Tell us a bit about yourself
Hello! My name is Niv and I’m a vision science graduate from UNSW. I’m currently working as the Health Promotion Coordinator at Macular Disease Foundation Australia. I’m a born and bred Canberra girl who moved up to Sydney for uni. I currently live in Petersham with my fiancé, where I binge on true crime documentaries and charcuterie boards.
After graduating, how did your career path evolve?
I wasn’t too sure what I wanted to do after I graduated! Having a Vision Science degree is so great because you have such a wide array of opportunities at your feet, however by the same token it can also be an overwhelming choice. I toyed with the idea of doing a PhD, but decided that I needed a break from uni (for a bit!) I considered research, but couldn’t find anything I was passionate about. When speaking to my honours course convener she suggested I explore non-for-profit work. I started looking at what was out there and stumbled across the Macular Disease Foundation Australia (MDFA). Although I admit I’m much more of an anterior than posterior eye girl, I loved the idea of working in health promotion and education.
I’ve been at MDFA for just over a year and a half as their Health Promotion Coordinator. I spend most of my time speaking to patients who have been diagnosed with a macular disease, as well as involved in other patient-focused initiatives and advocacy work. Getting to be the first port of call after a patient has visited their eye specialist is a great feeling. I can provide them with all the support and advice they may require during an otherwise very overwhelming time.
Every day in my role is different, and my desire to help people in this capacity originated at UNSW and has since been strengthened at MDFA.
What does your typical day or week at work look like?
A typical week at work prior to COVID-19 was very different to what it is now. Currently it’s all working from home, which I’m very fortunate to do. As I mentioned, I spend most of my time speaking to patients on the phone. Many come to us quite distressed after just receiving a macular disease diagnosis from their optometrist or ophthalmologist. I speak to them about their condition in layman terms and offer support services and resources that may assist them on their journey.
I also work with data a lot, which I surprisingly enjoy. I’m in charge of pulling patient and health care professional data and statistics for our community and try to manipulate them in a digestible way.
Another big component of my job is coordinating education sessions for seniors i.e. those most at risk of age-related macular degeneration. As you would all well know, prevention and early detection is key, so we work with our community to ensure their armed with the best resources to reduce their risk or slow progression of macular disease.
What are some obstacles you have experienced, and how did you overcome them?
My honours research project was investigating the role of intense pulsed light in contact lens discomfort. The inclusion criteria for participants was particularly niche and made it quite difficult to obtain the number of participants required for stats purposes.
Despite all our best efforts, I didn’t manage to get as many as I needed. Instead of scrapping the entire project, I pivoted to a completely different research proposal. I kept the participants I had, and created a small-scale, intimate version of my project where I could follow each participant individually. I also started writing additional papers to explore other aspects of my research, which in turn led me to publish two papers in CXO which was super exciting!
I’m guessing the moral of that story is don’t be afraid to pull a Ross Geller and pivot, pivot, pivot when necessary.
Where do you see yourself in the future?
I’m not too sure what the future holds. Career-wise, I hope to still be working in the education/innovation space within the general field of eye health. On a more personal level, I hope that I get to have my wedding (COVID-pending) and I hope that I still love true crime and blue cheese!
What do you know now that you wished you knew when you were a student?
I wish I didn’t sweat the small stuff. Failing one weekly quiz isn’t going to be the end of the world. As someone who can be a tad perfectionistic at times, if one thing didn’t go my way I felt that I may as well just chuck the whole thing out.
Learning to persevere through the setbacks was a lesson that took me a few years to truly understand. Gaining that state of mind really changed the game for me.
What advice would you give to a vision science student who is pursuing a career as a vision scientist?
Vision science is a pretty broad field, so it can become overwhelming when considering job prospects. Uni will unintentionally give you so many opportunities for growth and new interests, so grab them with both hands. It’s cliché, but I think I still wouldn’t have found my niche if it wasn’t for saying yes to every opportunity that came my way. Those opportunities may just open doors to things you didn’t even know were in your reach.
Why did you start up a business and how did you go starting it up?
We wanted to venture out of being an employee and practice how we wanted to practice. We started our practice because we are passionate about providing holistic and evidence-based eye care that was patient-focused.
