In collaboration with other global giants of the eye health community, Professor Brien Holden invested in research, development and education that could one day see the elimination of avoidable vision loss and blindness.It’s a lofty ambition but one that the founder and CEO of the Brien Holden Vision Institute was absolutely committed to.
In November last year, at the American Academy of Optometry in Denver, Professor Brien Holden was awarded optometry’s highest scientific honour – the Charles F. Prentice Medal – in recognition of a career-long record of advancement of knowledge in vision science. Over 50 years he worked to develop ground-breaking products which hope to optimally correct, treat and prevent refractive errors and where threatened, their pathological consequences. Effective treatments for eye conditions such as dry eye and meibomian gland dysfunction have also been a focus.
Perhaps surprisingly, Professor Holden hadn’t envisioned a career in optics – it was his mother who set the direction.
“Initially my mother said what are you going to do when you go to university,” Professor Holden told mivision. “I went through the options: medicine – too long; dentistry – teeth, pharmacy – pill pushing. She said well I know an optometrist, maybe we should go and talk to him. It seemed to me… that it was a nice, simple, people-related profession, nine to five, you’d make good money and have an opportunity to relate to people and do something of value in the community.”
I hope to leave a lasting legacy in the Institute – an institution that is creative, productive, self sustainable, generates ideals and delivers massively on the whole issues of how to see better and how to deliver to people everywhere the vision that they require…
Despite enjoying the clinical aspect of his studies, Professor Holden said he found studying the science tough. “I eventually graduated after failing second year and went into practice for a year in Melbourne with Harry Held, who was great to me and very patient. I then got married and jumped on the boat with my new wife (and half my football team) and sailed to England to do my Diploma of Contact Lens Practice and to see Europe.”
It was on his way to the UK that Professor Holden developed a strong desire to make a difference in people’s lives. More than 50 years on, that desire continues to drive his work, primarily fuelled, he says, by a sense of sadness for people who are disadvantaged, and frustration about those people and Governments that could and should do more.
“In those days, in the 50s, the definition of what to do to help your fellow man was about recovery after the war and the building of society. But the fundamental value of people being the most important part of the whole universe, and that you should treat every person as you would like to be treated yourself, were fundamental values from my family, school and friends.
“So when I saw the poverty in Sri Lanka and PNG in the 60s on the way to the UK (I’d not seen it in Australia), I was staggered. I became angry about it… I still am.
“It was just staggering that the world had such wealth and such lack of concern for human beings and that stayed with me; the combination of family and school values and the injustice of poverty, in a society that had all the wherewithal to do away with such problems.”
Professor Holden said it was 20 years before he had an opportunity to make a difference.
“In 1999, (globally renowned ophthalmologist) Nag Rao said to me ‘you know, you should do something about uncorrected refractive error… because it’s the major cause of vision impairment and along with vision impairment goes disability and poverty’. Of course this came to be understood very dramatically soon after that period of time… a mere six years later the World Health Organization said exactly that. So we went after making a real difference at Brien Holden Vision Institute, through Optometry Giving Sight and through eye and vision care development in societies in need.”
A Commercial Direction
Over the past 20 years, the Institute has largely funded its programs through research support from Australian Government Cooperative Research Centre (CRC) grants, collaborators and corporations; public health grants from the Australian and U.S. governments, and royalties from its successfully licensed breakthrough products.
Late in 2014, the Institute announced a new direction – it would launch a global series of Institute-owned commercial entities. Revenue from these subsidiaries will support the work of the Institute, which will remain a non-profit, non-commercial, science, translational research, licensing and humanitarian organisation.
Professor Holden believed this would enable the organisation greater freedom to invest in more high-risk, yet potentially high-return research opportunities that could make a greater impact on the incidence of blinding diseases.
“Eliminating disability, poverty and malnutrition demands our contribution to the world, to help take care of the needs of other people through development programs, educational initiatives and sharing technology,” he said.
