Eye Care

From everyone at Charl Laäs Optometrist we want to wish all our patients, clients, suppliers, friends and family a very blessed Christmas season.  May it be a period of rest, peace, love and family closeness.

We want to thank everyone who made 2011 a wonderful year for us all and hope that 2012 may bring you good health, fulfilment and joy.

Warmest regards

Charl, Basil, Johann, Nick, Ina-Marie, Jean, Ilse and Adre

The Registrar of Medical Schemes and the Council for Medical Schemes were successful in their application to have Bonitas Medical Fund placed under curatorship last week.

The South Gauteng High Court appointed Mr Joseph Maluleke as the curator of South Africa's third-largest medical scheme on 27 May 2011. Mr Maluleke is the chairperson of a well-established law firm and has a proven track record of stabilising organisations experiencing governance problems.

"This is a victory for the regulator but more importantly, for the hundreds of thousands of Bonitas beneficiaries and their families", Dr Monwabisi Gantsho, Registrar and Chief Executive of the CMS, said today. "We can all rest assured that the problems which had been plaguing the medical scheme are being addressed in a concrete way. After many months of interaction and litigation we are delighted that this protracted case has finally made satisfactory progress and we look forward to the outcome of the curatorship. I congratulate all the parties who negotiated the settlement order and I agree with the judge when he called for commercial statesmanship in resolving this matter."

At the end of 2009 Bonitas had more than 650 000 beneficiaries and a solvency of 35.7% which remains stable at above the 25% required by law. The audited figures for the year ending in December 2010 will be published in our Annual Report 2010-2011 later in the year.

What the ruling means
The court ruling means that the scheme's Board of Trustees and acting Principal Officer have been removed from office and replaced by the curator two years after the regulator first raised concerns over their fitness and propriety. What is more, they are not allowed to take office as trustees or Principal Officers ever again.

It was with a great sense of pride and enthusiasm that Moscon Optics was recently able to inform the optical industry that they had officially acquired the new agency for Diesel Eyewear covering the Southern Africa region. The agency was previously held by Safilo and has now been acquired by Marcolin Inc.

Moscon released the following statement: "Further to the numerous enquires we have received in response to this announcement, we would like to take this opportunity to inform both our existing valued customers as well as all prospective new customers that per the Diesel Eyewear International Press Release, the launch dates for Diesel are expected as follows;

SUNGLASS COLLECTION: Available for viewing and orders - October 2011

OPTICAL COLLECTION: Available for viewing and orders - January/February 2012

As the relevant launch dates get closer, we will endeavour to inform all Customers of the contact details of the relevant reps for your specific areas and availability of stock etc.

Please Note:
Moscon Optics Group, having been successfully awarded the NEW agency for Diesel Eyewear going forward, does not however at this juncture carry or have any access to 2010 stock or carry any spares for the 2010 range which was previously represented and sold by Safilo.

Regrettably we are thus unable to honour or assist with any warranty claims or stock queries related to models from 2010 and prior and sincerely apologise for any inconvenience this may cause in the interim period.

We thank you for your understanding in this regard and would like to ensure all customers that we are committed to developing a superior and successful relationship with you and the Diesel Brand going forward."

It's now an old cliche that times are a changing, but one thing that doesn't change and in fact is expected in South Africa is the annual price increase.  In Optometry, as in all medicine disciplines, all our suppliers diligently send out their notice of 'Price Increases for 2011' the moment the Post Office came back in service from its New Years break.

Unfortunately the same can't be said from our ever more confusing Medical Scheme arena and specifically when it comes to Medical Scheme Tariffs.  When Government in 2007, unilaterally took over the setting and management of the National Health Reference Price List (NHRPL), a process that normally involved some serious negotiations between service providers (medical fraternity), individual schemes and their 3rd party administrators, everything came to a standstill. 

The unilateral price setting of the NHRPL by Government was seen as unconstitutional and in most cases the fees set by Government was financially unsustainable for the Service Providers and many Providers feared for their lively hood. 