We first started off as a part-time practice from home in 2018. This operated after-hours and we also provided home visits, because we noticed a gap in the industry in these 2 areas. Starting up a practice involved doing a lot of research into how to run a business and learning about all the legal and financial aspects behind it. Megan did a Certificate IV in New Small Business, which was a good starting point. We also had discussions with other colleagues and other consultants.
Our patient base started to grow and we realised that we were outgrowing our space and entertained the idea of expanding to a full-time practice in a shopfront. By October 2020, we expanded our practice to a shopfront in Wentworth Point.
Should I take over a business or start brand new?
This is a big decision and it really is up to the individual. There are definitely pros and cons to both options and it is important that you weigh these up thoroughly and seek professional advice before you make a decision.
For example, taking over an existing business means that you already have an existing patient base. This has advantages in cash flow. However, this may also mean inheriting procedures and systems which you may not necessarily agree with. Making changes to these systems may lead to loss of some of your existing clientele.
Alternatively, starting brand new means it is a clean slate and you can set your practice how you want it from the beginning. However, it will take time to build a reputation and patient following.
These are just some things you need to consider before you make your decision.
What are some key points I should consider when going from employee to employer?
If you want your business to succeed, be prepared for long hours, taking work home and doing a lot of things outside the consult room. It is a steep learning curve because you now need to learn your legal obligations as well as be well organised in your administrative and managerial duties. However, we think it is incredibly rewarding in the long run because we are now able to do what we are passionate about without restriction.
How is your work life balance as a business owner?
Work life balance is an incredibly challenging aspect of being a new business owner. Aside from running a business, we both have other commitments and hence this is an area we are still working on HAHA ^^”.
What was the biggest obstacle you encountered during your journey, and how did you overcome it?
Work life balance and time management would be the biggest obstacles that we have encountered so far.
We have been working on these areas by improving efficiency within the workplace and scheduling in personal time so that it is not all work. We hold each other accountable so that we both don’t stray from our goals. Having a good support network really helps especially during challenging periods.
What advice would you like to give to all the YOs that are interested in opening their own business?
Running a business is like planting a tree. Do your due diligence and make sure you think it through before you make the decision. Plan it out. You need to find the location and prepare the land first. Then, you will plant the seed, nurture it, and protect it from the storms. Trees do not grow overnight. It takes time before you can reap the rewards.
There are many benefits associated with owning a business. However, be prepared to work hard as it is a massive investment and time commitment and expect some personal sacrifices along the way.
Tell us a bit about yourself and how you got into optometry
Simon: Like a lot of people, I didn’t really know what I wanted to do after high school. But the reason why I end up picking optometry was because pretty much everyone in my family – parents, sister, grandparents, uncles and aunties all wear glasses. I on the other hand somehow ended up emmetropic so I thought maybe I could become an optometrist to help the family out.
Where can we follow your adventures?
Instagram - @campingwithus
Video of our van build: https://www.youtube.com/watch?v=lB6OyX0VbAU&t=8s&ab_channel=Campingwithus
How did you get into what you’re doing in your time outside optometry?
Being optometrists, we do spend majority if not all of our working day cooped up inside a room. Both of us love being outdoors so we try to get out when we can to balance it out and mobilize those joints that get stiff from sitting all day.
Our van life journey started when NSW went into lockdown last year. Like majority of us we weren’t able to work. Being locums we both didn’t have work for a few months so we decided be productive and tick off a bucket list item which is to travel Australia in a van. We needed a van first of course so we started researching, learning from youtube videos and ended up spending about 3 months building our travel home.
Tell us about your most memorable experiences
One of my (Simon) favourite hobby is fishing. Being able to travel to all places in Australia allows me to target different species that are more local to a certain area. When we went down to Victor Harbor in South Australia, I wanted to tick off Bluefin Tuna off my list. Managed to hook up a 15kg fish and we spent the next week trying to finish eating it. We love being able to rock up to a place, pull out a chair and table, eat what we catch and enjoy the beautiful scenery Australia has to offer.
Do you find it easy to juggle your optometry career and your other passions?
Both of us have locummed for at 5+ years now and it has its ups and downs. One of the reasons why we decided to locum was because it gives us the flexibility to travel. I guess we are quite lucky to be able to do what we do as there aren’t many professions that allow you to take months off at a time. There are times where jobs can be scarce but in general, we try to load up on jobs during the busier periods and take time off when it gets quieter. So far it has worked well for us.
