Changing of the guard: optometry yesterday and today

The past year has seen many of New Zealand’s optical industry stalwarts step back from day to day operations. Jai Breitnauer asked them about the changes they’ve seen and what might lie ahead for their successors.

New Zealand in the 1940s was a very different place to now. A place where you could take a boat over the bar and pick up dinner unhindered. A place where DIY was less about Mitre 10 and more about number eight wire. And a place where Brian Black learned to make stink bombs out of old nitrate frames in his father’s optometrist practice.

 

Brian Black: the industry’s evolution

“I started working in dad’s shop in the school holidays to earn pocket money, helping with the stock count, sweeping floors and cleaning windows,” says Black. His father Reginald opened his eye care practice in Lower Hutt in 1937. It morphed into Black, Gates, Meek and Dong and now, Total Eyecare, one of the largest practices in New Zealand.

Black enjoyed tinkering with his dad’s equipment, and not just to make his famous stink bombs, he also learned how to do repairs, including soldering the metal frames.

“There were only three shapes then: panto, round and quadra,” he says. “Soldering was done by carbon resistance welding. You needed a steady hand and to be prepared to accept third degree burns on your fingertips.”

Despite the joy messing around behind the scenes in the shop gave him, Black originally eschewed the world of optics and joined the Union Steam Ship Company for a stint spanning two decades. Eventually, the call of the optics community drew him back when his father told him of the upcoming retirement of the owners of Dominion Optical Supplies.

“My brother Morris and I became the owners and after four years we sold to Standard Optical. I stayed on with them for a while as a director, manager and then a partner, before leaving to set up Eyeline Optical around 1990.”

Eyeline Optical specialised in the tools, parts and bits and bobs needed in the optics industry, all the things Black used to tinker with in his dad’s shop as a child.

“Over that time, I witnessed dramatic changes in the industry from hand grinding glass lenses, their replacement with plastic to completely automated laboratories using CNC equipment to laser welded frame repairs. I recall the removal of import licences; the disappearance of small local workshops, as they were once called; and the establishment of multinational chains.

“Once we supplied and fitted large quantities of high-power aspheric lenticular lenses, but these are seldom necessary today because of intraocular surgery.”

Black also notes the recognition and qualification of dispensing opticians – his brother, Morris was a founding member of the Association of Dispensing Opticians (ADONZ) – and the hard-won approval for optometrists to prescribe drugs, which all contributed to a paradigm shift in the industry.

Coming from a family so ingrained in the optics community (Brian and Diane Black’s son, Andrew, is also an optometrist), retirement was a hard decision for Black. However, some health failings - “my hearing is beginning to cause me a problem although it is helpful when Diane asks me to do something I want to avoid,” laughs Black - plus a desire to spend more time with his grandchildren and on other passions like painting and travelling, make it a positive move, he says.

 

Geoff Sargent: the evolving scope

Another grand master of the industry, Geoff Sargent, an optometrist at Barry & Sargent in Wellington and Porirua, insists with a smile that suggestions he’s retiring are mere rumour! One of the biggest industry shifts he’s witnessed over the years is the way optometry practices are actually run, he says. “The major change is really the arrival of disruptors into the New Zealand optical industry, which have changed the landscape and the way the public view the industry – and not always for the better.

“However, there has also been a shift in the public mindset, away from only having an examination if they have a specific problem. These days, more and more are wanting a comprehensive eye examination just to make sure their ocular system is healthy.”

Sargent says he’s also pleased to see how an optometrist’s remit has expanded over the last decade, allowing optometrists to become authorised prescribers, for example. “There are also expanding options for optometrists’ career pathways into areas such as public hospitals that have traditionally not utilized optometrists as much.”

The result is a profession offering many layers of specialised healthcare, with optometrists sitting on the frontline, making it an even more desirable industry for people and other players, which will create new challenges for today’s younger optometrists, he says.

“In an increasingly crowded optics retailing arena, the more entities that enter the New Zealand market, the more optometrists will have to concentrate on their clinical skills and practice to survive economically. I believe optical retailing will become less of a significant income stream for the practice than in the past. We will have to rely more on consultation services and fees.”

Sargent says he strongly believes that niche practices are the future for optical health professionals. “Well-managed expansion of the scope of optometry with inter-professional collaboration will be vital to its survival as a profession. Practices will have to differentiate themselves to their appropriate niche in the market. Being everything to everyone will be harder and harder to sustain.”

 

Maurice Sloane: the transformation in technology

Maurice Sloane has been involved in the technical, low vision side of the optics industry for more than 35 years as part of Vision Associates, now Humanware. Although the company’s manufacturing base moved offshore in 2005, after the unexpected death of the company’s Kiwi founder, Russell Smith, Sloane and his wife Santa continued to support the company as dedicated distributors but decided to take a step back last year.

“I’ve always been involved in low vision products,” says Sloane, who joined Humanware as a production manager in 1985. The biggest change he’s witnessed, he says, is the vast technological changes in the industry; not just the development of new products, but the increasing quality of existing products.

