lionseyeinstituteofwa

TO THE LIONS EYE INSTITUTE OF WESTERN AUSTRALIA

The following are copies of my letters sent to Mark McGowan, the RATBAG premier of Western Australia:

My letter to Mark McGowan dated 1 July 2018

To: Mark McGowan Premier of WA

Complaint Re: Roger Cook Your incompetent Minister for Health

SUBJECT: The Failure of the Lions Eye Institute to Cater for someone with a Rare Eye Condition such as Mine. Part 1.

The body charged with the responsibility of carrying out research into the area of Ophthalmology in Western Australia is the Lions Eye Institute. It is part of the private sector but is heavily funded by the State Government and private individuals and companies. No doubt your incompetent Minister for Health will say that the Lions Eye Institute is a private organisation which is beyond his power to control. This is a lame excuse. Your incompetent Minister for Health is responsible for the healthcare of every Western Australian and not just some Western Australians. If a person is afflicted with a rare eye disease then your incompetent Minister for Health bears some responsibility in assisting that individual and not simply saying that the matter is outside his area of responsibility or worse still telling that person that the Department of Health has in place a process of referral to specialists within the public health care system which is available to him through his General Practitioner. Why has your incompetent Minister for Health not provided proper research facilities for the people of Western Australia?

Looking through the staff list at the Lions Eye Institute we find that the only staff members who could possibly be of any assistance to me would be a certain Dr Wiffen and a certain Dr Ang. This is surprising, considering that the Lions Eye Institute is a multi million dollar organisation.

Dr Wiffen: He is a lecturer at the University of Western Australia where he teaches medical students. He specialises in ocular surface disorders, corneal transplants, and refractive lazik and prk surgery. His area of expertise is not cataract surgery but would involve doing corneal transplants. He would spend most of his time teaching.

Dr Ang: is a lecturer at the University of Western Australia where she teaches medical students. She specialises in pterygium surgery , corneal transplants, cataract surgery, and refractive lazik and prk surgery. Her area of expertise is not cataract surgery but would involve doing corneal transplants. She would spend most of her time teaching.

At the moment I am in urgent need of cataract surgery for hard cataracts followed very soon thereafter by glaucoma surgery. It is alleged that these two individuals, Dr Wiffen and Dr Ang would be of no assistance to me whatsoever. Their area of expertise is mainly involved in carrying out corneal transplant surgery a highly specialised area and not an area in great demand because of Perth's low population. In 2017, 250 corneal transplants were carried out at the Lions Eye Institute probably by Dr Wiffen and Dr Ang . Dr Wiffen and Dr Ang justify their salaries at the Lions Eye Institute by engaging in refractive lazik and prk surgery a surgery best carried out by the private sector and not by a research organisation. It is alleged that they do not routinely carry out cataract surgery on a day-to-day basis and would not have the experience necessary to deal with a case like mine involving hard cataracts . Dr Hock Meng Lim was aware of these facts when he sent me to see them. So why on earth did Dr Hock Meng Lim send me over to see them ? Did he expect them to carry out a corneal transplant on my eyes? For the information of Dr Hock Meng Lim , I do not require corneal transplant surgery. I require an urgent cataract operation.

The research work at the Lions Eye Institute is heavily skewed in favour of research into genetics and population health. To illustrate my point I cite some examples:

Retinal genomics and therapy. Dr Livia Carvalho Building on over 10 years of collaborative research that started when Dr Carvalho pursued her PhD studies in Professor Hunts laboratory at the UCL Institute of Ophthalmology in London. They are now working towards creating novel research platforms within the Lions Eye Institute to study inherited retinal degeneration gene therapy and neuroprotective treatment approaches and photoreceptive cell death mechanisms.

Genetic and population health. Prof David Mackey Prof Mackey overseas the Lions Eye Institutes clinical genetic and population health department. He has spent 20 years studying the genetics of the optic nerve with Leber Hereditary Optic Neuropathy the topic of his doctoral thesis.

Experimental immunology Prof Mariapia Degli Esposti The central focus of the general immunology research in Prof Mariapia Degli Espotis group at the Lions Eye Institute is to determine the key cellular and molecular interactions that occur in response to viral infections.

