Optometry Continuing Education 2018 New Zealand

Professor Michael Kalloniatis

Michael completed his optometry degree at the University of Melbourne after completing his master's degree at the same institute then undertook PhD studies at the University of Houston, Texas. After post‐doctoral training at the University of Texas, he returned to Melbourne where he was an academic staff member in the optometry department before moving to The University of Auckland where he was the Robert G Leitl Professor of Optometry and Vision Science and Head of School.

In 2009, he took up the position of Centre Director and Professor at the Centre for Eye Health, UNSW. His expertise is in retinal neurobiology, visual psychophysics (as it applies to clinical testing) with a keen interest in glaucoma and retinal disease diagnosis.

He is an active researcher publishing in a wide topic area and he also presents at both local and international meetings.

Lecture 1 (Kalloniatis): Colour vision assessment and modern clinical techniques applied to clinical practice (45 min)

Learning Objectives

• Be able to integrate colour vision and a range of other clinical results to help in the diagnosis and management of ocular disease
• Appreciate the different types of congenital colour vision defects and how some reflect a family of cone dystrophies that can be identified using multi‐model imaging
• Being able to put Köllner's law into perspective: acquired colour vision deficiencies impact all visual processing channels
• Understand how the results of colour vision testing can complement the understanding and help in the diagnosis of ocular disease through clinical cases
  

Lecture 2 (Kalloniatis): Ocular ischaemia in clinical practice (45 min)

Learning Objectives

• Understand how retinal and cortical blood supply impact vision and other neurological changes induced by ischaemic insult, including transient monocular vision loss (TMVL)
• Appreciate that in addition to routine ocular imaging, OCT‐angiography (OCTA) provides useful insights to clinical diagnosis in ocular ischaemia
• Through a series of case presentations understand the impact of ischaemic insult on the eye and visual system
• Understand the suitable management of TMVL, relating to the urgency of referral and where to refer

Lecture 3 (Kalloniatis): Managing the many facets of glaucoma (45 min)

Glaucoma management is complex even before diagnosis is made. In this lecture the multiple facets of glaucoma will be discussed from review cycles/frontloading visual fields and include a series of cases studies and some interesting imaging results.

Learning Objectives

• Appreciate the cost/benefit of testing review cycles for glaucoma suspects and the way the most efficient protocol is derived
• Understand why '2' is better than '1' when using the frontloading visual fields
• Appreciate that in addition to routine ocular imaging, OCT‐angiography (OCTA) provides useful insights to clinical diagnosis in optic nerve disease
• Through a series of cases, understand the multiple facets of glaucoma presentation including strategies in long‐term management of your glaucoma patients

Professor Steven Dakin

Steven's research career started with a PhD (1994) on psychophysics at the University of Stirling. He moved to the UCL Institute of Ophthalmology in 1999, where his work centred on vision through the lifespan and in individuals with neuropsychiatric and neurodevelopmental disorders (such as autism), and was promoted to Professor of Visual Psychophysics in 2010. He joined the School of Optometry and Vision Science in 2014, serving as Head for 8 years. At SOVS he championed the importance of community eye health research, raising funds for the first Associate Professor in Public Eye Health, first Professional Teaching Fellow Kaiāwhina, as well as for Vision Bus Aotearoa, New Zealand's first comprehensive mobile eye clinic.

His ongoing research into the treatment of amblyopia in children is the subject of an ongoing Phase 2 clinical trial in the UK. Current projects explore how technology can be used to improve assessment and treatment of visual function. In the last eight years he has shown how eye tracking can be used to provide objective measures of many aspects of vision including acuity, peripheral vision, fusion and colour vision and even to drive subjective refraction. He co‐developed the Auckland Optotypes, a set of chart‐symbols that are increasingly being adopted worldwide as a better way of testing acuity in children.

Abstract (Dakin): Could eye-tracking replace patient-report in an eye exam? (45 min).

Assessment of functional/useful vision is the cornerstone of optometric assessment. However it remains dependent on patients being able to make reliable forced‐choice judgements about visual stimuli. Various groups of patients (e.g. children, adults with cognitive impairment) struggle with such judgements. The cognitive/memory demands of tasks for assessing recognition acuity, for example, is known to contribute to the sometimes poor reliability of such an important test of visual function.

I will present work from my lab from the last seven years developing tests of vision that minimize cognitive/memory demands, by using an automated assessment of patients' eye movements as a proxy for subjective judgements. Having given some background about the types of eye movements we use and how we measure them, I will summarise the results of four studies. These show how eye movements can support:

• Assessment of contrast‐sensitivity and acuity
• Diagnosis of colour vision deficits
• Subjective refraction
• Measurement of fusional reserves

In almost all cases the reliability of such measure matches or exceeds the clinical gold standard (based on patient report) and I conclude by considering how we might best put these tests into the hands of clinicians.

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Source: https://www.nzao.nz/conference2022/speakers/