Chloe Davies, pictured above left with a school friend. Despite these positive outcomes, corneal transplantation as a treatment for Keratoconus is

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VisionNews ISSUE 24: NOVEMBER 2008 08 Centre for Eye Research Australia P r o m i s i n g n e w t

News may recall the story of Chloe Davies, a young Keratoconus patient who underwent a corneal

Chloe s story was profiled in the May 2006 edition of Vision News.

The disease causes the thinning and distortion of the front surface of the eye, known as the

After being diagnosed with the disease in both eyes at age eleven, Chloe s vision rapidly

Current treatment options available to Keratoconus patients are limited to glasses or contact

Given that the condition in her left eye was likely to worsen, Chloe s ophthalmologist

The transplant was successful in partially restoring sight to her right eye and in allowing her

Despite these positive outcomes, corneal transplantation as a treatment for Keratoconus is less

Many patients continue to experience low vision after the operation and approximately 7 percent

1 VisionNews ISSUE 24: NOVEMBER Centre for Eye Research Australia P r o m i s i n g n e w t r e at m e n t g i v e s h o p e to K e r ato c o n u s pat i e n t s Regular readers of Vision News may recall the story of Chloe Davies, a young Keratoconus patient who underwent a corneal transplant at just 13 years of age. Chloe s story was profiled in the May 2006 edition of Vision News. Keratoconus is a degenerative condition typically diagnosed in adolescence. The disease causes the thinning and distortion of the front surface of the eye, known as the cornea. As a result, a cone like bulge develops leading to significant visual impairment. After being diagnosed with the disease in both eyes at age eleven, Chloe s vision rapidly deteriorated until she could no longer see with her right eye. Current treatment options available to Keratoconus patients are limited to glasses or contact lenses, and in more severe cases, corneal transplantation. Given that the condition in her left eye was likely to worsen, Chloe s ophthalmologist recommended she undergo a corneal transplant in her right eye. The transplant was successful in partially restoring sight to her right eye and in allowing her to wear contact lenses. Chloe Davies, pictured above left with a school friend. Despite these positive outcomes, corneal transplantation as a treatment for Keratoconus is less than ideal. It involves invasive surgery and a lengthy and sometimes difficult recovery. Many patients continue to experience low vision after the operation and approximately 7 percent of patients will reject their donor corneas. Further, in some transplant recipients Keratoconus can return in the grafted cornea. For Chloe, her experience with vision loss has been difficult. continued over page... Vision News ISSUE 24 November /32 Gisborne Street, East Melbourne VIC 3002 T: F: (03) W: E: era-foundation@unimelb.edu.au

I S S U E 2 4 : N O V E M B E R 2 0 0 8 Promising new treatment gives hope to Keratoconus patients continued.

I m currently completing my final year of school, and my poor vision has added to the stress of the year. I m also unable to drive which is hard because all my friends are now driving.

The treatment involves the application of riboflavin (vitamin B2) to the eye before exposing it to ultra violet light (UVA).

CERA Research Fellow and Principal Investigator of the Cross Linking for Keratoconus clinical trial, Dr Christine Wittig hopes the treatment will eradicate the need for corneal transplantation.

2 I S S U E 2 4 : N O V E M B E R Promising new treatment gives hope to Keratoconus patients continued... While I m grateful for the transplant, I still struggle with low vision in both my eyes and the Keratoconus in my left eye continues to progress. I m currently completing my final year of school, and my poor vision has added to the stress of the year. I m also unable to drive which is hard because all my friends are now driving. A treatment currently being trialled by the Centre for Eye Research Australia (CERA) at the Eye and Ear Hospital is offering new hope for Keratoconus patients like Chloe. The treatment involves the application of riboflavin (vitamin B2) to the eye before exposing it to ultra violet light (UVA). The chemical reaction that follows results in an increase of the rigidity and strength of the cornea. CERA Research Fellow and Principal Investigator of the Cross Linking for Keratoconus clinical trial, Dr Christine Wittig hopes the treatment will eradicate the need for corneal transplantation. While current treatments for Keratoconus can improve a patient s vision, they fail to treat the underlying cause of the corneal weakness and distortion. By treating the condition in its early stages and halting its progression we hope to avoid the need for transplantation she said. The preliminary results of the trial have exceeded expectations. The treatment has halted the progression Dr Christine Wittig of Keratoconus in almost all the patients treated and in a significant number of patients there has actually been an improvement in the condition of their cornea and subsequently their vision. These are very exciting results. Dr Wittig recently received the prestigious Ronald Churches Bequest Award from the Royal Victorian Eye and Ear Hospital for this work. The award recognises research that displays originality, has potential significance and is of potential public interest. Chloe hopes to benefit from the treatment when it is made available next year. There are so few treatment options available for Keratoconus at the moment, so new research is our best hope. I hope that with this treatment I can avoid another difficult transplant and hopefully see future improvements in my vision. Given the potential of the project, it is hard to believe that a lack of funding almost saw the study terminated in its early stages. Chloe s father Stuart and her uncle Brett Davies learnt of the threat to the work in progress after attending a CERA information session. We couldn t believe that a study with the potential to save the sight of patients like Chloe was in danger of not continuing due to lack of funding said Brett. Determined to see the research continue, the brothers donated $50,000 to the Eye Research Australia Foundation to support the trial. The donation was gratefully received by the research team. Stuart s and Brett s generous donation enabled us to employ a trial coordinator to recruit more participants and broaden the scope of the study. Ultimately, the donation has allowed us to help more Keratoconus patients Dr Wittig said, pointing out that a relatively small amount can make a big difference to a project. When asked what she would say to someone who is considering a donation to eye research, Chloe is passionate: If you or someone close to you has experienced vision loss, you ll know how important eye research is. A donation in support of CERA s sight saving research can make a real difference in someone s life. CERA will hold a supporter information session, Diseases of the Cornea, on April 7, For more information or to reserve a place please contact the Foundation on

