s particular Paediatrics College of Surgeons. genetic and tumour profile. Prof Michael Brodsky Prof Kikkawa served as the Q How has your work contributed Michael C. Brodsky, M.D. is a 2014 President of the American to your field of expertise and what Professor of Ophthalmology and Society of Ophthalmic Plastic and are some of your most ground- Neurology and the Knights Templar Reconstructive Surgery (ASOPRS) and breaking findings/innovations? Endowed Professor of Ophthalmology is a Director for the American Board of at the Mayo Clinic in Rochester, Ophthalmology. He is director of an A Time is the best judge of one’s Minnesota. His practice consists of ASOPRS accredited fellowship and has career. I am not one to judge my own general paediatric ophthalmology been elected to numerous best doctor contributions. It's a privilege to care for and adult strabismus but he has lists. He co-directs the UCSD Thyroid patients and if I have helped at least a dedicated interest in neuro- Eye Centre and is a former program one patient see better, live a better life ophthalmologic disorders of childhood. director of UCSD’s ophthalmology or be more comfortable then that is a He just completed the 3rd edition of residency. big contribution for me. his single-authored textbook entitled Q Tell us a little bit more about the Q What do you see as your most Pediatric Neuro-Ophthalmology. He work / research you’re involved in. eminent accomplishment in your has also elucidated many of the career? neurologic mechanisms of infantile Our clinical service is very busy A strabismus and has defined the clinically and we train fellows from the I’d have to say balancing being the A subcortical pathways involved in the US and internationally. Our research best husband and father I can be to generation of these movements. He has is primarily clinical but we have my family with being the best doctor I proposed a mechanism to explain the collaborated on some interesting basic can be to my patients. development of infantile nystagmus science studies in thyroid eye disease. Q You’re presenting the in early infancy. He has published Q What prompted you to Oculoplastic Update Lecture at over 200 peer-reviewed papers and specialise in ophthalmic plastic and RANZCO’s 49th Annual Scientific given many guest lectureships both reconstructive surgery and what are Congress, can you give us a sneak nationally and internationally. some recent breakthroughs in this peek of your presentation? What You’re presenting the Paediatrics area? will be the focus of your lecture? Q Update Lecture at RANZCO’s 49th A Oculoplastics is a diverse field A I will present an update on Annual Scientific Congress, can you where we care for patients with eye oculoplastic surgery, including newer tell us a bit about what you’ll be and facial problems from a variety of surgical techniques and research in covering? What will be the focus of causes such as trauma, birth defects, the field with a clinical focus. your lecture? 42 Annual Scientific Congress
A I will be discussing congenital malformations of the optic disc and how they can be used to predict coexisting neurologic and systemic abnormalities. Q What would you like the audience to take away from your presentation? A My goal is to teach the audience how to identify each unique malformation and then to institute an appropriate neurodiagnostic evaluation. Q What prompted you to subspecialise in paediatric ophthalmology? A My specialty is in ophthalmology and my subspecialties are in paediatric ophthalmology and neuro- ophthalmology. I chose ophthalmology Congress App because I loved the fact that you The Congress app allows you to access details about speakers, the could see most lesions directly and program and the industry exhibition from the palm of your hand. You often diagnose them by their general can find speakers and sessions related to your specific area of interest, appearance. So, unlike in other create a personalised schedule of your Congress sessions, take notes subspecialties, once you look at the and view detailed maps of where events are taking place. The app will eyes you often don’t need to take be available closer to Congress. For iPhone (plus iPad and iPod Touch) much of a history to establish the and Android phones visit your App Store or Google Play on your device diagnosis. and search for RANZCO 2017. For all other phone types, in your mobile Q What advice would you give to browser go to http://www.core-apps.com/dl/invisage_ranzco17 young ophthalmologists looking to specialise in paediatrics? What is the most rewarding aspect of working Key Dates in the field? Late Rate Registration Commences A To play with the children in your (Fellows Only): office, and have windup toys and 3 October 2017 lollipops so that their visit will be fun Annual Scientific Congress: and exciting and memorable. It is 28 October - 1 November 2017 wonderful when mom says that they www.thinkbusinessevents.com.au have been looking forward to their next visit. Q What do you see as the most Keep up to date! eminent accomplishment in your Ensure you keep up to date with all the career? exciting developments as Congress A Probably the publication of draws closer by visiting the Congress the final edition of my book, which website www.ranzco2017.com is a compendium of experience in paediatric neuro-ophthalmology. Contact Q Tell us an interesting fact about For more information, contact yourself. the Congress organisers: A I grew up in San Francisco during Think Business Events the 60s and went to Golden Gate Park Level 1, 299 Elizabeth Street on Sundays to hear rock bands like Sydney NSW 2000 AUSTRALIA Jefferson Airplane and the Grateful Tel: +61 (02) 8251 0045 Dead play before they became Fax: +61 (02) 8251 0097 famous. Email: [email protected] Eye2Eye Spring 2017 43
Professor Fiona Wood AM to speak at RANZCO Graduation Ceremony The opening address at this year’s Graduation and Awards Ceremony will be delivered by a remarkable woman. Not only is Professor Fiona Wood a world leading plastic surgeon, burns specialist and researcher, she also Professor Fiona Wood spearheads the Fiona Wood Foundation – a not-for-profit “Since I started my career, I was very culture environment and using the focused on surgery. I really wanted to first stage of the tissue culture process. organisation dedicated to be a surgeon and I recognised that in Instead of putting the skin cells of the ground breaking scientific order to do so I needed a CV that gave person in the lab to grow, we put them and clinical research into me those choices. So I looked around back on that individual to grow in situ pioneering new treatments for – I was a very inquisitive and curious and that’s the fundamental difference. kind of person – and I realised that It’s all about reducing time.” healing burns and minimising doing research was a perfect solution. Fiona was also the first female plastic scarring. She has carried It gave me the opportunity to link with surgeon in Western Australia and knows out extensive research into people that I otherwise wouldn’t have, firsthand the challenges women face burns injuries, revolutionised people who were doing different and in the workforce and medicine more innovative things. I was able to start as specifically. “For me I was one of twelve the treatment of burns and a research assistant working from the women in medical school in my year. saved the lives of countless bottom of the pile. Research came really Surgery wasn’t that common for women burns victims globally. In 2002, easy for me because it was the right at that stage but it is increasingly so now. The most important thing to do as head of the Royal Perth thing for me to be doing,” she says. When asked what advice she would in overcoming barriers [that women Hospital's burns unit, Fiona give to young doctors starting out in face], is we have to keep asking the was instrumental in carrying medical research, she says that passion is question ‘why?’ and keep the issue out lifesaving treatment for the key to pursuing a career in research. front of mind because, clearly, there are plenty of women good enough! I 25 patients injured in the Bali “You’ve got to have a positive energy and a real passion for what you do. think we really need to work together terrorist attack. You have to be very interested in what collectively to make sure that surgery – From a young age, the importance you’re investigating; it has to really mean in ophthalmology or any specialty – is of education was instilled in Fiona by something to you.” a job that people are proud to do and her parents, who left school early and The theme of her talk at this year’s that they can explore their boundaries wanted to make sure they provided Graduation Ceremony – Striving for and add something to the body of their children with the best education Excellence – is something that Fiona knowledge. I think that we need to possible. “They taught us that education knows all too well. High on the list of her understand that diversity, whether it gives you choice – a choice to get up in achievements is the invention of spray be gender diversity or diversity in other the morning and enjoy what you do,” on skin, Recell, which has revolutionised ways, will actually bring a richness to Fiona says. burns medicine globally. Incredibly, the the table in such a way that the body When she left school, she took process works by harvesting healthy skin of knowledge will be expanded,” she inspiration from her brother who cells from a patient to develop a spray explains. was already studying medicine at St on solution that treats scars from burns Thomas’ Hospital in London. She also or trauma. “The whole process came Graduation & Awards Ceremony & had a knack for maths and science, about to try and solve a clinical problem President’s Reception Date: Sunday 29 October 2017 and knew that medicine would be a of speed of healing. The quicker we Time: 18:30 (for a 19:00 start) – 22:00 natural fit. Her studies would lead her heal, the less scarring we have. The Venue: Winthrop Hall down the path of medical research. whole focus is using the body as a tissue 44 Annual Scientific Congress
Women in Ophthalmology WIO Session Lunch at RANZCO 2017 The Case for Inclusion The Women in Ophthalmology (WIO) group Date: Monday 30 October 2017 is hosting a lunch at the upcoming RANZCO Time: 2pm – 3.30pm Congress in Perth on Tuesday 31 October, and Synopsis: The rise of diversity and inclusion is far all Congress attendees, male and female, are from an exercise in political correctness and in fact reflects the realities of daily life in multicultural welcome to attend. Australia and New Zealand. A cursory glance at your Professor Robyn Ward AM, who will be presenting Bridging colleagues and patients reveals a complex landscape the Gender Gap as part of The Case for Inclusion session, will of intersectionality. This session reveals the challenges be a guest at the lunch and is happy to be involved in informal and opportunities facing all Fellows and showcases discussion and to answer questions RANZCO members may have RANZCO initiatives designed to harness the very best about her talk. Professor Ward is a physician, scientist and Deputy each Fellow and potential Fellow has to offer. If you’re still not convinced, Clayton Utz Partner, Saul Harben, Vice-Chancellor (Research) at The University of Queensland where will speak about why his law firm has embraced she leads the University-wide research portfolio, in addition to diversity and inclusion and what the key learnings the Science in Australia Gender Equity (SAGE) Pilot program. The have been. SAGE Pilot program is modelled on the UK’s Athena Scientific Program highlight: Bridging the Gender Gap by Women’s Academic Network (SWAN) program, which has had Professor Robyn Ward proven success in addressing gender inequality in science, technology, engineering, mathematics and medicine (STEMM) Gender inequality in the workplace remains a in higher education and research institutions. She will explore real and prevalent issue in Australia and New Zealand. Women earn less than men for the same our knowledge of the barriers, and current understanding of work, are less likely to advance their careers, are why these inequalities persist, along with strategies to bridge the underrepresented in leadership positions and gender gap. by the end of their careers have half their male Please indicate your attendance via the registration form. If you counterpart’s superannuation savings. Why does have already registered and wish to attend, please send an email this gap exist and what can we do about it? to the Congress Office at [email protected] RANZCO Professional Development Workshop Session Date: Saturday 28 October 2017 Time Topic Sponsor/ Time: 12.30pm to 5.00pm Facilitator with a light lunch beforehand, 12:30pm Lunch afternoon tea and post-workshop Welcome remarks - Simon Janda - Manager, Professional 1.00pm – 1.10pm networking drinks Development (RANZCO) Venue: Perth Convention and 1.10pm – 1.50pm Practice, Personal and Investment Funding BOQ Specialist Exhibition Centre and Strategies Cost: $65 per delegate 1.50pm - 2.30pm Working collaboratively with allied health for Vision This newly developed Professional better person-centred outcomes: The case Australia Development Program is for referring patients to vision loss support designed to provide a broad services upon diagnosis ranging afternoon of education 2.30pm - 2.50pm Afternoon Tea and interaction. Each session has 2.50pm - 3.30pm Social Media and Advertising AVANT been specially developed with Navigating your financial responsibilities our facilitators to deliver relevant, Cutcher and 3.30pm - 4.10pm – A medical professional’s path to financial up to date news and information Neale to assist you in your daily practice. success Registration is open now and we How to avoid getting sued? Lessons learnt encourage you to register early to 4.10pm - 4.50pm from a review of over 500 cataract patient MIGA avoid disappointment records. Closing Remarks - Simon Janda - Manager, Professional 4.50pm - 5.00pm Development (RANZCO) ACCREDITED CPD ACTIVITY 2017 5.00pm - 6.00pm Networking/refreshments Eye2Eye Spring 2017 45
