Download Capabilities and professional highlights

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Capabilities and
professional highlights
Innovation
Undertaking scientific
research and creating
technology that will
provide better
solutions, transform
the eye care
of the future and
Licensing
improve peoples’
lives everywhere
Translating our
science into
commercially
viable products
and solutions
Education
Developing and
delivering a range of
eye care courses to
teach different skills
Public Health
from the community level to
professional development
Building local
and sustainable
systems – with
local people trained
to deliver quality
eye care services
Who we are
Brien Holden Vision Institute
is a non-profit global, scientific,
research, innovation, education,
licensing and public health
organisation, dedicated to providing
creative and advanced solutions to
ensure the provision of excellent vision
for everyone, everywhere.
Brien Holden Vision Institute
is a social enterprise, investing the
revenues from its work into translating
our science into solutions and
developing and delivering eye care and
education programs around
the world.
Our commercial entities,
the Brien Holden Vision (BHV)
companies, are bringing products to
market that will improve eye care and
generate revenues for our mission.
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Brien Holden Vision Institute Capabilities and professional highlights
Mission: Vision for everyone...everywhere
Through science and technology, research and development, education and public health initiatives, we will develop and
implement, globally, new and better solutions for vision care and blindness prevention that will improve the quality of
peoples’ lives and help reduce disability and poverty.
Values
•Sight is a fundamental right for all humans; vision excellence for all people is our obligation.
•Our passion for science and innovation is driven by the pursuit of knowledge that will create resources and solutions
to benefit all humanity.
•Our behaviour is influenced by global collaborations, local partnerships and cultural understanding, and the core principle
of sustainability.
•Our translational research is aimed at enabling better products that will enhance quality of life for all.
Goals
•To continue as the premier applied vision correction research institute in the world.
•To provide excellent and equitable vision care solutions globally.
•To be a leading centre for the advancement of optometry’s role in vision care, education and research.
•To achieve sustained growth in revenues for research, education and public health through product development.
•To establish and maintain best practices for motivating, managing and developing staff.
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Brien Holden Vision Institute Capabilities and professional highlights
5
Why we do what we do
Myopia
Uncorrected refractive error
•1700 million people with myopia in 2010; 2200 million
with myopia in 20201
•625 million people in 201410,18
•80%–90% of high school graduates are myopic in urban
areas of Singapore, China, Taiwan, Hong Kong, Japan and
Korea2
•U.S. – rise in the prevalence of myopia from 26%–43%
among adults from 1971–72 to 1999–20043
•Myopia significantly increases the risk of cataract4
(3.3X for myopia >6.00D), glaucoma5 (14.4X for myopia
>6.00D) and retinal pathology6 (7.8X for myopia >8.00D)
•517 million with uncorrected near vision impairment
(presbyopia)10 and 108 million with uncorrected distance
vision impairment18
•Vision impairment due to uncorrected distance refractive
error costs the world US$202 billion per year in lost
productivity, direct and indirect costs19,20
•US$28 billion is the one-off cost of providing
comprehensive eye care worldwide20
Child eye health
•Myopic macular degeneration is the number one
cause of blindness in Shanghai, China7 and Tajimi,
Japan8; 6%–22% of blindness in various countries is
due to myopia9
•1.4 million children worldwide are irreversibly blind for
the rest of their lives21
Presbyopia
•80% of what a child learns is processed through the
visual system22
•1040 million people with presbyopia in 200510
•Quality of life impact of uncorrected near vision
impairment (presbyopia) similar to uncorrected distance
vision impairment11
•An estimated 19 million children are vision impaired
(12 million due to refractive errors)22
Deficit of eye care practitioners
worldwide
Diabetic retinopathy
•47,000 functional clinical eye care providers needed
globally – to assess vision and eye health and prescribe
corrective lenses needed to restore good vision20
•347 million people diagnosed with diabetes in 2008
(up to 50% of diabetes undiagnosed)12,13
•18,000 optical dispensers needed globally – to provide
appropriate glasses20
•Diabetic retinopathy occurs in nearly all patients
with type 1 diabetes and >60% of patients with type 2
diabetes during the first two decades of disease14
Contact lens comfort and visual
performance
•Diabetic retinopathy is the leading cause of blindness
among working-age adults in the world.15
•5% of all contact lens wearers drop out annually due to
discomfort or dryness23
Dry eye
•140 million contact lens wearers in 2014; by eliminating
discomfort and dryness the market could potentially grow
to 190 million24
•Affects 5%–35% of the population; prevalence increases
with age and among certain ethnicities16
•20% of presbyopes who drop out of contact lens wear
annually do so because of poor visual performance24
•Artificial tear market globally is estimated to be
US$2 billion by 201817
•20 million presbyopic wearers in 2014 could increase to
35 million by 2020 by improving visual performance24
Myopia (near-sightedness) and
presbyopia (ageing sight) are two eye
conditions that are rapidly having an
immense impact on the visual welfare
and social well-being of the world.
It has been estimated that up to 60%
of the world’s population require some
form of vision correction for myopia,
hyperopia, astigmatism, presbyopia
(all ‘refractive errors’) or other clinical
needs.25
Yet, over 625 million do not have
the eye examinations and glasses
they need to see for distance or
near vision,10,18 162 million have
avoidable vision loss due to untreated
disease18 and, unnecessary blindness
and impaired vision is not being
comprehensively prevented.
Furthermore, evidence is mounting
that a major vision impairment
and blinding condition – yet to
be prioritized by the World Health
Organization (WHO), the major NGOs
and research agencies – known as
myopic macular degeneration (MMD),
will become the major cause of
blindness in Asia and a growing threat
for many other countries where the
prevalence of myopia is on the rise.