Does time away from optometry help you appreciate it more?
We definitely think so, we both love what we do at work but at times you do feel burnt out so it really helps to get away from it every now and then.
Do you have any advice for young optometrists out there who would like to pursue their passion but haven’t quite gotten started?
Just do it! If you keep holding off for whatever reasons there will always be a reason to not do it. Sometimes it just takes a leap of faith to get the ball rolling. Be open minded and flexible. Live with no regrets.
Gonioscopy is an important technique that enables viewing of the iridocorneal angle and allows assessment and diagnosis of different eye conditions.
Best practice standards for accurate diagnosis of Glaucoma are detailed in the National Health and Medical Research Council (NHMRC) guidelines. These include a comprehensive medical history (to identify risk factors), a full eye examination (including gonioscopy), an assessment of visual function (visual field analysis) and measurement of intraocular pressure.
Reasons for performing gonioscopy – what am I looking for?
Open-angle Glaucoma versus Closed-angle Glaucoma
Gonioscopy is important to perform in both patients with Glaucoma and patients that are considered Glaucoma suspects. It is a crucial box that needs to be ticked on your Glaucoma work-up checklist, to determine if an angle is wide open, narrow or closed. It can also detect the presence of peripheral anterior synechiae (PAS), a sign of chronic angle closure, and in certain instances can be used to break these aberrant connections of iris to anterior angle structures.
Occludable angles
An angle is considered to be occludable when the pigmented trabecular meshwork (PTM) is visible in less than 90 degrees of the angles’ circumference. This is determined using gonioscopy with the patient in primary gaze. If a patient is deemed to have an occludable angle, this is an indication for laser peripheral iridotomy (LPI).
Secondary glaucomas
Gonioscopy allows for the identification and appreciation of subtle findings such as pigmentation within the angle. Secondary glaucomas like Pigment Dispersion Glaucoma (PDG) will demonstrate very dark pigmentation of the trabecular meshwork (even, tiramisu pattern). In Pseudoexfoliation Glaucoma (PXG), white fluffy material can be seen in the trabecular meshwork. Sampaolesi’s line can be present in both PDG and PXG and is visualised as a dark pigmented line situated anterior to Schwalbe’s line.
Angle recession
Angle recession occurs due to rupture of the longitudinal and circular ciliary muscle fibres following ocular trauma. With gonioscopy, this appears as a localised area of iris bending posteriorly instead of running flat and can also be seen as widening of the scleral spur. Since patients can develop Glaucoma secondary to angle recession after days, months and even years, it is important to perform gonioscopy in cases where there has been ocular trauma both recently and in the past.
Neovascularisation of the angle
Gonioscopy can be used to detect growth of new blood vessels in the anterior chamber angle. These abnormal vessels are leaky and can cause inflammation. It can also lead to scarring and narrowing of the angle. Gonioscopy should be performed in patients at risk including those with a history of Central Retinal Vein Occlusion, proliferative Diabetic Retinopathy, or other retinal ischaemic conditions.
Helpful Gonio Acronym
Contraindications
Corneal or conjunctival inflammation or infection
Lacerated or perforated globes.
Hyphaema present
Significant corneal abrasions or erosion
Significant epithelial basement membrane dystrophy
NHMRC Guidelines for the screening, prognosis, diagnosis, management and prevention of glaucoma 2010 https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp113_glaucoma_1204 04.pdf
Herschler J. Trabecular damage due to blunt anterior segment injury and its relationship to traumatic glaucoma. Trans Am Acad Ophthalmol Otolaryngol .1977;83:239
I was inspired by my mentor and boss at the time who was (and still is) so driven and passionate about what she does and what she believes in. I wanted to create an environment where I could do the same - inspire a team and inspire my patients. I went through a 6-9 month program (called ‘Pathway’ which is run by Specsavers) to develop myself and to learn about the people and business aspect of being a business partner and employer. I had a lot of support from my mentors who helped me assess what opportunities were suitable for me from both a lifestyle and finance perspective. I had my accountant assist me in valuing potential business’ to ensure I also had professional advice.