Senior and Retired About Michael (Mike) Zekulich Fellows’ Group: In 2005, Mike retired from the West Australian newspaper after a career spanning 41 years which What’s on at included 20 years as an agricultural editor. In that time, Congress 2017! he has won numerous awards for his work including the University of Western Australia’s coveted Arthur If you are aged 65 or over, or are Lovekin prize for journalism following the awarding of retired, you’re invited to attend the a Churchill Fellowship and a tour of the Middle East. Senior and Retired Fellows’ Group Other media awards of which he is especially proud include: the Jack dinner to be held at The RANZCO Mann Memorial Medal for his contribution to the development of the Annual Scientific Congress on West Australian wine industry; the Royal Agricultural Society’s annual reporting prize; and the George Mulgrue medal sponsored by the West Monday 30 October 2017 from Australian Wine Press Club of which he has twice been president and 7pm. The Group dinner was was made a life member in 2013. first introduced in 2012 and has Mike has visited many of the world’s major wine producing areas cemented its spot in the Congress – in France, Germany, California, South Africa, New Zealand and all Australian states. His wine work has resulted in him being made a program as a great success with a legend of the WA hospitality industry and Icon of the Swan Valley. strong turnout each year. Currently, he writes for the national magazine Winestate where he Please contact the RANZCO has been a contributor for 35 years and contributed a monthly wine column to the Tatler magazine group in Asia for ten years. office on +61 2 9690 1001 or Mike’s talk will be based on the history of the Swan Valley grape and at [email protected] should wine industry since the first wine was produced in 1834. He will share you have any questions about the his father’s story of human interest – from a penniless 16-year-old who could speak no English arriving in WA in 1924, to becoming the dinner. financial umbilical cord for a destitute Croatian family devastated by The Senior and Retired Fellows’ Group war, to induction in the Western Australia Hall of Fame for his services Lounge will once again be available at to viticulture. Time permitting, this will be followed by anecdotes from Congress for Fellows to reacquaint with the trenches of journalism. colleagues, meet new friends, tour the museum section and hear interesting lunchtime presentations. This year, we are delighted to have Dr David Kaufman and Professor Ian McAllister giving talks on the museum display and the evolution of design and function in the ophthalmoscope. Dr Graham Henry will also be presenting on his profound interest in gemmology after retiring from ophthalmology practice. And lastly, we are thrilled to have local Perth resident, journalist and author of Spirit of the Swan, Mr Michael Zekulich come in to share a stimulating talk with us. Further details about Michael and his talk can be found on this page. Reserved seating with the best view in the house will be prioritised to the Group at the Graduation and Awards Ceremony held on Sunday 29 October 2017 starting from 6.30pm. Please make sure to identify yourself as senior or retired when you register for Congress and then simply announce yourself as senior or retired on the night and a staff member will escort you and your guests to the designated seats. 46 Annual Scientific Congress
Practice Managers’ Annual Conference 29 – 31 October 2017 About the program
Sunday 29 October Practice Mangers’ Social Dinner Direct Control Medical Turning the key on practice management Monday 30 October 2017 Australian Health Industry Group The Practice Managers’ Social Dinner will be held Performance management; effective interviewing; and at The Reveley Bar, a 15 minute walk from the staffing contracts (three separate presentations) conference centre, located on Eastern Promenade, Inservio Riverside Drive. The venue boasts stunning views Patient empathy of the picturesque Elizabeth Quay. The dinner Horizon HR includes a two-course meal and a drink on arrival Bullying, harassment and discrimination in the workplace - $30 per person (subsidised). Monday 30 October Places for the dinner are limited so please register quickly to make sure you don’t miss out. Partners Mind and Movement WA Workplace stress management are very welcome to attend. You can register for this dinner event along with your registration for Avant Mutual the conference. Social media Medical Matters Australia and New Zealand Update on strategic planning in ophthalmology RANZCO Practice accreditation via the RANZCO Nucleus program PracticeHub Practice Accreditation via the PracticeHub software Mrs Colleen Sullivan Customer service: the patient experience Medicare Advisory Committee Medicare question and answer session Dr Bradley Horsburgh Update on CADUCO practice costs calculator Tuesday 31 October St John Community Transport Service Information session for patients Nexus Hospital Benchmarking Australian Medical Association Terminating employment relationships dos and don’ts Melbourne Health and Bayside Eye Specialist Risk assessment and minimisation strategies: an orthoptics perspective Join RANZCO today! University of New England and Australian Association If you are a practice manager who of Practice Management is interested in joining RANZCO, we Pathway guideline for practice managers encourage you to contact RANZCO at The Emotional Intelligence Institute [email protected] or +61 2 9690 1001 to Thrive in your practice! How to be emotionally resilient in obtain an application form or for further changing times information. The annual membership fee is A$380 plus A$80 joining fee (GST exclusive) Tie in with Congress program – Stepping up to the challenges of the future and entitles members to concession rates to the Practice Managers’ conference, access Full conference details and regular updates can to RANZCO resources, regular RANZCO be found on the practice managers’ page on the correspondence and many more perks! RANZCO Congress website: http://ranzco2017.com/ practice-managers-annual-conference/ Eye2Eye Spring 2017 47
RANZCO Museum Ian Mcallister from Perth has a wonderful collection of ophthalmic antiques. Among them is an ingenious New Way Optical Company Optometer from 1920. This simple and cheap device was posted out. The recipient measured their reading distance and spectacle dimensions. Once mailed back, the spectacles were made to order.
New Way Optical Company Optometer from 1920 Case draft by Dr William (Bill) Box in 1935
With copperplate script and gonioscopic painting, this case draft was submitted for publication by The Book of Mnemonics is a curious reflection of Dr William (Bill) Box in 1935. attitudes from the 1930s. The Book of Mnemonics (which I always remembered the mnemonic but not the subject) includes the ever present syphilis and cautions against divorcees showing undue Preparations are well under way for the pleasure! exhibit at RANZCO’s 49th Annual Scientific Congress to be held in Perth in October 2017. An extraordinary display of the history of the ophthalmoscope, optometers and teaching models will be featured. The Tragedy of Gas Warfare, on the Museum website (search ‘RANZCO Museum Presentations’), was recently presented at the 14th Biennial Conference of the Australian and New Zealand Society of the History of Medicine, which was held in Sydney from Tuesday 30 June to Friday 3 July. Many thanks to donors of new and fascinating artefacts to the RANZCO Museum.
Dr David Kaufman RANZCO Museum Curator
Affections of the Retina from the Book of Mnemonics 48 Policy and Advocacy Matters
Policy and Advocacy Matters
Workforce matters 2017 RANZCO Workforce RANZCO has been very active at the federal, Survey: at a glance national and jurisdictional levels, ensuring Cultural and linguistic diversity greater understanding of workforce Survey participants were asked what languages apart dynamics, explaining ophthalmology practice from English they knew well enough to be of use in and advocating for improvement of patient their medical work. 216 responders (29.43%) indicated services. We have never had more need for knowing at least one other language well enough to be current information on the ophthalmology used in medical practice. Altogether, survey respondents indicated 48 different languages. workforce, to plan our activities to better serve the membership and successfully Table below of some of the most common spoken languages by survey participants: advocate to governments and regulatory agencies. Language Speakers Key solutions explored to strengthen the workforce French 38 included the development of RANZCO Referral Guidelines Mandarin 34 for diabetic retinopathy, glaucoma and AMD. Routine Hindi 29 ophthalmology screening for diabetes, glaucoma and AMD Cantonese 24 is now increasingly being undertaken by optometrists. Indications are that the oversupply of optometrists will German 20 continue well into the foreseeable future. Increased Italian 13 collaborative care arrangements will become more Afrikaans 12 common in both Australia and New Zealand. As the Spanish 12 RANZCO Referral Guidelines are refined we hope to create Greek 11 greater efficiencies and, with this in mind, a clinical efficacy Chinese (not specified) 9 study of the glaucoma guidelines is currently underway with the Sydney Eye Institute and Specsavers. Survey participants have gained their initial medical Increasing diversity in ophthalmology trainee selection, qualifications in 19 different countries. 116 (16%) of as a measure of improving service provision and addressing survey participants received their initial qualifications service maldistribution, is an issue for both Australia and in countries other than Australia and New Zealand. The New Zealand. Work is underway in this regard by the most common countries are the UK (39), South Africa federal and state QECs. Improved data collection to reflect (23), and India (21). Fellows’ regional/remote activities and matching supply to demand for services are both important to help develop Study in regional/remote areas appropriate solutions to workforce issues. Survey participants were asked if they had studied in The 2017 RANZCO workforce survey was conducted a regional/remote area for at least five years in their from 29 May to 26 June 2017. Over this period, 734 survey secondary or tertiary education in Australia/New responses were received. These include 614 from active Zealand. Regional/remote areas were defined as one of Fellows, 81 from trainees/registrars and 34 from Fellows thirteen urban centres which were listed in the survey who are retired. The previous RANZCO Workforce Survey question (10 in Australia and three in New Zealand). was conducted in 2014 with a slightly better response rate. I would like to thank Fellows who took the time to complete the survey and I am pleased to share a snapshot of some key data emerging from the survey for your information. Should you wish to get in touch with RANZCO regarding workforce Yes No matters, please email [email protected]. Number % Number % We will provide branch reports to the respective chairs All responses (730) 91 12.47 639 87.53 for sharing with their members and to assist them in their discussions with government departments to ensure Fellows (614) 76 12.38 538 87.62 improved service provision for our patients. Trainees (81) 11 13.58 70 86.42 Dr Brad Horsburgh Based in Australia (627) 65 10.37 562 89.63 Chair, Workforce Committee Based in NZ (91) 25 27.47 66 72.53 Eye2Eye Spring 2017 49