3 Bionic Vision Australia launched CERA participates in world-leading bionic eye research partnership Once, the prospect of a bionic optical device to help improve vision may have seemed fanciful or futuristic. But a new partnership that includes Centre for Eye Research Australia means the development of a bionic eye that can benefit tens of thousands of Australians with severe vision loss, will be realised sooner than first imagined. Bionic Vision Australia, a multidiscipline partnership, was announced last month and aims to pursue the development of the most technologically advanced bionic eye to help improve the sight of people with degenerative or inherited retinal disease. The partnership includes the University of Melbourne, the University of New South Wales, the Centre for Eye Research Australia, the Bionic Ear Institute, and the Victoria Research Laboratory of NICTA. The Royal Victorian Eye and Ear Hospital will be the clinical partner in this endeavour and will be the place where the first human transplants are performed. Professor Robyn Guymer, Head of CERA s Macular Research Unit, says that the new partnership plans to deliver a first prototype in 2011 and a higher-resolution model to follow several years later. The bionic eye will work by wirelessly transmitting images from a small camera to the retina at the back of the eye. Bionic Vision Australia is working on a bionic eye that has around 1,000 electrodes, which far exceeds other models around the world and increases resolution so that people might be able to recognise faces or familiar objects, Professor Guymer says. Bionic Vision Australia is developing a chip similar to this for an advanced bionic eye. More than 50,000 Australians have profound vision loss, caused largely by degeneration or death of the cells in the eye that receive light signals. Unfortunately, not all causes of severe vision loss can benefit from a bionic prosthesis. A bionic eye will assist patients with surviving functioning ganglion cells in restoring mobility, independence and quality of life by effectively replacing the function of damaged lightsensing cells in the eye, Professor Guymer says. Typically, this would include AMD patients or those with Retinitis Pigmentosa. Clarity and definition of vision may not be equal to normal sight, but the device will allow patients to move around, detect large objects and, in time, read text and recognise some facial features. Bionic Vision Australia partners are working on the many aspects required to produce a safe and effective device. CERA is currently involved in perfecting the surgical procedures for the placement of the electrodes. The Centre is also conducting focus groups with people who have suffered significant vision loss, to understand what visual stimuli recipients would most benefit from a bionic eye and the impact such a device might have on their quality of life. Vision News will keep you updated about the development of the bionic eye.

4 Prominent supporter visits Cera CERA Managing Director Professor Tien Wong and Ocular Genetics Unit Head Associate Professor Paul Baird recently welcomed founder of Clemenger Communications Ltd, Peter Clemenger, to the Centre to discuss their latest research. Mr Clemenger has, through the Peter and Joan Clemenger Foundation, generously supported Paul Baird s work on the genetics of myopia for a number of years. The genes in myopia (GEM) study has made several important discoveries regarding how genetic influences contribute to the development of myopia. In particular, the study identified a growth factor gene as well as another region on chromosome 2 as being associated with myopia. Associate Professor Baird said CERA is tremendously grateful for the Clemengers support over recent 08 VisionNews years. Our work into the genetics of this eye disease has benefited from Peter s keen interest and his Foundation s support, Associate Professor Baird said. Did you know? People with Type 1 and 2 diabetes have a higher prevalence for developing an eye disease that can lead to vision loss if it is not treated. Diabetic retinopathy is a complication of diabetes that damages blood vessels inside the retina at the back of the eye. There are no early-stage symptoms of diabetic retinopathy but in later stages of the disease people may experience blurred vision, eye strain and headaches. Proliferative retinopathy is an advanced form of the disease that can lead to sudden vision loss. Early diagnosis and treatment can help prevent up to 98% of severe vision loss from diabetic retinopathy. CERA s Retinal Vascular Imaging Centre is studying the use of retinal scans to provide early diagnosis of diabetic retinopathy. CERA has recently updated its general eye health information leaflets on age-related macular degeneration, cataract, diabetic retinopathy, glaucoma, refractive error and preventing vision. To obtain a complimentary copy of any of these or the full set, please contact us on or

