Meet Dr Mark Billson

With the VetPrac Ophthalmology Workshop fast approaching, let’s focus on Dr Mark Billson, whose career in veterinary ophthalmology began with researching bovine eye disease. Mark, together with Dr Martyn King and Dr Edith Hampson, will help you see many aspects of ophthalmology more clearly at the VetPrac Ophthalmology Workshop on February 8-9, 2018.

Dr Mark Billson has been a Specialist in Veterinary Ophthalmology for 18 years and has practised at the Small Animal Specialist Hospital, North Ryde, NSW since 2007.

Tell us about your path from researching bovine eye disease to specialisation in veterinary ophthalmology?

My involvement in bovine eye research led to a fascination with all things ocular and being exposed to the basic sciences of anatomy, physiology, microbiology and immunology fostered a desire to better understand the clinical diseases of the eye and management of these diseases.

What is your favourite ophthalmic condition to treat or manage or your favourite procedure to perform?

I do not enjoy treating glaucoma, but I enjoy trying to get solutions for problems. While it is a challenge and we do not have all the answers, I do enjoy glaucoma surgery and placement of implants to address high intraocular pressure.

Are you working on any projects at the moment?

I am continuing to try and develop the treatment of glaucoma and refining the use of drainage implants.

What have you learned from experience that you didn’t learn from a textbook?

The biggest thing I learnt was that not every disease presentation looks the same. So just because it appears a certain way in the textbook doesn’t mean that is what it will look like in the clinic. This includes differences in environment.

What in particular do you believe general practitioners would benefit from learning about ophthalmology?

How to do a good exam. Everything in the eye is visible.

What practical tips can you share with general practitioners regarding ophthalmic exams?

Do the same approach on every case and always assess both eyes. Make sure you are familiar with your equipment and its limitations.

What advice would you give new graduates?

Don’t be afraid of eyes and don’t be afraid to ask questions.

What do you like to do for fun and to unwind outside of work?

I like to spend time with my family (beach holidays and tennis) and to play golf.

Thanks for your time, Mark. We look forward to sharing your vision for ophthalmology at the VetPrac ophthalmology workshop. If you’re interested in registering today please click here.

Written by Alison Caiafa

Dr Mark Billson can be contacted at SASH
Email: mbillson@sashvets.com or phone: 02 98890289
Website:  www.sashvets.com

 

VetTips: Ophthalmology

Tip 1:

Pupillary responses to light, the menace reflex, the ‘dazzle’ response and even the ability to respond to a moving object in the visual field do not measure vision. Instead, they evaluate the integrity of certain neuroanatomical pathways. All these can be present yet the patient may still be unable to avoid obstacles or navigate.

Tip 2:

It is vital to the success of surgery to identify the cause of the entropion. Failure to do so will result in poor success rates and even worsening of the condition. Entropion can be either congenital, juvenile or acquired.

Before embarking on surgery ask:

  • Do I understand the cause of this entropion?
  • Have I planned the surgical procedure carefully?
  • Do I have the expertise and instrumentation to perform the procedure?
  • If the answer to any of these questions is no – consider discussing with your local specialist or join our Ophthalmology workshop to learn more.

Tip 3:

ENUCLEATION SURGERY
It is hoped that removal of an eye is not frequently necessary, but sometimes it is inevitable and we must decide which of the following procedures is best suited for the condition at hand. Most commonly the reason for enucleation is the “blind, painful eye”. Make an effort to recognise when there is pain and take time to explain to owners the usually extensive and irreversible loss of function in the eye and the difficulties in controlling the signs and symptoms, especially pain. Best practice indicates that the surgery is being carried out as an act of kindness for the patient.

Join VetPrac on the 8-9th of February 2018 for the popular Ophthalmology Workshop where you’ll develop skills that will build your surgical confidence. With over 7 hours of practical wet labs this hand-on’s stimulating environment will allow you to walk away with skills that can be immediately applied to general practice. Classes are intimate with unprecedented contact with specialist ophthalmic surgeons Dr. Mark Billson, Dr Martyn King, and Dr. Edith Hampson. Did we also mention the workshops are super fun?

Join us by registering now or read here if you’d like to find out more.

Seeing Things Eye to Eye…Meet Dr Martyn King

Back in the mid 1980’s as a recent graduate, Dr Martyn King didn’t always see “eye to eye” with his senior veterinary associates when they were managing ophthalmic cases. 

He sensed that there must be better ways to treat many of these cases, and began a long journey towards specialisation which initially involved reading, and then moving to the UK. Martyn has worked full time in veterinary ophthalmology since 1994, and has been a specialist ophthalmologist since 2002. 

Martyn now recognises that the best way of learning about ophthalmology is from experience, such as attending a VetPrac ophthalmology workshop, rather than just reading a textbook. He has found that vets often think that the picture in the ophthalmology textbook will show you exactly what glaucoma looks like, or what a corneal ulcer looks like, but that real life is very different. In Martyn’s opinion vets need to get their hands dirty if they ever hope to be an ophthalmic surgeon. 