As case and point you only have to look at your local Pharmacy where Government did succeed in regulating Pharmacy Fees and as a result many hundreds of Pharmacies closed their doors.  

Taking cognisance of these facts and after failed negotiations with the Government around the issue of the NHRPL it was decided to take the whole matter to the high courts of South Africa.

Melville, NY (November 4, 2010) – Marchon3D today announced that on October 7, 2010, the United States Patent and Trademark Office issued an official Notice of Allowance on one of Marchon3D’s patent applications relating to its curved M³D^™ 3D lenses, signifying that a patent will shortly issue.  The patent will also cover the method of manufacturing the patented lenses, which decode three-dimensional content in cinemas and on television and computer screens.  Once issued, manufacturing anywhere in the world of lenses covered by this patent for importation into the US will be prohibited.

According to David Johnson, the President of Marchon3D, “We are very pleased that the Patent Office has determined that all 12 of the claims in our patent application are directed to novel and patentable inventions.  In addition, we have other pending applications in the United States and other countries worldwide relating to different aspects of our M³D^™ lenses which will further strengthen our patent portfolio.”

 Marchon3D, a division of Marchon Eyewear, markets frames and lenses featuring a portfolio of patent-pending circular polarized 3D lens technologies that stand apart from all other premium 3D lenses due to its unique, curved lens design. The lenses are inserted into premium-style frames that offer wearers superior fit, comfort and an outstanding 3D viewing experience.  M³D^™ lenses also provide 100% UVA/UVB/UVC protection, allowing wearers to use Marchon3D eyewear as sunglasses. Additionally, Marchon3D eyewear is RealD certified, ensuring an optimized viewing experience in all RealD enabled theaters, as well as compatible passive-system 3D televisions, and laptops.   

Marchon Eyewear, Inc. is one of the world’s largest manufacturers and distributors of quality eyewear and sunwear. The company markets its products under prestigious brand names including: Calvin Klein, ck, Coach, DIANE von FURSTENBERG, Disney, Emilio Pucci, FENDI, Flexon, Jil Sander, KARL LAGERFELD, LACOSTE, Marchon, Marchon3D, Michael Kors, Nautica, Nike,  Sean John and X Games.  Headquartered in New York, with regional offices in Amsterdam, Hong Kong, Tokyo and Venice, Marchon distributes its products through numerous local sales offices serving over 80,000 accounts in more than 100 countries.

High Court Ruling on the Reference Price List Legal Challenge by Specialists and other Societies

Introduction and background to the RPL conflict

During 2004 the Competition Commission found tariffs published by various Professional Societies such as the  South African Medical Association (SAMA), the Hospital Association of South Africa (HASA), the Board of Healthcare Funders (BHF) and other Associations to have been in contravention of the Competition Act and fined the various Associations for publishing such tariff lists.

The Council for Medical Schemes (CMS) subsequently published tariffs for 2005-2007. The CMS acknowledged that these tariffs were however the “ result  of a historical accident “ and embarked on a process of negotiations with various Associations to rectify this position. Submissions were made by some Associations and more realistic tariffs were published for “ selected” Associations in 2005 & 2006. These Associations included Psychiatry, Audiology, Speech Therapy, Optometry, Physiotherapy and Anaestheology.

I have been invited to lecture on the subject of Orthokeratology at the October meeting of the Orthokeratology Academy of America called Vision by Design 2010 which will be held in Chicago, USA.

As part of the research and development team of GOV, lead by Dr. Tung Hsiao-Ching, I have been fortunate to be involved in a lot of the ground breaking developments in Orthokeratology.   Some of the interesting work included the rahabilitation of Post Lasik corneas with the use of Orthokeratology lenses and recently the correction of a Hyperopic Keratoconus patient with the use of overnight GOV orthokeratology lenses.