“Way back in the 1980s there was a US company offering close circuit TV; grainy images in black and white. The concept of how those things work hasn’t changed. What has changed is the improvement in the quality of the cameras, the need for less electronics to achieve the same task. Technology today is smaller, simpler and so much more reliable. There are just less things to go wrong.”

In the low vision sector the result is a huge increase in the quality of life for those who need these products, he says. “Humanware was one of the first companies to bring out pocket size magnifiers in 2002. That was quite a big leap forward. These days, hand-held gadgets are a big market as desktop products are too big for most people’s houses. The performance of those pocket-size gadgets is so much better, people can now use physically smaller – and cheaper – units for the same task.”

The functionality of this equipment is also vastly improved, says Sloane, with variable magnification to provide better contrast and sharper images, better use of colour and the ability to freeze images to process them in your own time, which have all benefitted the sector greatly. The technology today is cheaper, smaller and has better functionality.

The shrinking size of technology has also resulted in expansion in unexpected areas, he says. “We’ve seen a boom in ‘wheelables’ – portable equipment that previously failed because they were too big. Some of it was like wearing a lunchbox on your head. These days they are lighter and produced in more manageable sizes.”

Smart phone apps have come a long way in the last decade as well, Sloane adds, but there’s still nothing to rival specific and targeted low vision equipment. “The problem is smart phone apps don’t perform nearly as well as a custom-built device. The primary market is elderly, and they haven’t had a lot of exposure to tech like smart phones. They’re looking for simplicity. With a phone they’ve got to know how to use it before they even get to the app.”

Sloane admits this will change with time. “Younger people coming through are used to using a phone and don’t want to carry a lot of equipment. They’d rather use a smart phone app that’s only got 80% the performance of a custom device. They’d put up with that. As the current smart phone users get older there will be more of a trend toward using apps.

“Humanware have developed products that use an Android platform. It’s about what is driving the market.”

But matching the product to the market can be difficult, as technology is evolving fast and manufacturers tend to put more and more into each product, he says. “But the people in the market maybe don’t have the skills to navigate that. It’s an industry-wide issue. Because you can do it, people put functionality in, then other companies want to do better. But that’s not necessarily the right path to take. It could be too much for the user.”

Sloane says he thinks that improved technology could inspire closer collaboration between optics professionals and companies like Humanware, and lead to better patient outcomes. “Humanware has been trying to open up the market to eye care professionals, to help them see technology as another arm to their business. Low vision is quite time consuming for optometrists, so it’s not popular. But hand-held devices are simple for both the user and the optometrist to understand and could help them engage better with the low vision market.”

 

The new guard’s view

With so many changes gone before and continuing today, we asked some of the newest members of the profession about their view of the future.

“Optometry is a fast-evolving field with constant research happening across universities allowing clinicians to help patients more than ever, whether it be myopia control or treating dry eye. Technology is also becoming more accessible.

“We are fortunate to have the support of organisations like NZAO and Optometry Australia, pushing the field forward. I am optimistic about the future of optometry and look forward to what the next few years will bring.”
NZ Optometry Student Society (NZOSS) 2017 president, Alicia Han

 

“Overall I think the future of the industry is looking bright. The amount that we are now able to do for our patients is quite incredible thanks to the progression of the industry and advancements in technology. The recent advancements and availability of technology, especially the Specsavers’ OCT rollout, means we can take better care of our patients’ eye health.

“I also think the uptake of awareness around myopia control is incredibly important and exciting. The research and technological development (ie. the DIMS lens coming out from Hong Kong Polytechnic) going into this area is amazing and will hopefully allow us to make a difference in the worldwide myopia epidemic and individual lives.

“It seems New Zealand optometrists already have a large scope of things they are able to practice in and I believe that this will continue to expand in years to come. Hopefully the field of ophthalmology will continue to progress and better involve primary health care practitioners like optometrists in the care of patients to develop a successful model collaborative healthcare.”
NZOSS 2018 president, Nick Lee

 

“Considering the increase in optometry graduates, with even more to come from the new school (Deakin), I have a realistic mind-set towards future job prospects. Good clinicians will always be able to find work, but you may not get to 'cherry pick' as in the past. 

“I have a lot of faith in our profession and education; I would happily refer my patients to anyone else in my class. But the options we take as practitioners after graduation shape the way we practice… and how we practice is what changes the industry. I'd like to think that regardless of where we practice, a patient can go to any optometrist and receive a similar level of care, but it concerns me how this could change with the growth of the industry. I understand that there will always be a need for eye care with the ageing population, but (today’s) practicing optometrists will need to work harder to find their 'niche'. This could divide our industry, create more competition and further mark differences in the ways that we practice in different clinical settings. Technological advancements also mean we will have to consider what makes our roles as clinicians unique.

“But I am optimistic that our role in providing primary eye care will only grow as we build relationships and develop co-management pathways with ophthalmologists, GPs and other medical professionals.”
NZOSS 2016 president, Alexis Ceecee Zhang

 

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