The research work at the Lions Eye Institute consists mainly of clinical trials involving genetics and population health research which would take years and years to come up with any useful results. In 2017 the Lions Eye Institute was responsible for conducting more than 40 active clinical trials. The research work is designed to keep academic staff in employment for many years to come without ever having to produce any useful results. In the meantime no research work is ever carried out into my eye condition. There are no mathematicians or physicists

employed at the Lions Eye Institute and the eye specialists in Perth specialising in cataract surgery have little interest in mathematics or physics. They make use of equipment purchased from overseas and have no knowledge whatsoever in relation to how the computer software works. The same would apply to those working at the Lions Eye Institute.

In 2017 the Lions Eye Institute was responsible for producing 82 research papers. Looking through the list of 82 research papers we find that Prof Mackey was responsible for publishing a large number of them. His area of research is genetics and population health and the following are some of the papers published by him:

Expression QTL analysis of glaucoma endophenotypes in the Norfolk Island isolate provides evidence that immune related genes are associated with optic disc size. Genome wide linkage and association analysis of primary open angle glaucoma endophenotypes in the Norfolk Island isolate. Key challenge in bringing CRISPR mediated somatic cell therapy into the clinic. Pterygia are indicators of an increased risk of developing melanomas. Genome wide association shows that pigmentation genes play a role in skin aging.

Another research worker at the Lions Eye Institute is Prof Morgan. Examples of his research work include the following: Retrobulbar axonal degeneration due to optic disc drusen. The association between retinal vein pulsation pressure and optic disc haemorrhages in glaucoma. Glymphatics and lymphatics in the eye and central nervous system. Impact of retinal pigment epithelium pathology on spectral domain optical coherence tomography derived macular thickness and volume metrics and their intersection repeatability.

All these research projects are of questionable value to any one, especially to someone like me with a rare eye condition. I would require someone skilled in mathematics and physics and modern day intraocular lens formulas. People with these types of skills are not available at the Lions Eye Institute. Your incompetent Minister for Health is entirely responsible for this situation.

Looking through the research work between the years 2002 -- 2017 we find that it is the same old research work carried out by the same old people. We note the absence of any research work carried out by Dr Wiffen and Dr Ang. Have these two individuals ever published any research papers? What is more astounding is that there are no examples of any research work from the Lions Eye Institute published in the Journal of Cataract and Refractive Surgery which is a scientific journal published by Elsevier Verlag on behalf of the European Society of Cataract and Refractive Surgeons. Founded in 1975 as the American Intra Ocular Implant Society Newsletter, it changed its name to the American Intra Ocular Implant Society Journal in 1976 and has been the Journal of Cataract and Refractive Surgery since 1986. It appears with 12 issues a year. There are published papers dealing with the surgical treatment of cataracts in this Journal. Has any research worker in the Lions Eye Institute ever published a research paper in this journal or a journal of a similar nature? If they have not then they would be of little use to someone with an eye condition like mine. What is your incompetent Minister for Health doing to rectify this matter?

It is alleged that on 8 September 2017, a certain Dr Hock Meng Lim of Murdoch Ophthalmology carried out certain tests on my eyes at the end of which it is alleged that he pointed to the door and told me to get out. From that day on I have not been able to obtain any medical treatment whatsoever for my eye condition from any eye specialist in Perth. It is also alleged that Dr Hock Meng Lim issued me with a termination notice and a banning notice. Your incompetent Minister for Health has chosen to do absolutely nothing about this matter.

It is alleged that Dr Hock Meng Lim told me that he could not do a cataract operation on my eyes because he did not know what lenses to use. Note that he did not claim that the operation could not be done just that he did not know what lenses to use. For this reason he made an appointment for me to see a certain Dr Wiffen at the Lions Eye Institute. It is alleged that no useful purpose could be served in my seeing Dr Wiffen because no funding had been allocated by the Lions Eye Institute for me and besides the Lions Eye Institute does not do that sort of research. It is alleged that Dr Wiffen does not specialise in cataract surgery or cataract surgery involving hard cataracts. There would not be any advantage to me whatsoever in seeing Dr Wiffen.

Despite all of this, I attended at that appointment and met Dr Wiffen for the first time. He seemed to be in an agitated state of mind and he became even more agitated when I asked him what is keratoconus? In answer to the question he handed me a 10 page print out from a stack which he had conveniently located on his desk. I assumed that he kept this stack on his desk in case any of his other patients asked him the same question. I then proceeded to show him Dr Hock Meng Lims results and asked him what lenses he would have used for an operation on my eyes. He allegedly replied that he did not know.