The numbers alone suggest an
impending crisis. We believe there
were around 1.7 billion myopes
worldwide in 2010 and that this will
increase to around 2.2 billion by 2020,
with a significant number living in
urban areas of Asia.1
The other major concern is for
presbyopia, which affects over 1 billion
people and is expected to increase to
1.5 billion by 2050.10
History
In the early 1970s a group of researchers led by Professor
Brien Holden at the School of Optometry, University of
New South Wales (UNSW), began developing expertise in
contact lenses – a relatively new form of vision correction
at the time.
Strong collaborations with international researchers
followed and the group’s research output attracted industry
funding, leading to further expansion and the establishment
of the Cornea and Contact Lens Research Unit (CCLRU) at
UNSW in 1976. Over the next four decades the group built
a reputation as one of the leading contact lens and vision
correction research centres in the world and spawned a
number of global education and humanitarian initiatives.
In 1985, the Institute for Eye Research was established
by the founders of the CCLRU as an independent but still
university affiliated, research organisation. While the CCLRU
continued for some time it was the Institute that soon
flourished, inheriting many of its researchers, expertise
and reputation.
In March 2010, the Institute for Eye Research was proudly
renamed the Brien Holden Vision Institute in recognition of
the outstanding contribution to eye care research and global
public health of one of its founders, Professor Brien Holden.
The group broadened its focus beyond vision correction
products and in 1998 founded the International Centre
for Eyecare Education (ICEE), with the objective of building
eye care systems in developing communities to treat the
625 million people unnecessarily blind or vision impaired
globally. This formally became part of Brien Holden Vision
Institute in 2012.
Along the way, Professor Holden and colleagues also
established the Cooperative Research Centre for Eye
Research and Technology (CRCERT) in 1991, followed by
the Vision Cooperative Research Centre (Vision CRC) in
2003, both based at UNSW and attracting a global network
of collaborators, to pursue major research and technology
breakthroughs.
Research breakthroughs and product development
emanating from these organisations provided the impetus
and a revenue stream for Brien Holden Vision Institute to
Product development timeline
1972
Comfortable,
well performing daily
wear hydrogel spherical
and toric lens
(Zero 6® Hydron)
1975
1983
Extended wear soft
lenses, co-designed
Permalens® and
Permaflex® extended
wear soft contact lenses
1970
The Institute developed the first centre
distance and centre near soft bifocal
combination for treating presbyopia
with concentric bifocal contact lenses
(CooperVision)
1980
1990
1973
1985 - 1994
Endothelial response to contact lens wear
Saw methods develop for the definition of
the oxygen needs of the eye, methods of
using and screening extended wear lenses
which led to high Dk silicone hydrogel
lenses, (CIBA VISION, Bausch & Lomb)
move further ahead in creating improved ways of correcting
vision, with a particular focus on the most common
eye conditions – myopia, presbyopia, hyperopia and
astigmatism.
In 2010 a new stream of programs pursuing breakthroughs
in contact lens comfort, treatments for myopia and
presbyopia, and to enhance delivery of vision care to
Aboriginal and Torres Strait Islander Australians and
developing communities worldwide, began through a
5-year funding extension to Vision CRC from the Australian
Government. Development of an ‘intelligent retinal camera’,
a low-cost imaging technology that will accurately and
rapidly detect, and eventually diagnose, sight-threatening
conditions such as diabetic retinopathy and glaucoma,
was initiated in 2012, when further funding was awarded.
Outlook
In 2015, funding for Vision CRC ended, with the legacy
of nearly $100 million of Australian Government
investment across both CRCERT and Vision CRC. The
1998
The silicone hydrogel invention,
released initially by CIBA VISION as the
Focus® Night and DayTM contact lens
now accounts for more than 50% of soft
contact lens sales globally
research and industry networks, a significant percentage
of the intellectual property, and expertise in managing
collaborative projects, generated over 25 years, will
transition to Brien Holden Vision Institute, the major
participant in these organisations.
Vision CRC research to be carried forward by the Institute
includes the Intelligent Retinal Camera, Myopia Control and
Accommodating Gel projects.
Brien Holden Vision Institute is also pursuing breakthroughs
in contact lens technologies for treatment of refractive
errors, comfortable contact lenses that provide greater
comfort than no lens, and advanced dry eye treatments.
Furthermore, the Institute is extending its research scope
beyond vision correction, including an exciting project
developing a neuro-ophthalmic device (NODe), that can
measure pupillary response and eye movements to aid
in the diagnosis of a broad range of disorders affecting
the visual system, including: concussion, stroke, brain
tumour, Alzheimer’s disease, Parkinson’s disease and some
psychiatric disorders.
2009
Our collaboration with CIBA
VISION resulted in the AIR OPTIX®
AQUA MULTIFOCAL contact
lenses for correction of presbyopia
which is now the largest selling
multifocal in the US today
Present
In development:
•new generation multifocal/
extended depth of focus
contact lenses
•innovative myopia
control lenses
•comfort enhancing
moisture solutions for dry
eye and contact lens care.
2000
2002
2010
Our soft toric contact lenses design
for the correction of astigmatism
were successfully launched as the
Biomedics® Toric and later as the
Biofinity® and Avaira® toric lenses
MyoVisionTM spectacle lens was released
by Institute partner, Carl Zeiss Vision.