Doing the research for the lecture I found a wonderful article written by Dr Cary Herzberg, president of the OAA, called An Update on Orthokeratology, New technology and lens designs are expanding the applications for orthokeratology treatment which was published in the March edition of the Contact Lens Spectrum:

"This first decade of the new millennium could well be described as a decade of medical technological breakthroughs. Like the medical field in general, orthokeratology (or corneal reshaping) has seen its share of advances. Ten years ago many of us could not have anticipated all that would emerge as the modern practice of ortho-k progressed. Indeed, the process and tools that make up corneal reshaping today hardly resemble what I used in my ortho-k practice just a quarter of a century ago.

The purpose of this article is to present what constitutes a contemporary corneal reshaping practice as well as what may be in its future sights. Some of you may be surprised to learn how thoroughly ortho-k can meet the needs of a large percentage of your patient base.

The Consumer Protection Act (CPA) interpretation

The CPA is a watershed advance in the field of consumer protection. It will have a material impact on the relationship between consumers and industry under the banner of “consumer interest”, the overarching theme of the CPA. 

The CPA must be interpreted in a manner that gives effect to its purposes which are to promote and advance the social and economic welfare of consumers in South Africa. The provisions of the Medicines and Consumer Protection Acts are to be read conjointly (together as one) and in the light of the values enshrined in the Constitution and, unless it does not prove possible to do so, interpreted in a manner which respects those values. To the extent that this method cannot apply, the provision that extends the greater protection to a consumer prevails over the alternative provision.

Medicines are not a commodity of trade

Medicines differ from ordinary commodities in four crucial ways:

1. Prescribed medicines have a four-tiered demand structure – the patient, the prescribing doctor, the dispensing pharmacist and the payer (medical aid);
2. Medicines technical qualities are difficult to assess;
3. Medicines information is hard to interpret objectively, competitive bias may be present;
4. Medicines are inherently unsafe.

The CPA’s sting – strict liability

The law has changed from caveat emptor ("let the buyer beware") to strict liability for manufacturing defects that make a product unreasonably dangerous or unsafe for its intended purpose or use.

Strict liability involves extending the responsibility of the vendor or manufacturer to all individuals who might be injured by the product, even in the absence of fault. An injured party must prove that the item was defective, the defect proximately caused the injury, and the defect rendered the product unsafe for its intended use.

Lighthouse International is participating in an exciting research project that holds great promise for helping people who are blind to see. It is the only FDA-approved, long-term clinical trial of its kind to determine the effectiveness of a new retinal prosthesis — and it is already yielding promising results. We’re not the only ones sharing the great news; CNN’s Dr. Sanjay Gupta reported the story, as did The New York Times.

This prosthetic is a breakthrough in enhancing the vision — and life — of people with retinitis pigmentosa (RP) … people like Barbara Campbell.

Barbara, now 56, was diagnosed with RP, a congenital disease, when she was just 13. RP causes the degeneration of the photoreceptor cells in the retina and progressive vision loss. “I didn’t realize that I wasn’t seeing the same as everybody else,” Barbara says, until a teacher called her parents to say she was having difficulty in school. As her sight deteriorated over time, Barbara learned to adapt to seeing everything as a “gray, foggy haze.”

Cutting-Edge Technology

Bausch + Lomb (B+L) announced the launch of Biotrue multi-purpose solution across the U.S. Biotrue multi-purpose solution is bio-inspired to work like the eyes to help lenses stay clean and moist throughout the day, according to the company.

B+L reports that Biotrue was developed following intensive study on how the eye naturally works to clean, hydrate and keep itself healthy. It has exceptional disinfection properties, and is formulated to work like the eyes with three bio-inspired innovations. Firstly, it is pH-balanced to match healthy tears, helping to maintain the eye's natural condition and enabling optimal activation of Biotrue's dual disinfectants. In clinical trials 81% of patients who tried the solution said it felt like their natural tears.