I concluded that Dr Wiffen would not be of any assistance to me. Dr Wiffen does not specialise in cataract surgery. He certainly would not have had much experience in the removal of hard cataracts . His main job is involved in the teaching of medical students. His job at the Lions Eye Institute involves corneal transplant surgery and as there are not too many people in Perth requiring corneal transplants I would guess that he would spend most of his time carrying out laser refractive surgery in order to justify the salary that he receives from the Lions Eye Institute. To make matters worse he does not specialise in the treatment of glaucoma.

Dr Hock Meng Lim then made an appointment for me to see a certain Dr Ang again of the Lions Eye Institute. I went over to see Dr Ang at her office at the St John of God Hospital Murdoch. On that particular day she was carrying out laser refractive surgery on some of her patients. I waited all day in order to see Dr Ang. She refused to come out of her office not even to see me for a minute. This is somewhat surprising to me as I believe that she and Dr Hock Meng Lim are close friends and I would have expected her to be interested in a case like mine. In any event I managed to communicate with her through her secretary. I gave her Dr Hock Meng Lims results and asked her what lenses she would use. She replied through her secretary that it was not important and that she had no idea as well.

Dr Ang does not specialise in cataract surgery. She certainly would not have had much

experience in the removal of hard cataracts. Her main job is involved in the teaching of medical students. Her main job at the Lions Eye Institute involves corneal transplant surgery and as there are not too many people in Perth requiring corneal transplant surgery then I would guess that she would spend most of her time doing laser refractive surgery in order to justify the salary that she receives from the Lions Eye Institute. To make matters worse she does not specialise in the treatment of glaucoma.

The point to note in all of this is that even if Dr Wiffen and Dr Ang could be of any assistance to me there is no funding allocated to my case. So that I would be expected to provide payment for all the research work carried out by the Lions Eye Institute on my behalf which would amount to many thousands of dollars. The Lions Eye Institute is a private organisation and expects payment for all the work that it carries out. This would mean that even if the best cataract surgeons in the world were employed at the Lions Eye Institute then they would not be available to me because of the cost factor. I WOULD BE EXPECTED TO PAY FOR ALL OF THEIR COSTS MYSELF. What is the point of having a research organisation, if each person with a rare eye disease has to pay for all the research work involving their eyes, themselves? They may as well just simply employ a private ophthalmologist. That is assuming that they could find one in Perth. What is your incompetent Minister for Health doing to rectify this matter?

The only other person of interest at the Lions Eye Institute is a certain Prof Morgan.

Prof Morgan: He is involved in research work into glaucoma. He has completed a doctorate in philosophy and is a Professor at the University of Western Australia. He is one of the ophthalmologists working at the Lions Eye Institute. He is head of the Royal Perth Hospital Department of Ophthalmology where he is responsible for carrying out cataract surgery on the 50 public patients who attend there every 3 months. He does not do cataract surgery full time but only part time and would spend most of his time teaching.

Prof Morgan's main area of research work involves research into glaucoma . Cataract surgery would only be of secondary interest to him. I stand to be corrected but to my knowledge Prof Morgan has never published a research paper in the Journal of Cataract and Refractive Surgery. Most of his time is spent doing teaching or research work. Details of his failure rate for cataract surgery are unavailable as are any details of his failure rate for dealing with patients with hard cataracts or details if he has ever carried out cataract surgery on a patient with hard cataracts. This is a highly specialised area and very few eye surgeons are capable of carrying out this type of surgery. Looking through Prof Morgan's research projects referred to above we find that they would be of little benefit or relevance to my rare eye condition. My rare eye condition would require someone skilled in mathematics and physics and someone skilled in the knowledge of modern intraocular lens power calculation formulas. The fact that I have hard cataracts also means that I require someone who is skilled in the removal of hard cataracts .

Dr Hock Meng Lim did not refer me to Prof Morgan at the Lions Eye Institute. Though he did refer me to Dr Wiffen and Dr Ang both also at the Lions Eye Institute . Perhaps your incompetent Minister for Health may care to find out from Dr Hock Meng Lim why he did not refer me to Prof Morgan? Would a possible reason be that Prof Morgan does not specialise in corneal transplant

surgery? It is alleged that Dr Hock Meng Lim seems to be suffering under the misapprehension that specialising in corneal transplant surgery will be of some benefit to someone like me. This is a false belief because, for Dr Hock Meng Lims information I do not require a corneal transplant. I am in urgent need of cataract and glaucoma surgery. Skills in corneal transplant surgery would be of no assistance to me whatsoever. So why did Dr Hock Meng Lim keep referring me to specialists who specialise in corneal transplant surgery?

