Latest News. 2008 Calvin Ring Prize awarded to two students

Riyaz Bhikoo and Timothy Cutfield have become the 13th recipients of the prestigious Calvin Ring Prize at an awards ceremony held last month. The Prize has only once before had dual awardees.

The Calvin Ring Prize is awarded to the best all-round undergraduate medical student in Clinical Ophthalmology and judges were unable to choose between the two outstanding students. Selection for the award is based on excellence in examination, clinical knowledge, diagnostic and management skills in ophthalmology.

The annual award was established to encourage interest and awareness of Ophthalmology in memory of Dr Calvin Ring, who believed that ophthalmology in Auckland needed an academic focus. The Prize of $1,000 was divided between the two with their names being added to the commemorative board on display in the Department of Ophthalmology, University of Auckland. As has become the tradition, Professor Charles McGhee delivered a departmental ‘report card for 2008’ and being only ‘ten years young’ the list of achievements, successes and departments involvement was staggering.

Three scientific papers were also presented by postgraduate PhD and MD students, including past Calvin Ring Prize winner Dr Shenton Chew. Dr James McKelvie presented ‘Struggles of a higher power: the intrusion of a higher order’; Charlotte Jordan ‘Analysis of computerised anterior segment topography in keratoconic patients’; and Dr Shenton Chew ‘The NZ Glaucoma Eye Drop Study’ that was led by Professor Helen Danesh-Meyer.

Dr Peter Ring presented the Award on behalf of the Ring family, giving special mention to his mother who passed away last year. Dr Ring provided the Prize winners and guests with some background information on who his father was and some of the highlights of his career in the profession. Among other successes, he was instrumental in establishing the Sir William & Lady Stevenson Senior Lecturership (now Professorship) and the Maurice Paykel Foundation Chair of Ophthalmology. He was able to personally relay to both winners a tie between themselves and his own experiences.

Riyaz had attended St Kentigerns College, his old alma mater and been awarded the Jack Couglan prize for Chemistry, the same Jack Couglan who had taught Dr Ring Physics.

For Tim the connection is due to him completing his elective in Vietnam where Dr Ring spent time in the New Zealand civilian surgical team during the Vietnam war.

Dr Ring noted a word of advice for Riyaz and Tim; ‘I notice that your undergraduate interests are more medical than surgical but don’t forget that one of the attractions of ophthalmology is that both disciplines are well covered.’

Both Riyaz and Tim thanked Dr Ring and all those who had supported their study including the Ophthalmology Department and the Greenlane Eye Clinic, specifically the nurses and doctors who had given them an insight into ophthalmology. Special mention was made of the enthusiasm that the staff show to students and how it is that enthusiasm that makes it so much more worthwhile. Professor McGhee responded by saying that it was a reciprocal arrangement whereby an enthusiastic student helps to encourage the same in the staff.

Riyaz, whose father, Younus, is an optometrist, said he’s hoping that the award stands him in good stead for the future, as he looks to specialise in ophthalmology himself.

“My immediate goal is to be a proficient and sound medical doctor whilst maintaining the interests and hobbies I enjoy. Through my experience of working in an optometry practice I became interested in various ocular pathologies and my interest in this area still persists today. My long term career goal is to pursue the reason I went into medicine, and that is to become an Ophthalmologist,” he said.

The Prize evening has become very popular with a large turnout of around 70 from the ophthalmology community in Auckland along with previous Calvin Ring Prize Winners who continue to pursue careers in ophthalmology – including Drs Shenton Chew and Stuart Carroll.

NZ Optics asked each presenter for a short summary of their presentations.

Dr Shenton Chew
Glaucoma is the leading cause of preventable blindness worldwide. Prevention is only possible if compliance to treatment, usually in the form of glaucoma eye drops, is good. Amazingly, one quarter of glaucoma patients are not compliant with treatment.

We set out to look at factors that may influence compliance in glaucoma patients, in particular how satisfied patients were with the glaucoma eye drops. The postal survey was a 4-page, 45 question document that was mailed out to all 5,100 members of Glaucoma New Zealand.

We received a 51% response rate of over 2,500 people making this one of the largest glaucoma surveys in New Zealand. Almost half of respondents were on multiple glaucoma eye drops and a quarter were on some form of combination medicine. The majority were satisfied with their glaucoma eye drops as treatment for their disease and there was no difference by class of medication, yet almost half would prefer a tablet alternative if this was a possibility. Potentially modifiable factors to improve satisfaction included reducing the frequency and number of medications and bottle design factors, such as an easy to read label, easy to open bottle tops and ease of determining how empty a bottle was. This research has highlighted factors that influence patient satisfaction and thus compliance to glaucoma eye drops. We hope this will be of use to glaucoma patients, clinicians and pharmaceutical companies in making this disease less problematic in our community.

Dr James McKelvie
Following routine contemporary cataract surgery, visual outcomes are usually excellent, however, occasionally patients may complain of haloes, glare and altered quality of vision especially in low light conditions. Higher order aberrations (HOA) contribute to refractive error and impaired vision and some of these are increased, especially spherical aberration, as a direct consequence of cataract surgery and the introduction of a standard intraocular lens (IOL). To minimise HOA manufacturers have produced aspheric IOLs (technically hyper-aspheric) aimed at reducing HOA. In order to characterise and compare the HOA produced by three current aspheric IOLs we constructed a physical model eye for use with the Zywave (Hartmann-Shack) aberrometer.

Using MANOVA multivariate analysis three brands of IOL at three different powers were compared. Highly statistically significant differences for HOA were seen between different brands and powers of IOL – especially in respect to spherical aberration. Higher-power IOLs had greater differences in respect to HOA when analysed using multivariate techniques. Currently there is little to guide the selection of a particular IOL for a given patient, however, profiling the HOA of IOLs may assist in the selection of the most appropriate IOL to maximise visual outcome for a given patient after cataract surgery. This work has recently been published in the Journal of Cataract and Refractive Surgery.

Charlotte Jordan
Keratoconus is a non inflammatory conical ectasia of the cornea. Keratoconus is thought to be more prevalent within New Zealand populations, with a possible predilection for Maori and Pacific Populations. Our aim was to analyse a large database of keratoconic patients. In total, our study investigated 610 of the first presentation Orbscans of 348 keratoconic subjects presenting to the Ophthalmology Department at Greenlane Clinical Centre over a four year period. We obtained a retrospective overview of these patients using both clinical notes and the Orbscan images. From this study, we concluded that Maori and Pacific populations are indeed over-represented in terms of keratoconus, when compared to the overall population presenting to Greenlane Clinical Centre.

We also investigated possible differences in keratoconic characteristics in patients with associated ocular disease and commonly noted risk factors. For example, we were able to establish that there were significant differences in topographic characteristics between keratoconic patients with ocular allergy compared with keratoconics with a family history of the disease. Being able to characterise the keratoconic populations in NZ, and compare them to data from elsewhere in the world, is important in identifying any trends, or differences that may occur, allowing us to further investigate possible causative factors.