Paihia: host to NZAO's 2018 conference

The 88^th annual New Zealand Association of Optometrists (NZAO) conference was held in Paihia, mere meters from the Waitangi Treaty Grounds. The key themes of this year’s conference were encouragement through collaboration, growth through the honourable path of making horrible mistakes and, oddly enough, poetry.

Our opening sessions were introduced by NZAO president Rochelle van Eysden who began with a karakia, calling us to discover new ideology and encouraging us to work closer together as we considered the future of our industry.

This was followed by a pithy and practical talk by guest speaker, Professor Joseph Sowka from Nova Southeastern University (NSU) College of Optometry in Florida. His talk, Mistakes to avoid in neuro-ophthalmic disease, covered many topics, including Horner’s syndrome and glaucomatous fields masking neurophthalmic disorders (always look at the greyscale to see the “hole within a scotoma”). Each section was summed up brilliantly by a rhyming “ode” to help revise the salient points.

The next guest speaker, Paula Katalinic from the Centre for Eye Health at the University of New South Wales, covered diabetic retinopathy (DR). She reminded us to keep looking closely beyond the two central fields normally assessed in screening programmes as patients who have “peripheral lesions” had increased risks of non-perfused areas and of DR progression. Optometrist and PhD candidate Ally Xue presented her research on IPL and dry eye before the session was brought to close by another invited speaker, Associate Professor Lori Vollmer, also from NSU, who presented several case studies on nutrition and eye disease. Dr Vollmer challenged us not to stop at the ocular management of a condition and even if our patients were “healthy” to give them advice on how to stay within normal limits. Lunch followed, with plenty of socialising with the conference sponsors CR Surfacing and Alcon.

The afternoon then progressed with a lecture on Mistakes to avoid in glaucoma management by Joseph Sowka. He reminded us not to become reliant on just one measurement and which patients we should most worry about, including those who respond poorly to medications, have low peak pressures and reach maximal medical therapy quickly.

Dr Samantha Simpkin discussed the role of BLENNZ (Blind and Low Vision Education Network NZ) and made sure we were all informed on how to get our low vision younger patients the assistance they were entitled to. Alcon’s Helen Gleave described a theoretical patient’s needs and how the different contact lens products could be used or interchanged over time to suit them.

Paula Katalinc then gave a fascinating talk on advanced imaging techniques which left most of us quietly dreaming of an OCT capable of movement to image lesions in the periphery. Optometrist Danielle Ross closed the day by providing an interesting look at how community optometry was poised to catch the children who are struggling with reading. While we often focus on their amblyogenic risk factors, however, we don’t always consider the critical development period for reading, she said.

Odes were back the next day as NZAO council member Jack Crawford welcomed Dr Sowka back for another entertaining lecture, this one covering ophthalmic diseases and emergencies, including central retinal vein occlusion (CRVO) - have you considered Primary Antiphosopholipid Antibody Syndrome in your differential list if your patient is young? Greenlane optometrist Richard Johnson maintained the humour with some interesting cases involving lots of audience participation (and a few pictures not for the squeamish).

Auckland-based ophthalmologist Dr Trevor Grey described the contentious topic of monofocal vs multifocal intraocular lenses, while Paula Katalinic described things to look out for when it comes to lesions in the peripheral retina, gently reminding us not to become complacent with our dilated fundus examinations.

After lunch Sydney-based optometrist Dr Hans Vellara explained his research on the biomechanics of the cornea and its potential applications regarding IOP measurement, keratoconus and assessing risk of post-LASIK ectasia. His quick departure to catch his plane was described as the best “dad joke” of the weekend after he advised us we were about to observe a “slight of Hans”. Dr Vollmer shared some of her cases highlighting the treatment of ocular trauma, including a case of “bacon shrapnel” which made some of us contemplate reaching for the safety glasses next time we cooked breakfast. Ophthalmologist Dr Dean Corbett suggested we ask the patient “what do you want to see?” reminding us patient outcomes were determined by the patient’s tolerance level.

The final session covered some brutally honest cases where Dr Brian Kent-Smith, Jack Crawford, Richard Johnson, Lori Vollmer and Joseph Sowka all covered incidents where they had a gut feeling to check again or do that one extra test which provided them with a potentially sight saving, or even life-saving, diagnosis that would have otherwise been overlooked.

An excellent dinner with some lively chatter concluded the meeting. We headed home with some brilliant clinical pearls, still chuckling over the cringe-worthy poetic humour and with a renewed sense of camaraderie with our professional colleagues.

See you all in Napier next year for the 89^th conference!

Stephanie Wallen is a therapeutically-qualified optometrist working in a private practice in sunny Northland.