As Australians, we are proud of our ability to ‘punch above our weight’ on the global stage and, as inventors, we certainly do that. Evidence of Australian ingenuity abounds: from the boomerang, to the rotary clothes line, the ultrasound, and yachting’s controversial ‘winged keel’.
mivsion also discovered that the Australian optical industry has produced a very impressive track record of ‘world firsts’.
The term ‘world first’ can often be controversial. Today’s scientists and researchers stand on the shoulders of their predecessors and in a networked world, information and advances are often shared across various disciplines, institutes and international borders.
The feats of optical research and development in Australia are without exaggeration, remarkable. In 1960, the world’s first plastic spectacle lenses, which were 60 per cent lighter than glass lenses, were designed by Scientific Optical Laboratories of Australia. In 1992, optical research scientist Stephen Newman developed the world’s first multi-focal contact lens in Queensland. And the Australian ‘world firsts’ just keep coming…
Gene Discovery
An Australian collaborative research team last month announced the discovery of two new genes linked to open angle glaucoma in the only study of severe glaucoma cases in the world.
…the tailored application to making conductive diamond pillars that are suitable for electrical stimulation of the retina would classify as a first.
The study, published in the prestigious international science journal, Nature Genetics in May, established that 18 per cent of the population carry risk variants of these two genes, making them up to three times more likely to develop severe glaucoma than those that don’t.
Team leader Associate Professor Jamie Craig, from the Department of Ophthalmology at Adelaide’s Flinders University, said the research was done in collaboration with groups from five other Australian universities.
“The Australian study will help replace routine monitoring and hit-and-miss treatment for glaucoma, by identifying patients at the highest risk of going blind. It opens the pathway to developing completely new ways of treating patients that could delay disease progression and prevent blindness,” he said.
The Bionic Eye
The race to develop the bionic eye is one that has captured public imagination and has led to a series of ‘world first’ claims across the globe, including from Australia.
For a while, it looked like Australia was ahead of the pack, but researchers in Germany, the U.K. and the U.S. have developed several experimental versions of a bionic eye and fitted them into patients, allowing them to see flashes of light and distinguish shapes. These devices have taken various forms but perhaps none as unusual as so-called “tongue vision”. The BrainPort device, developed in the U.S. and fitted to a British soldier blinded by a grenade, converts images into electrical pulses which are sent to the tongue, where they cause a tingling sensation. The different strengths of the tingles allow the user to mentally visualise their surroundings and navigate objects.
Australian Developments
The Sydney-based Bionic Eye Foundation claimed a ‘world first’ in 2008 with its version of the bionic eye. Unlike other bionic eye research, the Aussie model was a device to be planted on the outer surface – the sclera of the globe of the eye – rather than needing to be placed inside the eye. A planned transplant was postponed, the project did not receive federal funding when it was allocated in December 2009 and mivision understands the researchers involved were investigating options to move it overseas.
The federal money for the bionic eye project was awarded to Bionic Vision Australia (BVA) in the form of an AUD$42 million dollar grant. BVA, headquartered in Melbourne, is a national consortium of researchers from a variety of disciplines.
The BVA has claimed “breakthroughs” in its project to bring an Australian retinal implant much closer to reality, including the development of a microchip, smaller than the figure ‘5’ on a five cent piece. The tiny device has 98 precisely-controlled stimulation channels and numerous features that allow for the delivery of electrical stimulation that can restore some sense of vision.
However, BVA spokeswoman Veronika Gouskova said the team is extremely cautious about what it claims as a ‘world first’.
“World first technically would be defined by a successful patent application and intellectual property (IP) registration. At BVA, this is managed through an IP Advisory Group,” Ms Gouskova said.
Professor Steven Prawer, BVA researcher and director of the Melbourne Materials Institute, said the BVA’s concept of an all-diamond encapsulated retinal implant is a ‘world first’.
“Conductive diamond and 3D diamond structures have been fabricated before, but the tailored application to making conductive diamond pillars that are suitable for electrical stimulation of the retina would classify as a first,” Prof. Prawer said.
Stem Cells
Sometimes, despite being a world first, innovations cannot get IP protection.
A team from the University of NSW (UNSW), led by A/Prof. Nick Di Girolamo, developed what it describes as a “novel and innovative” stem cell transplantation technique, which restores vision in damaged eyes using stem cells from the patient’s own eye.
