News

April 2009

The 2009 Evidence Based Ophthalmology Workshop is being held in Adelaide on 6-7 August. For information on program and registration contact Deb Sullivan on sull0085@flinders.edu.au

February 2008

Flinders Ophthalmology will be the home for two new national registries. The Australian and New Zealand Glaucoma Registry has been established by Associate Prof Jamie Craig and his team. The Registry is funded by the Eye Foundation which is affiliated with the Ophthalmic Research Institute of Australia and the Royal Australian and New Zealand College of Ophthalmologists who will contribute $500,000 over the next five years. The purpose of the Registry is to facilitate the identification of factors which contribute to a poor outcome for patients with glaucoma. Glaucoma blindness can in most cases be prevented if those at high risk of developing it are identified and treated appropriately at an early stage. Currently many people at high risk are asymptomatic in the early stages, and are not diagnosed until irreversible vision loss has occurred. Better identification of those people that are at high risk of glaucoma will result in an overall reduction of preventable blindness by treating the condition before any sight loss has occurred. Current research at Flinders is unravelling the genetic contribution to a bad outcome, and the identification of patients who have progressive disease.

For more information visit website www.anzrag.org.

The Australian and New Zealand Ophthalmic Surveillance Unit is being established by Dr Richard Mills and his team to assist Australian and New Zealand ophthalmologists identifiy patients with rare disorders (less common than one in one hundred thousand of population) and study them at a national level. The diseases that will be studied are so rare that research is difficult on an individual basis, but collectively cases from all regions of both countries can be studied as a group and often new information about each disease can be discovered. The Unit is being funded by the Eye Foundation which is affiliated with the Ophthalmic Research Institute of Australia and the Royal Australian and New Zealand College of Ophthalmologists and they hope to contribute $80,000 a year over the next five years.

The Evidence Based Ophthalmology Workshop was conducted for a third year by The Australian Centre for Evidence Based Ophthalmology (part of the NH&MRC Centre for Clinical Eye Research). The 3rd EBO Workshop, which was held in Adelaide in August, aimed to provide an interactive environment for those wishing to learn more about evidence based medicine. Additions to the 2007 program were sessions on elementary statistics and assessments of papers. The computer searching component of the workshop was also held again this year and was extremely well received. Attendance at these workshops is increasing each year as the popularity of them grow. The 2008 Evidence Based Ophthalmology Workshop will be held in Adelaide on 7-8 August 2008.

Awards, Prizes and Medals

Associate Professor Konrad Pesudovs received a Young Tall Poppy Science Award. The Young Tall Poppy Awards recognize and reward young researchers in the first ten years of their post doctoral careers who have made an outstanding contribution to science and research in South Australia. Eight awards were made to young scientists in 2007.

Dr Doug Parker, who has just recently completed his PhD Studies at Flinders, was invited and sponsored by the Australian Academy of Sciences to attend a Nobel Prize Winners retreat in Lindau, Germany in August. The meeting brings together Nobel Prize-winners in Physiology and medicine, and emerging young scientists. Doug is a Sydney graduate in medicine who has been at Flinders Ophthalmology for the last four years. He PhD project was on gene therapy approaches to prolong corneal graft survival.

Dr Alex Hewitt, who has just recently completed his PhD Studies at Flinders, was recently awarded the Jim McBride-White Medal for the best presentation at this year's Royal Victorian Eye & Ear Hospital Meeting. He presented material on the genetic contribution to short-sightedness. His research studies at Flinders concentrated on genetic aspects of glaucoma, work that was performed under the supervision of Associate Professor Jamie Craig.

March 2007

Flinders Ophthalmology received a high level of support from the National Health and Medical Research Council (NH&MRC) in 2006. Researchers were awarded $1.1 million in project grants, fellowships and scholarships. Flinders Ophthalmology has enjoyed generous support from the NH&MRC over many years, receiving its first grant in 1982. In the last three years the group has received $6.4 million from the same source. The successful applicants this year were:

• Keryn Williams, Helen Brereton & Doug Coster: Project Grant $261,750

• Kathryn Burdon, Jamie Craig, Shiwani Sharma & David Mackey: Project Grant $437,250

• Konrad Pesudovs : Career Development Award $445,000

• David Dimasi: PhD Scholarship $75,000
  

Professor Doug Coster has been awarded the Carey Medal for his services to the community.

Associate Professor Konrad Pesudovs , recently given an NH&MRC Career Development Award to support him through the next five years of research, was awarded the Inaugural George Wearing Medal for his contribution to the refractive surgery literature. The award was made by the International Society of Refractive Surgery and was to recognise a paper Associate Professor Pesudovs published last year – Pesudovs K, Garamendi E, Elliott DB. A quality of life comparison of people wearing spectacles, contact lenses or having undergone refractive surgery. J Refract Surg 2006;22:19-27 . Earlier in the year he was the joint recipient of the Peter-Abel Preis 2006 prize. Awarded by Die Vereinigung Deutscher Contactlinsen-Spezialisten e.V. (VDC) for the paper: Marsack JD, Parker KE, Pesudovs K, Donnelly WJ III, Applegate RA. Uncorrected wave-front error and visual performance during RGP wear in Keratoconus. This work was done during his time at The Visual Optics Institute at the University of Houston .Also in 2006, Associate Professor Pesudovs was awarded Best Free Paper Presentation at the 7 th International Congress of Wavefront Sensing and Optimized Refractive Corrections for the paper “Wavefront aberrations arising at the posterior corneal surface in normal and diseased eyes”.

