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Interview with Nina Kriel – Synapse

Nina Kriel (B Optom, BSc Hons, BA Hons, OD, LLB)


Ed – you have one of the longest strings of degrees of anybody I know in our profession – give us some insight into your obvious passion for study.

NK – My parents were always studying something or learning about something, often unrelated to their work. My dad’s an engineer, and we did Psychology III at the same time. He also made sure my sister and I could change brake pads and spark plugs. My mom also has multiple degrees, and she taught us to recognise beauty, whether in the sound of a language, the lines of a car or a building, a piece of fabric, music, a work of art or scenes in nature.

Ed – How did you go about getting an OD?

NK – The New England College of Optometry (NECO) has a 2-year Advanced Standing International Programme (ASIP) for foreign-qualified optometrists. It consists of an academic year and a practical year. Having reviewed our optometry courses at the time, the content of the academic year was presented in SA over several years. I think over 600 of us started and about 20 finished. Those of us who wanted to complete the OD had to write one more entrance exam and then do 4 x 3-month clinical rotations at accredited sites. I did 6 months in Boston and 6 months at Edendale Hospital, Pietermaritzburg. Colin Cook, now head of Ophthalmology at UCT, was head of the department. He is a remarkable man, with the ability to inspire people to give their best. At the time, that single hospital was doing more cataract surgery than the 3 teaching hospitals in my home province combined.

Ed – I am particularly intrigued by your LLB – how did that come about?

NK – That’s a very long story but the short version is that it came from an interest in human rights. I did a short course first, enjoyed it, and then did the four-year LLB. Law is a different way of thinking. It’s not about right and wrong but about analysing and applying rules.

Ed – Every time I read about your Synapse Meetings, I am struck by the diversity of the programmes – what is the concept behind that?

NK – Well, a synapse is a place of connection so it’s about connecting with other professions and exploring the areas where our work may overlap. We work mostly with ophthalmologists, but sometimes it’s more appropriate to refer to an endocrinologist, or a neurologist, a psychologist or a GP. As primary care providers, we need a wide and diverse knowledge to deal with the variety of patients we see.

We don’t repeat venues or topics, so every year it’s a once-in-a-lifetime event. I’m always on the lookout for the next picturesque town, game reserve, spa hotel or wine estate, and at conferences, planning the panel of experts that I can combine. It’s a wonderful challenge for me to choose an inspiring destination and develop a brand new programme each year.

Ed – Your next Meeting is in Port Alfred on the East Coast – why there? How does one get there?

NK – Besides great education, I want a family-friendly holiday feel, and it satisfies my own wanderlust. This one is special because it brings it home to the Eastern Cape. Port Alfred is 150 km from both East London and Port Elizabeth, with regular flights into both of those cities.

Ed – Who is topping the Bill this year? Who will be presenting?

NK – Our international speaker, Prof Langis Michaud, heads up the CL department at the University of Montreal, Canada. He is a myopia control expert and a co-author of the International Myopia Institute’s Clinical Management Guidelines. He has lectured extensively and authored dozens of chapters in textbooks.

Prof Jon Patricios is sports physician to several elite sports teams and concussion consultant to SA Rugby. He sits on several international sports medicine and concussions panels. Eye movements are now being used in setting baselines, in diagnosing and following various neurological conditions from Alzheimer’s and Parkinson’s to concussion.

Mariaan Botha, audiologist, talks bout vision and hearing co-morbidities. We know diabetes, for example, causes neuropathy, but I never thought about diabetic hearing loss.

Jane Jarvis, educational psychologist, talks about reading and how complex it really is. She’ll touch on ADHD as well, an area of special interest for her.

Lesley Mynhardt talks about industrial health and safety, and dispensing optician Jorina Lombard follows on with prescribing for industrial settings.

Dr Olodayo Awotedu is a mom, pediatrician and allergist, and could talk with great authority about multitasking, but is actually talking about allergies.

Having heard that other professions offer services that fall within our scope; training eye movements for sports- or reading performance (biokineticists, kinderkineticists, occupational therapists), recommending eye protection (occupational health experts) and visual hygiene habits (ergonomicists), we can make an informed decision about our own involvement.

Ed – You are still practicing optometry – right? Where?

NK – Indeed I am, in King William’s Town. It’s a small town, and fairly rural so we see really interesting pathology, and have the toys… er, tech, to study them. I’ve never regretted buying an instrument.

Ed – Tell me about your involvement in optometry outside your own private practice – past and present?

NK – I was very involved in the SAOA for many years, serving a term as vice president and a term as president. I am currently on the HPCSA’s PBODO, chairing the Prelim Committee. I guest lecture at the UJ and UFS optometry schools, and really enjoy the interaction with our future colleagues.

Ed – Is there a life for Nina outside of optometry? How do you like to relax?

NK – Travel! As often as I can. I’m always planning the next trip, even if it’s just a weekend away or a road trip. I usually have my passport on me and coins in a couple of different currencies in my purse. A girl can hope, right?

When I’m home, I surf the net. I marvel at how a device that I can hold in my hand can give me access to just about all the information available to mankind, plus memes and cat videos.

Ed – Is there one thing you can mention that will impact on the way we practice optometry today?

NK – I’m excited about what AI will bring to healthcare. There are over 1700 proven stroke risk predictors. Some of them are well-known, e.g. hypertension, but others are as random as how fast you can walk. Doctors can manage only a handful of those factors, but with AI we could be more accurate. Not only could we predict a stroke, but we could say when.

If the best human diabetic retinopathy screeners are 80% accurate, and AI is 90% accurate at identifying progression, why are we still stuck on diabetic retinopathy grading?

I hope we will continue to find novel applications for existing medications (e.g. cancer medications for AMD) and technology (e.g. expanding the use of OCT from retinal pathology to anterior segment and contact lens fitting.)

Ed – Good luck with your Synapse Meeting in Port Alfred.

For information on all the speakers, and the programme:
http://synapse.org.za/wp-content/uploads/2019/06/Synapse-Programme-and-Speakers.pdf

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