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Optometrical Practice Management Monthly Newsletter - Tips & Reviews. Volume 6. November 2005

Business Tip: Computerisation Part 2 (the elusive paperless office)
This month we again have special guest Richard Rees, who will expand further on advanced computerisation of your practice. This single investment will set up your platform for growth and efficiency.

Read on for more.


Porsche frames position our practice to the business professional.
Get your patients to test drive this premium product.  It's success in our practice has amazed us.


Product Review: Michael Kors Frame Range from General Optical

Our practice trys to attract the business professional, who is busy, image conscious and is looking for quality. Michael Kors is precisely what we must have.

Read on and find out why.


Therapeutic Review: Bacterial Keratitis
Bacterial infection of the cornea, especially with contact lens wear can be devastating. We will discuss its diagnosis and treatment.

More Detail.

Pseudomonal Keratitis

Business Tip: Harnessing the Efficiencies of Computerisation Part 2:

                      by Richard Rees IT Specialist.

Continuing on in our IT series this issue we’ll spend some time on how the basic IT hardware in your practice should be laid out for best effect, and how all the different ‘bits’ talk to each other. This can be referred to as network topology.

Why Network?

Well, in the last issue we spoke about the benefits of being able to access any of your data from anywhere, and to some extent, this is one of our main reasons for networking computers.

By connecting our computers and forming a network, we can share data (patient files, Practice Management Software, Diagnostic Images, Scanned Referral Letters etc.) to other people within our practice, and indeed throughout the world! In addition to data, we can share other (expensive) resources such as printers, internet connections and more importantly Diagnostic Machinery.

In a non-networked or ‘stand-alone’ environment, each workstation that needs to print must have a printer connected. Each workstation that needs access to email or the internet would need an internet connection, and each workstation that needed to look at Retinal Images would need a Camera!

Obviously the benefits of networking are self-evident. But wait; there are more great reasons to have all of your data in one place:

It’s much easier to back-up and protect if it’s not spread across a series of stand-alone workstations, and lastly, there is only ever one version of the data being worked on. Imagine each workstation keeping separate records of client data… a simple change of address would have to be entered in several places! 

So great, we’re going to network… but is it that simple?

Well, it is if you get the right help! Some more decisions have to be made in relation to how it’s going to look, the main one being this… will it be a peer-to-peer network or a client-server network?


This is where several workstations are connected, with no central control machine or server. Each machine is equal on the network and can choose to share resources (e.g. data, printers, patient files) to other machines, or not.



Cheap. No money to spend on a dedicated server. Every machine is a workstation!

Little control over security within the network

Simple to setup and maintain.

The workstation sharing the resource has to be turned on for anyone to access it, & it can bog down when they do.

OK starting point for 2-5 workstations, but don’t expect too much!

Can miss out on some added functionality provided by servers



Given the reduced cost of IT components overall, there is little reason not to bite the bullet and setup up a client-server network. In this scenario we have another computer dedicated to controlling the network and its users, to host the resources and manage things like backing up, email and internet access. This machine is generally never used as a workstation!



Greater control over what happens within the network and who has access to what.

Costs more. You need to pay for a server which no-one actually ‘uses’.

Run cool services like email, and remote access etc.

Is more complex to setup. Don’t try this one at home kids!!

Can grow as big as it has to, including 2nd practices, retail outlets etc.

If the server dies, or is otherwise compromised, the business can suffer.

All your stuff is on one machine which is never shut down. Always available.


So in a nutshell, that’s networking. To see what a typical client-server infrastructure looks like in an Optoms Practice. Check the Pic!


Contact Richard Rees for expert advice. Even if you are not in Sydney, Richard has a network of IT specialists around the country that can solve anything from your current problems to even setting up fully paperless practices from scratch.






Is this what the computer room of the future optometry practice will look like? Not likely as minaturisation of hardware is accelerating. Before long you will be able to run your practice off a PDA using voice recognition.










Enlarge the network topology image below









Product Review: Michael Kors from General Optical                                    This year we were eagerly awaiting ODMA to pick up a few different frame lines. Keeping your frame display fresh, colourful and vibrant is imperative to keep your numbers ticking over and patients eager to update their look.

Michael Kors is one of the fastest growing, new fashion designers in America for luxury accessories and sportswear, so when we found out that he was releasing his new frame range in Australia, it was on the top of our list to assess.

We were not disappointed. Of the three new ranges that we introduced straight after ODMA, it was immediately a hit. Not only with our patients but also with our dispensing staff. You know you are on a winner when your dispensers are prepared to pay to buy the product they are actually selling.

Contact General Optical today to view the Michael Kors range.

