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Head’s Circular
July 2012
Department
Departmentofof
Optometry
& Vision
Sciences
Infrastructure
Engineering
January 2012
Highlights
1
3
Head’s Report
DOVS Nest
4
Teaching & Learning
4
Clinical Matters
5
Clinical Pearl
7
Research
9
Student News & Safety
Issues
Webb Bridge, Melbourne ©Katy Jones
Head’s Report
The DOVS newsletter — a feast of research offerings
This newsletter will emphasise the research conducted by our department. It is an opportune time to do so, as this year witnessed a significant boost in research verve, highlighted well at the largest annual meeting in Vision Science and Ophthalmology
(ARVO) which was held for its final time in Florida. Next year ARVO moves to the west
coast and will be hosted in Seattle.
I still remember ARVO in its infancy. When I attended my first meetings at Sarasota in
1987-90 ARVO was a small niche group. These were vey special events that brought
scientist together to argue issues surrounded by Florida’s most gorgeous beaches,
sometimes scientific debate could be heard when walking up Lido Key or in the local
cafes, bars or restaurants. I remember going to dinner with Hugh Taylor at one of these
meetings and my children enjoyed the waters, the beautiful sands and the scientific
community: one of my sons was taken fishing by Loren Riggs (Brown University) who
with his wife, were keen fishing people. Such was the convivial environment of the old
ARVO. But from memory not too many people went from the Department in Melbourne in those days (at that time I was a post-doc in Ohio). How things change.
This year if you search the ARVO program you will find 17 presentations from department staff: 2 from Larry Abel’s group; 7 from Bang Bui’s Group: 3 from Andrew Metha’s
group: 1 from the McBrien group: 2 from Allison McKendrick’s group, and 2 from my
group. Most of these were posters although several were papers. Possibly most impressive is that Larry Abel and I have been made Fellows of ARVO and that Bang Bui was
chosen as a moderator for a scientific session this year in recognition of his scientific
standing. Indeed the department has a different face nowadays when it comes to
research.
This year has also seen some interesting outreach. Drs Allison McKendrick and Jonathan
Denniss have been invited to Japan to interact with research groups in that country,
Allison is also visiting Korea. Ms Bao Nguyen and Mr Jason Charng presented at the
50th ISCEV symposium in Valencia, Spain. Jason is undertaking a 4 month overseas
placement at the Pfizer Neusentis Research Laboratory in Cambridge UK. When we last
heard, Jason was radio-labelling GABA receptors in brain in preparation for his return to
DOVS at the Melbourne Brain Centre. Recent success was for Dr Larry Abel who secured research funding and Mr Joe Zhou a travel grant (see p.6)
It is with some sense of satisfaction that I report these changes to the department and
its research profile. At a recent review conducted by Faculty on the Department two
metrics of research output were considered to gauge the department’s standing: the
ARC Research Excellence Australia evaluation (ERA) and the H-index.
If you have any suggestions or items for the next
newsletter, please email:
Elaine Sundaram
([email protected])
Items need to be submitted by
Sept 7 2012.
Volume 2/2012
The ERA evaluation that was conducted in 2010 concluded that UoM achieved a 5star rating that places it at the highest level on an international basis. Interestingly, this
is supported by the departments Hirsch or H-index that ranks the school as 6th on an
international scale. Efron and Brennan (Clin Exp Optom 2011) have recently commented on the pre-eminence of Melbourne trained graduates noting that 7 of the top
10 most cited Australian vision scientists, are individuals who were trained in Melbourne.
To the staff go my congratulations for achieving such impressive outcomes, the future
needs to sustain and build on this solid foundation. To anyone interested, I invite you to
contact me to arrange a visit and see our world leading teams in action, they will inspire you in their effort, application, and scientific zeal and they will make you realise
how modern optometry has changed.