The technique has been successfully shown to improve patient’s vision within weeks and also heals corneal ulcers. Unfortunately, the breakthrough was not able to be patented, because of a previous U.S. patent on a similar strategy.
A/Prof. Di Girolamo said the UNSW transplantation technique “was the only autologous ‘self’ system used to treat corneal blindness for patients with damage or deficiency to their corneal stem cells. The technique, which cultivates stem cells harvested from the patient’s good eye or a different part of the eye in the patient’s own blood products, has been published and is now in the public domain for people to replicate.
Soft Artificial Cornea
The Lion’s Eye Institute (LEI), a not-for profit organisation based in Perth, claims its development of a retinal vein bypass treatment and the development and implantation of the world’s first soft artificial cornea, AlphaCor, as its ‘world firsts’.
AlphaCor is a small, flexible plastic disc that is designed to replace a scarred or diseased cornea. It is used in patients who have had multiple failed corneal transplants or in those patients in whom a donor graft is likely to fail.
The central part of the disc is clear and acts a bit like a lens, just like the natural cornea. The rim or skirt of AlphaCor resembles a sponge and acts to secure the device into place by allowing the patient’s own tissue to grow into it and hold it in place. It was the first internationally approved artificial cornea and the LEI claims it represents a “benchmark in the treatment of corneal disease”.
In 2010, after 15 years of research, the LEI claimed a world first treatment, proven to address the underlying causes of central retinal vein occlusion, which is one of the most common causes of blindness in developed countries.
Team leader Professor Ian McAllister said the technique “evolved from a laboratory base idea through to limited phase one and two human trials and (then)… the completion of a multicentre randomised prospective controlled phase three trial”.
He said the treatment involved using a high powered density laser to create a bypass channel around the blockage in the central retinal vein.
It was the first treatment of its type to directly address the pathology; previous treatments only addressed the end term sequela of this condition and required often repeated injections of medications into the eye.
“This procedure is the first one in the world which has proven to address the underlying cause and can provide a cure. The laser is painless and can be done easily in an outpatient environment. The large clinical trial conducted in Australia has proven that this treatment works and that patients treated with this condition had a significantly better end visual result than those treated with the current standard of care,” Prof. McAllister said.
Needleless Injections
The Centre for Eye Research Australia (CERA) is claiming a ‘world first’ with its needleless eye injection, currently being tested on animal models and pegged for human trials in 2012.
The device works by incorporating a measured dose of drug into a gel that is placed over the eye. A device attached to the gel sends out an ultrasonic pulse which propels the drug from the gel into the eye.
“It uses an innovative combination of nanotechnology and ultrasound to deliver a non-invasive and painless dose of medication that can specifically target the retina at the back of the eye,” Research Fellow Dr. Paul Connell said.
AMD Laser Therapy
Another world first for CERA researchers, is a trial of a novel laser therapy aimed at stopping the progression of the sight threatening disease, age-related macular degeneration (AMD).
Head of CERA’s Macular Research Unit, Professor Robyn Guymer said, unlike existing AMD treatments, the CERA laser therapy trial targets the disease in its early stages.
“In applying the laser therapy we hope to halt, or partially reverse, the progression of AMD before it threatens a patient’s sight.”
She said the treatment involves a specially designed novel laser device that delivers a controlled nanosecond dose of laser energy into the eye.
“Preliminary research suggests that the application of retinal regeneration laser therapy to the affected eye can eliminate the yellow deposits, known as ‘drusen,’ which are present in the retinal tissue of people with AMD,” she said.
“In eliminating the drusen from a patient’s retina, we hope to reverse the degenerative processes caused by the disease”.
The two year study began in late 2009 and is being conducted at the Royal Victorian Eye and Ear Hospital.
Blindness and Exercise
CERA Research Fellow Dr. Vicki Chrysostomou’s ‘world first’ study is investigating whether exercise can help to protect the optic nerve from injury.
“As we age, the function of our mitochondria, the part of the cells responsible for energy production, declines. This decline makes the optic nerve vulnerable to injuries that lead to glaucoma,” Dr. Chrysostomou said.
