Global Perspectives

Tell us about your background.

As a young myope, I walked into the local optician and thought, “This could be a fun profession.” Years later, I attended optician school, which here in the Netherlands is a separate 4-year education program. Upon finishing that, I wanted to do more and transitioned into optometry right as the first school of optometry in the Netherlands was opening.

What training did you receive to become an optometrist?

After 4 years in optometry school, I was one of two optometrists in the Netherlands—not joking! We shared a stipend offered by the Dutch Optometric Society to go to the University of Houston College of Optometry in the United States for a 4-month residency program with Jan Bergmanson, OD. When we returned to the Netherlands, I began teaching almost right away. Paul Clark, OD, and Luigi Bilotto, OD, FAAO, were my clinical optometry teachers and mentors.

I transitioned into a PhD project at Maastricht University in the Netherlands. That was the only place in the country at the time where an MD was willing to supervise an OD in a research project. Things have changed quite dramatically since then, and the two professions have a pretty good relationship now.

Tell us about your work.

Anything related to advanced contact lens fitting is my specialty, from corneal gas permeable lenses and corneal topography, to orthokeratology, soft specialty lenses, and scleral lenses—but from an educational and research perspective. Because limited resources on scleral lenses were available about a decade ago, I wrote A Guide to Scleral Lens Fitting.¹

My office is on the rooftop of a typical Amsterdam house, which means I have a 360° view of the city (Figure 1), including the Rijksmuseum Research Library (Figure 2), the 1928 Olympic stadium, and Vondelpark (the largest city park in Amsterdam).

What is the state of health care and eye care in your country?

Typically, contact lenses and general optometric care, such as eye exams, visual field examination, OCT, etc., are not covered by insurance; only direct care by an ophthalmologist is insured care. Payment for optometric services is high on the agenda for the optometric association (Optometristen Vereniging Nederland).

What does the scope of practice in the Netherlands include?

Optometrists cannot prescribe therapeutic drugs, only diagnostic drugs (eg, aesthetics, cycloplegics, pupil dilation, etc.).

Do you participate in any outreach programs?

Not directly. The scleral lens journey has been very rewarding, and my goal continues to be making scleral lenses available to anyone who can benefit from them. I like to say, “a happy view, not just for the happy few.” Eye care practitioners should be prepared to fit scleral lenses where needed. The scleral lens clinic has been referred to as “the Hug Clinic” (a term coined by Lynette K. Johns, OD, FAAO, FSLS, FBCLA) because people leave wanting to hug you, they are so happy with their renewed vision and/or dry eye solution.

What are some technological advances that you find exciting?

Big data is helping us decide which lens is best for any given eye. I would say more than 90% of corneal gas permeable and orthokeratology lenses that are fitted in the Netherlands are directly based off of corneal topography—pretty much 100% of optometric practices have a corneal topographer. This can aid in fitting soft lenses by measuring the sagittal height of the ocular surface. I call that finding NEMOS (Normal Eyes Measured Ocular Surfaces).

Additionally, myopia management is going to be huge—education is key.

What are some fun facts about you?

As I grow older, the more I realize and appreciate that education is really my thing. I enjoy speaking from a podium, writing articles, creating newsletters, and making podcasts. I like making music and playing guitar. As a good Dutchman, I also appreciate cycling (Figure 3) and speed ice skating. Amsterdam is a small city; I can be outside its limits within 10 minutes on my bicycle, and find myself in the countryside in between the cows and windmills.