Former Greenlane charge nurse Bronwyn Ward (with the John Parr medal, centre) with (L-R) Olga Brochner, Fiona Bamforth, Hutokshi Chinoy, Dr Sue Ormonde, Prof Charles McGhee, Bronwyn’s husband John, Carolyn Brown and Kathryn Millichamp

Although the flyer for this year’s RANZCO New Zealand Branch meeting promised ‘You can’t beat Wellington on a good day’, it didn’t specify how rare a good day is. But that didn’t really matter, since the quality of this year’s speakers meant delegates had no excuse to sneak out into the miserable weather.

Thursday afternoon’s conference prelude was a registrar training session led by conference co-chair Dr Kenneth Chan, Professor Jod Mehta, head of Singapore Eye Research Institute’s Tissue Engineering & Cell Therapy Research Group, anterior segment specialist Professor Charles McGhee and the University of Arizona’s Professor Michael Belin (of Belin/Ambrósio Pentacam progression analysis fame). The registrars later enjoyed a separate dinner, allowing an excellent networking experience for our future ophthalmologists.

Entitled ‘The future is here’, Friday’s first session was opened by Drs Chan and Peter Hadden, outgoing chair of the RANZCO New Zealand branch. A mihi from Kāpō Māori Aotearoa president Nigel Ngahiwi and a waiata, ‘Tutira Mai Nga Iwi’, eased delegates into the day.

Drs Casey Ung, Grant Raymond and Sean Every

His mind’s in the guttae

The first of the four keynotes, Prof Mehta discussed how endothelial cells from a single donor cornea can provide tissue for up to 90 eyes, highlighting how far we have come from full-thickness corneal grafts. He also continued the anterior-segment tradition of introducing new acronyms, such as CECI (corneal endothelial cell injection), SNECi (simple non-cultured endothelial cell injection), DSO (Descemet's stripping only), DWEK (Descemetorhexis without endothelial keratoplasty) and DMT (Descemet's membrane thickness). I would, however, debate his pronunciation of guttae (guht-ee).

Flinders University’s Professor Justine Smith’s first talk began with a paediatric flavour, giving an excellent overview of the management of juvenile idiopathic arthritis-associated uveitis. The University of Sydney’s Professor Matthew Simunovic then looked to the future of retinal disease, including gene and stem cell therapies and bionic retinae. He also reiterated the ethics of ophthalmology, discussing the US’ bogus stem-cell trials, which have blinded many people. Dr Penelope Stanford, ophthalmic nurse and senior lecturer in adult nursing at the University of Manchester, UK, drew on a potpourri of experience to discuss nursing care and the older patient.

Drs Verona Botha, Adeline Kho, Vince Wilkinson, Ruhella Hossain and Lucy Lu

From ocular sarcoidosis to the future of eyecare

The following session, entitled ‘Above and beyond’, split attendees into nursing (see ‘related stories’ below) and specialists’ sessions. The latter featured talks on ocular sarcoidosis from Prof Smith, brinzolamide dosing for cystoid macular oedema treatment from Dr Robert Barrett, paediatric ophthalmology fellow at Counties Manukau SuperClinic, and low-dose microdrop mydriatics for retinopathy of prematurity from the University of Otago’s Lisa Kremer. The segment on pterygium included Dr Riyaz Bhikoo’s talk on preventing post-operative pain with sub-Tenon’s bupivacaine, while Prof Mehta described his femtosecond laser’s new application in harvesting conjunctival grafts in pterygium surgery. Cataract topics covered toric and enhanced monofocal intraocular lenses, from Drs Brian Kent-Smith and Vidit Singh. The Auckland Cataract study is now through phase 4L, with Prof McGhee’s ongoing study now being led by Dr Corina Chilibeck.

Drs Corina Chilibeck, Stephen Ng and Dean Corbett

The afternoon’s sessions saw Prof Simunovic take the stage once more to discuss his experience with endophthalmitis. This was followed by the first of the rapid-fire presentations, including one featuring yours truly. Thorndon Eye Clinic’s Dr Delia Wang’s talk, ‘A multidisciplinary approach to resection of retrobulbar intraconal orbital venous malformation’, garnered her the informal award for most gruesome clinical photo.

