Australian optometry has been a global dynamic force for decades now, inspiring major innovations in research, education, product development and public health. The University of New South Wales (UNSW) in Sydney, has been a significant hub of activity in this area – home to a series of organisations that have had an important impact across vision care and eye health since the early 1970s.
The Cornea and Contact Lens Research Unit (CCLRU) was established in 1976, gradually building an international reputation for research in this area and having an important influence on the industry. The success of the CCLRU inspired its founders to branch out further: into academic and professional education, commercial product development through cooperative ventures with industry, establishing humanitarian eye care programmes as well as fundraising from the world optometric community to support those programmes.
The group behind the CCLRU was also responsible for establishing a unique research organisation, the Institute for Eye Research, which has managed to undertake breakthrough research, develop commercial products with industry partners, educate PhD candidates from around the world, continue a legacy of excellence in clinical research and support humanitarian programmes. After 25 years, the organisation was renamed the Brien Holden Vision Institute in March 2010 to honour the integral contributions of Professor Holden to that series of organisations and to the world of optometry.
In 1996, for the 20th anniversary of the CCLRU, Prof. Holden wrote: “In 1970 there were one to two million contact lens wearers worldwide, in 1986 there were 25 million, and today there are 67 million. There has clearly been incredible growth in the area in response to research developments in the field, in which the CCLRU has played a significant part. The organisation provided invaluable assistance to industry in improving lens design to avoid undesirable effects, and CCLRU designs are now used throughout the world.”
They performed ground-breaking research in understanding the eye and developing new vision correction and vision care systems, and helped industry to improve its products
“And of course our own research, activities and techniques have changed. In an article in 1976 we enthuse about our new computer installation to support research, which included 32 K bytes of memory and an all new ‘flexible disc mass storage device’. We certainly have come a long way since then!”
Contact Lenses and More
The history of this group of people has always been one of growth. The CCLRU was established in 1976 after Brien Holden began to attract other researchers to work with him at UNSW in this fledgling and rapidly growing area of research. Beginning in 1973 with three researchers, in 1976 the group had grown to over 30. In the 1970s, interest in contact lenses was increasing, following the development of comfortable soft lenses in the 1960s. However, very little was known about what was needed in lens materials or design to maintain a healthy eye. At the CCLRU, Brien’s initial goal of understanding contact lenses expanded to take in every aspect of the development, material properties, design, performance and effects of a wide range of ocular devices and procedures.
In the late 1970s, the CCLRU began to attract a substantial level of industry funding and the scale of its operations grew rapidly. It became a multidisciplinary organisation, including the work of optometrists, biologists, physiologists, biochemists, microbiologists and biostatisticians. It developed a strong postgraduate education programme, and in continuing education, delivered contact lens education to thousands of practitioners and educators throughout Asia.
When the Cooperative Research Centres (CRC) program was established in Australia in 1991 to provide funding for collaborative research and education, the CCLRU became the instigator and core participant in the CRC for Eye Research and Technology (CRCERT). CRCERT was succeeded by the Vision CRC in 2003.
The CRCs forged strong collaborative links between participants and with international collaborators and industry. They performed ground-breaking research in understanding the eye and developing new vision correction and vision care systems, and helped industry to improve its products. In particular, CRCERT was part of the international team which developed the first silicone hydrogel contact lens to be approved for 30 days continuous wear – the ‘Focus Night and Day’ lens from CIBA Vision.
The Vision CRC has been developing breakthrough technology and products for the correction of myopia and presbyopia; including designs to reduce the development of myopia, implantable contact lenses, and a dynamic gel lens to restore normal vision to ageing sight.
Years of research effort in the area of myopia by the Vision CRC and its participants, the Brien Holden Vision Institute and the University of Houston, came to fruition in March 2010 when it announced the release of a breakthrough new technology that has demonstrated an ability to slow the progression of myopia. The spectacle lenses that utilise this technology were released by Carl Zeiss Vision in April, 2010. The myopia control technology has also been licensed to Ciba Vision for contact lens applications.
Since 1976, an astounding array of other organisations have been established and fostered by Brien Holden and his group. The International Society for Contact Lens Research (1978), the International Association of Contact Lens Educators (1979), VisionCare NSW (1992), the International Centre for Eyecare Education (1998), and Optometry Giving Sight (2004) were all set up by the Sydney group to take on the various roles and opportunities that appeared in national and international eye care.
The central mission of all of the organisations has been Vision Excellence for All People. The organisations, and the people Brien Holden has attracted to work in them, have made tremendous progress in effectively delivering knowledge and systems that provide eye care to many millions.
The Institute for Eye Research was formed in 1985 to provide a core to all of these activities. At the CCLRU, Brien Holden was determined to create a strong, independent and influential organisation which would interact with and benefit the ophthalmic industry, but retain its own integrity. This goal in turn formed the basis of the Institute.
While the CCLRU was highly successful, Brien Holden saw the need for a strong Australian company, associated with the University of New South Wales, involved in eye care research and education. Brien and colleagues established the Institute for Eye Research as a non-profit organisation.
The aims of the Institute were to:
- Support, conduct and coordinate scientific research in matters in any way relating to vision, including detection, diagnosis, causes, prevention, cure and correction of abnormalities of the eye and vision system
- Integrate their work with eye research and educational programs undertaken by other organisations.
For 25 years the Institute has contributed to Australian eye care, and has grown to become a major participant and supporter of Australian eye care research and education. The successful commercialisation of its research activities has allowed the Institute to reinvest in further breakthrough research, expand its postgraduate education opportunities and to contribute substantial funding grants to organisations such as the International Centre for Eyecare Education, Optometry Giving Sight and Aboriginal Health and Medical Research Council of NSW’s recently established Aboriginal Health College.
Over 140 staff members now conduct research projects, educational and service delivery programmes, and provide professional and technical services to partner organisations.
Research at the Institute has been particularly focused on two vision-related issues: refractive error, and corneal infection and inflammation. A major achievement of the Institute was the development of toric soft contact lenses in collaboration with Ocular Sciences Inc and released worldwide as the Biomedics lens in 2002.
Toric contact lenses are used for the correction of astigmatism, a condition responsible for 30 per cent of all refractive errors, where the two principal meridians of the eye have different powers. Common problems encountered with fitting soft toric lenses were providing stable lens orientation, and lens wear comfort. A toric contact lens providing good quality vision could potentially attract up to 40 per cent of prospective lens wearers (over a billion people).
Institute researchers designed a lens with a unique wedge shape and smooth front surface. The Biomedics soft toric lens is the world’s fastest selling contact lens for this market and is attracting substantial royalties for the Institute. In September 2002 the Biomedics toric lens won a patent design award from the US Patent Office for novel and excellent design.
The Institute is currently pursuing novel solutions to ocular infection and inflammation, and also applying its research more broadly, through a series of projects. This includes research in the areas of antimicrobial contact lenses, new contact lens solutions, the tear film, dry eye, microbial keratitis and new ocular therapies.
Where to Now
As Professor Holden said; from a million contact lens wearers in 1970, there are now over 110 million contact lens wearers globally. Today, the eye care organisations fostered by Brien Holden and his group have taken their place of prominence in eye care on the world stage.
The founders of the Brien Holden Vision Institute (and many of its associated organisations) have made unique contributions to advancing the quality of life of people by initiating, obtaining funding for, and developing some of the most important initiatives and organisations in international optometry.
In 2009, the Board of the Institute for Eye Research decided that the role of Brien Holden in the Institute and in national and international optometry should be highlighted. New projects and technologies are set to expand activities, and the Brien Holden Vision Institute will continue to have an impact on the future of eye care.