The second innovation noted by the company is the use of hyaluronan, a natural lubricant found in the body and in the eye. This helps attract water to envelop lenses in a moisture-rich cushion and to stabilize the tear film and reduce friction. Even after 20 hours, a high level of hyaluronan has been shown to remain on both hydrogel and silicone-hydrogel lenses, helping to provide all day comfort. The third innovation is how Biotrue keeps certain beneficial tear proteins active longer. It surrounds and protects lysozyme, a protein found in tears, helping to maintain its natural antimicrobial activity and prevent denaturization. Additionally, Biotrue lifts and dissolves denatured proteins.

"By studying the eye, we're able not only to observe natural processes that have been proven evolutionarily, but we're also able to develop health care solutions that work with the body, rather than interfering with it," said Mo Merchea, Medical Affairs Manager, North America, Vision Care at Bausch + Lomb. "Biotrue uses the science of the eye itself, and therefore the lens care solution is optimally designed to work within the eye."

Biotrue exceeds FDA/ISO stand-alone procedure for disinfecting products and, according to information supplied by the company, it also has been tested against a broad range of bacteria and fungi, collected from clinically worn lenses, lens cases and infected eyes. It achieves consistently high log reductions against staphylococcus aureus, MRSA and fusarium solani and is also effective against acanthamoeba cysts and tryphozoites.

From Madam & Eve

The Council for Medical Schemes (CMS) has threatened accreditation suspension - or even withdrawal – for those medical schemes and administrators who fail to comply in respect of the provision and payment of prescribed minimum benefits (PMBs).

In a recent circular (No 37 of 2009), newly-appointed CMS acting-registrar and chief executive, Craig Burton-Durham, issued this warning after detailing several non-compliant activities uncovered during a recent compliance evaluation and complaints analysis conducted by the CMS. 

The registered rules of medical schemes correctly provide for PMBs, but, Burton-Durham noted, PMBs are often not implemented in terms of these. Among the other anomalies cited were that PMBs are paid for at scheme tariff and not at full cost as provided by the Act (Medical Schemes Act [Act 131 of 1998]), and PMBs are paid at cost only when a member or provider lodges a complaint with the medical scheme.

Also of concern was that short payments or co-payments were being conducted from members’ medical savings accounts.

• Finalisation of the Reference Price List (“RPL”) processes which were not completed by the Department of Health in 2008/9. In this regard the South African Private Practitioner Forum (“SAPPF”) and 22 other Associations have lodged an application against the Department of Health (“DoH”). The Application will be heard in the Gauteng North High Court on 22nd - 24th February 2010. The Application has been joined with similar applications brought by the Hospital Association of South Africa (“HASA”) and Netcare 911 & ER24. 
• Introduction of the Risk Equalisation Fund in 2011/12. This process has been delayed for a number of years but may be introduced as a forerunner to the introduction of National Health Insurance (“NHI”). 
• An expansion of full clinical validation of ICD10 codes as pressure on Prescribed Minimum Benefits (“PMBs”) increase. 
• Pressure on Medical Schemes to appoint Designated Service Providers (“DSPs”) in both General Practice (“GP”) and Specialist Practice. GP DSPs are already in place for Polmed, Discovery, Bankmed & certain schemes administered by Medscheme. Specialist DSPs could follow the appointment of Hospital DSPs for in-hospital PMBs. In this regard Spectramed has recently appointed Life Health as its hospital DSP.
• Re-defining of Prescribed Minimum Benefits as a Basic Benefit Package and possible price regulation thereof. The Council for Medical Schemes (“CMS”) has recently cautioned Medical Schemes to get their houses in order as to the proper administration of PMBs. 
• Greater interference by Health Professions Council of South Africa (“HPCSA”) in private practice matters as evidenced by the attempt to scrap the Ethical Tariffs during 2008/9. We expect that the HPCSA will review its position following the court application against the DoH in February 2010. 
• A re–introduction of the National Health Amendment Act to Parliament in 2010. This was successfully opposed by various Societies and Management Companies during 2008, but will be required if Government wants to price regulate healthcare services in South Africa. 
• The release of the long awaited Discussion Document on the introduction of National Health Insurance to South Africa. This document will be followed by a “White Paper” and draft legislation.  Timing is uncertain and could in fact take many years until implementation.  
• As part of the HealthMan input to the Private Sector Task Team on NHI we will be doing electronic research amongst Private Practitioners in the first quarter of 2010.