Overall, about 12.5% of survey participants indicated that Participants were asked about average waiting time they had studied for five or more years in a regional/remote for each of their practice locations, for both urgent and area in Australia or New Zealand. Those based in New non-urgent referrals. For urgent referrals, about 82% Zealand are much more likely to have had studied in rural or of practices would be able to accept an urgent referral remote areas compared to Australian-based Fellows (27.5% within the same day. Australian practices were indicated vs 10.4%). as having a higher capacity for accepting same-day On examining whether studying in a regional/remote area appointments for urgent referrals compared to New increases the chances to practice in a regional/remote area Zealand practices (83.9% vs 68.8%). in Australia, an analysis of work hours and locations among For non-urgent referrals, over half of locations indicated Australian-based participants offers the following results: that the average waiting time is estimated at up to four weeks (56.7% overall), with again noticeable differences Responded Responded Of all between Australia and New Zealand (58.3% vs 45.1%). Yes to No responses Despite the higher proportion of practices that can studying studying accept patients within under four weeks for non-urgent 5yrs+ rural/ 5yrs+ rural/ remote area remote area referrals, Australian practices also had higher reporting of over six months expected waiting times compared to New Working regularly (more than once a month) in at Zealand (8.7% vs 2%). 44.23% 22.29% 24.4% least one location outside major cities* Practice locations average waiting time (%) - urgent Percentage of work spent 70 35.23% 15.02% 16.95% outside major cities* 60 *Major cities defined as ABS remoteness (ARIA) category 0/ Modified 50 Monash Model category 1 40 Based on these findings, Australian-based survey 30 participants who have studied in rural or remote areas 20 were twice as likely as their colleagues to have at least 10 one regular practice (more than once a week) in a rural 0 or remote area (approx. 44% vs 22%). Furthermore, Available the same the beyond Australian-based Fellows who have studied in rural or within day following the remote areas were likely to spend over 35% of their work 3 hours day following day hours in rural or remote locations, compared to 15% Australia New Zealand among those who did not study in rural or remote areas. Practice patterns Practice locations average waiting time (%) - non Most RANZCO Fellows regularly work in more than one urgent location. When asked in how many different locations do they regularly practice more than once a month, less than 40 30% of clinically active survey participants (678) indicated 35 to work in only one location. Fellows were likely to work in 30 2.7 locations on average, while trainees work on average in 25 20 1.4 locations. Over a quarter of Fellows worked out of four 15 or five regular locations (16.1% out of four locations, 11.9% 10 out of five locations). 5 When asked whether they work in a public hospital or 0 clinic, close to 70% indicated that they work in a public Available 2-4 5-6 7-8 2-4 5-6 7-8 9-10 11 hospital or clinic, an increase of over 7% from the previous within weeks weeks weeks months months months months months survey. The most common reasons cited to working in 2 weeks or more the public sector include: the opportunity to teach, doing Australia New Zealand community service, collegiality, and research opportunities. When asked how the total clinical time is divided among the different tasks, participants indicated that over 64% of When asked about changes with practice patterns a their time is spent on consultations. decade ago, participants indicated that the proportion of their clinical practice which includes therapeutic Overall responses (571) % prescriptions and/or dispensing more than doubled. Consultations 64.54 Paediatric appointments: almost 57% of survey Operations 17.75 participants indicated that they routinely see children Admin/ paperwork 9.18 in their clinic. This is an improvement over the previous Research 2.77 workforce survey (49.4%). Teaching/training 4.9 Telehealth: Over 10% of participants indicated to have participated in telehealth consultations during Other work activities 0.87 the previous year. 50 Policy and Advocacy Matters
Work/ life balance activities. Of those participants who indicated some amount of volunteering, each one indicated to volunteer on average Overall, across their regular locations, survey participants just under six hours per month (5 hrs, 52 mins). indicated to working on average over 42 hours per week, Over 28% of participants indicated that they expect to excluding on-call cover. Trainees worked more (48.5 hours) increase their level of College volunteering over the next than Fellows (42.1 hours), and those based in New Zealand five years while only 6.5% expected to decrease their level more (44.2) than those based in Australia (42). Survey of College volunteering activities. participants worked on average almost 45 weeks in the year prior to the survey. For more information about RANZCO development guidelines, please visit the RANZCO website: https://ranzco.edu/about-ranzco/our-organisation/ policies For more information about RANZCO international WORK LIFE volunteering opportunities, please email [email protected] Average number of Cohort (number of responses) hours per week All active Fellows and Trainees (598) 42.48 RANZCO Clinical Practice Fellows (534) 42.13 Guidelines Development Trainees (56) 48.55 New Zealand (75) 44.24 Framework launched Australia (523) 41.98 In June 2017, RANZCO launched a Clinical Practice Guidelines Development Framework. When asked whether they would work more or less hours if given the option, only 5% of participants indicated that they The document is the culmination of a project would work more hours, while 44.8% would prefer to work less which was initiated in the Clinical Standards hours. Just over half of participants indicated that they would Committee meeting held during the 2016 not change their work hours. RANZCO Congress in Melbourne. The most common barriers stopping those who wished Having identified the need to ensure that clinical practice to reduce their hours are: needing the income (46.9%), lack guidelines development in RANZCO is in line with NHMRC of ophthalmologists available to share clinical work with standards as well as recognised best practice in the area, (26.6%), and lack of success recruiting new colleagues to the Clinical Standards Committee set out to develop an their clinic (25.4%). appropriate process for the College. After the first draft was Participants were also asked how much they expect to be developed, an internal consultation stage was held, with working in five years’ time. 475 (70%) indicated that they feedback sought from RANZCO special interest groups, expect to be working as full-time ophthalmologists, 167 societies and committees. The Framework was then (24.6%) part-time ophthalmologists, and 37 (5.45%) expect amended based on the consultation feedback, before its to be retired. These rates are very similar to past workforce final approval by the Board. surveys. The main challenge with creating the Framework was Survey participants were asked if, in addition to work to make it robust enough to ensure that clinical guidelines responsibilities, they currently function as primary carers for are produced to the highest standard, via a rigorous, other individuals – including children, partners or parents - transparent and collaborative approach while also keeping 39.4% of responders indicated Yes while 60.6% responded the Framework simple, clear and succinct enough to ensure No. that it is used by Fellows. The Framework itself consists of two separate processes: Volunteering a 12-stage process for developing new RANZCO clinical Over the past year, almost half (48%) of RANZCO Fellows and practice guidelines, and a fourstage process for RANZCO to trainees participated in domestic volunteer ophthalmology- endorse external clinical practice guidelines. Both processes related activities, and over a fifth (21.33%) of RANZCO Fellows include guidance on convening a development panel and trainees participated in international activities. while the development process also includes planning, The most common domestic volunteer activity was consultation and dissemination stages. The Framework teaching, while the most common international volunteer document also includes a list of useful resources, which activity was service provision. informed the Framework’s development. Altogether, survey participants volunteered in at least The RANZCO Clinical Practice Guidelines Development 31 different countries around the world in the year prior to Framework document is available in the Policies and the survey. The countries most visited were Cambodia (22 Guidelines section of the RANZCO website. For more volunteers), Myanmar (21), Fiji (14) and Vietnam (10). information, please contact [email protected]. Over 40% of respondants indicated some monthly amount Rick Wolfe of time spent on voluntary College activities, excluding CPD Chair, Clinical Standards Committee Eye2Eye Spring 2017 51
Along with over 90 other organisations and individuals, Possible changes to RANZCO’s New Zealand Branch made a submission on HWNZ’s paper. While we supported the underlying intention funding for post-entry of the proposal, we felt that the contestable funding process clinical training in New was overly onerous for the amount of money being allocated and expressed concern that disinvestment from current Zealand training programmes could destabilise the specialist medical workforce, including ophthalmology. Health Workforce New Zealand (HWNZ) HWNZ’s early analysis of the submissions, published on released a paper to stakeholders in March their website, confirms that RANZCO is not alone in these this year that proposed changes to the funding sentiments. HWNZ noted that there was a strong view model for post-entry clinical training. Currently, from stakeholders that existing funding is inadequate and considerable concern was expressed about the proposed HWNZ allocates $180 million per annum to process for disinvesting from current training programmes district health boards (DHBs) for this purpose, and the risk of unintended consequences. They also noted subsidising DHBs for approximately a third of there was strong support for a transparent and robust the costs of employing a trainee. process for decision making about investing in the health workforce and that a majority of the submitters preferred The HWNZ paper proposed a new contestable funding process which would require parties to make annual funding a funding model that encouraged cooperation rather than bids to subsidise training in particular medical specialties, competition. HWNZ expects that they will complete the allied health professions or geographic areas. An expert analysis of submissions by the end of July 2017 and that a advisory committee would be established to then prioritise decision and information about next steps will be available the bids using a PHARMAC-like model. As the total amount in the coming weeks. More work will be needed before of funding would remain static, low priority areas would they can develop a detailed funding model that is ready to need to be identified for disinvestment to free up funds to implement. If the new funding model proceeds, it will not be moved in to high priority areas. HWNZ’s professed goal is be implemented until 1 July 2018 at the earliest. HWNZ has to be able to direct funding into areas with significant unmet stated that trainees who are part-way through their planned need and a high return on investment instead of relying on training programme when changes are implemented will be historic precedent. assured of funding until they have completed.
P P P P P P P P P P 52 International Development
International Development
RANZCO registrar and consultant representatives from the Divine Word Collaboration visits per year to Nepal, with the first University and the Pacific Eye Institute visit commencing early next year. and RANZCO Fellows experienced on international Also key to upskilling Nepalese in building capacity in low resource ophthalmologists is encouraging settings. Two optometrists from the educational participation on leadership Australian College of Optometry activities development and scholarship (ACO) have also been invited to programs where available through participate, giving effect to an In May this year, RANZCO and RANZCO. When RANZCO put out a call agreement that RANZCO has with the the Nepalese National Society for RANZCO International Scholarship ACO to collaborate on international for Comprehensive Eye Care program applications in May, NNJS development activities. proactively encouraged application (Nepal Netra Jyoti Sangh – submissions from NNJS hospital NNJS) signed a Memorandum faculties. Two ophthalmologists from of Understanding to work Nepal were awarded the scholarship: together regarding the Dr Tushar Sarbajna from Kedia Eye Hospital and Dr Koshal Shrestha from upskilling of registrars Lumbini Eye Institute. Vision impairment is a from Australia and new RANZCO continues its engagement worldwide health concern graduates from Nepal in with stakeholders in PNG to lead affecting 285 million people. The effect is most felt in manual small incisional the review of the ophthalmology training program. Following a countries and communities cataract surgery (MSICS) and scoping visit of training sites in with limited resource phacoemulsification surgery, PNG by a team led by Dr Sloan in availability where people face respectively, through teaching November last year, RANZCO has poor access to services. visits to Nepalese hospitals signed a Letter of Agreement with Papua New Guinea (PNG) the University of Papua New Guinea is the largest and most offering mutual learning and to conduct a review of the training populous country in the teaching opportunities. program. The desk review of the South Pacific, with high levels Dr Anil Sharma, mainly through ophthalmology curriculum is currently of vision impairment and support from the Queensland underway. Key participants include blindness. Branch, aims to organise up to eight local ophthalmologists from PNG,
The estimated national prevalence (age-sex adjusted) of blindness in PNG is 4.3% Untreated cataract is the most common primary cause of blindness Diabetes and diabetic retinopathy PNG Australia in PNG • Prevalence of diabetes was Estimated national Age-adjusted prevalence of vision impairment in estimated to be 7.8% in prevalence (age 50 Indigenous Australians adults aged 50 and older and over) of visual (age 40 and over): 13.60% in NCD impairment (VA<6/18 in in non-Indigenous Australians (aged 50 and over): • Over 80% of those with the better eye): 16.6% 4.57% known diabetes never had an eye examination for diabetic retinopathy before Cataract surgical Cataract surgery coverage rate of Indigenous • Approximately half (49.5%) coverage (aged 50 and Australians (aged 40 and over): 61.47%. of the people with diabetes over): 33.5% non-Indigenous Australians (aged 50 and over) (known and “newly- 87.63% diagnosed”) had some form of diabetic retinopathy and or maculopathy.