The body charged with the responsibility of carrying out research work into the area of Ophthalmology in Western Australia is the Lions Eye Institute. It is part of the private sector but is heavily funded by the State Government and private individuals and companies.

In 2017 it : Carried out 62,000 patient consultations , carried out 5,000 surgeries, carried out 250 corneal transplants , carried out 40 clinical trials, published 82 research papers, received $2.5 m in donations, received $5.6 m in grants, $0.8 m in bequests, had total assets of $53m, receipts from customers $21 m, current cash in bank $7.7 m. The Lions Eye Institute charges the same fee for cataract and glaucoma surgery and corneal transplants and refractive lazik and prk surgery as do the the other private ophthalmologists.

It could be argued that the Lions Eye Institute is only another ophthalmology company providing a fee for service activity and any research work that is carried out by it is only a minor incidental activity. The Board of Directors claim that any profits that are made during the year are plowed back into research work. I would contend that this is not so. I would contend that any profits that are made at the Lions Eye Institute are used to pay for the ophthalmologists and the support and administrative staff that are employed there. The research work is funded purely by government and private individuals and companies. I suffer from a rare eye condition and I went there and found that I had to fund the research work that would have been necessary for the treatment of my rare eye condition by myself. The Lions Eye Institute may as well close down its so called research activities and simply operate as a fee for service private company and allow the Federal Government to undertake research work into ophthalmology in Western Australia. What is your incompetent Minister for Health doing in relation to this matter? The answer is absolutely nothing.

I refer to the article Use of the toric intraocular lens for keratoconus treatment Jasmin Zvornicanin Emir Cabric and Edita Zvornicanin. Acta Informatica Medica Academy of Medical Sciences of Bosnia and Herzegovina Sarajevo Bosnia and Herzegovina Afilacija Polyclinic Doboj Jug Bosnia and Herzegovina Institute of Public Health Tuzla Canton Bosnia and Herzegovina. Corresponding author: Jasmin Zvornicanin MD Eye Clinic University Clinical Centre Tuzla Trnovac bb 7500 Tuzla Bosnia and Herzegovina.

In this article it is shown how a small poor country like Bosnia and Herzegovina treats a person with a rare eye condition like mine. This patient with a similar eye condition to mine presented to the University of Tulza Eye Clinic with bilateral visual impairment. Clinical examination revealed low visual acuity and keratoconus in both eyes white cataract in the right eye and diabetic retinopathy in the left eye. Ultrasonography examination was normal. The patient

underwent Trypan blue capsule staining phacoemulsification and implantation of intraocular lens Acryl Soft SN60T9 16D spherical and 6D cylinder power. Phacoemulsification was uneventful and early postoperative recovery was successful. Visual acuity improved to 0.8 and fundus examination revealed background diabetic retinopathy. Postoperative follow up two years after surgery showed no signs of keratoconus progression and visual acuity maintained the same.

It can be seen that the man from Bosnia and Herzegovina was never once subjected to the treatment that I was forced to endure. He was never transferred over to some so called corneal specialist. He was never forced to have an unnecessary corneal transplant. He was never forced to have sections of his corneas surgically removed during unnecessary lasik surgery. He was never forced to have unnecessary experimental surgery carried out on his corneas. He was given proper medical treatment in the form of cataract surgery carried out by competent cataract surgeons.

It is amazing how a small poor country like Bosnia and Herzegovina can achieve such a high level of excellence in the field of medical science and how well it can treat one of its own citizens who are in need of urgent medical assistance. Bosnia and Herzegovina is a small country of area 51,000 sq km, population 3.5 m, GDP $45 b ,and per capita income $13k . Following the dissolution of Yugoslavia the republic proclaimed independence in 1992 which was followed by the Bosnian war lasting until 1995. Despite the Bosnian war, Bosnia and Herzegovina still manages to provide its citizens with world class, excellent , medical services.

Australia, on the other hand , is a large wealthy country which has just emerged from a mining boom and has never once had a civil war in its history. It can gladly abandon one of its citizens to their own fate and not even one person in the whole country is willing to lift a finger in order to help. What does your incompetent Minister for Health have to say about that?

My letter to Mark McGowan dated 26 June 2018

To: Mark McGowan Premier of WA

COMPLAINT Re: Roger Cook Your incompetent Minister for Health .