• Premier Rate A (In Hospital) 135%
• Premier Rate A (Out of Hospital) 160%
• Premier Rate B 145%

• Essential and Coastal Plans (Can Balance Bill) 100%
• Classic Plans (In Hospital) (No Balance Bill) 215%
• Classic Plans (Out of Hospital) (Can Balance Bill) 100%
• Executive Plan 300%

1. Approx 85% of members are on the middle-income plans.
2. If you wish to participate e mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it
3. Where coding issues are raised, please advise the HealthMan offices.
4. Whilst the Scheme rate has only increased by 7% above 2009 RPL we recommend that you apply 7.9% in order that there is a consistency in the schemes administered by Momentum.

With a multitude of whistles and thunder claps cracking through the night air, upon which immediately followed explosions of brightly coloured light, we welcomed in the new year of 2010.

Standing on the beach of Lambertsbay, a small fishing village 350km north of Cape Town, we watch the impromptu display of communal fireworks lighting up the evening sky.  It was a perfect ending to a busy, taxing and yet rewarding 2009.

• the children should be between the ages of 6 and 13 (grades I – VII);
• the children concerned should have been diagnosed as ADHD/ADD by a health care professional registered with the HPCSA;
• the diagnosis should have been made before July 2009.

Dr. Shabeer Jeeva, Psychiatrist and ADHD Specialist
Terry Wilke, Psychologist & Director of ADHASA

Date: 30 November 2009
Time: 08h30 to 16h00
Venue: Bishops College, Memorial Theater, Campground Rd, Rondebosch
Cost: R300 (morning tea and lunch included)

Program:
08h00 - 08h30  Registration
08h30 - 09h30  Diagnosis, treatment (Dr Jeeva)
09h30 - 10h30  Medication (Dr Jeeva)
10h00 - 10h30  Tea 10h30 - 12h00  ADHD and the Movies (Dr Jeeva)
12h00 - 13h00  Frequently asked Questions 13h00 - 13h30  Lunch 13h45 - 14h30  Identification of the ADHD child (Terry Wilke)
14h45 - 15h45  Coping with ADHD in the Classroom and at Home (Terry Wilke)
15h45 - 16h00  Final Word (Dr Jeeva)

Booking by e-mail to This e-mail address is being protected from spambots. You need JavaScript enabled to view it stating

• Name, Surname , Institution, contact number.
• Payment, in full, to T. Wilke, Standard Bank, Account 201074125, Branch 006-405.  Reference – attendees first name and surname.

Deadline for bookings and payment  :   23 November, 2009

• Bausch & Lomb Conditioning Solution and Concentrated Cleaner was discontinued
• Customers are being transitioned to  Boston Advance Cleaning Solution and Boston Advance Conditioning Solution

Tel: 087 808 6014 email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

I'm really excited about launching our new practice Blog.  The blog will have a number of authors who will be writing and commenting on issues surrounding eye care, our practice and other bits of interests that catch our eye.

One future blog category we are looking forward to will be covering the often misunderstood condition called Attention Deficit Hyperactivity Disorder (ADHD). 

Nick, our lab manager, will also be discussing some technical dispensing issues in the category 'From the Dispensers Desk'.  If you are an avid gamer my suggestion is to keep a backlink to his blog, knowing him, I'm sure there will be a number of comments about Sony PS2, PS3 and Xbox games in between.

I will be writing mainly on issues of eye care and eye health.  Some of the big events on the eye care calender is Eye Care Awareness Week, Glaucoma Week, Retina and Diabetes days.  As always our practice will be knee deep involved and we will be posting some stories and pictures as the events unfold.

If you have a questions for us please make use of the forum on the web site or otherwise leave us a comment.  We look forward to hear from you.