The spectacle lens was found to slow the
progression of myopia by 30% in children
with at least one myopic parent
Our capabilities and
professional highlights
Innovation – Science and research
Licensing
Education – Human resource developement
Public health – Sustainable service delivery
•Achievements
•Current products and outlook
•Clinical research
•Technology
•Biological sciences
•Chemistry
•Intellectual property management
•Commercialisation
•Strategic partnerships
•Investments
•Professional education programs
•Postgraduate research education
•Brien Holden Vision Institute Academy
•Education resources
•Child eye health programs
•Vision centres and outreach services
•Social enterprise
•Spectacle supply – Global Resource Centre
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Innovation
Science and research
Achievements
Brien Holden Vision Institute has driven
market trends through breakthrough
technologies and collaboration.
Product success
•Our collaborative development
with Ocular Sciences Inc. (now
CooperVision) for soft toric
contact lenses for the correction
of astigmatism has seen what
was previously an infantile market
develop into a market that is now
growing two times faster than that
of spherical lenses.
•Co-development of the silicone
hydrogel polymer with CIBA VISION
(now Alcon) has created a class of
material that now accounts for more
than 50% of the soft contact lens
market in the U.S.
•Development efforts in multifocal
soft contact lenses with CIBA VISION
(now Alcon) has seen that market
segment grow from 5% to over 8%,
and is forecast to grow by more than
50% per annum going forward.
Sales accrued and royalties generated
Sales from products co-developed
by the Institute:
•all silicon hydrogel contact lenses
•CooperVision soft toric lenses
•Alcon AIR OPTIX® AQUA MULTIFOCAL
lenses
… are expected to total $37 billion in the
20 years since release onto the market.
Royalties returned to the Brien Holden
Vision Institute on these products so
far amount to around $200 million.
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Brien Holden Vision Institute Capabilities and professional highlights
Innovation
Expertise
Research achievements
•Clinical evaluation of contact lenses, multipurpose
solutions, spectacles, new instruments and techniques
•Approximately 1100 peer-reviewed publications
•microbiology
•2014 Charles F. Prentice Medal – optometry’s
highest scientific honour – awarded to Professor
Brien Holden
•cell and molecular biology
•2013 Garland W. Clay Award from American
Academy of Optometry for a manuscript
published in Optometry and Vision Science
that has been most widely cited in the world of
scientific literature in the preceding five years.26
•biochemistry
•immunology
•chemistry
•instrument design and development
•precision optical and biomedical engineering
•software development and engineering – especially in
data and image acquisition and analysis
•metrology work, specialising in ophthalmic and optical
components and devices
Landmark findings (5 most cited papers)
•Holden BA, Sweeney DF, Vannas A, Nilsson KT & Efron
N. ‘Effects of long-term extended contact lens wear on
the human cornea’, Investigative Ophthalmology & Visual
Science, Vol 26 Nov 1985.
•Stapleton F, Keay L, Edwards K, Naduvilath T, Dart JKG,
Brian G & Holden BA, ‘ The incidence of contact lensrelated microbial keratitis in Australia’, Ophthalmology,
2008; 115:1655-1662.
•Holden BA & Mertz GW, ‘Critical oxygen levels to avoid
corneal edema for daily and extended wear contact
lenses’, Investigative Ophthalmology & Visual Science, Vol
25 1984.
•Naidoo KS, Raghunandan A, Mashige KP, Govender
P, Holden BA, Pakharel GP & Ellwein LB, ‘Refractive
error and visual impairment in African children in South
Africa’, Investigative Ophthalmology & Visual Science,
2003;44:3764-3770.
•optical modelling and design, including visual optics.
Key collaborators
•Bascom Palmer Eye Institute, University of Miami, U.S.
•Dr Tom Aller, U.S.
•Johns Hopkins University, U.S.
•LV Prasad Eye Institute, India
•Shanghai Eye Disease Prevention and Treatment Centre,
China
•University of Alabama at Birmingham, U.S.
•University of Houston, U.S.
•Zhongshan Ophthalmic Centre, Sun Yat-sen University,
China
•Holden BA, Mertz GW & McNally JJ. ‘Corneal swelling
response to contact lenses worn under extended wear
conditions’, Investigative Ophthalmology & Visual Science,
February 1983.
Brien Holden Vision Institute Capabilities and professional highlights
13
Current products and outlook
for the future
Extended depth of focus (EDOF)
contact lenses
Many commercial multifocal lenses
claim to provide simultaneous vision at
various visual distances but often this
comes at the cost of reduced contrast,
increased ghosting and compromised
overall vision satisfaction. These
shortcomings are often exacerbated
with low illumination levels. Such
visual compromises have been
associated with an increase in patient
dropout rate and lack of confidence in
fitting by practitioners.
Our EDOF contact lenses:
40 years
of innovation
1998
SILICONE HYDROGEL
CONTACT LENSES
SILICONE HYDROGEL CONTACT
LENSES, the class of contact lens
materials that has captured over
half of the $7 billion global contact
lens market was co-invented by the
Brien Holden Vision Institute as part
of a CIBA Vision and Vision CRC
collaboration.
This class of materials now
accounts for more than 50% of the
soft contact lens market worldwide.
•use higher order aberrations to
optimise retinal image quality over
a wide range of distances from far
to near while eliminating ghosting
and haloes
•perform relatively independent of
patients natural aberrations and
variation in pupil size
•are designed to meet the vision
needs of emerging, moderate and
advanced presbyopes.
EDOF technology for presbyopia
The Institute is currently developing
a range of EDOF contact lenses,
incorporating higher order aberrations,
which are designed to provide optimal
visual performance from distance to
near with minimal ghosting.