* no recent studies available for New Zealand Eye2Eye Spring 2017 53
RANZCO has continued its advocacy new and interesting for each annual and New Zealand Society of to stakeholders who are interested congress in my country.” Ly Marina, Ophthalmic Plastic Surgeons (invited in supporting the Cambodian Cambodia. 2017 workshop collaborators). ophthalmology training program, “I gained a lot of knowledge, for The 2017 workshop focusses on emphasising the need to avoid example, during the workshop there oculoplastics - key issues, successes development of a parallel and were many experts who have a long and challenges in low resource competing program. RANZCO experience in dealing with problems settings. Complementing this will participate in a continued especially in developing countries. theme is a teaching component professional development program I can apply this knowledge in my exploring teaching surgical in Phnom Penh later this year, and own practice as well as in working skills frameworks and teaching has awarded a scholarship to a together with other organisations in on-the-run using oculoplastics as Cambodian ophthalmologist the eye health care sector.” Kham Od a platform. It is anticipated that (Dr Sophal Heng from the Khmer Nouansavanh, Laos. Fellows who regularly conduct Soviet Friendship Hospital) to attend teaching in low resource settings the Annual Scientific Meeting in Perth International will be able to contribute to, and and the International Development gain from attending, the workshop Workshop on oculo-plastics in low Development - providing a valuable platform for resource settings in October 2017. Workshop knowledge sharing and exchange of Also joining the scholarship Since 2012, the International information. recipients from Cambodia and Nepal Development Workshop has (listed above) is Dr Claude Posala become part of the planning of The International from the regional eye centre in the the International Development Development Solomon Islands and Dr Minh Vo Committee and it has been a regular Committee advocates Ngoc Bich from Ho Chi Minh City Eye annual event on the Friday prior Hospital in Vietnam. to the RANZCO Annual Scientific for improved Foreign As always, we find RANZCO Congress. The workshop is aimed at AID Policy Fellows provide a warm welcome providing opportunities for Fellows The International Development to scholarship recipients each year, with an interest in strengthening Committee – representing RANZCO and the engagement and sharing ophthalmology in low resource international development activities of knowledge and experiences settings to present and participate in and speaking on behalf of RANZCO is fruitful. With many RANZCO discussions on issues of importance Fellows committed to volunteering Fellows committed to conducting such as diabetic eye disease and their time to development work – is development work in various cataract. Similarly, opportunities are regions, meeting scholarship advocating for continued investment offered to ophthalmologists from in eye health to help alleviate recipients each year is often a developing countries to present on reconnection of a RANZCO Fellow’s poverty and contribute towards specific issues in their local context sound community and regional previous visit on a volunteer trip, or and discuss with their peers from it provides the opportunity to start development. other countries, including Fellows that collaboration. Recipients from In response to the call for comment from Australia and New Zealand. the 2016 scholarship commented on the Foreign Policy White Paper, RANZCO also runs a scholarship particularly on how the congress RANZCO recommended that Australia program to support individuals provided a platform to talk on a focus its foreign policy investment in from developing countries to personal level and face-to-face the health-related areas of: education participate in the workshop and to with some names they know or and training, workforce development, attend Congress and network with have previously only exchanged and building professional networks. Fellows to strengthen their clinical emails with. RANZCO looks forward The fourth high level forum on knowledge and build relationships to another year of welcoming aid effectiveness, held in Busan in that can be leveraged in future. engagement and collaboration. December 2011 by the Organisation The International Development for Economic Co-operation and Comments from 2016 Workshop provides an opportunity Development (OECD), confirmed that International Scholarship to make a head start on networking, poverty and inequality remain the recipients. collaboration and catching up before central challenges to achieving the “I gained a lot of information the bustle of the actual Congress. Millennium Development Goals. The related to medical knowledge which The International Development revised Sustainable Development is relevant to my clinical work and Workshop seeks to foster Goals provide a framework within management lessons in eye care such collaboration with special interest which countries can grow and alleviate as in the International Development groups, associations and NGOs poverty in a systematic manner by Workshop which talked about the based on particular focus areas for achieving particular goals and targets. advocacy activities.” the workshop each year. Workshop Australia’s foreign policy should be “I could bring this useful information collaborators include, for example, cognisant and supportive of existing to my juniors as well as my colleagues the Pacific Eye Care Society, Vision international frameworks such as to motivate them to find something 2020 Australia and the Australian these, particularly when considering 54 International Development
its development aid contribution. in blindness prevention and eye such as RANZCO have built special Health, human dignity and enhanced health programs has been shown links with institutions and societies quality of life should be an integral to positively contribute to poverty in the WHO Western Pacific region. part of any future direction. reduction, particularly in developing A solid investment in eye health Poor eye health outcomes countries, and positively impact on can build on past successes and have been consistently linked economic development. implement improved systems for to heavy economic burdens on RANZCO ophthalmologists have a sustainable development of eye care individuals and communities, which proud track record of participating in in the region. Such investment may directly impacts on economic and international development activities, help alleviate poverty and contribute development prospects. The total some as volunteers on short term towards sound community and worldwide financial and health teaching visits, others spearheading regional development, while further burden of visual impairment is global strategies through global establishing Australia as a regional estimated to be over US$3.5 trillion peak bodies such as the International and global leader in eye health and 150 million Disability Adjusted Agency for Prevention of Blindness development. Life Years (DALYs) by 2020. (IAPB) and the International With the development of a foreign The World Health Organization Council of Ophthalmologists (ICO), policy white paper, Australia has a (WHO) estimated that, in 2010, 90 inspiring NGOs, governments chance to cement its commitment million people in the Western Pacific and industry to do their bit to to improving health care and health Region had a visual impairment, eliminate avoidable blindness. systems of our regional neighbours out of which 10 million people were RANZCO will host a number of and, by doing so, help improve eye blind. However, eighty percent of high-profile global ophthalmology health outcomes. An investment sight loss is preventable or treatable. conferences in the near future, in eye health outcomes has been Cost-effective interventions are including the Asia-Pacific Academy proven to be of direct benefit in available for the major causes of of Ophthalmology in 2020 as well as avoidable blindness. the International Association for the the battle against poverty, and for The estimated impact of vision loss Prevention of Blindness’s General sustainable economic development, and blindness has been consistently Assembly in 2020. Over time and in in line with Australia’s foreign policy linked to considerable economic collaboration with local stakeholders interests. burden on affected persons, as and prominent NGOs, and mainly A full reference list is well as their families, caretakers, with funds received through DFAT, available upon request from and society as a whole. Investment Australian based NGOs and colleges [email protected]
An International Development Workshop in collaboration with ANZSOPS Ophthalmic plastic surgery and teaching methods in low resource settings Friday 27 October 2017 Meeting Room 8 Perth Convention and Exhibition Centre Eye2Eye Spring 2017 55
Branch Musings
New South Wales Chair A/Prof Andrew Chang Vice Chairperson Dr Robert Griffits Hon Secretary Dr Daya Sharma Hon Treasurer Dr Christine Younan Country Vice Chairperson Dr Neale Mulligan The late Kim Frumar, former Prince Tesso with RANZCO Fellows NSW Branch Committee eye surgery with sessions addressing – the Syphilis Capital of Europe, and Treasurer, was recently risk management and medico-legal Efficacy and dynamics of self-targeting implications. Stay tuned for more CRISPR/Cas constructs in the retina. honored at a charity event information in the coming months Selected presentations and abstracts attended by the HRH Prince A/Prof Andrew Chang from the meeting are now available Sisowath Tesso of Cambodia. Chair, RANZCO NSW Branch through the meeting webpage: The event was to raise funds for the http://www.conferencedesign.com.au/ Kim Frumar Scholarship to enable Tasmania Branch ranzcotas2017 training of eye surgeons from Cambodia. Chair The scientific program was Members of the NSW Committee joined A/Prof Paul McCartney complemented by several social events that took place during the meeting. with RANZCO Fellows and ophthalmic Hon Secretary industry partners to attend the function Attendees were honoured to be Dr Andrew Traill to support the work of the Khmer Sight hosted by Her Excellency Professor the Foundation and The Eye Surgeons’ Hon Treasurer Honourable Kate Warner, AC, Governor Foundation. Dr Andrew Jones of Tasmania at a private welcome The RANZCO NSW Branch Committee The RANZCO Tasmania Branch function on the Friday evening, while has been exploring opportunities was pleased to welcome over the meeting dinner was regarded as to support and educate general a highlight for all who attended. A 70 attendees to our annual practitioners in the screening of diabetic Younger Fellows Networking event was patients using the RANZCO guidelines. meeting held at the Hobart also hosted during the meeting. The Health Minister has raised the issue Function and Conference Hobart’s mid-winter festival, Dark of waiting lists for cataract surgery. Centre from 10 to 11 June in Mofo, provided a unique backdrop The NSW Branch is currently gathering Hobart. to the meeting, allowing attendees to information regarding this issue in experience one of Australia’s premier preparation of further meetings with the The theme for this year’s meeting was arts and culture festivals and take full Minister. Uveitis Unplugged: Simplifying A Complex advantage of the long weekend. In other developments, several Problem, with attendees travelling The meeting was very well attended Committee members are benefiting from as far as Ontario, Canada to listen by industry sponsors and we would like to a series of informative lectures from media training sessions organised to extend our thanks for their ongoing from leading experts Professors Peter by Emma Carr, RANZCO General support. McCluskey and Tony Hall. Manager - Communications. This will The branch and organising committee provide valuable tools in speaking to The Branch would like to thank would finally like to thank all delegates and representing RANZCO in the media. Professors McCluskey and Hall for taking who attended this year’s meeting. The The NSW Branch Committee is the time to participate in this year’s 2018 meeting will be held from Saturday currently preparing for the 2018 Annual meeting and for their contributions. 9 to Sunday 10 June and we invite all Scientific Branch Meeting to be held Delegates also enjoyed hearing from Fellows and their partners to join us at the Hunter Valley. The theme of the colleagues in dynamic challenging cases for what promises to be an excellent meeting will focus on management and audit sessions. Topics included scientific and social opportunity. of complications encountered Patient reported outcomes of the Tecnis during ocular surgery. The scientific Symfony extended depth of focus IOL, A/Prof Paul McCartney program will cover the breadth of Ocular Experience from Manchester Chair, RANZCO TAS Branch 56 Branch Musings