Authorised by the Head of Department, Department of Optometry and Vision Sciences
2
DOVS Nest
Department
Scientific and Educators’ Meeting in Optometry 2012
We are delighted to invite you to participate in the 14th Biennial Scientific Meeting, 8th Educators’ Meeting in Optometry, 2012.
The meeting will be hosted at the University of Melbourne, Australia, and will be
held from Saturday 22nd September till Monday 24th September.
Registration is now open and closes Friday 14th September 2012. Abstracts are due by Friday 17th August.
For more information, please visit: http://www.optometry.unimelb.edu.au/
semo2012
New Staff
Daryl Guest has been appointed as the new clinical director. He will start in this
role on August 14th and we sincerely look forward to him joining our clinical
group.
DOVS is delighted to welcome the following as honorary staff to its teaching
group:
Associate Professor Peter Keller, Head, Advanced Ocular Imaging Service.
Dr Anne Weymouth, Clinical Trial Coordinator (Servier)
Associate Professor Robyn Tapp, Principal Research Fellow
Dr Neil Shuey, Clinical specialist and supervisor (neuro-ophthalmology)
Mr Graham Lakkis, Casual lecturer and tutor
Mr Ian Douglas, Casual lecturer and tutor
UME
Neuro-Ophthalmology Clinic at University of Melbourne Eyecare (UME)
A neuro-ophthalmology clinic at UME has commenced. It is run by Dr Neil Shuey, a Neurologist who has specialised in Neuro-ophthalmology, and Dr Kwang Cham, an optometrist
and academic with the Department of Optometry and Vision Sciences.
The clinic operates every Thursday morning from 9am to 1pm. Examples of conditions managed include double vision, vertigo, facial palsy, migraine, trigeminal neuralgia etc. All
consultations are Medicare bulk-billed. A GP referral is required for patients attending the
clinic.
To book for an appointment call UME at +61 3 93471714
Zeiss donates clinical equipment
The Carl Zeiss company has generously donated two of the most up-to-date perimeters
(Matrix and HFA) as well as providing progression analysis for the existing Cirrus OCT. We
are grateful to David Haupt and the company for arranging this donation in anticipation of
our extended mode of practice.
Volume 2/2012
Authorised by the Head of Department, Department of Optometry and Vision Sciences
3
OD Course Advisory Committee
Teaching
& Learning
Ms Julie Martin
[email protected]
Dr Michael Pianta
[email protected]
The Doctor of Optometry Course Advisory Committee has been established and held its
first meeting on Mon 28 May. The purpose of this committee is to provide advice and
direction to the Department of Optometry and Vision Sciences and the Melbourne
Graduate School of Science to assist in the development, delivery and marketing of the
Doctor of Optometry (OD) course. The committee comprises representatives from relevant stakeholders (e.g. placement providers, Optometrists Association Australia, etc).
The committee will usually meet twice a year.
OD on GEMSAS
The OD Course has achieved its rightful standing on recruitment websites. The course is
being marketed to potential students through the ’Graduate Entry Medical School Admissions System’ (GEMSAS). Please have a look at how the new OD appears at http://
www.gemsas.edu.au/
OCANZ
An OCANZ site visit was held on Tue 22 May. Feedback from the committee was very
positive, and we await the committee’s report.
BIO Simulator
The Department has taken delivery of a new BIO simulator that will be used to teach Optometry students and refresh clinicians in methodology. More details will be provided in
the next newsletter.
Start of Neuro teaching at UME
Clinical
Matters
We are very excited to have started our Neuro Clinic at UME which is being run by Neurologist Dr Neil Shuey with able assistance from Dr Kwang Cham. The Clinic is running at
UME on Thursday mornings and students are assisting with the Clinics operation and getting a chance to see some very interesting cases — papilloedema, nystagmus, Duanes to
name a few. Final year optometry students are involved in patient consultations and are
expected to evaluate cranial nerves, take blood pressure, assess eye movement and
pupil anomalies and be challenged with complex neurological presenting complaints.
