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HomemieventsBrien Holden Vision Institute Lecture Series

Brien Holden Vision Institute Lecture Series

(Click here to view images from the Brien Holden Institute Lecture Series)

The first official Brien Holden Lecture Series was held on Friday 26 March at the University of New South Wales following the official launch of the newly renamed Brien Holden Vision Institute the night before. The Lecture Series, which will henceforth be an annual event, is accredited by the Optometrists Association Australia for 10 CPD points.

The lecture series looked at the future of eye care, the latest discoveries in vision research and the pathway required to eliminate avoidable blindness and vision impairment.

Nine speakers were featured at the Brien Holden Lecture Series, including Professor Holden himself. Below is an overview of each topic covered by the featured speakers, all of whom work at the forefront of vision research and public health for eye care in Australia and abroad.

The World Of Vision Correction And Its Challenges

Presented by Professor Brien Holden: CEO, Brien Holden Vision Institute

“Excellence with equity: providing high quality eye care for all people. Unless we achieve this there is no point talking about eliminating blindness.”

The future holds both tremendous opportunities and challenges for optometry.

Myopia, a disease that already affects 1.6 billion people worldwide, is on the rise. By 2020 it is expected that this number will have risen to 2.5 billion.

In the U.S., 132 million people are currently suffering with myopia. This number reflects 44 per cent of the current worldwide total, a number that is significant globally as the United States and its movements in health care have a dramatic impact upon the rest of the world.

Presbyopia is also increasing with an estimated billion people in 2009, 500 million of whom did not have glasses. This equates to four billion people worldwide who are in need of vision correction which equates to AUD$89 billion at the retail level.

In the next five to ten years the goal for the vision institute is:

  1. Control the progression of myopia
  2. To develop truly comfortable contact lenses
  3. Corneal onlay to eliminate the need for LASIK
  4. Gel IOL for restoring accommodation and vision at all distances
  5. Elimination of avoidable blindness and impaired vision

The Case For Peripheral Treatment Strategies

Presented by Professor Earl Smith III: Dean of the College of Optometry, University of Houston

Professor Earl Smith III reinforced Professor Holden’s urgent message to effectively treat myopia. He said “today more than ever it is important to develop ways to treat myopia. This is one of the most prevalent diseases in the world, with a significant increase in the U.S. and the rest of the world over the last 30 years.”

Today, anti-myopia spectacle lenses and contact lenses improve refractive error. The therapeutic effect upon the control of myopia is also on the right track. There is also a need to design the reverse: a lens to correct hyperopia.

Professor Smith said he has every confidence that the Brien Holden Vision Institute will be successful in this research as the institute has already breathed new life into research.

The Business Of Vision Correction

Presented by Dr. Shyamy Sastry : Head, Asia Center of Excellence , CIBA VISION

Over the last 30 years the contact lens industry has made many game changing advances in providing the gift of sight through the invention of new technologies. More than 125 million people and counting have had their lives transformed through improvements in the contact lens industry.

Continuous innovation in vision care has changed the way that practitioners address the specific needs of their patients. The combination of fundamental and applied research will continue to address unmet consumer needs, providing vision correction solutions to improve lives the world over.

In the future, expect to see contact lenses that preserve vision, lenses that are more comfortable than no lenses at all and lenses that can dispense medicine to treat diseases. However, Dr. Sastry said such innovation will only occur through the joint efforts between industry and research institutes.

The Challenge Of Delivery Breakthrough Products

Presented by Ms. Sylvie Franz: CEO, Adventus Technology Australia

The three essential Ps of breakthrough technology which need to be satisfied said Ms. Franz are: Product, Practitioner and Patient.

However, there are challenges in the search for a breakthrough product. These include:

  • Requires significant investment
  • The development time is usually long term – e.g. greater than five years
  • High risk – there is a high chance of failure
  • Often unwanted results are achieved and this change is disruptive to previous research

However, the optical industry requires breakthrough technology for the following reasons:

  • Unmet needs in eye care
  • The vision correction market is huge
  • These products are revolutionary for patients, practitioners and the industry
  • Adaptable to existing technology

The goal at Adventus is to develop breakthrough products. The two breakthrough technologies currently being worked on are:

1. The Corneal Onlay procedure: This is a small lens placed under the outer layer of the cornea to change the eye shape to correct refractive error.

2. Dynamic Vision gel: technology which refills the crystalline lens capsule with an injectable polymer to restore accommodation for presbyopes.

Vision Research And The Fight Against Infection

Presented by Professor Mark Willcox: Chief Scientific Officer, Institute for Eye Research

“There are 140 million people worldwide who are contact lens wearers,” said Professor Willcox. “Contact lens wear is the number one cause of corneal infection and there is also the risk of vision loss post-infection.”

To reduce the occurrences of contact lens-induced corneal infection (and other CL-induced infections) there is a need for:

  • Safer contact lenses that prevent microbes from adhering to/growing on the surface of the lens.
  • Safer ways of disinfecting: There are commercially available products such as silver contact lens cases that disinfect.
  • Provide wearers with evidence-based education for contact lens wear and hygiene e.g. lens case hygiene instructions, educating patients about where to store their contact lenses and cases (the bedroom is better than the bathroom) and educate them to replace cases after three months of use.