The range of EDOF designs aim
to deliver a vision solution for all
presbyopes including emerging, early,
medium and mature presbyopes.
EDOF technology for myopia control
We did that
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Brien Holden Vision Institute Capabilities and professional highlights
The Institute has designed contact
lenses using EDOF technology that
influence retinal image quality and eye
growth and thus myopia progression.
The technology is being assessed in
clinical trials.
Innovation
Dry eye drop
We are developing a dry eye over-the-counter (OTC) drop
that will protect against bacterial lipases and help maintain
a healthy tear layer. This is the first such product on the
market that directly targets the etiology of dry eye. The
Institute believes this BHV-Artificial Tear product could
revolutionise the dry eye/comfort drop market.
Revolutionary treatment for presbyopia and cataract
The Accommodating Gel project is developing a clear
gel-lens system that will replace the old presbyopic or
cataractous lens. The lens is removed during a simple
procedure and replaced by the polymer gel. Existing
‘mechanical’ accommodating intraocular lenses have
shown limited accommodative power – around 1.00 D to
1.50 D. In contrast, internal tests on an earlier gel prototype
have shown accommodative amplitude comparable to the
focusing ability of someone in their early 20s.
Intelligent retinal imaging technology for detecting and
diagnosing eye disease
In development is the most advanced technology for use in
real-time detection and assessment of common blinding eye
disease and general health disorders. The Intelligent Retinal
Camera will accurately and rapidly detect, and eventually
diagnose, sight-threatening conditions such as diabetic
retinopathy and glaucoma. The camera is being designed
for ease of use in the most extreme environments so that
it can be used by technical support staff and in the most
remote and under-served locations.
Neuro-ophthalmic device (NODe)
Brien Holden Vision Diagnostics is developing a neuroophthalmic device that can measure pupillary response and
eye movements to aid in the diagnosis of a broad range of
disorders affecting the visual system.
This exciting new product will likely have applications in the
following areas:
•ophthalmology to measure visual fields, vergence, phorias
and tropias, saccadic movements and smooth pursuit
movements
•neurology to diagnose concussion, stroke, brain tumour,
Alzheimer’s Disease, Parkinson’s Disease and some
psychiatric disorders
•long-term patient care to evaluate and track the impact
of treatment.
Brien Holden Vision Institute Capabilities and professional highlights
15
Clinical research
Australia
Brien Holden Vision Institute
Sydney
Our Clinical Research Trial Centre
in Sydney is a specialised clinical
research facility with capabilities and
programs specifically designed to meet
the needs of the ophthalmic and vision
care industry.
Dedicated clinical research teams
aim to identify and understand
clinical problems by evaluating the
performance of contemporary products.
We have the capacity, technical
expertise and experience to generate
effective product-based solutions.
Extensive laboratory facilities and the
expertise of the scientific team provide
a vital adjunct by enabling in-depth
evaluation of the interaction between
products and the ocular environment.
Clinical research activities are
dedicated to developing and testing
products for vision correction, including:
•contact lenses
•contact lens solutions
•spectacles
•new instruments and techniques.
All optometrists are highly qualified,
required to demonstrate concordance
at regular intervals, and undergo
regular training to maintain and
enhance general and specialised
optometric skills.
Local and international regulations
and guidelines met include:
•National Statement on Ethical
Conduct in Human Research
•Access to Unapproved Therapeutic
Goods
•Good Clinical Practice
•Declaration of Helsinki.
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Brien Holden Vision Institute Capabilities and professional highlights
Innovation
We currently have almost 3000 active participants on
our comprehensive register, with a range of ages and
backgrounds, on the database of our Sydney facility.
Brien Holden Vision Institute has clinical research centres in
China and India and three overseas collaborators for trials
that require special populations or a larger sample size.
China
Brien Holden Vision Institute
Guangzhou
India
Brien Holden Vision Pvt. Ltd.
Hyderabad
Developing and coordinating clinical and marketing studies
related to the use and performance of products in India and
the region, such as:
•intelligent retinal imaging system
•myopia control products
•products for presbyopia and other advanced technology
Clinical trials facilities and expertise allowing for
assessment of key factors associated with development and
progression of refractive errors and other ocular conditions,
product development and testing for vision correction,
including:
•innovative, sustainable vision care delivery systems and
facilities.
•contact lenses
•One of the leading eye research, teaching and treatment
hospitals in India
•contact lens care solutions
•spectacles
•new optical instruments and techniques.
Zhongshan Ophthalmic Centre at Sun Yat-sen University
Guangzhou
•The major provider of advanced eye care in China
•integrating teaching, eye research and blindness
prevention activities
•treating nearly 500,000 outpatients and conducting
30,000 surgeries each year.
LV Prasad Eye Institute (LVPEI)
Hyderabad
•World Health Organization Collaborating Centre for
Prevention of Blindness
•served over 18 million people since 1987 awarded 35
PhDs and published over 1550 research papers.
South Africa
African Vision Research Institute (AVRI)
Durban
Our partnership with AVRI enables access to the University
of KwaZulu-Natal optometry discipline, and through this, the
capacity to conduct clinical research and product evaluation.
Brien Holden Vision Institute Capabilities and professional highlights
17
Technology – novel instruments and know how
Improvements
Instruments critical to understanding the performance
of the eye and novel vision correction devices can be
designed and custom-built by our in-house technology team,
enhancing research possibilities.
•Modified Autorefractor (2007)
•Aberrometer (2009)
•Measuring Microscope (2013)
Comprising highly-skilled engineers, scientists, optometrists
and technicians, the Technology team offers tremendous
knowledge and skills related to vision science, optical
design, software development and biometry and metrology
system engineering, possessing services in the areas of:
Biological sciences
•contact lens metrology
•developed and validated clinical assessment tools
•material testing.