New Zealand The Ministry of Health has greater numbers of elective operations. allocated a one-off sum of $2 million My late father-in-law would have called Chair to address the backlogs in clinics. As that ‘paying your school fees’. I consider Dr Brian Kent-Smith of the end of June they had signed off my fees paid in full. Hon Secretary & Hon Treasurer 17 contracts covering 19 DHBs. Early Dr Brian Kent-Smith Dr Andrea Vincent indications are that backlogs have Chair, RANZCO SA Branch Two months into my new been reduced by an average of 10-15%. The Ministry has also convened the South Australia role it has quickly become first National Ophthalmology Advisory Chair apparent to me that the Service Improvement Advisory Group Dr Garry Davis meeting. We await their proposals with Chair is really just the face Hon Secretary & Hon Treasurer of the branch; there are a lot interest. In May we hosted the RANZCO NZ Dr Stewart Lake of good people doing a lot of Branch meeting in Northland for the The RANZCO SA Branch hard work behind the scenes. first time. Waitangi is the birthplace meeting was held in April at Like any chairman, my job of our nation so it was fitting that the conference was held in that location. the Sanctuary, Adelaide Zoo. is not to be the expert on all We had four excellent invited speakers The focus was Medical Retina matters but rather to seek in Ken Nischal, Tien Wong, Tim Sullivan – current practice and future the opinions and expertise of and Marian Macsai. Each speaker trends. people who know more than managed to strike a balance between explaining cutting edge research in their The meeting was well attended, with I do. An example of this is our fields while giving practical tips that are over 80 delegates, and A/Prof Alex recent collaboration with useful in daily practice. As a generalist, Harper and Dr Fred Chen provided a wonderful overview of current Dr Dianne Sharp and Macular I particularly enjoyed Tien Wong’s talks issues, supported by high quality local Degeneration New Zealand on macular degeneration and diabetic retinopathy. His talk on disruptive speakers. The real highlight of the (MDNZ) on the EY (formerly technologies was applicable to many program was the paediatric session, Ernst and Young) report into spheres of life, not just ophthalmology. focussing on Retinopathy of Prematurity. Finally, the Conference Dinner was held macular degeneration. Next year’s meeting will be hosted by Dr Sue Ormonde and Prof Trevor at the iconic Jolley’s Boathouse, which District Health Boards across New Sherwin in Auckland. provided a wonderful venue for a night Zealand have been caught wrong- As RANZCO is tightening its policies of good food, wine and conviviality. footed by the anti-VEGF tsunami. and procedures in response to its There are a number of ongoing issues We have had some unfortunate and recent accreditation, so too must the in South Australia that the SA Branch well publicised incidents of people branches. I look forward to working with are actively monitoring and engaging losing vision because of delays in my colleagues on the Branch Executive with, in particular the imminent opening treatment. Dr James Stewart and to improve our policies including of the new Royal Adelaide Hospital, Kate McIntyre undertook a review stewardship of our finances, female which has a significant reduction in of 34 ophthalmic incidents in the representation on the Executive and outpatient capacity. The closure of Southern DHB. In all but one of the underrepresentation of Maori people the Repatriation Hospital in October cases the issue was that the patient in our profession. I feel strongly that we is still creating uncertainty about how wasn’t seen in a timely manner. In have to constantly evolve in order to to cater for the tens of thousands of response to the crisis, the Ministry of remain relevant. outpatient attendances and hundreds Health commissioned EY to write a My predecessor Stephen Ng told me of surgical procedures within the report and make recommendations. that the hardest part of his job as chair already at capacity Flinders Medical RANZCO NZ Branch and MDNZ were was dealing with the media. I recently Centre and other public facilities. among the stakeholders invited experienced this first hand. I was The promised stand-alone public eye to participate. We have now seen contacted by a TV reporter who told me centre in the Adelaide CBD is yet to be the preliminary report and its 18 she was doing a report on Avastin. After realised, despite two years of ongoing recommendations. We are not yet at spending 15 or 20 minutes explaining negotiations with the state government liberty to discuss the contents of the what the medication is, what it does, and SA Health. As well as the impact on report as it has not been released in which diseases it treats and how many patients, these changes have negative its final iteration but I will say that people it helps, I was quoted on TV as implications for training, accreditation the NZ Branch and MDNZ have made saying “At the end of the day it’s just an and research. a joint submission to the report’s injection.” It turns out the report wasn’t The SA Branch continues to monitor authors. We are hopeful that the final about Avastin after all, rather it was this situation, apply pressure on recommendations will be adopted about how the government is allegedly decision makers and raise awareness by the Ministry and the DHBs and using the number of Avastin injections of the issue with the wider community. that this will ultimately lead to better to skew its surgical statistics in order to Garry Davis care for our patients. show they are achieving significantly Chair, SA RANZCO Eye2Eye Spring 2017 57
The RANZCO Victoria Branch
G R A N T S Programme $$
The Victoria Branch is pleased to announce the establishment of a programme of grants to support the development of ophthalmology in Victoria. These grants have been established by the Branch Committee after consultation with Branch members. Three types of grants are currently available and each is briefly Applications described below. Full details are available via the RANZCO Applications are now open for the website at www.ranzco.org inaugural round of Professional Development and Branch Research Professional Development Grants Grants. These grants are intended to assist trainees and early career Fellows to develop subspecialty interests that will enhance the practice Important Dates 1 August 2017 of ophthalmology in Victoria. The grants are intended to support the development of new or under-resourced subspecialties. The Applications Open for Professional primary recipients are envisaged to be trainees who are considering Development and Research Grants subspecialising in such areas and who wish to attend events at which 30 September 2017 they can further explore the subspecialty and make contacts that may assist with a future training Fellowship. Applications Close 29 October 2017 Branch AGM – Grants for 2018 Branch Research Grants Announced These grants are intended to support research projects by Victorian Fellows where a modest amount of funding may be necessary, perhaps for a specific piece of equipment or to cover the costs of professional statistical assistance. The application process is simple so as to encourage Fellows to undertake small but useful projects Note that the Indigenous that may not otherwise proceed. Eye Care Grants operate on a rolling basis. As each Indigenous Eye Care Grants series of clinical activities becomes available, there The Victoria Branch wishes to assist all Fellows in delivering front- will be an announcement line eye care to Indigenous Australians. These grants will assist to Victorian trainees Victorian trainees to participate in front-line eye care with Australian Indigenous communities to foster a longer-term interest in such with an invitation for activities. Each year a series of front-line Indigenous eye care applications. The next activities will be available. The grants will be made available to assist round of activities is trainees to travel and participate in these activities. expected to be announced in October 2018. 58 Special Interest Groups
Special Interest Groups
Attendees at the 2017 PSIG Meeting, Noosa (apologies to those that had to leave early and are not included). Paediatric Special Interest Group The Paediatric Special range of topics to be discussed from paediatric subspecialist Fellows of the Interest Group (PSIG) held anything like a simple discussion College actively leading comment on the management of blepharitis and discussion at this meeting. As a highly successful meeting (not that simple, it turns out) to the one senior attendee remarked “You in Noosa from 13 to 15 July. difficulties in managing uncertain would recall, once upon a time all the PSIG has now been holding clinical scenarios such as incomplete of the paediatric ophthalmologists in annual meetings for 12 years. vascularisation of the retina in ANZ could meet in a telephone box. premature infants. A number of We have definitely grown. It is so great The informal nature of the discussions illustrated the complex to see our wonderful subspecialty has meeting has persisted with legal, ethical and social dimensions become attractive to a new generation all attendees expected to to the practice that paediatric of ophthalmologists.” At the conclusion of the meeting, present two cases or topics ophthalmologists negotiate on a daily basis. A discussion on “The dangers of attendees overwhelmingly supported for discussion. potato chips” nicely illustrated all of the continuation of the meeting in its The lack of a formal program or these points! current format and we will be meeting agenda enables the group to pursue It was enormously encouraging once again in Noosa in July 2018. discussion in whatever detail or depth to see the number of Fellows in James Elder appears appropriate. The diverse subspecialty paediatric ophthalmology Chair, Paediatric Special Interest interests of attendees enables a wide training and more recently trained Group
Don’t miss out on this year’s paediatrics lecture by Professor Michael Brodsky, held during the 2017 Annual Scientific Congress in Perth Monday 30th October 2017* *Schedule subject to change Eye2Eye Spring 2017 59
RANZCO Affiliates
ONZ continues to support RANZCO Polkinghorne and Derek Sharwood. ONZ Update in lobbying the Ministry of Health Finally, we are close to unveiling for increased funding for follow-up our own website, where members While most ophthalmologists appointments. will find: and their staff in New We thank the members who • details about events and issues Zealand have been battling attended our Business Forum in of interest to ophthalmologists; May for taking the time to give with the cold and heavy • information on benefits to us feedback on our activities. members of ONZ; weather we have been Subsequent to this feedback and the • links to useful NZ bodies and experiencing, ONZ members response at the Forum, we will be regulatory areas; and have been working behind planning a standalone function for • links to newsletters. February or May next year. We plan the scenes supporting our We still have time for suggestions, for this to take place in Auckland so if you have any please email members. this time, so that it is a bit more [email protected]. We accessible for members. We would like to thank one of would welcome these suggestions to At our AGM in May, we were incorporate on the website. our members, Dr Sonya Bennett, pleased to welcome the new Meanwhile here is a sneak peek… for involving us in meetings with board members Dean Corbett and The ONZ Board Southern Cross Health Insurance Shenton Chew. We would also like regarding funding MIGS (minimally to extend our thanks to our previous invasive glaucoma surgery). We will “co-opted” board members, who be updating our members with this have, and still do, advise us from issue and others via our Eyes OnNZ time to time. These members are newsletter. Michael O’Rourke, Professor Philip
A sneak peak of the new ONZ website 60 RANZCO Affiliates
Campaign Ambassadors Kirk Pengilly and Beth Sligar cut the ribbon to start the first ever EYEcon Walk in Sydney