SUBJECT: The Failure of the Lions Eye Institute to Cater for someone with a Rare Eye Condition such as Mine. Part 2.

I refer to your incompetent Minister for Health letter dated 5 June 2018 in which he states:

I note your comments regarding the resources available in Western Australia for individuals with your particular eye condition.

Your incompetent Minister for Health does not even have the decency to be even able to name the rare eye condition which I have. For his information the name of the rare eye condition is KERATOCONUS and as he is so sadly lacking in any knowledge on this rare eye condition I am only too willing to enlighten him on the subject. I note that he does not even possess any qualifications in medicine only in business. How this qualifies him to be a Minister for Health I do not know? Little wonder that he is so incompetent.

Keratoconus is a degenerative process affecting the cornea the clear window of the front of the eye distorting it out of shape and interfering with the focus of the eye. The cornea becomes more conical in shape and this makes vision blurry by making the eye more short sighted and distorts vision by producing irregular astigmatism. The condition usually affects both eyes but one eye may be much worse than the other. Keratoconus is a genetically determined condition.

In Australia keratoconus is estimated to occur in about 1 out of every 2,000 people. Considering that Western Australia has a population of about 2.6 million people this would mean that about 1,300 Western Australians are afflicted with this rare eye condition. Now not all of these people would require cataract surgery but I would estimate that about 400 people would require cataract surgery. Based on my experience they would all end up at Royal Perth Hospital. Unfortunately for them Royal Perth Hospital does not possess any means of diagnosing this rare eye condition. Perhaps Prof Morgan the head of the Royal Perth Hospital Department of Ophthalmology could explain to you what happens to these people and perhaps he can also explain to you as to what happens to the people who have received cataract surgery at Royal

Perth Hospital and who also suffered from this rare eye condition?

At the present time it is not possible to work out what lenses to implant into such a patient. If Prof Morgan has implanted lenses into such patients how did he arrive at what lenses to use? If he did implant lenses into such patients then it is quite possible that such poor unfortunates are walking around the streets of Perth with wrong lenses implanted into their eyes? Has a study ever been carried out in Perth in relation to this matter? If not why not?

What is the Department of Health doing in relation to this matter? It would be relatively easy for them to locate all of these people at little expense to the State Government. Initially all that would be required would be for the Department of Health to send out emails to every optometrist in Western Australia requesting the number of patients affected by this rare eye condition. Then it would be a matter of finding out which of these patients had a cataract operation at Royal Perth Hospital by checking the records held at Royal Perth Hospital.

Your incompetent Minister for Health has been provided with all of these details. What has he chosen to do in relation to this matter so far? So far he has chosen to do absolutely nothing.

Your incompetent Minister for Health states that he notes my comments regarding the resources available in Western Australia for individuals with my particular eye condition. In response I note that he did not even have enough courage to provide any of his own comments on the matter because he knows full well that there aren't any resources available in Western Australia for individuals like myself and the incompetent Minister for Health is content to do nothing about it.

Royal Perth Hospital Department of Ophthalmology does not carry out any research of its own and the organisation charged with the responsibility of carrying out eye research in Western Australia is the Lions Eye Institute.

In 1925 Helen Keller urged Lions Clubs to join her in a crusade against darkness. 45 years later in 1970 Lions Clubs in Western Australia formed the Lions Save Sight Foundation. It established the Lions Chair in Ophthalmology at the University of Western Australia in 1975 and in 1983 the Lions Eye Institute was created. In 2003 the Lions Eye Institute became a not for profit limited liability company. Just like the Royal Perth Hospital Department of Ophthalmology the Lions Eye Institute is a secret organisation with very little known about it. It receives funding from fee for service, the National Health and Medical Research Council ,companies and individual benefactors and of course the State Government of Western Australia who also provided it with all the land and the building that it occupies in the grounds of Sir Charles Gardner Hospital.

The Lions Eye Institute has a Chairman Peter Forbes a managing Director Prof Mackey and a Board of 5 Directors. It also has a Scientific Advisory Committee made up of 5 people.

These 5 people are : Prof Lyn Beazley Prof of Medicine and Pharmacology Prof Beilin Director of UWA Oceans Institute Prof Collin Head of the School of Animal Biology Prof Dunlop area of expertise unknown and Prof Klinken Chief Scientist of Western Australia. As can be seen none of these individuals specialise in mathematics or physics or modern day intraocular lens formulas. So that they would be hardly likely to recommend research into my

eye condition and I would be expected to fund the research work into my eye condition by myself.