Our novel instruments
•Optical modelling and lens design (ongoing since 1980s)
•Optical Quality Analyser (1985)
•CRCERT-Belmonte Aesthesiometer (1998-2000)
•Ex Vivo Accommodation Simulator (2002-2005)
•Eye Tracker (2003-2004)
•Micro-Tensometer (2003-2004)
•Model Eye (2007-2011)
•EyeMapper (2007-2011)
•OCT Profilometer (2014)
•Friction Meter (2015)
Our Biological Sciences team undertakes research that
enhances our understanding of ocular health and explores
novel avenues of combating ocular diseases. These
investigations are vital in predicting the ocular response to
new and existing contact lens designs, as well as contact
lens solutions and cases.
Research and product development capabilities are in
the core areas of microbiology, cell biology, biochemistry,
molecular biology and immunobiology, including:
•diagnostic microbiology
•evaluation of antimicrobial efficacy of contact lens care
products and hygiene practice
•determination of efficacy of novel antimicrobials
•cell culture facility
•biochemical analysis of tears, meibum and contact
lens deposits.
Technology development highlight
– modified pachometer
Innovations in technology and instrumentation often pave the
way to new scientific and industrial breakthroughs. The Institute
recognises this and has, from its earliest history, maintained
world-leading developments in metrology and biometry systems.
For example, in 1979, we optimised the optical pachometer
for high accuracy and direct data acquisition. Harnessing
the capabilities provided by the early personal computers
and enhancing the resolution by the coupling of precision
potentiometer to the basic pachometer, the Institute’s
pachometer provided the technology platform that enabled
the first overnight corneal swelling studies to be conducted.
These studies led to the definition of the minimum oxygen required to maintain a healthy cornea during overnight
contact lens wear. Our discovery provided the target specifications that eventually saw the availability of the first
silicone hydrogel contact lens and the accompanying silicone hydrogel revolution.
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Brien Holden Vision Institute Capabilities and professional highlights
Innovation
Chemistry
Medical device design and manufacture capability are
provided through our entity, Brien Holden Vision Pty Ltd, with
laboratory activities conducted as part of an EN ISO 13485
compliant quality management system. This includes:
•qualification of components in formulations:
•polymer synthesis capability
•qualification of components:
•polymer characterisation, inclusive of in-house gel
permeation chromatography (GPC) and rheology
- materials specification
- raw materials identification and procurement
- shelf life testing
- reagent compatibility.
Brien Holden Vision Institute Capabilities and professional highlights
19
Technology highlights
Optical quality analyzer
Model eye
Invaluable assessment of contact lens
quality, optical design, and defects not
possible with conventional tools
Assessing eye-lens design interactions to
achieve optimal lens performance
Brien Holden Vision Institute has been
investigating the design and performance of
bifocal contact lenses since the late 1970s.
In the early years, some aspects of the
geometry of even relatively simple designs
such as centre-near bifocals could not be
quantified. The first optical quality analyser
(OQA), also called Zonometer, was developed
in 1983 to meet this need. Through successive
generations of improvements, the OQA has
evolved into an invaluable system for the
assessment of the quality of contact lenses
as well as a tool for the rapid identification of
optical design features and optical defects not
detectable using conventional instrumentation.
While computer-assisted optical modelling
and design can go a long way in facilitating
the development of new vision correction
systems, there are factors specific to contact
lenses, such as the optical effect of the tear
layer, that cannot be readily predicted on
paper. The Brien Holden Vision Institute Model
Eye was developed between 2007—2010 to
provide a physical model for evaluating the
performance of new designs. It overcomes the
limitations of computer-models, but without
incurring the variability often experienced in
clinical studies. This Model Eye is capable of
assessing peripheral as well as central optical
performance.
Eye mapper
An important tool in controlling
myopia progression
One of the hypotheses Brien Holden Vision
Institute has been testing, to aid in developing
optical interventions that can reduce the
progression of myopia in children, is that
peripheral refraction can modulate eye growth.
Beginning in 2007, working in close collaboration
with Professor Earl Smith, University of Houston,
a world-leader in myopia research, we have
developed spectacles and contact lenses with
optical designs that have demonstrated efficacy
in reducing myopia progression. In order to
refine and optimise this strategy, the peripheral
refractive state of individual eyes need to be
known precisely. The Eye Mapper has been
developed as a method for rapidly assessing the
refractive state across the visual field of an eye.
Manufacturing transfer
and quality assurance
Closing the R&D loop
In addition to the optical design expertise, a
range of software tools has been developed
to optimise all other design features for toric,
multifocal and single vision contact lenses.
Mathematical descriptions of complete front
and back surface shapes can be translated
into machine readable code for the various
production platforms and lens materials.
Sophisticated metrology closes the loop to
ensure that lenses are manufactured to
specifications, applying correction factors to the
design files if required to compensate for any
deviations.
Licensing
Brien Holden Vision Institute has two
pathways for translating our research
into products and solutions – through
licensing our intellectual property
and through the activities of our
commercial entities.
Intellectual property (IP)
management
The IP portfolio of the institute
(patents, trademarks and domain
names) is managed by an in-house
team (IP Counsel, IP Manager and
an IP coordinator). The team actively
oversee and manage the prosecution,
registration and maintenance of the IP
portfolio in consultation with external
IP and trademark attorneys and
registries.