Final Year student Capstone Experience - around the world in 80 days!
Ms Anthea Cochrane
[email protected]
Mid May sees our final year students starting to head off overseas for their overseas externships. This year students are heading to Canada, New York, Chicago, Connecticut,
Singapore, China, Nepal, Vietnam, New Zealand, Atlanta, India and Ireland! The overseas externships give our students an opportunity to see how optometry is practiced in
other parts of the world and also to be exposed to different types of eye conditions to
what they might see in our clinics in Australia.
New Zealand is a new overseas site and this will be an exchange site where some of our
students travel to New Zealand at the same time as some of the New Zealand students
travel to Australia. We welcome Suchi Rathod and Soek Lee to our program from New
Zealand.
Funding from DEEWR for student overseas externships
We have been fortunate to receive funding from the Department of Education Employment and Workplace Relations (DEEWR) to assist with the cost of students travel to overseas destinations. The top 22 students (based on their Year 4 average marks) received
funding from DEEWR this year.
Thanks to our contact lens practices who assist with Year 5 placements our students have
been visiting contact lens practitioners during semester 1 to see first hand contact lens
patient management in action.
Thanks to Laura Downie, Sue Trewin, Richard Vojlay and Michael Wicks and their staff for
assisting with these placements.
Volume 2/2012
Authorised by the Head of Department, Department of Optometry and Vision Sciences
4
Transient Visual Loss
Clinical
Pearl
Dr Kwang Cham
[email protected]
Dr Neil Shuey
[email protected]
History
A 22-year-old woman was seen at the University of Melbourne EyeCare Neuroophthalmology clinic complaining of transient visual loss in both eyes that lasted for 1020 seconds. She also reported severe headaches daily with occasional double vision
when looking at extreme right and left gaze. The patient mentioned that whenever she
bent down, she could hear her ‘pulse’. All these symptoms began 3 weeks ago. The patient is not on any medications and is in good general health. However, she reported
recent weight gain of 15kg over the past year. A family member reported that she was
undergoing high levels of personal stress.
Examination Findings
Uncorrected visual acuities were R and L 6/4.8 with +1.00DS R and L. Cover test showed
8PD esophoria at distance (similar in R and L gaze) and orthophoria at near. Ocular
motility revealed bilateral abduction deficit in extreme gaze consistent with bilateral
sixth nerve palsy. Colour vision was normal (Ishihara plate) in both eyes. Pupil reactions
Kevin Teong
were equal with no relative afferent pupillary defect .
[email protected]
mmHg. The patient’s height was 168cm and weight 105kg.
Blood pressure was 114/77
Optic nerve head
Right eye
Left eye
Figure 1: Fundi of the patient
Dilated fundus examination (Figure 1) showed moderate bilateral disc edema (L>R) in
both eyes with clean fundi. Parts of the vessels overlying the discs were obscured. The
veins were dilated (AV 1:3) and tortuous. Both maculae were normal.
Differential diagnoses of disc edema
 Bilateral pseudopapilledema – the most common causes are disc drusen1 and high
hypermetropia

Refractive state rejects high hypermetropia (+1.00DS) and drusen are not visible. The drusen might be buried but the venous congestion (AV = 1:3) suggests
not likely and the concurrent presence of neurologic and systemic symptoms
mandate investigation for other cause of disc edema
 Malignant hypertension with papilledema2

The normal blood pressure (114/77 mmHg) and no evidence of other signs of
hypertensive retinopathy rejects this possibility
 Optic neuritis with disc swelling3


Volume 2/2012
Vision loss typically over hours to days and visual acuity often worse than in this
patient. Presents with orbital pain on eye movement, acquired loss of color vision, relative afferent pupillary defect and visual field defect
Presence of neurologic and systemic symptoms mandate investigation for other
causes
Authorised by the Head of Department, Department of Optometry and Vision Sciences
5
Transient Visual Loss— (Continued)
Clinical
Pearl
 Orbital nerve tumour or intracranial tumour/abnormality4
Dr Kwang Cham
[email protected]

Orbital - typically unilateral disc swelling or very asymmetric if bilateral with mass
that crosses chiasm. Proptosis and restriction of ocular motility often present.
