World-first in fight against corneal disease

Save Sight Institute has launched the world’s first large-scale assessment of collagen cross linking, an increasingly common approach to treating the corneal eye disease, keratoconus.

Save Sight Institute has launched the world’s first large-scale assessment of collagen cross linking, an increasingly common approach to treating the corneal eye disease, keratoconus.

This exciting new research is an extension of the Save Sight Registries initiative, an online platform established eight years ago to analyse real-life treatment outcomes across the world.

Collagen cross-linking to counter the progression of keratoconus is the third module to be added to the Save Sight Registries framework which is also analyses treatment outcomes for macular degeneration and diabetic retinopathy.

Save Sight Registries uniquely allows any clinician administering treatments and performing procedures to contribute, and the project already has ophthalmologists from across Australia, New Zealand, Europe, Asia and the United States of America participating.

“Collaboration is our most powerful tool in the fight against blindness” said Clinical Professor Stephanie Watson, who heads up the keratoconus module of the registry. “By working together and harnessing the huge amounts of available data, we can help more people who suffer from debilitating diseases such as macular degeneration, diabetic retinopathy and now keratoconus.”

Last month, Save Sight Registries released results to show that Australia achieves significantly better long-term patient outcomes than Europe or the United States when it comes to treating wet age-related macular degeneration.

Data from the registry showed that after six years the average Australian patient had vision that was as good as, or better than, their starting vision. In the USA patients only retained that vision for four years, compared with just two years in the UK.

These insights are helpful for deciding upon the most effective treatment regime for people. “Clearly what we are doing in Australia is working “ said Professor Mark Gillies, head of Save Sight Registries “and because of the registry, ophthalmologists from throughout the world can see exactly where the differences are.”

Save Sight Registries is an example of true collaboration in action. Specialist ophthalmologists from around the world are invited to participate, and patients and support groups such as Keratoconus Australia also have an active role in the project.

President of Keratoconus Australia, Mr Larry Kornhauser, attended the launch of the new module on Friday which will initially assess the outcomes of collagen cross linking for people affected by keratoconus.

“One of the most important aspects of this registry” said Mr Kornhauser “is its inclusion of patient reported outcomes. It is so critical to include those with the most at stake in the process, to ask them about their lived experience and to incorporate their responses in the overall assessment of treatment approaches.”

Keratoconus can have a significant impact on lives, particularly as it tends to appear during young adulthood. Michelle Urquhart is one such person who has struggled with eye disease throughout her life, addressing the audience at Friday’s launch event.

“It’s not been an easy road” said Michelle. “I was diagnosed as a teenager, and my world has often turned fuzzy as my eyesight fluctuated. I’ve felt very unsure about what the future held for me. I’ve had a few corneal grafts, a few serious infections, have been legally blind at times and have spent a considerable amount of time in hospital. I wasn’t always able to see the features of my beautiful babies. It’s been quite a journey for me, but I’m now benefitting from the amazing research already undertaken. This new phase is very exciting, and I know that the results from this registry will benefit many more people in the future.”

Eight years ago Prof Gillies instigated Save Sight Registries as a research tool with several key differences to randomised clinical trials.

“Registries track patient outcomes in the real world” said Prof Gillies. “Clinical trials tend to exclude certain patient groups, and are also conducted for a limited time frame with a limited number of patients. We track all patients over the long-term. It’s quick and easy for clinicians to use during routine consultations, taking just 15 seconds to enter patient data.”

Save Sight Registries allow eye doctors to audit their own patient outcomes, anonymously comparing results so that they can benchmark themselves with other clinicians. There is no cost to use the system, and all patient and doctor data is anonymous. Reports are easily generated in simplified graphical form to illustrate whether treatment approaches are working relative to the broader population of people affected by the same condition.

“Reports help clinicians anticipate how a prescribed treatment regime should work” said Prof Gillies “and these are increasingly becoming important communication tools to graphically show individual patients the consequences of not complying with particular treatment regimes”.

Patients, optometrists, clinicians and industry stakeholders attended the launch of the keratoconus module of Save Sight Registries on Friday. Presenters included Professor John McAvoy, Professor Mark Gillies, Clinical Professor Stephanie Watson and members of the Save Sight Registries team. Michelle Urquhart and Larry Kornhauser spoke on behalf of patients, and a panel of specialist corneal specialists answered audience questions on a wide variety of questions relating to keratoconus (Dr Yves Kerdraon, Dr John Males and Dr Con Petsoglou).