5 I S S U E 2 4 : N O V E M B E R News bites > Professor Robyn Guymer, Head of the Macular Research Unit and Professor Jill Keeffe OAM, Head of Population Health were both promoted to full professor by the University of Melbourne, effective 1 July Congratulations! > Prof Rasik Vajpayee, Head of Surgical Research and his team are making their mark in educational videos showcasing their work. Their video Deep Anterior Lamellar Keratoplasty Using the Big Bubble Technique in Hurler Scheie Syndrome, produced in India has won the Best of Show award from the 2008 Joint Meeting of the American Academy of Ophthalmology and the European Society of Ophthalmology, while The DSAEK Triple - the RVEEH technique was awarded equal first place in the 2008 Australasian Society of Cataract and Refractive Surgeons Annual Film Festival. > CERA has recently been awarded two project grants by the National Health and Medical Research Council (NHMRC). Associate Professor Paul Baird will receive funding for two years for the study Aetiology of myopia through identification of refraction and ocular biometric genes. Professor Jonathan Crowston s project Impact of fluid mechanics on wound healing after glaucoma surgery will be supported over 3 years. Both grants start in 2009 and will bring a total of over $950,000 to CERA. Professor Robyn Guymer. > In addition, Professors Robyn Guymer, (Macular Research Unit Head) and Jonathan Crowston, (Glaucoma Research Unit Head) have been awarded NHMRC Practitioner Fellowships. Only 15 of these fellowships were awarded Australia-wide this year. Professor Jonathan Crowston. > Dr Ecosse Lamoureux will receive an NHMRC career development award, starting in Dr Ecosse Lamoureux (pictured below right) > Three CERA researchers Dr Alex Hewitt (Refinement of putative loci predisposing to glaucomatous optic neuropathy), Dr Luba Robman (Inflammatory markers of early AMD progression), and Associate Professor Ian Trounce (Mitochondrial defects in Glaucoma) have received grants from the Ophthalmic Research Institute of Australia (ORIA). > Dr Amirul Islam has been awarded an Early Career Researcher grant by the University of Melbourne. > In the October issue of the British Journal of Ophthalmology (vol.92; issue 10), six articles published were authored by researchers with CERA and the University of Melbourne Department of Ophthalmology affiliations, while in the same month in Ophthalmology (vol.115; issue 10), four such articles were published. It is significant that our group can contribute to advances in knowledge at this volume and quality in two of the leading international academic journals in our field, said Professor Tien Wong. > CERA received a 30% increase in its infrastructure funding from the Victorian government under the Department for Innovation s Operational Infrastructure Support scheme for medical research institutes. CERA is the only institute that has achieved this maximum annual increase for the second year running. Updates about CERA s work in progress and news can be found at our website: research/

6 08 VisionNews C o m m u n i t y e y e c a r e i n i t i at i v e l a u n c h e d A public health initiative involving CERA aims to develop and trial a model of collaborative care between the Royal Victorian Eye and Ear Hospital and primary eye-care practitioners. The Community Eye Care Partnership was launched recently at the RVEEH and will see the hospital refer patients with stable and no more than mild disease, who require monitoring not treatment, to participate at primary eye-care sites. Collin McDonnell of the Population Health Unit says the purpose of the initiative is to make efficient use of scarce resources, strengthen links between primary, secondary and tertiary eye-care sectors and improve networks between eyecare providers. Three modules are being developed, one for each of the clinical streams in the project. These modules are self directed learning and assessment tools, developed to be used by primary eye-care practitioners participating in the Community Eye Care Partnership. Community Eye Care Partnership stakeholders at the program s launch. D e p a r t m e n t O F H u m a n S e r v i c e s S e c r e ta r y V i s i t s Victorian Department of Human Services Secretary, Ms Fran Thorn, visited the Centre recently for a briefing on research activity and progress. Photographed right, Fran Thorn inspects an image of a corneal procedure for which Professor Rasik Vajpayee was awarded the Australasian Society of Cataract and Refractive Surgeons Award for The DSAEK Triple the Eye and Ear Hospital technique. Professors Tien Wong and Jonathan Crowston brief the DHS secretary in the glaucoma laboratory with Eye and Ear Hospital Chief Executive Officer Ann Clark. Centre on show at AusBiotech 08 Delegates and visitors to AusBiotech 08 conference in Melbourne this past October have seen how CERA contributes to Victoria s vibrant biotechnology and life sciences sector. AusBiotech is the Asia-Pacific region s premier biotechnology conference and attracts global industry representatives and official trade and investment agencies from other countries (from the United Kingdom, Italy, Canada and Korea attended the conference.) CERA shared floor-space with NICTA, Australia s Information and Communications Technology Centre partners in the development of a bionic eye. (See also Bionic Vision Australia story in this issue).

VisionNews. Bionic eye success; All of a sudden, I could see a little flash!

VisionNews. Bionic eye success; All of a sudden, I could see a little flash! VisionNews SUMMER 2012 New diabetic retinopathy screening service Stem cell treated contact lenses to repair damaged eyes New chair takes the reins at CERA Optometrists & ophthalmologists working together