Flinders Ophthalmology was a finalist in the 2006 Premier's Science Excellence Award . The group was cited for the research they had done for “better public outcomes”. Being a finalist was rewarded with a substantial benefit to support future research activities.

2nd Evidence Based Ophthalmology Workshop

In recent times the evidence based medicine movement has been an important force in clinical practice, including ophthalmology. The fundamental purpose of the movement is to encourage clinicians to manage patients on the basis of the best available evidence. However the impact of evidence based medicine extends beyond this. The philosophy of the movement affects every aspect of medicine – the management of individual patients, preparation of best practice guidelines, research priorities, editorial policy of journals and the way research findings are written up. Like all change movements, the evidence based medicine movement has its own language, conventions, procedures and skills.

The purpose of the workshops is to introduce ophthalmologists to new ideas and ways of thinking so that they can provide care to their patients based on the best available evidence and to help them be comfortable with the dominant philosophy of clinical medicine today.

Retinopathy of Prematurity

The improved survival of premature babies is one of the miracles of modern medicine. Very small babies that would have no chance of survival a few decades ago can now survive and thrive. Much of the improvement in the prospects of low birth weight babies is attributable to improvements in the incubators and respirators that can assist or even take over a babies breathing.

Although the majority of very small babies do very well some, fortunately a minority, develop eye trouble. An Australian paediatrician, Kate Campbell was the first to recognize the condition. She worked in two hospitals in Melbourne during the 1950's. One hospital was poor and could not afford the newly developed incubators the other more affluent hospital had. Survival was better in the hospital with incubators but some babies developed a serious and previously undescribed blinding eye condition. The oxygen required to keep very small babies alive affects the blood vessels in the small, premature, developing eye. This condition, retinopathy of prematurity, is increasingly important because smaller and smaller babies are being kept alive and they require considerable amounts of oxygen.

The condition did not exist before incubators for premature babies were invented. Before this many premature babies died. Incubators save many lives. However some surviving babies develop retinopathy of prematurity. Often the condition is mild and of no consequence but in some the outcome is blindness or visual disability.

An intriguing aspect of the condition is that the same exposure to oxygen will do nothing to some babies and create serious and potentially blinding changes in others.

There is a genetic predisposition. Researchers at Flinders Ophthalmology, lead by Professor Keryn Williams, have received financial support from the National Health and Medical Research Council to identify the basis of the genetic predisposition.

The work on retinopathy of prematurity has relevance beyond the neonatal nursery. The condition develops as a consequence of abnormal growth of blood vessels in the premature retina. This is a very similar process to that which underlies many cases of age related macular degeneration and diabetic retinopathy. These conditions also have a strong genetic aspect to them. Only some diabetics develop diabetic retinopathy.

Uncovering the basis of the genetic predisposition and the molecular mechanisms through which it develops will not only facilitate the identification of individuals at risk, but will open up the possibilities of more specific therapies.

Retinopathy of prematurity is a long-standing interest of Flinders Ophthalmology. Dr Glen Gole (now Professor at Brisbane Children's Hospital) received an MD for the research he conducted in this field in the 1980's, and more recently Dr Peter Van Wijngaarden was awarded a PhD for his research on the subject under Professor Keryn Williams.

June 2006

A century of eye transplants

This year marks the hundredth anniversary of the first corneal transplant. The cornea, a thin clear layer at the front of the eye was first transplanted in a human in 1906 by Dr Edward Zirm, an Austrian Ophthalmologist.

Corneas may become cloudy through disease or injury. This prevents light entering the eye and passing through to the light-sensitive retina. Corneal damage is the second most common cause of blindness. Corneal graft transplantation offers a chance for people to see who otherwise may have become blind.

Many changes have occurred since Dr Zirm first performed a transplant on a man that was blinded by lime burns, using the cornea from the eye of a boy that had lost it through injury.

Today, corneal graft transplantation is fairly common, and relatively routine surgery in many cases. There are over 1,000 operations performed in Australia each year, and well over 40,000 annually in the USA.

Due to advances in tools such as microscopy, introduction of antibiotics, use of steroid treatment on the eye surface and improvement in surgical technique, the likelihood of a successful transplant has improved dramatically.

The Australian Corneal Graft Registry (ACGR), based in the Department of Ophthalmology in the School of Medicine at Flinders University has been monitoring the success of corneal graft operations performed in Australia since 1985.

he 2004 report of the ACGR shows that over 70% of grafts survive beyond 5 years.

The success of corneal graft transplantation not only depends on the work of medical professionals but also on the goodwill of the general community through the donation of corneas after they pass away. The generosity of hundreds of South Australians and their families have given many people a chance to see well again that may never have had that opportunity.

The South Australian Eye Bank based at Flinders Medical Centre is responsible for the management of tissue donation for transplantation. In this year of the hundredth anniversary of the first corneal transplant, it seems an opportune time to remind people of the important work of the Eye Bank and to encourage people to donate. Almost anyone of any age, regardless of whether they wear glasses, with healthy corneas is eligible to donate for surgery. The eye bank will never allow transplantation without the consent of the family of the donor, so if it's important to you, you should discuss this with your family.