vision News
Spring 2020
Looking to the future The Lions Eye Institute creates a roadmap for the future.
New treatment First in WA to offer new wet macular degeneration treatment.
‘Made in WA’ Drug to tackle the leading cause of childhood blindness.
Lions Eye Institute | 2 Verdun Street Nedlands | (08) 9381 0777 | www.lei.org.au Like many other organisations, the Lions Eye Institute has had to navigate the very real risks and challenges of a global pandemic without a rule book. We have dealt – and continue to deal – with uncertainty, lockdowns, safety and hygiene issues and the many health, social, emotional and financial risks inherent in the spread of the virus.
Above all, we have had to ensure we can continue to save the sight of our patients, no matter what.
To say I’m proud of the way the Institute has performed during these turbulent months is an understatement. Due to the tireless efforts of our committed employees, we have managed to safely see and treat as many patients as possible, in Perth and throughout Western Australia through Lions Outback Vision. From the To you, our patients, thank you for your understanding and your ongoing faith in our ability to care for you. To our donors and supporters, thank Managing Director you for supporting us through these tough times. To our staff, volunteers, collaborators and everyone who is part of the Lions Eye Institute’s family, I offer my sincere gratitude for your dedication and hard work. Hello and welcome to our first Managing Director’s column. Because our newsletter goes to so many of Despite the COVID-19 challenges, our Board and our valued patients and supporters, I thought this management team remained active and continued to column would be a personal and direct way for me to plan for the Institute’s future advancements in both communicate with you about what’s happening at its clinical and research activities. We finalised our the Institute. new research strategy, as part of our broader strategic plan, and have refreshed our organisational values. What a year 2020 has been so far! For eye specialists, You can read more about this later in the newsletter. the term 20/20 – a measure of visual clarity – is part of our daily vernacular. Back in 2019, we naturally We have great plans for the future, including thought the year 2020 would be full of opportunities continuing our ground-breaking research, providing to highlight our work at the Institute under the unparalleled care and treatment, and expanding our 20/20-2020 banner. community outreach work. As always, our work is only made possible by you, and I thank you for your However, with a mind of its own, 2020 stumped us all continued support – it is truly valued. and caused us to redirect our energies to working out how to survive and thrive in a world none of us could I hope you and your loved ones stay safe and well for have foreseen. the remainder of 2020 and beyond.
Thank you from Riley Bill Morgan MB BS, PhD, FRANZCO Riley sends a special thanks to everyone who donated to this Managing Director, Lions Eye Institute year’s EOFY appeal. These times have highlighted the importance of medical research and people like Follow us on social media you who help to make it happen.
lionseyeinstitute lions-eye-institute LionsEyeInstAus Associate Professor Turner said, "Lions Outback North West Vision was extremely grateful to Wen Giving Foundation and Hawaiian Group which donated the Hub Update Kimberley Klub building and associated land as well as being strong advocates for the outreach work."
Refurbishment funding has come from the Australian Government, Australian Capital Equity and The Fred Hollows Foundation. Optical technology companies It’s all systems go at 62 Frederick Street Carl Zeiss, Novartis and Topcon have donated surgical Broome, as the former Kimberley and diagnostic equipment. Klub backpackers hostel begins its transformation into the Lions Eye Exciting developments! This is our first Hub update and we’ll keep you posted on progress. Institute’s first remote eye health care centre – our North West Hub.
Builders began work on the site in the first week of July, kicking off the refurbishment with an interior demolition of the building that will be the new Lions Outback Vision (LOV) clinic.
Phase two of development planning – which includes administration, training, community areas and landscaping for the new clinic – is also well underway.
The transformation of a backpackers hostel to an eye health centre is also a transformation of a dream to reality for LOV McCusker Director, Associate Professor Angus Turner.
“This new base gives us a clinic facility where patients can be seen, using the latest diagnostic equipment,” he said.
“Initially it will be a base for an Aboriginal health worker, optometrist and four resident doctors, and will include an education centre. It also makes monthly visits to more remote Kimberley and Pilbara locations far more efficient and cost effective from a Broome base."
“Ultimately we hope to have a multi-disciplinary clinic, sharing facilities and fostering collaboration with visiting specialists – cardiology, ENT, dentistry, for example.”
With some of the LOV team already located in Broome and the hub under development, the team has begun collaborating with community groups across the Kimberley, organising diabetic education and working with the Broome prison to offer assistance with eye health problems in diabetic inmates.
The Lions Outback Vision team at the front of the Broome Hub
Spring 2020 3 Yearly, comprehensive eye examinations are recommended as preventative care, especially for those 65 and older.
Frederick, patient and Lions Eye Institute nurse Vicki
The new treatment, administered by Associate Professor Chandra Balaratnasingam of the Lions Eye Institute, aims to allow patients with AMD to maintain First in WA good vision with less frequent injections.