In addition, the IP team also
supports the needs, as required,
by the stakeholders of the Institute,
involving inventors, project and legal
teams, board, senior management,
collaborators and industry partners.
Commercialisation
In 2013, we launched Brien Holden
Vision, a group of commercial entities
of the Brien Holden Vision Institute,
to develop our own pathways for
advanced and beneficial products
and services for those in need of
vision correction and to detect signs
of conditions that threaten vision, eye
and general health and to generate
resources for our mission.
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Brien Holden Vision Institute Capabilities and professional highlights
Licensing
These are:
Adventus Technology Inc. (ATI)
•Brien Holden Vision Innovation Pte Ltd, Singapore
Owned by the Brien Holden Vision Institute and Vision
CRC participants, ATI, a U.S. corporation, is working on a
revolutionary polymer gel to provide full visual rehabilitation
to presbyopia and cataract patients, restoring distance and
near focusing ability similar to that of a young eye.
•Brien Holden Vision Diagnostics Inc., U.S.
•Brien Holden Vision Care Inc., U.S.
•Brien Holden Vision Innovation Inc., U.S.
•Brien Holden Vision Pty Ltd, Australia
•Brien Holden Vision Pvt Ltd, India
These products and services fall into the following strategic
approaches:
1.Vision care products – such as contact lenses and lens
care solutions that improve health and vision, control
myopia and correct presbyopia.
2.Enabling technology – technology and/or products that
detect eye and health problems to deliver better health
and vision care at affordable cost.
3.Social entrepreneurship – innovative, sustainable vision
care delivery systems and facilities based on bestpractice affordable vision care.
Bioptigen Inc.
As a pioneer in the development and manufacture
of leading edge Spectral Domain Optical Coherence
Tomography (SDOCT) equipment and software, Bioptigen
is helping researchers open windows into the wonders of
ocular development and the mysteries of ocular disease.
In 2011, Brien Holden Vision Institute, Adventus Technology
Inc. and Bioptigen Inc., teamed up to create a state-ofthe-art intra-operative imaging device that provides a new
standard of real time ophthalmic imaging.
Adventus Technology Inc. has licenced its intraoperative OCT
patent to Bioptigen Inc., and Brien Holden Vision Pty Ltd is
representing Bioptigen through demonstrating, sales and
service support of their OCT system to Australian clients.
Strategic partnerships
By establishing Brien Holden Vision entities in many
countries and through collaborations with industry,
practitioners, optometry schools, professional bodies and
governments, we have created a network of connections
with the capacity to build awareness, conduct education
around, and promote the distribution of, new ophthalmic
and optical products.
Investments
The Institute has invested in two commercial companies
focused on the areas of surgical solutions for presbyopia
and cataract, and on advanced optical imaging
technologies.
Brien Holden Vision Institute Capabilities and professional highlights
23
Education
Human resource development
Professional education
programs
Brien Holden Vision Institute has
extensive history in practitioner and
educator education, in developed
markets, particularly in the area of
spectacle and contact lenses, including:
•professional contact lens and
spectacle lens education programs
to over 82,000 practitioners and
students globally
•education and promotion around
breakthrough contact lens material
•continued participation and
involvement in key international
conferences and symposia
•postgraduate research education
Major contact lens programs
•International Association of Contact
Lens Educators (IACLE) – education
programs now exist in over 60 countries
•Asia Pacific Contact Lens Education
Programme (APCLEP) – over 15,000
practitioners trained since 1990
•Indian Contact Lens Education
Programme (ICLEP) – almost 5000
practitioners trained since 1990.
Other programs
•Global Contact Lens Education
Program (GCLEP)
•Middle East Contact Lens Education
Program (MCLEP)
•Gas Permeable Contact Lens
Education Program (GPCLEP)
•Growing the Australian Contact Lens
Market program (GACLM)
•Collaboration with Essilor – growing
the progressive lens market.
24
Brien Holden Vision Institute Capabilities and professional highlights
Education
Professional development programs with Essilor
Brien Holden Vision Institute (formerly the International
Centre for Eyecare Education) has conducted professional
education programs with Essilor for over 17 years, including:
•Varilux Academy Asia Pacific (VAAP) program – 8000
practitioners, with almost 40,000 educated by
presenters trained
•Varilux Academy Initiative (VAEI) – implemented in 70
universities and colleges across the AMERA region –
1350 educators and 1900 students trained.
Promotion of a breakthrough contact lens material
As a co-inventor with CIBA VISION (now Alcon) of the first
silicone hydrogel contact lens, the Institute was at the forefront
of efforts to promote and gain acceptance of the benefits of
this new material, estimated in 2013 to account for around
50% of all new contact lens fits.27 These activities included:
•Silicone Hydrogels website – the major source of information
about these new lenses for practitioners and researchers
•symposia hosted in several countries
•sessions for practitioners held throughout Australia
•presentations at major international conferences for over
a decade
•extensive peer-reviewed publications
•conducted the first clinical trials that generated much of
the efficacy data and a site for FDA trials conducted to
gain regulatory approval
•clinical information based on above studies were
published by the Institute, which was used in marketing
by CIBA VISION.
Highlight education program –
EyeTeach©
Globally, eye care practitioner numbers are
low, with a deficit in training institutes a major
factor. EyeTeach© is a series of programs
targeting optometry school development and
equipping educators with teaching skills.
The program encompasses best practice for
learning and teaching, clinical skills teaching
and integrating research within the optometry
program/faculty.
