In Contact - September 2011

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Out of Afrika

This missive comes to you from an unseasonably warm South Africa. What a pleasure.

It’s been a whirlwind trip so far and in less than a week I’ve slept in six different beds in five different places.

Cape Town was, as always, a highlight with one day reaching a glorious 27°C but two days later there was snow on Table Mountain. There are few cities in the world that canmatch Cape Town. I caught up with family, old friends and colleagues. One of my old mates is renowned photographer Dale Yudelman with whom I shared a darkroom for nearly two-years, over three decades ago. His talent is exceptional and he recently won South Africa’s richest photographic award. Competing against sixty-nine others – sporting all the best gear – he won using nothing more than his skill, iPhone4 and the $1.99 Hipstamatic App. The series, ‘from the Hip’ is remarkable. Check it out. I stayed at the fantastic, modern Crystal Towers Hotel, venue for my first presentation. I’d rate it among the best hotels I’ve stayed in anywhere in the world with great, friendly service and a marvellous ambience. Worth a visit! The more colonial Oyster Box Hotel in Umhlanga Rocks also rates highly and was chosen for the recent honeymoon of the Monaco royals. I last stayed there over forty years ago.

The mood of optometrists in ZA is still relatively positive, although many say patient volumes are down as a result of the lingering GFC. They have however yet to undergo the deregulation of ownership that has forever changed the landscape of NZ optometry, these past few years. They have also yet to experience the challenges posed by internet sales of contact lenses and spectacles. We discussed the reasons for this; some surmised that one reason was that people shy away from purchasing things online as much of it gets stolen at customs or within the postal system! 

I guess that’s one solution to the problem…

RWC

Still in Africa I watched the ABs convincingly thump the Wallabies on TV. On an eye-related theme it was a pity to see that Sivivatu, who played a great game, suffered anorbital fracture. He will thus miss the next Tri Nations game in South Africa as will a few other star All Blacks who are being ‘rested’ ahead of the RWC. That said I doubt the ABs ‘B team’ will battle too much as the off-form Springboks sadly got beaten (again) in a try-less defeat by the Wallabies on home soil. Not good enough.

By the time you read this it will only be a matter of days to the opening ceremony and first game of the RWC. Of course confidence in the Springboks is low, albeit probably not at an all time trough as there have been bad times in the past. The general feeling is that the Springbok team has too many oldies, a poor backline and not enough depth. I’m of the opinion that off-the-wall coach De Villiers has too many ‘favourite’ players, plays some out of position while ignoring potentially great up-and-coming talents. The team seems to be lacking a game plan or set pieces with poor tactics in evidence. Hopefully he’ll wake up in time and send the best team he can muster. Does he have some secret weapons and tactics up his not-so-hilarious sleeve?

I wonder if the Boks will be bringing their own food and chefs to NZ so they don’t end up with gastro-intestinal problems like the ABs suffered at the hands of Suzie at the 1995 RWC? Some say it wasn’t South Africans that masterminded this devious act but rather an Asian betting syndicate; knowing what we do about game fixing and the money at stake it wouldn’t be surprising. A mate involved in a billion pound spread betting syndicate that utilises high-level actuarial analysis tells me that one sport they don’t bet on is cricket; the rampant match fixing skews the stats too much and makes it impossible to get the fine winning margins required to make a profit. He also jokes that the RWC final should be played by the All Blacks A & B teams. He’s in no doubt the ABs will win even though, like me, he’s a staunch Bok supporter having gone to school with John Smitand Chiliboy Ralepelle at my alma mater, Pretoria Boys High School.

One would have to concede that the ABs are favourites for taking the Webb Ellis Cupand it would be great for NZ. Of course one can never be sure and the Boks may step up and the ABs could choke; it’s not unheard of. Watching the skills the ABs possess would however have most people quivering in their boots. Remarkable.

I have tickets to a few core games and look forward to them as I do to The Wall in February 2012.

Bring it on!

A Sparkle in the Eye?

Chandrashekhar Chawan, an Indian colleague I’ve met previously lecturing in Vegas and elsewhere, recently emailed me to say he had developed the world’s first diamond-encrusted gold contact lenses. The reaction of colleagues in this article was similar to mine; why?

I guess there are some who will wear them just as there are some who will wearspectacles attached to piercings through the nose bridge!

Objective Perimetry: At Last!

For anyone who deals with patients – especially older ones – we all know that perimetry can be very frustrating and time consuming for all concerned.

Way back in the mid-80s I applied to do a Masters Degree at Berkeley University in San Francisco. I passed the GRE exams in the top tenth percentile and satisfied all the other entrance criteria and was on track to leave South Africa for the USA. At the last minute my application was rejected despite having been allocated a graduate advisor and having everything lined up. Although being involved in the process for almost a year, I had only supplied the University with my visa application and photograph toward the end. I was told (off the record) that as soon as they discovered I was a white person from South Africa – at the time of the infamous Rubicon speech and apartheid dramas – that I had been summarily rejected. In retrospect it was probably a good thing as I am not that keen on bureaucracy and the hierarchical structures typical of academic institutions.

I’m a clinician at heart and have no regrets.

The reason I mention this background is that apart from my interest in doing research in corneal physiology and contact lenses I had some other more esoteric goals. At that time, before the advent of automated perimetry, I was keen to utilise the visual evoked potential to achieve objective autorefraction and perimetry. Autorefractors had only appeared on the market in the late 70s. We obtained one such early Humphrey unit at the Optometry School in Johannesburg around 1979. It was a massive unit, consisting of a long, heavy box that took up a whole table, a far cry from the four-in-one fully automated Topcon TRK-1P that we now have in practice.

At any rate I am pleased to tell you that such an objective perimeter, utlising the VEP is now finally a reality, thirty years on. I wonder if it would have happened sooner had I done my research back in the 80s?

The objective perimeter can perform visual field assessment in a very short time with no required input from a patient; they simply look at an alternating checkerboard for a few seconds and the results are obtained. Check it out.

Little old grannies that are reluctant to undergo visual field testing will be relieved. 

So will we.

Invisibility?

Since I was a kid sci-fi writers and action hero comics made use of ‘invisibility cloaks’ to render a person or object invisible to those around them. It seems we are now one step closer to this dream of invisibility with scientists now tinkering with optical devices that can achieve this. 

Imagine such technology in the wrong hands.

It could certainly help the Boks win the RWC…