event based fundraising component, The new EYEcon Walk was a fun Eye Surgeons’ the EYEcon Walk, and a new website community event where participants Foundation with greater online fundraising walked a 5km course while taking functionalities. in the sights of their city. There were celebrating 10 We also welcomed back seasoned downloadable maps for each of the JulEYE Ambassador Kirk Pengilly and major capital cities on the JulEYE years of JulEYE paediatric ophthalmologist website with Sydney staging the first Dr Caroline Catt as well as several new event organised by The Eye Surgeons’ 2017 marked the 10th year Foundation team on Saturday 29 July. patient ambassadors including Beth of the JulEYE campaign with We had more than 130 people Sligar, James Curtis, Lorin Nicholson, turn out to the Sydney Walk at some great work done over Andrew Russek and Amber Wilson, who this time to raise awareness Nawi Cove, Barangaroo including generously shared their personal stories teams from RANZCO and Bayer who of the importance of eye on eye disease and vision impairment. collectively raised $30,000 through health and get people to have peer sponsorship for the walk. Led by their eyes checked. With campaign Ambassador Kirk Pengilly, this heightened community participants geared up for the night- awareness from the campaign walk with glow sticks and neon and there was a need to shift glow in the dark face paint! The course followed the path around Barangaroo the focus to building the and the beautiful Sydney Harbour fundraising capacity and Foreshore, before turning around at raising funds to support much Circular Quay and returning along the needed medical research that same course. will help solve some of the Next year we hope to organise walks biggest issues in eye health. in Melbourne and Brisbane with several supporters indicating they would With this in mind, the JulEYE love to volunteer as part of their local campaign went through a refresh this committee to organise a walk. year that saw the signature branding for We also had great support from the campaign maintained but a stronger more than 30 practices across the emphasis on raising money. This was country who signed up to support primarily achieved through a new Campaign Ambassador Kirk Pengilly JulEYE, fundraised and promoted Eye2Eye Spring 2017 61
the Foundation with donation value of $600k - up from the $475k news story plus editorial placements boxes, posters and brochures in their from last year. They also ran a in leading aggregates Kidspot and practices. The Hobart Eye Surgeons and survey for us for free on behavioural Essential Kids. Tasmanian Medical Volunteers led the insights! • Dr Stephanie Watson also featured way with their fundraising efforts for the • Partnering with Lorin Nicholson and in a half-hour session on the Chris campaign. his App which shows what it is like to Smith program on 2GB. The campaign once again achieved live with an eye disease. significant social and traditional • Television provided strong support • Launch story appeared in the media exposure with some highlights with Seven News, The Morning Show Sunday Telegraph and ran across including: and key regional stories secured News Corp sites nationally including • A revised television commercial with WIN Illawarra, WIN Bendigo, Herald Sun, Courier Mail, Perth Now, across Channel 9, Prime 7, Channel 7 NBN Central Coast and WIN News and WIN for an extended campaign Adelaide Now, NT News, Gold Coast Riverina. starting mid-June and running Bulletin, etc. through to mid-August. • Brisbane Times undertook a story Whilst there is still some work being • Secured ABC TV for the first time. and ran across the entire Fairfax done to wrap up the campaign • New radio CSA recorded with an syndicate online. and analyse performance, the new extended campaign from mid-June • Dr Caroline Catt featured extensively approach has set a great foundation to mid-August. in the media, including a half-hour to grow JulEYE and build an engaging • Extended out of home campaign session on the Wendy Harmer platform to raise funds for vision with Shopper Media group to the program for 702 ABC, in a Seven research. Social media highlights:
4,500 people ‘talking about this’ on the campaign’s Facebook page 1,001 post reactions 131 post shares
2,079 traffic to JulEYE Site (all social channels) 7,324 total clicks (likes, plays, shares, links) 4,515 link clicks
127 total new page likes 307, 484 post reach 631,993 impressions and 123 new followers 62 RANZCO Affiliates
In recent months, ASO has been active Former MDA National Business ASO update on a range of issues, most notably our Development Manager Sandra Reed lobbying efforts regarding managed was recently appointed to the role of Advocacy in action care. Private health funds continue to ASO Business Development Manager. — help us make an pursue pre-approvals and bully style Sandra comes to the ASO with more behaviour from big name insurers than 20 years’ experience working impact over operating contracts is on the rise. in business development, account Membership is the lifeblood ASO will be taking these two issues to management and senior management of any professional society, Canberra in September for our next roles in health care and professional but it is more than just round of face-to-face meetings with services across Australia. health sector politicians. Her newly created role will focus numbers. A growing and on working to solidify our existing active membership base has Meanwhile, the impact of the Government’s decision to amend MBS membership base and then helping a dramatic impact on virtually item number 42758 for goniotomy in us to grow. “My goal is to ensure that every part of a society’s order to exclude minimally invasive each and every ophthalmologist who operations. implantation of glaucoma drainage is a member of the Society derives value from their investment and that In 2016, membership of the Australian devices – commonly referred to as MIGS – continues to be felt. this value sees us continue to grow as a Society of Ophthalmologists grew by ASO is determined to pursue the group,” Ms Reed said. 21%. presentations we have already made to This boost to our numbers delivered Have you renewed your both Health Minister Greg Hunt and to a range of benefits, from enhancing our ASO subscription? MSAC Chair Professor Robyn Ward about ability to speak with authority about the value of MIGS in the treatment of The timely renewal of your the issues affecting ophthalmologists glaucoma and the very real impact membership subscription ensures that to forging important new professional limited access to the procedure is having ASO is able to continue to provide the partnerships that are going to pave the on patients. representation and support you have way for greater protection of our craft come to expect from it. group and the patients we care for. In ASO expands Renewing your ASO subscription is 2017 we are a stronger, more credible, organisational team to as simple as logging in to the ‘members and more dynamic representative group enhance member services only’ section on the ASO website and this is thanks to our membership. ASO has recently recruited a business www.asoeye.org or calling our office To all of our members we say ‘thank- development specialist in order to on (07) 3831 3006. you’. We appreciate the commitment enhance the services it delivers to Dr Michael Steiner you have made. members. President,ASO
ASO MEMBERSHIP 5 REASONS WHY IT’S ESSENTIAL
ASO exists to safeguard the practice of ophthalmology: PROTECT YOUR CAREER to ward off outside influence and encourage conditions that will see our specialty flourish.
Every paid membership subscription to ASO makes the STRENGTH IN NUMBERS Society a stronger, more formidable medico-polticial force.
ASO wants to help you build your business, so we host the CAREER RESOURCES annual Business Skills Expo and other events to make it happen.
CONNECT WITH YOUR Professional networking is made easy when you are an COMMUNITY active ASO member.
ASO membership delivers a range of financial benefits, such BENEFITS as savings on your medical indemnity insurance. Eye2Eye Spring 2017 63
Ophthal News Congratulations to RANZCO Fellow and Past Recipients of the President Bill Glasson 2017 Queen's Birthday receives AMA's highest Honours honour
Congratulations are in order for two Congratulations are in order for Dr Bill RANZCO Fellows who made the Queen's Glasson who was presented with the Birthday 2017 Honours List for their prestigious AMA Gold Medal – the highest hard work and dedicated service to honour the AMA can award – for his ophthalmology and vision care over the dedicated service to the AMA over the years, years. and his ongoing commitment to improving Indigenous eye health. Dr Catherine Green, RANZCO’s new Dean of Education and a former RANZCO Board member, was awarded AMA President, Dr Michael Gannon, who nominated an AO for her dedicated services to ophthalmology, Dr Glasson for the Medal, said that no one deserves including important roles in professional groups and her the honour more. “Bill’s generosity and altruism know work in furthering education and research in the area of no bounds. His work extends to outback Queensland, eye health. Indigenous communities, and East Timor… (He) is Dr Roger Welch, founder and principal of the Vision a champion, true blue, and one of a kind – a truly Centre Gold Coast practice at Southport, was awarded deserving recipient of the AMA Gold Medal.” an OAM for his work delivering and campaigning for eye care services for people in outback communities. RANZCO offers our warmest congratulations to both Dr Green and Dr Welch on their remarkable achievements. Queen’s Birthday Honours: Officer (AO) in the General Division Dr Catherine Mary Green, East Melbourne, VIC. For distinguished service to ophthalmology as a clinician, through executive roles with national and international professional groups, to research and education, and to eye health care programs in the Asia Pacific. Dr Green is RANZCO’s new Dean of Education and a former Board member. Medal (OAM) Dr Roger Thomas Welch, Southport QLD. For service to ophthalmology. Dr Welch has been awarded an OAM for his hard work in outback communities, working out of a surgical bus to deliver ophthalmic care to those most in need. He is also the founder of the state-of-the-art Vision Centre Day Surgery on the Gold Coast.
RANZCO Past President Dr William (Bill) Glasson working in East Timor, photography courtesy of Ms Ellen Smith 64 Ophthal News
Joint effort to improve referral pathways Last year RANZCO introduced its Referral Pathways for Glaucoma Management, Age-related Macular Degeneration (AMD) Management and Diabetic Retinopathy Management. (L-R) Dr Mitchell Lawlor from the Sydney Eye Hospital; Emma Carr, Gerhard Schlenther and Dr The pathways have been David Andrews from RANZCO; and Peter Larsen, Jeena Tan and Dr Ben Asbhy from Specsavers developed with the input In addition to Dr Lawlor, NSW The collaborative research project of both ophthalmologists ophthalmologists A/Profs Ivan officially launched on 11 July 2017 in and optometrists and aim Goldberg, Andrew White and John Sydney at an event attended by the to provide a clear guide Grigg are taking part in the project. first Specsavers optometrists to sign for referring patients to Specsavers optometrists who refer up to participate. RANZCO’s Dr David to any of the four ophthalmologists ophthalmologists. Andrews, CEO; Gerhard Schlenther, are eligible to participate in the General Manager Policy and Programs; Following the introduction of research. The Save Sight Institute has and Emma Carr, General Manager these guidelines, RANZCO and provided a registry where referrals Communications also attended, along Specsavers announced a world- for glaucoma patients submitted by with Specsavers’ Optometry Director first research project specifically project participants will be logged. Peter Larsen and Head of Optometry designed to enhance collaborative The software will assess the quality of care by improving the quality of the referral against defined standards. Dr Ben Ashby. referrals. The project, being led Personalised, individual reports will be This research project is part by Sydney Eye Hospital Neuro- sent back to participating optometrists, of RANZCO’s commitment to a ophthalmologist Dr Mitchell Lawlor, advising which aspects of the referral collaborative approach in eye care to aims to assess how the guidelines were or were not present, and what the achieve the best possible eye health are being implemented in the care of final diagnosis was, as determined by outcomes for people across Australia patients. the ophthalmologist. and New Zealand.