Initiated in 2011, EyeTeach© has trained
over 700 educators from: Bolivia, Cameroon,
China, Colombia, Ethiopia, Fiji, Guyana, India,
Kenya, Lebanon, Malawi, Mali, Mozambique,
Pakistan, Papua New Guinea, Peru, South
Africa, Tanzania, Thailand, Trinidad & Tobago
and Vietnam.
Postgraduate research education
The Institute offers postgraduate research opportunities in
Australia and through our associated organisations in South
Africa, China and India, including;
•African Vision Research Institute, Durban, South Africa
•India Vision Institute, Hyderabad, India
•LV Prasad Eye Institute, Hyderabad, India
•Zhongshan Ophthalmic Centre, Guangzhou, China.
We have educated 185 PhD and MSc students.
Brien Holden Vision Institute Capabilities and professional highlights
25
Brien Holden Vision Institute
Academy
Education is key to our strategies
to deliver quality eye care to the
625 million people globally with
uncorrected refractive error.
The Institute has developed
the expertise to set up relevant
educational programs including
optometry schools, as well as a range
of courses to teach competencies from
the community level upward, offering
professional development of personnel
and further career opportunities.
These initiatives and programs include
offering education courses in clinical,
pedagogical, research and business
areas and developing teaching and
learning tools and resources. This
includes:
•online resources
•primary eye care education
•refraction
•technical and optometric education
•vision centre management
•faculty development
•professional education
•improve optometry standards.
Education resources
Global Optometry Resources website
One of the challenges for emerging
optometry schools is limited access to
teaching and learning resources.
The Institute’s Global Optometry
Resources website offers free
optometry modules that comprise the
backbone of an optometry curriculum
that educators and students can utilise.
Including PowerPoint presentations
and course notes, these materials are
available in four different languages
– English, French, Spanish and
Portuguese.
26
Brien Holden Vision Institute Capabilities and professional highlights
Education
Other resources
Interactive student materials
Additionally, a series of downloadable resources for
other levels of eye care education are available, including:
In development are materials for student self-learning
which also allow for setting assessment protocols to
measure student progress. These include:
•Primary Eye Care Manual
•Refraction Manual
•Virtual Refractor
•Vision Centre Toolkit
•interactive learning activities
•Basic Refraction for Ophthalmologists.
•Student Refraction Manual.
Highlight education resource – Virtual Refractor
The Virtual Refractor is a web-based learning tool that:
•simulates a distance subjective refraction using a refractor head
•provides virtual patients with numerous demographic profiles who respond to various test charts and questions
regarding the effects of lens combinations
•allows optometry students to gain a strong working knowledge of how to perform a refraction prior to practical
clinical sessions
•a useful teaching and assessment tool for optometry educators.
Brien Holden Vision Institute Capabilities and professional highlights
27
Public health
Sustainable service development
28
Brien Holden Vision Institute Capabilities and professional highlights
Public health
More than 625 million people are unnecessarily blind or
vision impaired due to refractive error, simply because
they don’t have access to an eye examination and a pair
of glasses. As both leader and collaborator, Brien Holden
Vision Institute advances vision care on the global public
health agenda and builds sustainable, culturally appropriate
systems for vision care in local communities.
In addition to our education and human resource activities,
we achieve this through the following approaches:
Child eye health
Children in all regions of the world are affected by a range
of eye diseases and conditions. We believe in order to be
effective and sustainable, child eye health programs must
be integrated within the national and provincial health
systems, and also within existing school health services. It
is essential that child eye health services are linked with
extended education and social development systems.
Brien Holden Vision Institute believes it is important that
children are not simply the beneficiaries of eye health
activities, but important links in the process of care. To
achieve greater success it is essential to involve children in
health implementation activities; promotion aimed at family
members, neighbours, their peers, and communities.
Vision centre and outreach
We recognise the importance of building sustainable eye
care systems in collaboration with national and regional
health systems to ensure we meet community needs.
The Institute’s strategies are based on establishing
environments that enable trained eye care professionals to
provide clinical and refractive services.
Social enterprise
Social Enterprise is about maximising human well-being,
taking the power of the market place to solve some of
the most pressing issues in society. The Institute is using
social enterprise philosophies to help answer eye care
provision challenges. Local people are being skilled in an
eye care profession, working actively in their community
and breaking free from the poverty cycle. This sustainable
and self-generated income enables a better quality of life
for people and, their families, while providing much needed
services in their communities.
Spectacle supply
The Global Resource Centre, was initiated to sustainably
supply affordable spectacle frames, lenses, readymade
readers, low vision aids and eye care equipment to the
global population. The availability of eye care service
delivery infrastructure by itself does not guarantee access to
spectacles because of the lack of availability or prohibitive
costs, particularly in developing countries.
Through being actively involved in the supply chain at
multiple levels, the Global Resource Centre circumvents
much of the compounding effect of price mark-ups, which
normally drives product prices upwards. Complementing
this with a bulk buying, bulk discount and a pricing strategy
driven from a social mission, as opposed to a profit
perspective, enables the Global Resource Centre to keep
the products affordable.
We develop new solutions for vision care to get services to
places in need so everyone, regardless of their location,
gender, culture or economic situation, can have access the
same kind of care. Outreach programs are coordinated with
other Institute activities to ensure eye care services are
delivered and managed by local personnel, supported by
local health systems, and are therefore sustainable.