Highly unlikely, but need a CT/MRI scan to rule this out

Intracranial – the papilledema, systemic and neurologic symptoms are consistent with an intracranial mass/lesion or with cerebral venous sinus thrombosis.
This diagnosis is NOT rejected at present and there is a need for scans to do so.
 Idiopathic intracranial hypertension5
Dr Neil Shuey
 The patient’s clinical signs and symptoms fit this diagnosis. Further work-up is required to dismiss the possibility of intracranial mass (above).
[email protected]
Further investigations and results
Kevin Teong
[email protected]
Visual field results
A central (22 deg) neurological visual field test was performed on both eyes. Both visual fields showed an enlarged blind spot typical for papilledema.
Imaging/Cerebrospinal fluid (CSF) analysis

CT – no abnormalities detected

MRI/MRV - no abnormalities detected

Lumbar puncture - normal CSF constituents with mildly increased opening pressure
(27 mm Hg) – note the lumbar puncture was performed at a time when the patient’s symptoms had spontaneously improved considerably
Concluding remarks
The diagnosis of Idiopathic intracranial hypertension is one of exclusion, in this case for
malignant hypertension and intracranial mass/abnormality. A weight loss strategy (low
calorie diet and exercise) is to be aggressively pursued. The patient is reviewed in 4
weeks. The provisional prognosis is good as the patient still retain normal visual acuities,
pupils, colour vision and no presence of significant visual field defects.
References
Volume 2/2012
1.
Lam BL, Morais CG Jr, Pasol J. Drusen of the optic disc. Curr Neurol Neurosci Rep. 2008 Sep;8(5):404-8
2.
Tajunisah I, Patel DK. Malignant Hypertension with Papilledema. J Emerg Med. 2011 Aug 3. [Epub ahead of pri
3.
Protti, A, Spreafico, C, Frigerio, R et al. Optic neuritis: diagnostic criteria application in clinical practice.Neurol
Sci, Sup 3. 2004;s296-s297
4.
Eggers H, Jakobiec FA, Jones IS. Tumors of the optic nerve. Doc Ophthalmol. 1976 Apr 28;41(1):43-128.
5.
Friedman DI, Jacobson DM. Idiopathic intracranial hypertension. J Neuroophthalmol. 2004 Jun;24(2):138-45.
Authorised by the Head of Department, Department of Optometry and Vision Sciences
6
Research &
RHD Matters
Dr Allison McKendrick
[email protected]
Prof Trichur Vidyasagar
[email protected]
A/Prof Andrew Metha
[email protected]
The past couple of months have been an exciting time for Research Higher Degrees
(RHD) at DOVS. We have had one PhD (Doctor of Philosophy) candidate successfully
competing her degree and a further three students submitting their theses for external
review: two for PhD and another for Master of Philosophy (MPhil). We also have a new
arrival to celebrate, and have seen a lot of trafficking of our RHD students across the
planet to attend conferences.
Top 10
The world’s three top-ranked international optometry journals have launched a joint
website featuring hot topics that your peers are reading. Clinical and Experimental
Optometry, Ophthalmic and Physiological Optics and Optometry and Vision Science
each lists 10 papers that are all open access. The website is
www.whatshotoptometry.org and it is free!
2 young researchers from DOVS, Dr Zheng He and Dr Vickie Wong have their article
listed among the top 10. This work has been guided by Dr Bang Bui, and it is pleasing to
see our young staff being recognised by their peers and our profession, congratulations to all.