Attending an ophthalmology workshop will offer an opportunity to learn how to do a thorough ophthalmic examination and to recognise a normal eye, 2 areas which Martyn considers vital to becoming competent enough to be able to accurately diagnose and appropriately manage ophthalmic cases. He suggests that “vets should keep looking at everything to build up a repertoire of normal, and to be thorough, doing every test on every eye. Start with checking for comfort, then do the neuro-ophthalmic testing – any eye that does not have a PLR and you don’t know why needs to be referred. Then start at the front and work towards the back – use magnification – look at everything. Do exactly the same protocol on every eye and don’t get distracted by obvious things when sometimes the more subtle things can give you the diagnosis. Always examine both eyes.” 

Martyn believes that GPs should have a certain skill set to be able to deal with simple lid and lash surgery, or enucleations etc, and be able to cope with some surgeries (e.g. conjunctival grafts) where owners can’t or won’t go for referral. Another valuable lesson GP vets can gain from attending an ophthalmology workshop, according to Martyn, is the ability to recognise the difference between eye conditions that they are able to manage themselves and those that should be referred. 

Practising in the UK offered many opportunities for Martyn to develop a special interest in ophthalmology due to the high rate of insurance, allowing scope to investigate and treat fully, and the large size of practices which tend to be very well equipped. Martyn returned to Australia in 2005, after 19 years of practice in the UK, to be back in his home town. He would encourage all vets to have a stint in the UK – not necessarily the 19 years he spent there but a few years would be good. He was a little worried initially on his return to Australia because insurance was not as common in 2005 and he thought that referral was going to be less commonplace in Australia than in the UK, but this has not been his experience at all. Martyn has found that vets here and their clients are very keen to be referred, insurance or not. 

Martyn’s work in ophthalmology is extremely rewarding, especially when he’s able to restore sight or relieve pain. “The happiness of a pet and their owner when they “see” each other is amazing. You can just see how happy the animal is – and the owners are so grateful. Whether it be cataract surgery or performing laser surgery or gonioshunt surgery for glaucoma, or corneal grafts – all these techniques are very rewarding.”  He’s currently setting up an endolaser unit at Perth Animal Eye Hospital to improve the management of glaucoma and intraocular neoplasia. 

Martyn loves teaching the students at Murdoch University and at the Vetprac courses. “Imparting knowledge is wonderful, and seeing the amazement on student’s faces when they see the fundus for the first time is fantastic! It’s wonderful to know that by helping these people to learn we are not just helping them but also all the patients they will be seeing themselves”. He encourages new graduates to listen to nurses! “They know heaps and are a great source of information! Keep asking your boss for help and if they won’t help then find a new job! Admit things if you are not sure so you can work them up with your colleagues, or to give you time to practice examining the fundus etc. Keep practicing, keep looking” 

Martyn looks forward to opening your eyes to the area of veterinary ophthalmology at the VetPrac ophthalmology workshop in February at UQ Gatton. Register today or click here to read more information.

Written by Alison Caiafa

 

Contact information:
Dr Martyn King
Perth Animal Eye Hospital
Phone (08) 6110 1616 

 

VetTips: Ossability Cruciate Repair

Tip 1:

Patients will commonly present with medial meniscal disease secondary to cranial cruciate ligament (CCL). Meniscal disease is uncommon in patients with partial CCL ruptures or no cruciate disease.

Tip 2:

TTA was first described by Maquet in 1976 to reduce patellofemoral contact pressure in human knees with patellofemoral pain. TTA has never been used in humans as a treatment for cranial cruciate ligament (CCL) insufficiency. The concept of TTA being used for canine cruciate disease was proposed by Montavon and Tepic in 2002, and is based on a mechanical model of the human knee by Nisell in 1986. Nisell assessed cranial tibial thrust throughout human knee flexion and described a “crossover point” at which the cranial tibial thrust was neutralised. This crossover point has been shown in the dog to occur when the patellar tendon angle is approximately 90 degrees to the tibial plateau angle.

Tip 3:

When planning a thicker crest cut, use Gerdy’s tubercle as the caudal limit. Gerdy’s tubercle can be seen on a mediolateral stifle radiograph as a bone prominence immediately cranial to the tibial plateau and long digital extensor tendon sulcus.

Want to learn more about how and why Dr Brent Higgins and Seamus Tredinnick created OssAbility, and their vision for the future of veterinary orthopaedics?

Thanks VetScript for allowing us to share with the VetPrac community this article from VetScript December 2017.

If you’d like to learn how to use this state of the art technique in your own practice, join us at the join us at the Ossability Stifle System workshop 9 – 10th February 2018.

The techniques for cruciate repair keep evolving and each one has its place.The one thing everyone wants is a reliable method that can be used in most patients to increase the functionality of the limb and reduce their pain. The Ossability Stifle System has engaged engineering principals and high levels of personal supportive guidance to ensure your patients have successful outcomes. An evolution on the original TTA with improvements that address complications seen in other methods, this is a technique VetPrac is proud to bring the Australian veterinary community.