What is known about the Lions Eye Institute is that it is allegedly a questionable organisation that conducts questionable research. In other words allegedly it is a white elephant. It does not carry out any research into eye conditions like mine. Instead it conducts research into useless things like genetics and population health. Things that will take years to study without ever producing any useful results. Other research work involves a pointless study into various aspects of the eye. To illustrate my point I cite some examples:

WA ATOM Study -- Myopia Researchers from the Lions Eye Institute are currently recruiting school aged children with myopia to participate in a randomized controlled clinical trial on low dose atropine eye drops for the treatment of myopia progression . Cystoid macular edema and cystoid macular degeneration as a result of multiple pathogenic factors in the setting of central serous chorioretinopathy. Retrobulbar axonal degeneration due to optic disc drusen.

Though these topics may prove to be interesting to the research workers involved what practical benefit are they to anyone else? The Lions Eye Institute is a waste of public resources. It is a retirement home for geriatric ophthalmologists. Money that is spent on it could be better spent elsewhere. It is in effect a private fee for service organisation and I cannot work out why it is allowed to collect money as though it were a charity and why it is allowed to operate as a tax exempt organisation. Though it claims to return any profit that it makes it will not reveal details of the salaries it pays to its administrative staff and ophthalmologists. The two growth areas in Perth requiring urgent attention are in cataract and glaucoma research and surgery. Your incompetent Minister for Health is doing nothing to address either of these issues.

The Lions Eye Institute is involved in laser refractive surgery. It is the second most commonly performed eye operation in the world after cataract surgery. All that it is designed to do is to reshape the surface of the cornea. The Lions Eye Institute first became involved in laser refractive surgery in 1991. Now it has a whole office devoted to it at St John of God Hospital at Murdoch. It has 4 surgeons trained to carry out laser refractive surgery including Dr Wiffen and Dr Ang. The Lions Eye Institute claims that it's mission is to achieve leadership in scientific research practice in the prevention of blindness and eye disease. How on earth are these ideals achieved by running a laser refractive surgery clinic. At the clinic I spoke to one patient and asked him why he was having it done. He replied vanity I guess. I look better without glasses. This type of work should be left to the private sector and not what is supposed to be a research organisation. In the meantime I am left to carry out research work by myself on my own eyes. What is your incompetent Minister for Health doing in relation to this matter?

Looking through the list of ophthalmologists at the Lions Eye Institute we find that none of them specialise in cataract surgery let alone cataract surgery for people with hard cataracts. We find:

Dr Andrea Ang: specialises in corneal transplant, laser refractive surgery part time and spends most of her time teaching.

Dr Wiffen: specialises in ocular surface disorders, corneal transplant, laser refractive surgery part time and spends most of his time teaching.

Dr Giubilato: specialises in glaucoma surgery and research involving glaucoma and teaching.

Prof Morgan: specialises in glaucoma research and teaching.

It is alleged that on 8 September 2017 Dr Hock Meng Lim of Murdoch Ophthalmology carried out certain tests on my eyes at the end of which he pointed to the door and told me to get out. It is alleged that from that day on I have not been able to obtain any medical treatment whatsoever for my eye condition from any eye specialist in Perth. It is alleged that Dr Hock Meng Lim also issued me with a termination notice and a banning notice. Your incompetent Minister for Health has chosen to do absolutely nothing about this matter.

Dr Hock Meng Lim ( aka Jason Lim ) : specialises in cataract and glaucoma surgery. Claims to have completed his cataract and glaucoma fellowship at St Paul's Eye Institute in the Royal UK Liverpool Hospital . Provides services in sclerectomy and MIGS devices. Operates at St John of God Hospital Murdoch , Perth Eye Hospital, Bentley Hospital for uninsured patients and Fremantle Hospital.

At any rate this Dr Hock Meng Lim told me that he could not do a cataract operation on my eyes because he did not know what lenses to use. Note that he did not claim that the operation could not be done just that he did not know what lenses to use. For this reason he made an appointment for me to see a certain Dr Wiffen at the Lions Eye Institute. I attended at that appointment and met Dr Wiffen for the first time. He seemed to be in an agitated state of mind and he became even more agitated when I asked him what is keratoconus? In answer to the question he handed me a 10 page print out from a stack which he had conveniently located on his desk. I assumed that he kept this stack on his desk in case any of his other patients asked him the same question. I then proceeded to show him Dr Lims results and asked him what lenses he would use for a cataract operation for my eyes. He replied that he did not know and sent me over to have some tests done.