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Students visit SSI for work experience

This week Save Sight Institute had the pleasure of hosting two students from Alexandria Park Community School for their Year 10 work experience.

This week Save Sight Institute had the pleasure of hosting two students from Alexandria Park Community School for their Year 10 work experience.

Mateeha and Labiba both gained hands-on experience over five days under the guidance of  staff across a range of departments in the Institute. A rotating program was developed to ensure the students had an informative and interesting work experience over the week.

Mateeha and Labiba prepared a brief report on their time at Save Sight Institute, writing that:

“From our time at Safe Sight Institute, we participated in numerous tasks in both the clinic and the lab.

“We gained valuable knowledge on the background and understanding of eyes through various activities including watching first hand tests and machines being utilised on patients and conducting experiments using parts of eyes.

“What we particularly enjoyed was testing antibodies on tissues using UV sensitive materials, cell culture and learning about diseases affecting the eye including AMD and glaucoma.

“Through this opportunity we gained a new experience in the scientific field and learnt about the work environment.

“The outcome of our work experience here showed that we will consider research as a possible career path due to getting a taste of what it’s like. We would recommend Save Sight Institute for friends interested in science or searching for a possible work placement, or basically anyone looking to increase their knowledge on eyes.

“We would like to thank all the people that worked with us, in both the clinic and lab; we greatly appreciate the time that you took out to guide us throughout this memorable week.

“We also want to thank everyone we met for being so kind and approachable especially Emma, who organised and instructed this trip and was so friendly and welcoming.”

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Rat vision may give humans best vision of all

Humans have the best of all possible visual worlds because our full stereo vision combines with primitive visual pathways to quickly spot danger, a study led by the Save Sight Institute at the University of Sydney has discovered.

Humans have the best of all possible visual worlds because our full stereo vision combines with primitive visual pathways to quickly spot danger, a study led by the Save Sight Institute at the University of Sydney has discovered. 

The surprising finding published today in Current Biology shows that in humans and other primates, information from the eyes is not only sent to the visual cortex for the complex processing that allows stereoscopic vision, but also could feed directly into deep brain circuits for attention and emotion.

“The brain cells that we identified suggest that human and other primates retain a visual pathway that traces back to the primitive systems of vertebrates like fish and frogs,” said the Save Sight Institute’s Professor Paul Martin who led the team that made the discovery. 

“These connections may not have been lost during evolution of humans and other primates after all,” says Martin, who speculates that primates have the best of all possible visual worlds: full stereo vision, and the ability to quickly spot and respond to danger. 

The ability of the primate visual system to generate 3-D pictures of its surroundings is well recognised – that’s what enables humans to play a game of tennis, and enjoy other fine motor skills such as threading a needle.

To do this, primates have two forward-facing eyes that capture the same view from slightly different angles, and a visual system that keeps information from each eye separate until it reaches the brain’s visual cortex. There, complex processing combines the two views of the same scene to create 3-D vision. 

Rodents, on the other hand, are more preoccupied with detecting and avoiding predators, and their visual systems reflect this: their eyes are on each side of their head, scanning different fields of view, and stereo vision is poor.

In both primates and rodents, messages from the two eyes enters the brain through a small structure called the lateral geniculate nucleus or LGN, which is made of slivers of nerve cells, arranged like sponge in a layer cake. And whereas in rodents LGN cells may fire in response to one or both eyes, until now, neuroscientists had thought that in primates, LGN cells fired only in response to inputs from a single eye.

Now, the Martin team has found a subset of cells, squeezed in between the main LGN layers in marmoset monkeys that fire in response to inputs from both eyes. The properties and connections of these “two-eye” cells resemble cells in the rodent LGN.

“At first we thought we’d made a mistake, but we repeated the experiment, and we were right — the cells responded to inputs from either eye,” says Natalie Zeater, a Centre of Excellence for Integrative Brain Function (CIBF) PhD Student and lead author on the paper.

What’s more, in rodents the two-eye cells hook into sub-cortical areas of the brain such as the amygdala that help process emotion and fear responses, and areas that play a role in an animal’s ability to spot salient events in its environment — an approaching cat for instance. How these primitive circuits work exactly is still mysterious. But they can be traced back in vertebrate brains from fish to frogs to rodents. The available evidence suggests that they trigger an alarm circuit that makes the brain more attentive to important visual cues — those to do with danger or food, for instance.

“There is no doubt that processing of complex visual information in the cerebral cortex is what enables uniquely human behaviours,” says Martin. “But these two-eye cells suggest that other types of visual information are just as important — they allow the human species to survive to engage in the complex behaviours.”