four categories: an open category, what a privilege it is to be able to mEYE World junior, macular disease community, restore sight.” and healthcare professional. This year the high profile judging Photographic Foundation CEO Julie Heraghty panel includes media identity and Competition said “There is a great synergy Patron of Macular Disease Foundation between the visual arts, the world of Australia Ita Buttrose; internationally 2017 photography, and the work of eye recognised photographer Rex Dupain healthcare professionals in saving and one of Australia’s longest serving sight. Photographs entered by Macular Disease Foundation news photographers, Alan Pryke. Australia is calling for healthcare professionals each year are truly amazing and remind us all entries into the mEYE World of the precious nature of our sight. I Photographic Competition encourage all eye health professionals 2017 and is asking healthcare to be involved and enter a photograph professionals to submit a into this year’s competition.” Ophthalmologist Dr Colin Chan was photograph that captures 2nd runner up in last year’s Healthcare mEYE World Photographic a glimpse of their world. Professional category. Describing Competition runs until This year’s theme is: ‘See his entry Dr Chan said “Sometimes 3 October 2017. My World - in your own after a long day of seeing patients or operations, I like to take a walk in the For more information and to enter, backyard’. local bush near home. Soaking in the visit www.mdfoundation.com.au Now in its seventh year, this free sights and sounds and smells around competition is open to all and offers me helps inspire me and remind me Eye2Eye Spring 2017 65
Cambodian Prince thanks RANZCO for its ongoing support at Khmer Sight Foundation fundraising dinners (L-R) Prof John Downie, HRH Prince Tesso, Dr Celia Chan, Dr Peter Cooper The Khmer Sight Foundation (KSF) collaborated with the scheduled for completion at the end of awarded to Dr Kossama Chukmol. She Eye Surgeons’ Foundation 2017. is undertaking a glaucoma fellowship The Cambodian residents graduate with the eminent Professor Manchima (ESF) to raise funds for as general ophthalmologists without Makornwattanaat at the Thammasat the Kim Frumar Cambodia specific skills in any one area of University in Thailand. On completion Ophthalmology Scholarship ophthalmology. They are not trained of the fellowship, she will lecture on to train Cambodian eye well enough to take over the role glaucoma for five years. of lecturer in the Residents Training The dinners were well attended surgeons. Cambodia’s HRH Program, which is dependent on by ophthalmologists and guest Prince Sisowath Tesso visiting lecturers from RANZCO. speakers including Maurice Newman, attended two fundraising Part of Kim’s vision was to give former Chairman of the Australian dinners in Sydney on 31 May one or two Cambodian doctors each Stock Exchange and the Australian year the opportunity to complete Broadcasting Corporation. Honoured and in Canberra on 2 June. an international fellowship in guests were Dr Diana Semmonds, As well as being a Trustee of the sub-specialties that Cambodia training Vice President of RANZCO; Dr Andrew Khmer Sight Foundation, HRH Prince does not offer. The aim is that they will Chang, Chairman of RANZCO New Sisowath Tesso is also an Adviser to the then return to Cambodia to take over South Wales Branch; and Ms Lisa Private Secretary of His Majesty the the role of lecturer in the residents Cheng, CEO of the Eye Surgeons’ King Norodom Sihamoni and Assistant training program. The training program Foundation. to HRH Princess Norodom Buppha Devi. will progressively become independent There was entertainment from a Khmer Sight Foundation’s vision of external aid and will ultimately be jazz duo and Cambodian dancers. is to train the next generation of purely Cambodian. This is the real Enough funds were raised from both ophthalmic surgeons and eye care staff legacy. dinners to enable another scholarship in Cambodia, so that the country can “Tonight’s dinner is an opportunity for 2018 through the generosity of the become self-reliant in the provision of to say a heart-felt thank you to all the sponsors, including RANZCO; the sale high quality, safe and effective eye care. volunteers and organisations that have of dinner tickets and a charity auction Established by Dr Kim Frumar and Sean worked so hard to eradicate avoidable that included beautiful gold-plated Ngu in 2007, Khmer Sight Foundation blindness in Cambodia. This scholarship Apsara crowns donated by HRH Prince (KSF) was initially set up to support will help our doctors to help our own Tesso and Mr Sean Ngu, the Cambodian volunteer surgeons to treat avoidable people,” said Prince Tesso. Secretary of State. blindness. “I would like to thank RANZCO for Both evenings were hailed a success KSF performed more than 50,000 its continued investment and support and many of the guests left asking if medical eye screenings and 6,320 eye in our people. Tonight we honour this was going to be an annual event. operations in 2016. In 2017, KSF will Professor John Downie, Drs Celia provide 10,000 eye operations over Chan, Peter Cooper and Laurence 24 weeks with over 100 international Sullivan for their years of dedication Tax deductible donations to surgeon groups from Australia, the and commitment, to teach in the the Kim Frumar Cambodia UK, Germany, Japan, Singapore, India, Cambodian Ophthalmology Residents’ Ophthalmology Scholarship Brunei and Italy. They will also be Program. Peter, Celia and Laurence also can be made through the Eye providing surgical training and lectures gave their time and expertise as the Surgeons Foundation at: https:// to ophthalmology residents and local selection committee for the Kim Frumar www.esurgeonsfoundation.org. doctors during the missions. KSF is Cambodia Scholarship.” au/donations/nate/?project=14 also building an independent eye care The funds raised in 2016 enabled and teaching facility in Phnom Penh this year’s scholarship that was recently 66 Ophthal News iFixPen to revolutionise the treatment of corneal ulcers Researchers at the Save more prone to corneal ulcers, ulcers can very much a team achievement.” Sight Institute, University also occur as a result of a fungal or viral With the injection of seed funding, infection, or injury or trauma. Currently the future of the corneal iFixPen looks of Sydney, NSW Organ and the most common form of treatment is bright and the first prototype will be Tissue Donation Service and topical antibiotic, applied to the affected available for use in 2019. The project the University of Wollongong area. also highlights the importance of are revolutionising the While a similar device has been strong collaboration and partnership, used to treat knee cartilage damage which brings research, technology treatment of corneal ulcers as a result of arthritis, the iFixPen is and innovation to the forefront of with the development of a the first of its kind to be developed to ophthalmic practice in the region. “The new iFixPen. Led by Professor treat injuries or diseases of the eye. The iFixPen project is one of the cornerstone Gerard Sutton, the iFixPen is project may still be in the early stages projects of the Australian Corneal of development, but it is already being Bioengineering Centre, which has been an innovative delivery system recognised, with the team awarded established on the Sydney Eye Hospital for a specially designed “ink” nearly $50,000 in funding from the Campus. It was set up to foster the that can treat corneal ulcers by Sydney Innovation and Research development of corneal bioengineered Symposium’s “Big Idea” Award in products to treat corneal disease and promoting wound healing. June this year. “It has captured the makes use of the unique synergies of Corneal ulcers are predominantly imagination of many people…and is having the Save Sight Institute, Sydney caused by bacterial infection, which actually our second innovation award. Eye Hospital, The Lions NSW Eye Bank causes an open wound on the front We were runners-up in the Innovation and The Australian Ocular Biobank in the of the eye. These ulcers can become Competition within the Local Area same location. We are also collaborating serious and cause vision loss or Health District as well,” said Professor with Professor Gordon Wallace from blindness and early treatment is Gerard Sutton. “It was great to get the Wollongong University’s Intelligent essential. While contact lens wearers are award for the whole team...[as] this is Polymer Institute,” said Professor Sutton.
Tax deductible donations to the Kim Frumar Cambodia Ophthalmology Scholarship can be made through the Eye Surgeons Foundation at: http:// www.eyesurgeonsfoundation. org.au/donations/ donate/?project=14. Eye2Eye Spring 2017 67
gained from this cleverly constructed the original residence of the eccentric, Review: conference. Scottish surveyor-general, Alexander It all kicked off on Saturday morning Macleay. This was followed by an Ophthalmology with The Watery Eye, highlighted by ambrosial degustation meal at the Updates! 2017 most as a not to be missed topic. A/Prof trendy 12-Micron restaurant at the Raf Ghabrial gave great insight into his Barangaroo waterfront. Then it was off I recently attended subspecialist approach to this all too to bed (for most…). the second annual common problem. The fact that, by the Day two kicked off with what was end of the presentation, I was looking my favorite talk of the weekend, the Ophthalmology Updates! forward to my next watery eye referral charismatic A/Prof Geoff Painter AM Conference held in Sydney really says a lot. discussing zonular instability during at the enchanting Westin There was no let up with talks from cataract surgery and IOL formulae, Hotel on 29-30 July. On the Prof Stephanie Watson, Prof Peter passing on his wealth of knowledge in a captivating manner. first day, Sydney basked McCluskey and other distinguished subspecialist field leaders, all with an The day continued in the same in a winter heat wave with uncanny ability to deliver thought vein with high quality lectures temperatures reaching a provoking and highly relevant encompassing relevant, useful topics balmy 26°C. Although Bondi information on both common and for both generalists and subspecialists alike. Beach would’ve been a nice frontier topics. The day finished up with A/Prof John Interestingly, I also spoke to several alternative, the conference Grigg and Electrophysiology 101. I think upcoming RACE candidates who had was worth every minute of I’ve had electrophysiology lectures attended from interstate. The feedback missed UV exposure. more times than hot dinners but just was so positive amongst registrars who attended last year for the quality As a subspecialist VR surgeon never get it! I put it down to my own and quantity of high-yield information with a general component to my personal intellectual ceiling, I guess. that I’m sure this event will become a practice, I found this conference to A/Prof Grigg’s unique understanding regular fixture in the registrar calendar. be exceptionally enlightening and of electrophysiology and clever way Hats off to A/Prof Adrian Fung for stimulating. It brought me back to the of simplifying each test to include bringing together the illustrious team good old days of Eye School during my its ‘specificity’ and ‘sensitivity’, for of eye ‘Avengers’ to deliver one of the registrar training, with the familiar faces once [somewhat] solidified my most engaging conferences of the of many of my revered mentors on the understanding of this complex area of year. See you all again in 12 months. podium. I went back to my practice on ophthalmology diagnostics. the Monday, and within one week I had Day one finished up with a pleasant Dr Richard Barry already used numerous clinical pearls tour of the iconic Elizabeth Bay house,
Ophthalmology Updates! 2017 68 Obituaries
Obituaries Gordon Sanderson 5 August 1946 – 5 July 2017