There are pros and cons to both. The main advantage of taking over a business is that it has an established database and customer awareness of the store and its services and values.
Starting a brand new store allows you to create your own “brand” and culture, and enables you to build your own team from the bottom up. It will depend on your personal preference, however you should assess the potential you see in the business, and how able and quickly you believe you can grow it. A lot of research and due diligence is required for both avenues.
Do a lot of research (e.g. reading, courses, talking to other employers and colleagues) to understand thoroughly both the finance and business side of it, as well as the leadership side to being an employer.
Be clear on your “Why” before you dive into “what” needs to be done and “how” you will make it happen.
How did your business survive COVID?
We remained open the whole time (for urgent care) in order to service our community. Our customers were very grateful for this service and it also allowed us to gain new customers. Many of our customers had to hold off their “routine eye examination” for several months, hence when the lock down eased, we knew we would get an influx of customers returning. In order to both survive and thrive, we needed to be strategic with extending our trading hours to ensure we were able to capture all existing and new customers by looking after their eye care needs in a covid-safe manner.
It was a big adjustment when I initially started, as “work” can easily carry on at home and on days off. I’ve since learnt that planning ahead is key. I schedule quality time with my family and friends, and also block out time for myself to do things I enjoy. To keep myself accountable, I also schedule time slots in my calendar to fit in exercise, journaling and meditation. Having my own “me time” allows me to reflect my day/week and reassess when I'm “off balance”. I don’t always get it right and sometimes life can throw new challenges at you, however a balanced lifestyle is one of my goals and is something I’m consciously striving towards.
Tell us a bit about yourself and how you got into optometry?
My name is Austin and I am currently in my 3rd year of practice. I chose optometry out of an interest in helping people and also healthcare. I currently work at an independent practice in Dubbo, in Central Western NSW, having previously practised in Broken Hill in Far West NSW. Relocating to rural Australia has naturally allowed me to develop professionally as well as personally. It has provided me many unique opportunities, including doing visiting clinics in smaller towns in Central Western NSW, being able to carry out clinical duties in the public ophthalmology clinic, doing a nursing home visit, and also is carrying out optometry duties at the Macquarie Correctional Centre in Wellington, NSW. I’ve also rekindled some old hobbies through meeting like minded individuals in the rural towns that I have worked in. The article will focus on my work at the correctional centre and also more generally my experience of working regionally.
Tell us about your typical day testing at a prison? What do you find are the most challenging aspects and most rewarding?
A typical day testing at the Macquarie Correctional Centre starts with a check-in and equipment screening. Before entering the premises, I am required to run through a checklist of equipment being brought into the correctional centre’s clinic. As a visiting optometrist, the clinic is conducted with portable equipment, including a trial lens set, portable slit lamp, ret and DO, BIO, diagnostic drops and the spectacle frames. I am then equipped with a personal duress alarm to be worn onsite. Afterwards, I am escorted through the grounds to the clinic where I am met by the clinic staff and set up the room for my eye examinations.
I perform a typical eye test, with a history, refraction, ocular health check, some gross binocular vision tests and also do the dispensing in cases where glasses are required. Not having access to additional testing such as OCT, perimetry, fundus photography and wide field imaging can leave you feeling ‘handcuffed’ at times, especially when you suspect certain presentations such as glaucoma, visual field defects, macula changes or unexplained headaches. Inmates cannot simply attend a private practice externally to perform the indicated tests. In cases like these, clinical decision making is important and referral necessary.
I work closely with Justice Health and Forensic Mental Health Networkmedical and nursing staff, who facilitate ophthalmology care, including cataract surgery. The Network provides care to the 30,000 people who move through the NSW adult correctional system each year; with many experiencing higher rates of chronic and complex health conditions than the general community. Clinicians working in this setting are positioned with a unique opportunity to respond to the health needs of these individuals, who commonly have had minimal contact with mainstream health services in the community.
An inmate I saw for the first time towards the end of last year had a family history of glaucoma in his mother, large cupping in both eyes, and IOPs of 26mmHg in each eye. Based on the risk factors, I decided to commence him on Xalatan Eyedrops despite not having all the pieces of the clinical puzzle. I was fortunate to follow up this inmate on my subsequent visit and note a satisfactory pressure reduction. The most rewarding part is that inmates appreciate the eye examination service provided as many have been without glasses.