So You Think You’re An Ophthalmology Genius?

…but are you really?

Click here to take the quiz to see whether you have earned yourself bragging rights…

If you want to refresh your skills in Ophthalmology, join us at the Ophthalmology workshop coming up on 8-9th February at the University of Queensland, Gatton Campus. Places are filling up fast so sign up today!

optho quiz

Diagnosing and treating ocular and peri-occular conditions quickly and effectively is vital to saving the vision and maintaining the quality of life for your patients. With over 7 hours of practical wet labs this hand-on’s stimulating environment will allow you to walk away with skills that can be immediately applied to general practice. Classes are intimate with unprecedented contact with specialist ophthalmic surgeons Dr. Mark Billson, Dr Martyn King, and Dr. Edith Hampson.

If you’d like to know more please take a look at the brochure.

We hope to see you there!

Who and what is Knight Benedikt??

Every day Knight Benedikt helps veterinarians across Australia and New Zealand provide quality animal care, with the right equipment that’s essential for optimal performance and positive outcomes. Our focus on orthopaedic technology for veterinarians means that you can trust our products for even the most demanding orthopaedic procedures.

Matt Knight

Matt Knight BVSc

Established in 2010 by two veterinarians,Vince Frank and Matt Knight, Knight Benedikt has grown rapidly to become one of New Zealand’s leading veterinary suppliers. With the establishment of a Sydney distribution centre, Knight Benedikt’s range and expertise are now easily accessible for Australian vets.

Our range includes orthopaedic implants from OssAbility, VOI and Arthrex, plus a rapidly expanding selection of Knight Benedikt orthopaedic implants. Knight Benedikt also offers veterinary-specific instruments, suture, consumables and equipment. Our products are manufactured in facilities with the highest international certifications and have proven themselves in clinical practice for years.

Vince Frank

Vince Frank BVSc

With warehouses in Auckland and Sydney, Knight Benedikt ships directly to veterinary clinics throughout Australia and New Zealand with zero shipping or handling charges. Ordering is easy via the online ordering portal or you can ring our helpful customer service team.

As OssAbility’s distributor, we are passionate about continuing education and proud to support OssAbility in upskilling veterinarians to better manage cruciate disease. If you’d like to learn more join us at VetPrac’s OssAbility workshop held 9th of February. Register now or read more about the workshop here. 

Written by Knight Benedikt – your local veterinary orthopaedic company, owned and managed by vets.

The General Practice Surgeon With Extraordinary Abilities… Meet Dr Abbie Tipler

Meet Dr Abbie Tipler – she’s an educator joining VetPrac in 2018 and will make her “debut” assisting Dr Brent Higgins at the OssAbility Stifle system workshop at UQ Gatton on February 9-10, 2018. Abbie is a fellow Kiwi, who moved to Australia to find warmth, as she only likes cold weather if there’s snow nearby. Abbie has 2 young children which keep her very busy, as well as 2 Ragdolls. One of the Ragdolls is cross eyed and not very intelligent, but is nevertheless much loved by Abbie and her family. Abbie has a love and a passion for surgery, and was born an animal lover, so it’s no surprise she became a veterinarian. Soon after graduation she developed her surgical skills, initially in London, in a combined GP and orthopaedic referral centre. Luckily the series “Suits” was not aired when Abbie was at secondary school, as she may have become a lawyer instead of a veterinary surgeon. Abbie watches Suits on constant repeat (when not running after her 2 young children, running, skiing or doing ballet), and thinks she was the character Donna in another life. She secretly would love to be called up for Jury Duty one day!

2018 Abbie Tipler surgery photos

Abbie performs mainly orthopaedic procedures now, but loves ophthalmic surgery, as she gets to wear Loupes which, in Abbie’s words, make her feel more intelligent. Her advice for general practitioners who wish to pursue further education in surgery is to invest in CPD like you did your university education. In Abbie’s opinion your practice CPD allowance is usually not enough. She also suggests to not let anyone tell you that you can’t do a particular surgery, but pick the right cases with help from more experienced mentors and build gradually. Abbie highly values practicing on cadavers to help with improving skills with tissue handling, identifying surgical landmarks and anatomy. Sounds like Abbie will fit in perfectly with the VetPrac philosophy which is “Practical skills for practical vets”.

Abbie rates the support from OssAbility highly, and appreciates the safety of the whole system. She likes its step-by-step approach, and is keen to assist Brent to help others benefit from the OssAbility system. Like Brent, Abbie realises the importance of post-operative rehabilitation exercise in order to optimise outcomes, and involves her nursing staff in the delivery of advice to owners at discharge. She values a good team spirit in her workplace, and encourages new graduates to develop enhanced client communication skills, and to involve the owner in the decision making process.

VetPrac is excited about Abbie joining our team. For more information about the OssAbility stifle system workshop, click here. Or check out the workshop brochure here.

Written by Alison Caiafa