Brien Holden Vision Institute Capabilities and professional highlights
29
Vital Statistics - Global
2,742,599
474,517
4451
139,309
9
Total eye examination
Total spectacles dispensed
Total low vision devices dispensed
Personnel trained
Schools of optometry
369
Optometry students
124
Optometry graduates
814,963
Total children’s vision checked
Impact on vision care worldwide
Since 1991 we have:
provided optometric services and glasses to
3.2 million people
trained at different levels of eye care
139,000 people
430 vision centres or sites for eye care
worked in over 50 countries
established offices in Australia, China, Cambodia, Colombia, India,
Malawi, Nigeria, Pakistan, Papua New Guinea, South Africa, Sri Lanka,
Tanzania, Uganda, Vietnam.
Vision Centre development
285
Vision centre
toolkit downloads
429
Eye care clinics
established
114,500
Direct beneficiaries
766,320
Indirect beneficiaries
Practitioners & students
communities the
“refractionists” serve
Refraction
1160
1,160,000
7,797,637
Downloads of
refraction manual
Direct
beneficiaries
academics, practitioners
& students
Indirect
beneficiaries
communities the
“refractionists” serve
Postgraduate education
185
30
Postgraduate research
students educated
Working in industry
Global reach
MOLDOVA
UNITED STATES
MALI
HAITI
GAMBIA
COLOMBIA
GHANA
NIGERIA
PERU
CAMEROON
BOLIVIA
CHILE
ARGENTINA
WHERE WE OPERATE
Brien Holden Vision Institute
Main offices
Sydney, Australia (Head Office)
Durban, South Africa
Guangzhou, China
Brien Holden Vision Institute
Regional offices
Bogota, Colombia
Hanoi, Vietnam
Islamabad, Pakistan
IVI, Hyderabad, India
OPTOMETRY SCHOOL
DEVELOPMENT
Cameroon
Yaoude School of Nursing
Eritrea
Asmara College of Health Sciences
Kenya
Masinde Muliro University
Malawi
•Mzuzu University
•Malawi College of Health Sciences
Mali
Institut d’Ophtalmologie Tropicale
de l’Afrique
Mozambique
University Lurio
Vietnam
Pham Ngoc Thach
University of Medicine
MONGOLIA
CHINA
BANGLADESH
VIETNAM
ERITREA
INDIA
ETHIOPIA
UGANDA
SRI LANKA
KENYA
TANZANIA
PAKISTAN
CAMBODIA
SINGAPORE
PAPUA NEW GUINEA
SAMOA
MALAWI
AUSTRALIA
MOZAMBIQUE
FIJI
SOUTH AFRICA
EYE CARE SITES
Cambodia
Eritrea
Ghana
Kenya
Mozambique
Nigeria
Pakistan
Papua New Guinea
South Africa
Sri Lanka
Tanzania
Uganda
Vietnam
*400+ eye care sites established
*120 low vision clinics serviced
COMMERCIAL ENTITIES
INVESTMENTS
Brien Holden Vision Innovation Pte Ltd,
Singapore
Adventus Technology Inc.,
U.S.
Brien Holden Vision Diagnostics Inc.,
U.S.
Bioptigen Inc.,
U.S.
Brien Holden Vision Care Inc.,
U.S.
Brien Holden Vision Innovation Inc.,
U.S
Brien Holden Vision Pty Ltd,
Australia
Brien Holden Vision Pvt Ltd,
India
Accreditation and
Accountability
Brien Holden Vision Institute is an accredited Independent Research Institute with the National Health and Medical
Research Council (NHMRC) of Australia and a member of the Association of Australian Medical Research Institutes (AAMRI).
Our microbiology laboratory is Physical Containment Level 2 (PC2) certified by the Gene Technology Regulator – enabling
genetically modified organisms (GMOs) to be cultured or grown in controlled temperature conditions.
Brien Holden Vision Institute, Public Health is an Australian Government accredited non-governmental organisation (NGO).
The Institute is a partner in the Vision 2020 Australia Global Consortium, which administers the Australian Government’s
Avoidable Blindness Initiative in Asia-Pacific. It is a member of the Australian Council for International Development
(ACFID), the peak body for Australian international development NGOs, and adheres to the self-regulatory Code of Conduct
mandated by ACFID.
Brien Holden Vision Pty Ltd – located in Sydney, Australia, holds a multi-site EN ISO 13485 quality system registration for
the design, manufacture and distribution of ophthalmic medical devices and solutions.
34
Brien Holden Vision Institute Capabilities and professional highlights
References
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Sankaridurg, P., Frick, K. D. & Resnikoff, S. 2014. Prevalence of
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3. Vitale S, Sperduto RD, Ferris FL, 3rd. Increased prevalence of
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CJ, et al. National, regional, and global trends in fasting plasma
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Epidemiology%20of%20Dry%20Eye%20Disease.pdf
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journals/langlo/ article/PIIS2214-109X(13)70113-X/fulltext
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24.Brien Holden Vision Institute estimates, 2014.
25.Vision Impact Institute. The social and economic impact of poor
vision. Paris, France: 2012.
26.Sankaridurg P, Donovan L, Varnas S, Ho A, Chen X, Martinez
A, Fisher S, Lin Z, Smith EL, Ge J, Holden B. ‘Spectacle Lenses
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27. Contact Lens Spectrum, 2014, International Contact Lens
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aspx?articleID=109321
Brien Holden Vision Institute Capabilities and professional highlights
35
®
Global Head Office
Level 4 North Wing, Rupert Myers Building
Gate 14 Barker Street, University of New South Wales
Sydney NSW 2052 AUSTRALIA
Tel: +61 2 9385 7516
Find out more at: brienholdenvision.org
For more about products: brienholdenvision.com
™
BrienHolden
HoldenVision
VisionInstitute
Institute Capabilities
Capabilitiesand
andprofessional
professionalhighlights
highlights
36 Brien