and Dunedin, and the month long Gordon served on the board of prep for RACE in Dunedin. These the Fred Hollows Foundation. courses are seen by the College as RANZCO recognised Gordon was important for training and exposing an outstanding individual and trainees to the curriculum and contributor to our profession and learning sets: Gordon knew his job awarded him an Honorary Fellowship was to get each and every trainee in 2003. I think of all the accolades over the hurdle of the exam and that he received, Gordon valued that the is what he achieved in most cases. most. To him it meant he was valued Not that he did that alone, but he and appreciated by his peers. had the knack of persuading the best Outside his working day, Gordon on both sides of the ditch to give up their private or academic time to spent a great deal of time and teach on his course. effort rummaging through antique Selling an idea or concept is what shops and catalogues. His particular Gordon did best. He moved to New passion was the Georgian period Zealand from the United Kingdom and his home in Arthur St was jam in 1972 having just finished an packed with his prized collection. undergraduate degree in Optometry It may be only a coincidence but at the University of Manchester. The as Arthur St became, shall we say, late Professor Parr then employed full, he acquired a church in Central Gordon, on a whim really – his CV Otago that in all essence became a was largely devoid of anything fishing lodge. The church could not but enthusiasm, but as it turned become cathedral sized so he built out that was more than enough. another dwelling, ‘the vicarage,’ and From a lecturer for undergraduate so there was even more room for the medical students to receiving the mementoes, the fishing tackle and Prime Minister’s Supreme award for occasional mounted trophy. Gordon Tertiary Teaching Excellence in 2013 entertained many visitors there, is but a precis of his teaching career. Having said that, to paraphrase most to be fair were not going to fish Kipling, he treated successes on but rather enjoy the atmosphere and an equal footing with knock backs. bonhomie. Gordon Sanderson In his office, framed side by side, As for Gordon’s legacy, history will The Royal Australian and is the award from the then Prime determine that. But he does leave an New Zealand College of Minister and a letter from a former adoring partner Suzanne and two employer declining promotion. As adult children, Charlotte and Adam. Ophthalmologists (RANZCO) a result, Gordon was destined to Both being the apple of his eye – was very saddened to hear of remain an Associate Professor at Charlotte perhaps for producing the sudden passing of Gordon Otago University, but a full Professor the best grandchild on the planet in Hong Kong where he visited Sanderson. Gordon died and Adam for staying awake while regularly. attending his father’s lectures at unexpectedly at Christchurch Gordon moved in many circles medical school. Time will tell if Adam Hospital on 5 July 2017, aged outside the teaching arena. He was becomes as expert as his father with 70. Chairman of the Blind Foundation piscatorial pursuits. for many years, for which he was Gordon will long be remembered He was well known to many awarded a NZ Order of Merit. Gordon but terribly missed by Suzanne, and ophthalmologists both in Australia was a keen supporter of Glaucoma for the rest of us as a great friend, a and New Zealand because of his NZ at a governance level and was contribution to teaching, particularly also Chairman of the NZ Corneal witty raconteur, and loyal to the end. the basic sciences courses in Sydney Eye Bank since 1993. More recently, Professor Philip Polkinghorne Eye2Eye Spring 2017 69
Professor Akira Nakajima 14 July 1923– 16 June 2017
world. His clinical areas of interest continued as I became more involved included corneal and external disease, with the ICO. He was immensely wise corneal surgery, ocular genetics, and and patient and had an unexpected and inflammation. He was the Director of the cheeky smile. Research Institute of Ophthalmology His contributions over time to of Juntendo University where he also ophthalmology as a whole cannot be led research into retinal degeneration, overestimated. Prof Nakajima was a uveitis including Bechet’s disease, and founding member of the Academia glaucoma. Throughout the decades, he Ophthalmologica Internationalis (AOI) has made unparalleled contributions and he was its President from 1988 to to ophthalmic teaching and training, 1990. clinical and laboratory research, and Prof Nakajima first became clinical ophthalmic practice in Japan, the a member of the International Asia-Pacific region, and well beyond. Council of Ophthalmology (ICO) in From 1972 to 1976, Prof Nakajima 1974 and he was the President of was the President of the Asia-Pacific the 23rd International Congress of Academy of Ophthalmology (APAO) and Professor Akira Nakajima receiving the Ophthalmology held in Kyoto in 1978. then its Secretary-General from 1976 to Vietnamese Medal for Peoples’ Health in He joined the Board of Trustees of the 1990. In addition, he was the President December 2004 ICO in 1982 and was the ICO President of the Japanese Ophthalmological Professor Akira Nakajima Society from 1985 to 1987. from 1990 to 1998. Prof Nakajima began died on 16 June this year Prof Nakajima received the APAO’s a major reorganisation and elevation of the ICO during his tenure as President at the age of 93 years. José Rizal Medal in 1987 for both his outstanding contributions to the (1990–1998), and he continued this He was a great leader of development of clinical ophthalmology service as an Honorary Life Member of international ophthalmology and for his work on the prevention of the ICO Board. Under his presidency, and instrumental in the blindness in the Asia-Pacific region. the ICO set up education programs that included starting the ICO Exams. growth and development of Subsequently, the APAO Nakajima Award was established in 2005 to The ICO Immediate Past President ophthalmology in Japan, the honour his contributions. It is presented Dr Bruce Spivey said “Akira was an Asia-Pacific region and around at the APAO Congress to distinguished intense worker, inveterate traveller, the world. It is with immense young ophthalmologists from the Asia- and a kind individual.” To acknowledge sadness that we recognise Pacific region for outstanding work in his enormous contributions to international ophthalmology. ophthalmology and ophthalmic the passing of this great man. Prof Nakajima was the Director of research, the ICO presented Prof He was probably the best- the World Health Organization (WHO) Nakajima with the highly prestigious known ophthalmologist in Collaborating Centre for the Prevention Gonin Medal in 1986. In 2000, he was Japan during his time and was of Blindness in Tokyo from 1980 to awarded the very prestigious 3rd Order 1989. During this time, I had the great dedicated to improving clinical Middle Rising Sun by the Emperor of pleasure of working closely with him Japan. care, ophthalmic education and in this capacity and we would attend He had nursed his wife, Dr Michiko research, and the prevention of WHO and International Agency for the Nakajima, whom he had married in blindness. He was also a very Prevention of Blindness (IAPB) meetings 1953, for a number of years during together. Through the 1990s and early warm and caring person. her final illness. They are survived 2000s we spent a lot of time together by a son and a daughter who is also He studied at the Tokyo University and with Dr Konyama at regional, an ophthalmologist. I last saw Prof and became a Doctor of Medicine in sub-regional and national meetings Nakajima in Tokyo in 2014 during the 1945 and a Doctor of Science in 1953. for the IAPB and Vision 2020 activities World Ophthalmology Congress. He He became an Assistant Professor at the in the Western Pacific, especially in had been in poor health for a number Juntendo University in Tokyo in 1954. Vietnam. We also had some other less of years and in the end died peacefully. In 1960, at the age of 38, Prof Nakajima conventional links; his first publication He was a great ophthalmologist and a succeeded Prof Sato as Professor of was on trachoma in Japan (trachoma Ophthalmology at Juntendo. He held being a longtime interest of mine) and magnificent international leader, we are this position until he retired in 1989. he had worked with my grandfather in all the better for his contributions and He created a very strong department the 1950s on strabismus and orthoptics. for his committed leadership. which became known around the Our friendship and his mentorship Professor Hugh Taylor 70 Obituaries
Classifieds
Positions vacant OPHTHALMOLOGIST ASSOCIATE OPHTHALMOLOGY CONSULTANT WANTED KATOOMBA POSITIONS, WELLINGTON OPHTHALMOLOGIST ASSOCIATE An opportunity exists for an HOSPITAL, NEW ZEALAND INNER WEST SYDNEY associate – regular part time Two exciting opportunities exist for We are seeking an associate to join progressing to full time – experienced Ophthalmologists to our growing practice in Sydney’s Ophthalmologist to join a practice join our team on a fixed-term basis. Inner West. Our practice is modern in Katoomba NSW which is in the 1. One year (maternity cover) and purpose built with the latest beautiful Blue Mountains. - preferably with paediatric equipment including Cirrus OCT, In a purpose built facility, the experience and general Optos, IOL master, B-scan, HVF, practice has an increasing ophthalmology experience YAG, SLT, retinal and micropulse workload, on-site Zeiss OCT, IOL (0.77 FTE) laser. This position would suit a Master, Humphrey Field Analyser, 2. Three months - general young RANZCO graduate, general Angiography, Pentacam, lasers ophthalmology (0.95 FTE) or sub specialists in paediatrics, (including Retinal, VITREOLYSIS, (There is flexibility for less FTE oculoplastics, glaucoma, or cornea. YAG, SLT etc.) procedure room in both) Onsite parking is available. and networked electronic medical The Ophthalmology service is a C: Khanh-Linh Luu records system. progressive and expanding clinical P: 0488 110 886 Secondary locations in Springwood service providing a comprehensive and Lithgow, public hospitals in inpatient and outpatient ophthalmic the region pay fee-for-service care. for public operations (subject to OPHTHALMOLOGIST PRACTICE The successful candidates will appointment) and private hospital OPPORTUNITY IN QUEENSLAND have good communication skills, a access. willingness to teach medical/surgical Seeking an ophthalmologist to Would suit a young RANZCO skills, a proven track record in clinical work in a long established, busy, graduate, subspecialist with general audit and be able to demonstrate a private ophthalmology practice in Ophthalmology ability or general commitment to research. Townsville with an older general ophthalmologist with subspecialty Applicants must hold or be eligible ophthalmologist. The practice is in a interest. to hold vocational scope registration new purpose built facility with up- Must have Australia Specialist with the MCNZ. to-date equipment. recognition. E: [email protected] Applicants must be an AHPRA A significant work-load is registered medical specialist with anticipated. Fellowship of The Royal Australian E: [email protected] Full Time/Part Time and New Zealand College of Ophthalmologist Ophthalmologists. LOCUM OPPORTUNITY PORT E: [email protected] Opportunity in South Australia with MACQUARIE a long established private practice. Ongoing locum work available in We are seeking an ophthalmologist beautiful Port Macquarie, NSW. - general adult/cataract, with or OPHTHALMOLOGIST ASSOCIATE Direct flights from Sydney daily. without sub-specialty interests CENTRAL WEST NSW Growing regional city with plenty in glaucoma, medical retina, Associate, part time or full time, of work. Fully equipped, modern oculo-plastics to join our busy, required for busy, well equipped practice. well-equipped practice in South practices in Orange and Lithgow. Would suit new fellows looking for Australia located at North Adelaide Will suit general or sub specialists extra work, opportunity to increase and Glenelg. The practice is able in Paediatrics, Oculoplastics, to associate or VMO arrangement if to offer a variety of sessions and Glaucoma, or Cornea. suitable. you will receive support from fully Our practice is well supported May also suit semi-retired fellow trained administrative and nursing by an orthoptist and ophthalmic looking for occasional work on an staff and senior ophthalmologists. nurse. Equipment includes Cirrus ongoing basis with a great lifestyle This would suit an ophthalmologist HD OCT, Lenstar, iTrace, Octopus included in sunny Port Macquarie. with a view to future partnership. 900 VF, Iridex micro pulse laser and Arrangement is flexible and Lumenis IPL. includes private operating P: +61 8 8267 6544 We are a busy practice and are privileges at our onsite day facility. E: [email protected] confident to be able to offer a Assistance with accommodation is satisfying and stimulating practice provided. for the right person. P: +61 5527 8032 E: [email protected] E: [email protected] Calendar of Events 2017
EVENT DETAILS CONTACT Joint GCMA/VMDA Medical Conference 21-23 September 2017 W: https://gcma.org.au/Fiji-2017- Warwick Le Lagon Resort, Efate, Conference.aspx Vanuatu Elluk Road, Off Kumul Highway, Erakor Lagoon Port Vila, Vanuatu European Association for Vision and 27-30 September 2017 W: www.ever.be/ Eye Research (EVER) Congress 2017 Acropolis convention center 1 Espace John Fitzgerald Kennedy Nice, France The 2017 RCH Paediatric 6-8 October 2017 E: [email protected] Ophthalmology Seminar Royal Children’s Hospital, Melbourne 50 Flemington Rd Parkville, VIC, Australia 2017 RACMA Conference 18-21 October 2017 W: www.racmaconference.com.au Melbourne Convention and Exhibition Centre
49th RANZCO Annual Scientific Congress 28 October - 01 November 2017 W: www.ranzco2017.com Perth Convention and Exhibition Centre Western Australia Branch Annual 3-4 November 2017 C: Bec Piccoli Scientific Meeting Venue to be advised E: [email protected] Health Business Excellence Program 4-5 November 2017 E: [email protected] - Sydney Hilton Sydney 488 George Street Sydney, NSW, Australia American Academy of Ophthalmology 11-14 November 2017 W: www.aao.org/annual-meeting (AAO) 2017 Ernest N. Morial Convention Center 900 Convention Center Blvd, New Orleans, United States of America Dunedin Ophthalmology Clinical 20 November - 1 December 2017 W: www.ranzco.edu and go to the Course (Part 2 Course) University of Otago calendar of events 362 Leith St E: [email protected] North Dunedin, New Zealand Women Ophthalmologists Society 25-26 November 2017 W: www.ranzco.edu and go to the Annual Conference, Jaipur Amer Road, Amer, Jaipur, Rajasthan Calendar of Events 302028, India Rajasthan, India APVRS 2017 8-10 December 2017 W: http://2017.apvrs.org 11th Asia-Pacific Vitreo-Retina Society Kuala Lumpur Convention Centre Congress Stall 7, Jalan Pinang, Kuala Lumpur City Centre Kuala Lumpur, Malaysia Joint SPOSI and DOS International 9-10 December 2017 W: www.ranzco.edu and go to the Congress India Habitat Centre Calendar of Events Lodhi Road New Delhi, India More expertise. More reputations protected. We’ve got your back.
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Dr Jolly Gilhotra Ophthalmologist and Avant member
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