The Lions Eye Institute is a private medical practice so that every patient receives an account following a consultation and treatment. There are usually a number of tests that have to be carried out which will be charged for and there will be no reimbursement from Medicare. Payment on the day of treatment will be required.

I asked the girl responsible for carrying out the tests how much they would cost. She replied $500. As I could not afford the fee I left the Lions Eye Institute. Dr Hock Meng Lim of Murdoch Ophthalmology had charged me the same amount for the same tests only a matter of several weeks before . Other eye specialists that I had been to see in Perth did exactly the same thing.

I cannot keep going around to every eye specialist in Perth and pay $500 for tests which are never used. The eye specialists in Perth should arrange for one eye specialist to carry out all the tests and they should all be able to use his results. This money gouging on the part of the eye specialists in Perth has to stop. What is your incompetent Minister for Health doing in relation to this matter? The answer to this question is absolutely nothing. Why couldn't the results obtained by Dr Hock Meng Lim have been emailed straight over to Dr Wiffen at the Lions Eye Institute. After all according to my information they are close friends.

The other point to note is that I am in urgent need of cataract surgery. I do not require a corneal transplant. Dr Wiffen does not specialise in cataract surgery. He certainly would not have had much experience in the removal of hard cataracts. His main job is involved in teaching medical students. His job at the Lions Eye Institute involves corneal transplant surgery and as there are not too many people in Perth requiring corneal transplants I would guess that he would spend most of his time doing laser refractive surgery in order to justify the salary that he receives from the Lions Eye Institute. He does not specialise in the treatment of glaucoma. So why on earth did Dr Hock Meng Lim send me over to see him?

Dr Hock Meng Lim then made an appointment for me to see a certain Dr Andrea Ang again at the Lions Eye Institute. I went over to see Dr Ang at her office at Murdoch. On that particular day she was carrying our laser refractive surgery on her patients. That is where I spoke to the person about why he was having laser refractive surgery done to his eyes. Anyway , I waited all day in order to see Dr Ang. She refused to come out of her office. This is somewhat surprising as I believe that she and Dr Hock Meng Lim are close friends and I would have expected her to be interested in a case like mine. In any event ,I managed to communicate with her through her secretary. I gave her Dr Hock Meng Lims results and asked her what lenses she would use. She replied ,through her secretary that it was not important and that she had no idea as well.

Dr Ang does not specialise in cataract surgery. She certainly would not have had much experience in the removal of hard cataracts. Her main job is involved in the teaching of medical students. Her main job at the Lions Eye Institute involves corneal transplant surgery and as there are not too many people in Perth requiring corneal transplants I would guess that she would spend most of her time doing laser refractive surgery in order to justify the salary that she receives from the Lions Eye Institute. She does not specialise in the treatment of glaucoma. So why on earth did Dr Hock Meng Lim send me over to see her?

I refer to clause 4.3 of the Medical Code of Conduct:

Referral involves a doctor sending a patient to obtain an opinion or treatment from another doctor. Referral usually involves the transfer of responsibility for the patients care for a defined time and for a particular purpose such as care that is outside the doctors area of expertise.

Clause 4.3.1: The doctor who refers a patient must take steps to ensure that the patient is referred to someone who has the qualifications ,experience ,knowledge ,and skills to provide the care required.

It is alleged that by referring me to Dr Wiffen or Dr Ang, Dr Hock Meng Lim breached clauses 4.3 and 4.3.1 of the Medical Code of Conduct of Australia.

Did Dr Hock Meng Lim transfer me over to the Lions Eye Institute in order to benefit me or to benefit himself by saving himself the time and expense of carrying out a cataract operation on my eyes?

SOURCES

https://sites.google.com/view/keratoconus

https://sites.google.com/view/markmcgowan

https://sites.google.com/view/royalperthhospital

https://sites.google.com/view/lionseyeinstituteofwa

https://sites.google.com/view/cystoidmacularedema

ULIB- The keratometer index problem (by W. Haigis)

ocusoft.de>czm>texte>kprobl>kprobl

https://sites.google.com/view/dryeye

https://sites.google.com/view/cataractoperation

https://sites.google.com/view/xengelstent

https://sites.google.com/view/xen45