“Research by my colleagues indicates that diet restriction can dramatically improve mitochondrial function and the health of the optic nerve. Exercise activates many of the same pathways as diet restriction including improved mitochondrial function. It also protects against a range of diseases. The effect it has on eye health, however, is unknown.”
To test the hypothesis, Dr Chrysostomou is putting middle-aged mice through a vigorous swimming regime while testing their mitochondrial function.
Dr. Chrysostomou expects that the mitochondria in the exercised mice will stand up against the aging process better than those of the non-exercised mice. She says the implications of her world-first study are huge.
“Doctors regularly prescribe exercise to guard against heart disease and hypertension. One day, they may give the same advice to protect against eye disease,” she said.
CERA also claims ‘world firsts’ in a study investigating whether myopia and keratoconus share a common genetic basis and another to investigate different aspects of auditory function in glaucoma patients.
It also boasts a world first in an iPad training application to help eye-care practitioners assess their glaucoma diagnostic skills. The Glaucomatous Optic Neuropathy Evaluation (GONE) App is designed to allow practitioners to hone their skills in optic nerve evaluation, a key factor in glaucoma diagnosis and management.
Education and Training
Any discussion on Australia’s ‘world firsts’ in the optical industry is incomplete without mentioning the work of the internationally renowned Brien Holden Vision Institute and the International Centre for Eyecare Education (ICEE).
The ICEE has played a pivotal role in the global development of optometry education, training and screening programs, including:
- Initiating a global optometry curriculum and training materials for use in the development of optometry in Africa.
- Working in partnership with local institutions to develop Schools of optometry in Africa (Malawi, Mozambique, Eritrea, Mali).
- Setting up a Global Resource Centre in China to procure and distribute spectacle lenses, frames and equipment to public health partners.
- Conducting the largest ever screening and implementation program in uncorrected refractive error in Africa (in KwaZulu-Natal in South Africa).
- The development and dissemination of competency-based education programs to create capacity for refractive service provision in Africa, the Asia Pacific and Latin America. This includes screening programs, primary eye care, refraction, optical dispensing, and vision centre management.
The Brien Holden Vision Institute and its partners collaborated with Ciba Vision to invent the silicone hydrogel contact lens. This invention solved the problem of supplying high enough levels of oxygen to the cornea to overcome the problem of hypoxia. The lens material now accounts for more than half of the soft contact lens market in the U.S.
The work of the Brien Holden Vision Institute with partners through the Vision Cooperative Research Centre (Vision CRC) also led to the development of the first spectacle lenses to slow the progression of myopia in children. The current Vision CRC Anti-Myopia Program demonstrated the spectacle lenses are able to control the progression of myopia by approximately 30 per cent in younger children (aged between six and 12 years of age) with certain parental history of myopia.
To the Future
There’s no doubt that the contribution of Australian science to eye care research and development has made a vital contribution to the lives of the visually impaired around the world. Yet the Australian Government continues to threaten its viability by limiting available funding.
In an effort to keep our talented researchers on Australian soil, and enable them to move forward with confidence and the resources they need, the government must commit to an increased pool of funding. Further, this should be coupled with a strategy that encourages emerging scientists as well as those with a proven track record to pursue new discoveries.
Without this commitment there is a danger of eye care stagnating in Australia and our nation losing its position as a leading force in eye health on the world stage.
Some Other Australian Firsts |
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Australia can legitimately lay claim to a large number of ‘world firsts’. For example, Aussie ingenuity changed the face of agriculture with the development of the grain stripper and the stump-jump plough. Our inventors also came up with black box flight recorder, the atomic absorption spectrophotometer, and the orbital internal combustion engine. The world’s first ever feature film, The Story of the Kelly Gang, was made in Australia. And which nation was it that came up with the idea of trousers with a permanent crease? You guessed it, Australia. In the scientific field, the ultrasound scanner, now an essential piece of medical equipment, was first built in 1961 at the ultrasonics institute in the Commonwealth Department of Health. We can lay claim to the first in-vitro fertilisation (IVF) pregnancy (reported from Monash Medical Centre in 1973) and later the first baby born from a frozen embryo (Zoe Leyland, born in Melbourne in 1984); the cochlear implant (by Professor Graeme Clark in 1979, again in Melbourne); and in 2006, Queensland’s Professor Ian Frazer was named Australian of the Year after developing the world’s first cervical cancer vaccine. |