The researchers plan to delve deeper into the function of the two-eye cells, initially investigating whether there are the same direct connections between two-eye cells and emotion-processing centres as there are in rats.

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New book teaches children about vision impairment

Inspired by vision-impaired clients she works with, Sydney-based author Jacqueline Johnson has written a children’s book to raise more understanding of vision impairment in younger children.

Inspired by vision-impaired clients she works with, Sydney-based author Jacqueline Johnson has written a children’s book to raise more understanding of vision impairment in younger children.Her book, “Sarah, Misty and Scribbles’ journey to the house by the sea” stars characters who have a vision impairment.

Each of the characters of Johnson’s book has a different ocular condition: Sarah is missing an eye, Scribbles has scratched eyes, Misty cannot see well despite her eyes appearing healthy and Grandpa and Grandma Monkey wear glasses. “Sarah, Misty and Scribbles’ journey to the house by the sea” explains each condition, and it also offers solutions others can use to help people who have a vision impairment.

“Though there is an educational theme here, I hoped to write the story in a format that appeals to the imagination of the young reader,” Johnson says. “There is an element of mystery and a happy conclusion at the end of the story.”

Johnson believes that her book has a place in educational settings. She states that “Sarah, Misty and Scribbles’ journey to the house by the sea” can be a valuable resource to teachers and parents trying to teach a better understanding and awareness for individuals who have a vision impairment.

“Sarah, Misty and Scribbles’ journey to the house by the sea”

By Jacqueline Johnson

Softcover | 8.5 x 8.5 in | 40 pages | ISBN 9781482829907

E-Book | 40 pages | ISBN 9781482829914 | Available on iTunes and Amazon

Softcover available for purchase at www.sarahmistyandscribbles.com for $15.95.

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Prof McCluskey a highlight at 2015 RANZCO Congress in Wellington

Professor Peter McCluskey attended the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) 2015 Congress in Wellington this week, his Norman Gregg lecture identified as a particular highlight of the event which provides an important platform for interaction and collaboration between ophthalmologists, surgeons and researchers from Australia, New Zealand and internationally.

Professor Peter McCluskey attended the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) 2015 Congress in Wellington this week, his Norman Gregg lecture identified as  a particular highlight of  the event which provides an important platform for interaction and collaboration between ophthalmologists, surgeons and researchers from Australia, New Zealand and internationally. RANZCO organisers said that:

“The Sir Norman Gregg lecture was given by Peter McCluskey who gave us an engaging overview of scleritis reviewing the increased understandings gained by Peter and his co-workers and colleagues over the last 30 years.

“The established system of classifying scleritis as nodular or diffuse is still valid and useful and with good imaging such as good quality ultrasound or high definition MRI posterior scleritis can be classified in the same way.

“The importance of identifying and adequately treating the underlying systemic disease such as rheumatoid arthritis is now well understood and with improved systemic treatment of these disorders the dramatically named scleromalacia perforans has largely been relegated to the history books.

“News to many was that Surgically Induced Scleral Necrosis is usually infective in cause and needs to be aggressively treated with appropriate anti-infective agents.”

For more information about Professor McCluskey’s research into inflammatory eye disease please click here and to make a donation to support this important work please click here and select ‘Inflammatory and Infectious Eye Disease’ from the research areas.

SSI Ambassador wins gold at the 2015 ParaDuathlon World Championships

Save Sight Institute is proud of its Ambassador, Jonathan Goerlach, who is proving everyday that blindness is no barrier to achieving greatness.

Save Sight Institute is proud of its Ambassador, Jonathan Goerlach, who is proving everyday that blindness is no barrier to achieving greatness.

Jonathan has Usher Syndrome, affecting both his vision and his hearing. He represents Australia in the paratriathlon and paraduathlon.

Diagnosed as a teenager, Jonathan struggled to adapt to his new situation for several years before embarking on a personal journey which has helped him to discover a strength and courage he never knew he had.

Jonathan is a role model for young people affected by blinding disorders of the eye.

“It’s been quite a journey for me” said Jonathan to an audience of teenagers at Save Sight Institute’s information day this year “and has involved huge highs and lows. Many lows as I struggled to come to grips with an unknown future. I didn’t know back then what I know now… which is that the only thing which can hold me back is me.”

Jonathan competed in the men’s PT5 in the Paraduatholon in Adelaide last month, (with guide Jack Bigmore), grabbing the gold in a close fought race with Amaud Grandjean (France) with Daniel Searle (also from Australia) picking up the bronze.

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