Beovu (Brolucizumab), developed by Novartis, is a to offer new TGA-approved Anti-VEGF agent for the treatment of wet AMD. Anti–VEGF treatment improves vision in a wet macular significant number of AMD patients by controlling the growth of new blood vessels under the macula. degeneration Beovu is currently being used under a limited release program with strict guidelines as the long terms effects treatment are being monitored in ongoing surveillance studies. Associate Professor Chandra Balaratnasingam said, “Beovu is a useful addition to the anti-VEGF therapies that are currently available to retina specialists. We EXCITING NEWS… A Lions Eye Institute have a number of effective drugs which block VEGF in the eye. However, the size and pharmacokinetics patient at our Murdoch Clinic is the first of each drug are different. Beovu is the smallest of person in Western Australia to receive the anti-VEGF therapies and there is some evidence a new TGA-approved treatment for wet to suggest it has a longer duration of action in select age-related macular degeneration (AMD). patients, resulting in a need for less injections.” More information about AMD VEGF stands for Vascular Endothelial Growth Factor – a protein produced by cells in your body. VEGF produces new blood vessels when your body needs them.
Retina Then why Anti-VEGF? Sometimes Lens cells can over-produce VEGF, causing abnormal blood vessels to grow in your eyes. These abnormal Cornea Optic cells damage your eye and can er e lead to low vision or blindness.
AMD is a progressive eye condition that occurs when a part of the retina called the macula is damaged. Activities which rely on the macula functioning well are reading, writing, looking at Some of our patients require intensive treatment detailed objects, and colour vision. with frequent visits to the Lions Eye Institute for anti-VEGF injections over many years, causing a significant burden for the patient, their carers and There are two types of AMD - dry and wet. the health system, and sometimes resulting in Most AMD starts as the dry type and under-treatment and sub-optimal visual outcomes. progresses to the wet type. Frequent patient visits for injections has also been a consideration for the Lions Eye Institute during Wet AMD is rarer and leads to sudden COVID-19 as we endeavour to lessen risk. and significant changes in vision, due to VEGF caused vessel damage. “Results from clinical trials indicate that Beovu may have wider application than solely for wet AMD and could be effective for treating vision loss due to Those most at risk of developing other conditions such as diabetes and retinal AMD are people with a family vein occlusion," Professor Balaratnasingam said. history, people over the age of 75 and smokers. The approval of Beovu was based on findings from the Phase III HAWK and HARRIER clinical trials. The Lions Eye Institute participated in the HAWK A healthy diet rich in antioxidants and clinical trials and is also currently participating in regular exercise is important in reducing the TALON, RAVEN and KESTREL studies which are the risk of macular degeneration and in assessing the use of the same product for different slowing the progression of the disease. eye conditions.
We are constantly undertaking a range of ongoing clinical trials here at the Lions Eye Institute. If you notice sudden changes in your If you would like more information, email central vision, or your ability to see colours [email protected] and fine detail becomes impaired, see your optometrist, doctor or ophthalmologist to rule out AMD as the cause.
Spring 2020 5 Focus on vision
Of all our senses, eye sight is the one we value the most.
For those of us who have good vision, our eyes open in the morning and the world instantly reappears to us – the light, the landscape, our homes, our families.
And while this most powerful facility comes to us effortlessly, in reality our eyes are intricate and fragile organs which need our care. While they’re looking out for us, we need to look after them. Professor David Mackey AO That’s why every year July is a big month for eyes – it’s ‘JulEYE’ – national eye health awareness month. Professor David Mackey AO is a clinician, scientist and academic. In 2019, he was awarded an Order JulEYE is an initiative of the RANZCO Eye Foundation of Australia for distinguished service to medicine, in (Royal Australian & New Zealand College of the field of ophthalmology. A renowned international Ophthalmologists) which annually aims to raise researcher on the genetics of eye disease, Professor community awareness of eye health and to encourage Mackey leads the Lions Eye Institute’s genetics and Australians to have regular eye checks. epidemiology research group which pursues multiple Perth ABC Radio’s Focus program recently put the projects aimed at understanding how genes and spotlight on vision and the Lions Eye Institute’s environment interact to influence an individual’s risk Professor David Mackey AO, discussed all things eyes of eye disease. with the program’s host Jessica Strutt. In case you didn’t catch the show, here are some excerpts in Q&A format.
Jessica Strutt: How important is eye health?
David Mackey: Eye health is critically important. It’s actually the most valued of our senses. People who have poor vision can have trouble functioning. The main things people complain about if they’ve lost their vision significantly, are that they can’t read, they can’t recognise people’s Save the date faces, they have trouble getting around and they can’t drive safely. We invite you to join Jessica Strutt: Professor David Mackey’s presentation: What is the focus of this year’s RANZCO JulEYE campaign? Why do we wear glasses? David Mackey: This year’s campaign is looking at the prevention of eye When: 12pm Monday 19th October injuries, and although I’m a genetics researcher – we Where: McCusker Auditorium, Harry Perkins Institute look at the way genes and environment interact – we’re of Medical Research, 6 Verdun Street, Nedlands doing extensive research on prevention of eye injuries RSVP: [email protected] or 9381 0795 in children here in WA.