Recent Publications
On a bimonthly basis, the Department runs ―Press Gallery‖ where recent research publications from our labs are highlighted. Many of these are authored or co-authored by
our research higher degree students. The following papers were available for the April/
May meeting:
―Is primary open angle glaucoma part of a generalised sensory neurodegeneration? A
review of the evidence.‖ O'Hare F, Rance G, McKendrick AM, Crowston JG. Clin Experiment Ophthalmol. 2012 May 18.
―Shape perception is altered by normal aging.‖ Weymouth AE, McKendrick AM. Invest
Ophthalmol Vis Sci. 2012 May 31;53(6):3226-33.
―Electrical stimulation of retinal ganglion cells with diamond and the development of
an all diamond retinal prosthesis.‖ Hadjinicolaou AE, Leung RT, Garrett DJ, Ganesan K,
Fox K, Nayagam DA, Shivdasani MN, Meffin H, Ibbotson MR, Prawer S, O'Brien BJ. Biomaterials. 2012 Aug;33(24):5812-20.
Successful Research Grants
Congratulations to Dr Larry Abel on the success of his application for funding from The
Jack Brockhoff Foundation. Larry and his team have received $26,973 for the project
entitled: ―Investigating the neurobiological and cognitive features of Anorexia Nervosa.‖ Part of this project is being conducted by one of our new PhD students Ms Andrea Phillipou.
Postgraduate Travel Scholarship
PhD candidate Joe Zhou from the Vision and Biophotonics Laboratory was awarded
the 2012 Postgraduate Travel Grant from the Optometrists Association Victoria. The
award was worth $1500 and was used towards the presentation of a research poster at
the Association for Research in Vision and Ophthalmology (ARVO) annual meeting
during May in Fort Lauderdale, U.S. Joe travelled with his supervisors Assoc. Prof. Andrew Metha and Dr Phillip Bedggood, as well as students and staff from other research
laboratories within the Department.
Research Higher Degree Information Session
DOVS recently held an information session for prospective research higher degree students for our BOptom students. Interested students were toured through our new research labs in the Alice Hoy building and Melbourne Brain Centre and processes for
enrollment and scholarship opportunities explained.
Volume 2/2012
Authorised by the Head of Department, Department of Optometry and Vision Sciences
7
Research &
RHD Matters
Dr Allison McKendrick
Research & RHD Matters (Continued)
RHD opportunities are also open to optometrists returning from time in practice or other
activities, and to people with interests in the vision sciences but non-clinical backgrounds. In the past couple of years we have welcomed back several of our past students who have decided to give research a go after several years in practice. Interested people should contact our Postgraduate coordinator, A/Prof Andrew Metha.
[email protected]
Recent Graduates - CONGRATULATIONS!
A hearty congratulation to Dr Vickie Wong, whose PhD thesis,
―Susceptibility of the diabetic rat retina to intraocular pressure challenge‖ received laudable reviews from her external examiners. In
her thesis work, proudly supervised by Dr Bang Bui and Professor Algis
Vingrys, Vickie considered the relationship between diabetes and
the blinding condition, glaucoma. She showed that diabetes makes
the eye more sensitive to increased pressure, and that this occurs
because the eye’s capacity to maintain blood supply is damaged
by diabetes. She provides direct evidence that those with diabetes
may be at greater risk of developing glaucoma.
Prof Trichur Vidyasagar
[email protected]
A/Prof Andrew Metha
[email protected]
We also congratulate the hard work done by our RHD candidates who have submitted
their PhD theses for external review. Eagerly awaiting reports from their respective external examiners, we have PhD candidate Renee Karas and MPhil candidate Nikki
Rubinstein. Both these research theses are in the general field of ―The Ageing
Eye‖: Renee’s PhD work is entitled ―Perceptual surround suppression in older adults‖,
supervised by Dr Allison McKendrick; Nikki’s MPhil thesis is titled ―The effect of ageing
and visual field loss on visuo-motor control‖, and was jointly supervised by Drs Andrew
Anderson and Allison McKendrick.