The Michael Kors EyeWear Collection delivers chic European style, updated for today’s discerning high end consumer. The frames are classic in style, with texture and colour the standout features. Comfortable and light, the frames are very easy to wear,and compliment today's jet-set lifestyle.

Michael Kors has an impressive optical and sunglass selection. There are two lines:

  • Michael Kors design (premium) and
  • Michael (for the more price conscious customer).


The sunglass range has both small and large frames. The colours are warm with some wood grain textures, and then there are some of those great 60’s retro colours to choose from as well. The finish on these frames is second to none. They are one of the neatest lines we at The Eye Practice have ever encountered.

The optical frames compliment the sunglasses again with the warm colours, and beautiful finishes. The temples on these frames include the press studs and the link chain finish, quite often seen in his clothes and other accessories.

All Michael Kors sunglasses are presented in a beautiful brown leather look, zip up case, with cloth. The optical frames come in the same finished hard case with a magnetic seal. The cases are magnificent!

Apart from the fact that Michael Kors was instantly successful, what amazed me the most was the brand's positioning compared to our own:

Our practice tries to attract the business professional, who is busy, image conscious and is looking for quality. Michael Kors is precisely what we must have.


Contact General Optical today to view the Michael Kors range.






Contact General Optical now for this unique range

Therapeutic Review: Bacterial Keratitis

One of the most feared consequences of contact lens wear is bacterial keratitis, especially if the Pseudomonas Aeruginosa bug is involved. These infections have been commonly traced to contaminated eye makeup, fluorescein solutions and contact lens cases.

Signs and symptoms include:

  • Unilateral, intensely inflammed, painful and photophobic eye.
  • Usually there is a focal infiltrate with excavated overlying epithelium and more commonly located centrally near or over the pupil.
  • A thick mucopurulent discharge is common.
  • In severe cases it can be associated with a sympathetic uveitis and hypopyon.
  • Intraocualr pressure can be reduced if there is ciliary body involvement but commonly is raised due to inflammatory cells blocking the trabecular meshwork.

Sometimes bacterial ulcers like this can occur near the limbus

Peripheral infiltrates are more commonly related to an immune response. If the infiltrate is closer to the pupil than it is to the limbus, it is essential to assume that it is an infective process and treat with prophylactic antibiotics. Severe central infiltrates need to be cultured first and then treated empirically with a fluoroquinolone such as Ciloxan every 15 minutes for the first 6 hours and then every hour for the next 18 hours. This means that it has to be used all through the night. A family member must be responsible to supervise every hour by setting an alarm every hour. If this is not possible it might be safer to hospitalise, so that nursing staff can control the process.

Reviewing the next day  we need to be sure that the lesion has not got worse and then we can taper the antibiotic to every 2 hours and wait for the culture results. The culture might confirm that the treatment is appropriate or that the germ is more sensitive to fortified antibiotics. At this level only a corneal specialist should be dictating the treatment.

To keep the patient comfortable, as pain can be significant, treatment with topical cyclopegia such as Homatropine is important. It will also help to reduce the internal inflammation.

Another decision to be made once the infection has been brought under control is if and when to introduce topical steroids. Bacterial keratitis can cause severe inflammation, which can be more destructive than the infection. A vicious cycle of corneal melting can occur, which can cause permanent visual acuity reduction if not supressed. Topical steroids are normally introduced after a few days of careful observation and whilst re-epithelisation has not occured to obtain maximun effect. If topical steroids are appropriate then it is important to choose the most potent. Prednefrin Forte or Maxidex fall into this category.

Again it is best to have a corneal specialist dictate this in Australia at present.

It will only be until ocular therapeutics amongst optometrists, evolves to the next level, like it has in the US.

Bacterial keratitis can be difficult in country areas that do not have a culture laboratory readily available. In this case treating empirically is appropriate but if the lesion is not resolving, transportation to an appropriate facility ASAP is needed.

For a detailed review of bacterial keratitis follow this link. It is a PDF file so you will need Acrobat Reader.

Bacterial keratitis deserves to be in a whole days seminar. Register your interest for Ocular Therapeutics 2006 , which will devote a session to the diagnosis and management of this ocular disease. Efficient implentation of ocular therapeutics is another great way to differentiate your practice and thus make you more profitable.




Porsche frames position our practice to the business professional.
Get your patients to test drive this premium product.  It's success in our practice has amazed us


Streptococcus keratitis in a corneal transplant







Resistance to fluoroquinolones is on the increase. Fourth generation fluoroquinolones have now been released in the US, which will follow soon to Australia.

These topical antibiotics (Zymar being one), are currently extremely effective as monotherapy. No doubt resistance will occur with these, but hopefully the scientists will be able to stay ahead of the evolutionary capabilities of bacteria.

I think that with the incredible development of genetic engineering, bacterial infections of the eye and the rest of the body might one day be extinct.


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