In Contact - February 2004
Wasssup?
After a great break we're back.
I can?t recall a better start to a New Year in NZ. We enjoyed some of those perfect, clear, hot days. We were also fortunate to have a few days of fantastic sun and surf on the Coromandel. Of course as we go to press, parts of NZ are experiencing some of the worst summer storms in living memory.
I always enjoy Auckland around Christmas as there is minimal traffic and rarely a problem getting a seat at the local coffee shops. Come mid January we could see most people were back in town with the traffic back to its dismal standard.
After much rearrangement of the local roading network it almost seems worse? We also had to deal with the government?s revenue collectors in their macho Holdens and RADAR speed trapping devices.
One lot even used blinding headlights, facing oncoming traffic at night, on the wrong side of the road, to aid their revenue gathering. Not only is it downright dangerous and irresponsible but rather stupid too.
More on that later, if I get some feedback from the LTSA and police?.
Something old, Something New, Something Borrowed, Something Blue?
From a contact lens point of view we can look forward to some more aberration controlled disposable lenses in various lens forms and modalities but probably the most exciting lens we can expect to hit our shores will be the Acuvue Advance second-generation silicone-hydrogel lens. It was released in the US in late 2003 so I expect we will have it before mid-year?
Watch this space?
Unlike Night & Day and Purevision, the lens is not ?surface treated? but a novel polymer allows better wetting. It is intended as a high Dk, DAILY WEAR lens and as such it should be a winner. Preliminary reports look good. Find out all about it at the JNJ site.
We are also most pleased to have a range extension to the SofLens 66 Toric, since late last year. The -2.75DC has been a boon to those tricky fits, cones and RGP intolerant astigmats. It fits well on an amazingly wide range of corneas too. As with previous versions one can often correct a lot more astigmatism than 2.75DC and I have had some good results with astigmatism being well corrected even up around the -3.50DC to -4.50DC levels. These features are largely due to the aberration control and reverse geometry design that have always been part of the SofLens 66 family.
Now what we want [and need] are high Dk torics and daily disposables?
If you like Flash animated websites check out AMO?s new Complete-rapidcare site for an MPS solution that promises cleaner lenses in two minutes. It uses a specialised cleaning unit and Complete MoisturePlus MPS.
Coming soon to NZ. This year we hope?
There are, I am sure many other developments that we can look forward to and as usual you will be among the first on the planet to hear about them via In Contact.
The Hubcap Fell Off?
I have previously expressed my concerns - not so much in the direction in which optometry is heading - but rather to an apparent lack of recognition of the core fundamentals of our profession.
Issues regarding the HPCA act have also been a worry for many and I, and many others, were not exactly overjoyed when we saw some of the proposals in the Opticians Board?s ?discussion document? many of us received in late 2003.
I can tell you that there are a number of practitioners that have had enough and would give up their chosen profession rather than spend the rest of their professional lives jumping through hoops to please the powers that be in Helengrad.
While it would seem the plan is to have special certification for, among other things, ?Diabetic Retinal screeners? and ?Behavioural Optometrists? it seems ?simple old contact lenses? can be practiced by any old optometrist, with less CE and less special certification? I would suggest that the risks of ?loss of sight? are no less for contact lenses, in the ?wrong? hands, than for the aforementioned ?specialities? with many more contact lenses in the market place than proliferative diabetic retinopathies or those in need of behavioural vision care.
It also appears to me that it may be very difficult for part-time practitioners to stay registered. Take for example an optometrist who has had a family and has chosen to stay home and take care of their kids. I know some excellent optometrists like this. Working one day or one Saturday a week it would seem, is not going to give them the hours they need to stay registered, never mind the COST in time and dollars needed to satisfy ?regency of practice? and CE requirements.
I already know of one top level, overseas based Professor of Pathology, with decades of experience, and a leader in the field who may be chucking it in rather than kowtow to PC pollies and professionals who seem hell bent on the path of ?certification? and so forth. Indeed it seems they also want to foist self performed and external ?audits? on us, as well as a host of other time-sucking and costly processes to prove ?compliance? and so on.
we're into another loop ? from the deregulation of the past decade into an era of over-regulation, as predicted in this column.
What has become of the value of skill, experience, and existing qualifications? A perfect academic record, and tons of CE and re-examination, does not necessarily make for great optometrists.
The way I see it is that we should simply licence all tasks that optometrists do ? like retinal screening, anterior segment care, refraction, oculomotor assessment, visual fields, vision therapy and so on. All currently registered and qualified optometrists should be allowed to continue in practice as we have.
I am a strong believer in CE and furthering one?s knowledge but like many don't like being dictated to by bureaucrats. Like medical practitioners we should be able to perform any tasks for which we show competence. Only where there is a failure in the standard of care should this competence be questioned. Why make rules that affect all for the sake of trying to prevent the rare and exceptional failure?
Optometry?s track record does not seem to indicate that there has been a bunch of under-skilled, loose-units destroying the public?s vision.
I really tire of all this.
I know that there are well intentioned, intelligent and hard working professionals that have been involved in this process and this is not an attack on their efforts.
I do hope that the end result of the discussion process leads to a balanced and workable solution. However, even if 50% of the intended proposals see the light of day, we will unfortunately lose some excellent practitioners and we may in fact see a reduction in standards, and an increase in costs and salaries that will ultimately increase the cost of eyecare in NZ.
If they decide to include all these proposals then they'd better add another: ? That of ?tertiary care practitioner? so we can focus on our areas of speciality and the referrer can take care of all the other stuff and responsibility for DFEs, path, fields, glaucoma etc.
We need to be very careful in what we allow to occur.
Have you say, by 6th February, or else live with the consequences of your inaction.
BDO 04
I was fortunate to attend the 2004 Big Day Out in Auckland on January 16th with one of my young at heart optometric mates. I'm often amazed at the melange of people that populate NZ. A day at the BDO certainly cements that view.
Whew!
Salmonella Dub were, in our opinion, the ?gig of the day? They played in the aptly named ?Boiler Room?- an almost enclosed big rubber tent - which was filled to overflowing with thousands of hot, sweaty, gyrating bodies. They, more than any others, apart maybe from Metallica, really got the crowd going.
Some in the audience were shirtless, others grooved to the skanking reggae dub in bikini?s, which further raised the extreme heat. Add to that some rather pungent aromas that seemed to be de rigueur, and it would have had to be the most effective form of mass glaucoma control one could find anywhere. With each person shedding litres of body fluids and direct or second hand ingestion of IOP reducing substances the average drop in IOP must have been around 2 to 4 mmHg?
Now there's a great project for final year optometry students.
Simply measure a statistically significant number of ?before and after? IOPs and compare to a control group and you may well have the next form of glaucoma treatment. Not that I can see eighty year old grannies getting into it.
It was good to see 40,000 people enjoying a great day out with no signs of violence.
It certainly beats a day at a British soccer match.
I've been instructed to chaperone my fourteen year old daughter and her mates next year.
Or will they take care of me should the old ticker conk out during a session in the Boiler Room?
For more information or any comments email Alan at incontact@optom.co.nz.