Rene Karas
Nikki Rubinstein
In breaking news, a third PhD candidate has joined this group: Tina Tsai
has just submitted her PhD thesis, titled ―Functional correlates between
the rat electroretinogram and visual evoked potential‖. Tina’s work was
supervised by Professor Algis Vingrys & Dr Bang Bui, and was supported by
a Melbourne Research Scholarship (MRS). Well done, Tina!
New RHD Student
The Department warmly welcomes Ms Elham Azizi as a PhD candidate working in Dr
Larry Abel’s Eye Movement Laboratory. Her project, ―The effect of action video games
as a rehabilitation technique for traumatic brain injured patients‖, began in April and is
supported by an Australian Postgraduate Award – International (APA-I) and an International Postgraduate Research Scholarship (IPRS).
Information
The Department has a very active research front that it is keen to expand. We welcome enquiries from anyone interested in vision and eye-health related research; our
research programs range from basic neuroscience to clinical outcomes. The University
of Melbourne offers a range of scholarships for local and international applicants. Information about Scholarships can be found at:
http://services.unimelb.edu.au/scholarships/research.
Volume 2/2012
Authorised by the Head of Department, Department of Optometry and Vision Sciences
8
Student
News
UMOSS
[email protected]
With mid-year exams just around the corner, it's been a busy time for staff and students
alike. Station exams, case reports, research projects and group assignments, and with
deadlines approaching thick and fast, student life seems pretty gloomy at the moment.
It's a different story, however, for some. The first group of fifth year students on externships
have just completed their clinical
placements and are keen to begin
their overseas holidays. The countries on offer this year include Canada, China, Nepal, New Zealand,
Singapore, USA and Vietnam.
Taken under the wings of different
optometrists and ophthalmologists
around the world, with different
styles of teaching, communicating
with patients in different tongues
and sampling a plethora of cultural
differences will certainly push students out of their comfort zones,
but integral to providing a wellrounded educational experience.
Meanwhile, the first year OD students have started looking at different equipment to purchase, an investment for their degree and for their careers. Second year OD students
have also just survived their station exams, certainly a harrowing experience, but a rite of
passage on the road to becoming optometrists.
On the home front, UMOSS has tried their best to give the staff and students some much
needed R&R during the busy semester. From ice-skating in March and trivia night in April,
to the more recent end-of-semester BBQ kindly sponsored by Optiqueline, students, clinicians and those from the wider optometry community have had the chance to mingle in
a casual and welcoming atmosphere. Please shower your UMOSS reps, Kristina and Nina,
with thanks and appreciation for all their hard work and quick thinking to move the BBQ
inside on such short notice and to Jonathan for leading the clean-up party after everyone else whirlwinded out of there. These reps would like to give a special shout-out to
some amazing helpers on the day: Emma Brewster, Hannah Thorp, Vianh Huynh, Mina
Teimoori, Jonno Ng and Welson Charngmander; without your help, we would have had
to go fishing for food and most probably had a bout of dysentery disease no amount of
fibre or electrolytes could cure. Lastly, the arrival of the official Unimelb optometry jackets
has also gotten everyone excited and here we must thank Nina (again!) for the time and
effort she has put in to coordinate this.
The next UMOSS event to look forward to is the Bowling and Karaoke Night on the 20th of
August. The UMOSS team looks forward to seeing everyone there and we wish everyone
good luck with their exams!
Visitors
Safety
Issues
Mrs Ana Lara
[email protected]
Volume 2/2012
As part of the relocation process, DOVS has set up a visitor and after hours log book
which will be located on the 4th floor of the Alice Hoy Building next to the lift.
All visitors and staff members will be required to sign in and out and wear a visitor’s
badge outside regular business hours (8.00am-6.00pm). The same will apply to the University of Melbourne Eyecare Clinic based on their opening hours
This is to comply with University & EHS regulations.
Authorised by the Head of Department, Department of Optometry and Vision Sciences