Society Must Step Up
“There is no doubt that the major vehicle for alleviating poverty and disability and even uncorrected refractive error and preventing blindness is a responsibility of society – it’s a responsibility of the leadership of society to sell the concept to every person and every country that if your fellow human being is disadvantaged, suffering, and especially if they are unnecessarily in poverty and poor socio-economic circumstances, that society should do something about it, that government should be there for the people – for all the people – their education, health, housing, physical wellbeing education – all of these things are basic rights and every citizen of every country has the right to these rights as well as the right to sight. So it has to be that society provides an opportunity for people to think about, and contribute to, the welfare of every person in society.”
Professor Holden said he was ashamed at the government’s recent decision to cut billions in foreign aid.
“The massive changes that have been wrought, in my experience, by the appropriate and focused investment of government funds in helping people to see overseas, is just phenomenal. To back away from that because we want eight lane highways or the next big refrigerator – as a society – is sad.”
He also believed more could be achieved by encouraging non-government organisations (NGOs) to change their approach. “I think this is one of the biggest disappointments of my life that the big NGOs don’t work together – they work together at a superficial level but genuinely interested in the common good and using the expertise of each NGO to best advantage? That hasn’t happened yet.
“That doesn’t mean to say that we don’t cooperate with other NGOs but in general, there’s not a lot of interest in the collaborative spirit in the NGO movement to use the skills and knowledge in each NGO most effectively.
“Conversely that’s exactly why the Cooperative Research Centre scheme, which the government is now dismantling, is so successful. Because you go to the best in the world who know a lot more about the subject than you do and you say ‘Earl (Smith, Dean of the College of Optometry, University of Houston), we want to do a project on myopia’, or ‘Jean-Marie (Parel, Bascom Palmer Eye Institute), we want to do something about curing cataracts’… those collaborations have been absolutely fantastic.”
The opportunity to do this, said Professor Holden, was his proudest career achievement.
Collaborating with Giants
“I have collected, as friends, colleagues and partners, many giants and great collaborators… a giant is somebody who is creative, who cares about people, who is at the top of their field and who is generous of spirit enough to share and want you to achieve your potential by interaction and giving anything that they’ve got by way of ideas and knowledge to the common goal of better lives for people at large – like Otto Wichterle, Antti Vannas, Serge Reznikoff, Earl Smith, Nag Rao, Jean-Marie Parel, Monty Ruben, Dick Hill, Kovin Naidoo – too many to mention really.”
Additionally, he said, collaborating with around 360 people – PhD students, colleagues and friends – to create and disseminate knowledge, has been a joy.
The Process of Creativity
He said inspiring creativity, the development of new ideas and technology, is an interesting process. “Part of it… is to sit in a room with a group of interested people, who have the same sense of values with regard to innovation and creation, who are knowledgeable people… We talk about ways we might be able to tackle something as simple as contact lenses for presbyopes, or how to deliver vision care in the remote parts of Africa, for example. Quite often that interaction doesn’t capture the idea at that moment, the most creative idea. But certainly I go away and think about what’s been said and that’s often when I think of a new idea to try – and I think that’s the same for my friends and colleagues who are also in the process of creating new ideas.”
On hopes, plans and goals, Professor Holden said if he had the chance to eradicate one disease, it would be myopia.
“I’m a little biased here, because what I’d like to eradicate is the serious risk of high myopia and myopic blindness which is, as yet, a very unrecognised cause of loss of sight for many, many people –
in fact myopic macular degeneration is the number one cause of blindness in adults over 40 in Japan – now that’s incredible. So I think it would be a great thing for optometry, for the Institute, for the Government, for society, for us, to reduce the rate of progress of myopia in children so that later in life they’re less at risk from retinal damage, glaucoma and cataract.”
For his family, Professor Holden said he hoped that, “my children and my grandchildren – are all healthy, well and have good sense of values and enjoy life. My contribution to that is relatively minor compared to the contribution of my magnificent wife…”
And job wise: “I hope to leave a lasting legacy in the Institute – an institution that is creative, productive, self sustainable, generates ideals and delivers massively on the whole issues of how to see better and how to deliver to people everywhere the vision that they require. A sustained and sustainable Institute that has the resources to chase the goals of vision for everyone, everywhere and create new and better ways to do just about everything we do.”
Not too much to expect really, from someone who already has already achieved so much.