This lecture is FREE to attend. This year, we’ve also been looking at the impact of the 50 years – before smart phones, tablets and increased lockdowns associated with COVID-19 on eye injuries screen times. What these kids were doing was studying and other aspects of eye health. What we found over hard and staying inside, so we think this is the main the last three months with the COVID-19 restrictions, contributory factor in why East Asia has lots of myopia. particularly with outdoor sports, was that there’s been a Australia has very little myopia and the flipside of the significant reduction in kids coming in with eye injuries coin here is that we do spend a lot of time outdoors. due to sport. You need to have your kids going outside to prevent them from developing myopia. The Lions Eye Institute was very fortunate 10 years ago to receive a gift from the estate of the late Joyce Jessica Strutt: Henderson to set up a fellowship position to specifically What advice would you give people about trying to lessen look at the prevention of children’s eye injuries and the chances of getting myopia? we did some major audits of injuries relating to children’s sports. David Mackey: I think especially with the increased stay at home Probably the most important sport for severe eye messages that we have had from COVID-19, you can injuries was squash. A squash ball is about the size of be ‘at home’, but you don’t have to be ‘in’ the home. an eyeball, and is small enough to go straight onto the If your kids want to be at home reading, you can have eye, and cause a massive increase in pressure or rupture them sit outside or in a sunny room of the house. the eye or cause major bleeding. Eye protection is recommended for playing squash and all of the squash Jessica Strutt: courts will usually mandate that. How often should we be getting our eyes checked? What are the key signs that you need to get your One of the great things about organised sport is that eyes checked? you can give recommendations to sporting bodies about the use of head and eye protection. So with different David Mackey: sports we can recommend to the governing bodies, If you’re having trouble with your vision, then it’s schools and other organisations that they make sure kids important to get your eyes checked. Most of the time it are wearing eye protection. will just be getting your glasses fine-tuned. However, if you have a family history of age-related macular Jessica Strutt: degeneration, glaucoma or if you have diabetes, then What about the flip side to the COVID-19 issue – we’re it’s important to have regular eye checks. Then you’ll spending more time presumably on screens these days. What get recommendations on whether you’re high or low is the impact on children’s eyes of screen time? risk and how often you need to be seen.
David Mackey: One of the big studies we’re doing in conjunction with The issue is probably not the screens themselves - the Lions Outback Vision is a targeted family screening issue is being inside and looking up close at screens and program where we’re talking to people with glaucoma reading them that increases the risk of myopia. and asking them: “Who are your brothers, sisters, sons and daughters”? Then we’re contacting those family People also need to be careful about keeping children members and saying “mum or dad’s got glaucoma, away from laundry and kitchen chemicals, cleaning you’re at risk and we need to do a check and we can products and the contents of the garden shed. If anyone organise this for you”. A pilot study on this was done in gets a chemical in the eye, it’s very important to wash it Tasmania and South Australia and showed it was very out with running water immediately. effective. So now we’re running this out through all Jessica Strutt: of remote and regional WA in association with Lions What is myopia and what age groups are most at risk Outback Vision. This way we can pick up people who of that? don’t have eye services or eye checks regularly and encourage them to come along when the Vision Van’s David Mackey: in town. Myopia is when people can’t see things clearly at a distance. This affects about 20% of children ending high JulEYE is an initiative (and trademark) of RANZCO, school and starting university in WA – this information through its Australian & New Zealand Eye Foundation came from the Raine Study. If you compare this with (ANZEF). children in East Asia, say, China, Singapore and Hong Kong, 90% of kids going to uni are short-sighted and this massive increase has happened in East Asia over the last
Spring 2020 7 RP begins in childhood and inevitably leads to From discovery blindness in patients between the ages of 20 and 40. There are currently no treatments available. to delivery Head of the Lions Eye Institute’s Ocular Tissue Engineering Laboratory, Dr Fred Chen, together with Professor Sue Fletcher, Chief of Research and Development at PYC and of Murdoch University, have ‘Made in WA’ drug to tackle the leading undertaken ground-breaking research resulting in cause of childhood blindness. an experimental drug that can correct the deficiency responsible for one form of RP (RP11) in cells derived from patients with the disease. In developing what is potentially the first ever drug conceived and designed in Perth, researchers from the Lions Eye Institute and PYC Therapeutics Their results have been so promising that it attracted are creating an innovative and highly promising the attention of PYC and gained its Board’s support experimental treatment for Retinitis Pigmentosa (RP), to advance the program to the clinic, with subsequent the leading cause of youth blindness in Australia. testing of the drug in humans scheduled to begin late next year.
More about Retinitis Pigmentosa (RP)
Retina Lens