What to expect in the future:

  • The Brien Holden Vision Institute has been developing its own disinfecting solution
  • Clinical trials of antimicrobial lenses to show reductions in disease response

Perspective Of Basic Eye Research In China

Presented by Professor Junwen Zeng (replacing Prof. Lian Ge): Director, Optometric Services, Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, China

China’s health and eye care has seen a rapid development since the 1980s. This has taken the form of an increase in government investment, the development of world class instruments and facilities, successful international cooperation and the frequent hosting of international congresses.

According the Chinese Prime Minister Wen Jiabao, China’s future is driven by science and technology in education and research.

In the mid to long term, the contributions by science and technology are expected to increase by 60 per cent and the total investments to science and technology will reach 2.5 per cent gross domestic product. The percentage of young researchers who receive grants is also expected to increase.

Vision 2020 and avoidable blindness

Presented by Professor Nag Rao: Chair, LV Prasad Eye Institute; Chair, International Centre for Eye Care Education (ICEE)

Nag Rao’s close friendship with Brien Holden began 32 years ago in the lobby of a hotel in Zurich when Prof. Holden congratulated the young Professor Rao on a paper he had presented.

The global distribution of blindness by cause: cataract has remained the leading cause of blindness.

Success stories so far have been seen with onchocerciasis, trachoma, vitamin A deficiency and cataract. However, new challenges in the fight against blindness include refractive error, diabetic retinopathy and glaucoma.

The steps we need to take are:

  • Global partnerships – to enhance local capacity
  • Public and private partnerships
  • Translation work – translate laboratory findings to the community
  • Innovative models
  • Focused approaches

From 2010 to 2020, in order to move forward in the elimination of global blindness there are a number of critical factors to be considered:

  • Excellence with equity: providing high quality eye care for all people. Unless we achieve this there is no point talking about eliminating blindness;
  • Comprehensive eye care;
  • Eye care team;
  • Sustainability, but not at the cost of neglecting the neglected;
  • Integration into other health care strategies – blindness is low on the list of important diseases to take care of and can sometimes get overlooked;
  • Effective public and private partnerships – with government support in the private sector.

Economic Impact Of Refractive Error

Presented by Professor Kevin Frick: Professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health

The epidemiological measurement of uncorrected refractive error in large scale population studies is a relatively recent study. Historically, best corrected visual acuity was reported without measuring, presenting visual acuity and determining whether the difference was due only to uncorrected refractive error.

Previously our research team used the prevalence rates and the most up to date age-specific population data from the U.S. Census Bureau’s International Database, to project the number of individuals with uncorrected refractive error worldwide. Data also allowed us to calculate separately the number of individuals with visual impairment and the number who were blind.

We then applied relevant disability adjusted life year weights, country-specific GDP per capita, relevant labour force participation rates, relevant employment rates, and additional measures of productivity loss related to the care that needs to be provided for individuals with visual impairment, to estimate the global potential productivity loss associated with uncorrected refractive error

In 2007 international dollars, the estimated economic impact of uncorrected refractive error was AUD$269 billion. A somewhat more conservative estimate was calculated based upon the assumption that individuals aged 50 and older would not lose productivity. This estimate was AUD$121 billion.

Professor Kevin Naidoo: Africa Chair, International Agency for the Prevention of Blindness (IAPB) and Global Programmes Director, International Centre for Eyecare Education (ICEE)

Meeting The Challenges Of Providing Global Eye Care

Presented by Professor Naidoo outlined why certain countries and regions have disproportionate amounts of blindness.

Poverty is a pandemic:

Half of the world’s population is living in poverty – with living costs of AUD$2.50 or less per day. There is a link between poverty and poor health care as many causes of blindness are related to poor health or development.

Requirements for the future:

  • Vision 2020 needs to be a push for developing world governments
  • Addressing trachoma from a development perspective
  • Expand beyond what is currently being done
  • Organisations need to get involved to engage in blindness prevention
  • Integrated and supporting development efforts
  • Move away from a disease approach and towards a systems approach e.g.: focus on cataracts, comprehensive eye care
  • There is a need for an integrated but realistic approach: retain trained people in local settings (like the vision technicians in India)
  • Partnerships with non government organisations are essential including advocacy
  • Government resources need to be mobilised
  • Catalytic role of programs to stimulate growth, raise the bar and create demand

Reaching The Underserved – Aboriginal Eye Health

Professor Hugh Taylor: Harold Mitchell Chair, Indigenous Eye Health, Melbourne School of Population Health, University of Melbourne

Professor Taylor is very passionate about closing the vision care gap so that indigenous people in Australia receive better quality eye health.

Goals:

  1. Define the scope of the problem
  2. Characterise the current service model
  3. Develop recommendations for effective eye care
  4. Fast-track trachoma treatment.

While Aboriginal children have one-fifth of the amount of vision problems in relation to European children, by the age of 40, Aboriginal people have six times more common vision loss.

The causes of this vision loss are 32 per cent cataract, 14 per cent refractive error and nine per cent trachoma/diabetic. However, 94 per cent off all Aboriginal vision loss is totally unnecessary. Blinding cataracts are 12 times more common in Aboriginal people. Also, in Aboriginal people with diabetes, 36 per cent have diabetic eye disease.

There is a need for proper refractive and dispensing services of Aboriginal people – as almost 50 per cent of vision loss is due to URE (uncorrected refractive error).