‘The future of eye care in Aotearoa’ was the day’s closing theme. Our most glorious leader, RANZCO president Dr Grant Raymond educated us on how to be the best membership organisation we can be. Previous president Professor Nitin Verma and Greenlane department head Dr Sarah Welch then provided information on Vision 2030 and its rollout in Aotearoa. These talks were supplemented by Dr Justin Mora with our Te Tiriti Action Plan and Kāpō Māori Aotearoa’s (KMA’s) provision for Māori blind and vision impaired from KMA CEO Chrissie Cowan. Middlemore Hospital trainee intern Isaac Samuels delivered ‘Ngā Mata O Te Ariki: a Māori eye health framework’ – the meeting’s best talk by a junior clinician.

Drs Jie Zhang, Sarah Welch, Peter Hadden and Rebecca Stack

Saturday concluded with the AGM (congratulations to Dr Liz Insull on her election as new RANZCO NZ branch president!) followed by dinner at the Public Trust Hall, with catering by Nosh. The first year I attended the NZ branch meeting in Paihia, poet and GP Dr Glenn Colquhoun provided the evening’s talk and poetry readings, allowing reflection and insight into our roles as doctors. This year’s entertainment was provided by magician Jonathan Usher, who notably achieved the messiah-like refilling of an empty can of Speight’s.

Dr Nisha Sachdev with new RANZCO NZ chair Dr Liz Insull and Drs Shira Sheen and Lior Lipsky

More than meets the eye

Day two kicked off with a plenary session, ‘More than meets the eye’ (I like it when the title of the movie appears in the film itself). Prof Simunovic talked us through new anti-VEGF options – the established ones are disappointing and, in some instances, appear to be ‘evergreening’ (in the case of double-dose Eylea). Prof Smith then discussed everyone’s favourite topic, syphilis, while Prof Mehta asked some not-so-basic questions about immune privilege and the cornea.

More rapid-fire presentations followed, including Dr Singh’s second presentation, ‘Evaluation of ophthalmic prescribing patterns and ethnic disparities in New Zealand over a 10-year period.’ It wasn’t clear whether it was this talk or ‘Visual and patient-reported outcomes for Māori and non-Māori public cataract surgery patients with an enhanced monofocal intraocular lens’ which won him the runner-up prize for junior clinical talk. He did, however, admit that his $500 prize may have to go to a new laptop to process all the data he’s generated.

Drs Shanu Subbiah, Graham Reeves and Yi Wei Goh

Sunday’s lunch was a delightful affair in the sponsors’ exhibition theatre, where NZ Optics’ editor Lesley Springall finally tracked me down for a photograph (I’d been avoiding her all weekend). It also gave us a chance to inspect this year’s posters, which included Dr Lize Angelo’s best-poster-winning ‘Addressing the use of different topographic and tomographic devices for keratoconus management in primary care optometry and secondary care ophthalmology practices’.

The afternoon’s session featured the Dorothy Potter and John Parr Medal Lectures. It was a joy to have ophthalmology nurse educator Bronwyn Ward treat us to stories and anecdotes from a career spanning more than 45 years. Having had the privilege of working with Bronwyn prior to her retirement, I’m hoping I wasn’t among the more needy registrars she alluded to.

Prof Smith delivered the Dorothy Potter Medal Lecture, ‘Challenges in the diagnosis and treatment of vitreoretinal lymphoma’. With Anne-Marie’s ‘Corneal neurotisation for congenital corneal anaesthesia in children’ taking the runner-up prize for most gruesome clinical photo, it made me wonder if it’s a Wellington thing. ‘Future nostalgia’ rounded out the meeting, leaving delegates full of new ideas and insights (and, for some, Covid-19) to take back to their departments. I look forward to next year’s meeting!

Drs Wallis McIsaac, Vidit Singh, Aqeeda Singh, Sam Newlands (author) and Jessica Michaels

Dr Samuel Newlands is an ophthalmology fellow at Te Whatu Ora Canterbury. A keen sportsman, he placed 11^th in 2021’s Coast to Coast and second in this year’s New Zealand Kayak Marathon Championships.