On leaving the clinic, I am escorted back to the check-in area and once again go through the equipment checklist before leaving the facility.
Do you have any goals for your optometry career?
Further experiences in optometry will allow me to formulate these goals, however the most fulfilment is gained in helping those who most need help. It is a matter of continuing to do so.
What keeps you sane outside of your work life? Do you have any hobbies or passions you pursue?
I do enjoy a few different hobbies; the two main ones are tennis and art, which allow me to channel my active and creative sides. I feel these hobbies have allowed me to form connections within the communities I’ve immersed myself into, and that this is a crucial component in the overall success and/or fulfilment in regional stints.I often get called upon to make the controversial line calls in tennis since “I’m the optometrist”.
Broken Hill Artwork and Tennis
Interactions with local artists in the Broken Hill and Dubbo regions.
What advice would you give to other optometrists who may be looking to venture beyond conventional optometry?
Have an open mind in trying new things as you can be pleasantly surprised by what new opportunities bring you.
Once upon a time, every year January that ticked around, I would scramble to Kmart for the $5 diaries and jot down my "3 goals for the year". Then I'd put my pen down, close the book and be satisfied. That's how it works right? Surely by the time December comes around, you would have achieved those goals... and keep in mind they were the same 3 goals every year:
1. Spend more quality time with friends and family
2. Be more health conscious
3. Some career/education aspiration goal
Truth be told, I never followed through or even self-reflected during the year to see if I was on the right path or direction. Although now I no longer write goals down every January, this is what I learnt about goal setting and accountability that I follow now.
Be more specific
I was failing because everything was too broad. I wanted to spend spending quality time with "friends and family", but did this mean hitting up the 500 Facebook acquaintances every Sunday? I started singling out people and groups I truly wanted to build relationships with and making more of a conscious effort.
Holding true to your word
It's tempting and easy sometimes to find excuses to not attend events, meetings or even meet-ups. However, most of the time we at least put in some effort to stay true to our word if we said we were going to attend. But, it's even easier to make excuses to not do or commit to something, if the only person keeping you accountable is yourself.
Accountability
This was and still is one of the hardest things for me to grasp. I am weak-willed at best and self-accountability is difficult. So I bought apps, books, made friends and accountability partners to keep me on track.
Micro-Goals
I had to be honest with myself - I was never going to read a book a week, become an Instagram fitness star and learn Spanish all within a year. So instead I set mini-goals and celebrate mini-wins. Maybe just 20 pages a night before bed? Start off by going to the gym? Learn and practice a handful of phrases a week?
Review and reset
I stopped waiting until December to review and realise I had made no progress, then consequently remaking the same goals. I became more realistic and also honest with myself - if I saw I had set visions that were far beyond my potential at that time, I would readjust and reset them.
Now, in no way, shape or form am I perfect - but this is what simply is working for me!
Unprecedented. Unmotivated. Confused.
Those were the words swirling around in a cacophony when we came to realise that university this year would be changed indefinitely.
It was near the end of March when we found out that the situation of COVID had reached its boiling point – a sense of panic striking students to return back to their homes interstate and overseas for the uncertainty of what was to come.
When it came to optometry, the cloud of confusion covered our minds severely. For myself, learning the course and the way to become a fully functioning optometrist meant that I relied heavily on practicals and conducting the tests and concepts I learnt to grasp the notions. Learning through memorization with the rote learning that I grew so accustomed to during high school was something I quickly realized was ineffective – it passed the threshold of remembering but faltered when it came to understanding. Going to the labs, using the appropriate apparatus, and asking questions directly upon making mistakes in class was the way that I gradually was able to grasp the ideas being taught. This was how I was able to understand the concepts in a holistic point of view and how it is relevant in a clinical setting – deviating away from learning just how to distinguish between one module to another.
But with life transitioning virtually, this method was eradicated, and I was left to submerge myself back into comfortable method of memorizing and watching others carry out the tests on YouTube videos as my main point of reference. One thing I quickly learnt was that comfort can be woeful and the transition was difficult to say the least.
Add the stress of the world and my fellow peers and I swiftly realised that that it was going to be an arduous period.
How on earth were we meant to cope?
Fast forward a couple of months and it has reached the end of the year. Two semesters have passed, and the sun never looked brighter. The situation around the world is still a pressing issue but the initial turbulence of shock and panic has passed. And with every tumultuous period, there was an equally constructive period of learning and adapting to the changes. To reflect back on the time and some strategies that I was able to implement to make life just that little bit more tolerable and easier, I broke it down into three principles (an idea that I’ve started to implement into other aspects of my life).
The triple Cs.
The years to come will remain uncertain as we progress through optometry but one principal takeaway that I have garnered through this year was that resilience is key. Being able to bounce back and realise that this is a collective struggle that we will eventually overcome is an idea that needs to be ingrained into our minds as students.
We have faced hurdles before and we will continue to face them but with the right prioritization and organization, it can be less stressful than we conjure it up to be in our heads.
Onwards and upwards!
Tell us a little bit about yourself and how you got into Optometry.
I completed my Optometry degree from India in 2017. After the completion of my undergraduate degree I worked for a while in Nepal and I was also involved in the eye camps organised in Nepal by Eyes4Everest. I flew to Australia last year to study Master of Optometry at UNSW.
I come from a very small village in the mountain region of Nepal and the people there still do not have access to proper health services. This was the reason that I always wanted to contribute to the health sector there. Since there was not even a single optometrist in my hometown, I decided to study optometry so that I could provide eye care services for them.
Tell us about your typical day of studying and working.
Being an international student in Australia, it was a bit challenging for me to balance my work and study in the beginning. But time has taught me this and now I find it ok. I work 3 days a week and the rest of the time, I study.
What do you miss most about Nepal? What do you love most about Australia?
I miss my family. I have never been away from home for such a long time. When I was in India, I still used to visit them every 3-4 months. But after coming here it has nearly been two years since I last saw them. Though I often talk to them through video chat I still miss their presence.
I like everything about Australia. Everything is easily accessible and organised here which has made life easier. I also enjoy going to the beaches during my days off.
Once I finish my degree here, I plan to go back to Nepal and start working there. My dream is to open a practice there. Starting from a small practice in my hometown, I want to expand it to other remote areas as well. I especially want to work in small villages where people are still unaware of the advancement of technology.
Working in a peaceful environment that is very far from the city of chaos is something that I am looking forward to.
When I am a bit stressed with work and study, I talk to my family and I like sharing everything with them. I consider this as my therapy.
When I was at school, I used to play basketball and I wanted to continue playing, but due to some circumstances, I stopped playing. At the moment, I have started being more conscious about my fitness and I have started learning boxing. I would not say it is my passion, but I enjoy boxing.
What advice would you give to other optometrists, who may be in a similar position to you or are striving to be in your position?
Well, I am not sure if I have still achieved that position where I can advise people. But from my experiences, I would say not to give up on your dreams. There might be some difficult times where you want to quit but in the end, they are just a part of the journey to your dream. Be positive and just keep doing what makes you happy.
It’s become a part of the uniform for many of us, and masks have become essential in combatting the spread of COVID-19, however, it has given rise to increased reports of associated dry eye.
This happens, especially if the mask is poor fitting, and exhaled air funnels upwards and across the surface of the eyes. In turn, this may accelerate tear film evaporation causing ocular surface irregularity and discomfort.
This problem can become exacerbated especially in mask wearers who have pre-existing dry eye, contact lens wearer and people who have to use a mask for an extended period of time, use in air-conditioned environments, use in front of screens (e.g. health care workers, food preparers etc.). In turn, they may find themselves touching their face and eyes all the time, possible with unwashed hands, which may increase their risks for an infection and spread of the virus.
Tips we can offer our patients include: ensuring the mask is well fitted, using lubricant drops and limit screen time and time in an air-conditioned environment. Although MADE can make us uncomfortable, don’t ditch the mask!
Moshirfar, M., West, W.B. & Marx, D.P. Face Mask-Associated Ocular Irritation and Dryness. Ophthalmol Ther 9, 397–400 (2020). https://doi.org/10.1007/s40123-020-00282-6
White, D.E. MADE: A new coronavirus-associated eye disease. Healio.com. June 22, 2020. Accessed Sept. 10,
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