Download Insights into the clinical sequelae of tear hyperosmolarity in dry eye

Dr Laura Downie BOptom, PhD(Melb), PGCertOcTher, FACO, FAAO, DipMus(Prac), AMusA
University of Melbourne
Dr Laura Downie is Lecturer and a NHMRC Translating Research
Into Practice (TRIP) Fellow in the Department of Optometry and
Vision Sciences at the University of Melbourne. In this role she
coordinates and delivers didactic and clinical training to Doctor of
Optometry students and provides clinical leadership within the
Cornea clinic at the University of Melbourne Eyecare clinic. She is
also the Research Leader of the Downie Laboratory: Anterior Eye,
Clinical Trials and Research Translation Unit.
Dr Downie graduated from the University of Melbourne with a
Bachelor of Optometry in 2003 and a PhD in 2008. Her doctoral
research, entitled “Vascular, neuronal and glial cell changes in retinopathy of prematurity”
characterised the intricate relationship between vascular, neural and glial cell changes in an
experimental animal model of this potentially blinding retinal vasoproliferative disorder. Following
completion of her doctorate, she obtained the Postgraduate Certificate of Ocular Therapeutics and
undertook five years in optometric practice. As a practicing clinician, she developed clinical
expertise in anterior ocular disease, in particular dry eye disease and keratoconus, which formed the
basis for her clinical research career.
In 2014, Dr Downie was awarded two NHMRC Fellowships and achieved international recognition
for her research achievements with the award of the prestigious Irvin M and Beatrice Borish Award
from the American Academy of Optometry. She has been an invited speaker at more than 40
national and international conferences since 2010 and is a member of several national and
international expert panels, including the International Dry Eye Workshop II.
Insights into the clinical sequelae of tear hyperosmolarity in dry eye disease
Tear hyperosmolarity defines a state in which the solute concentration of the tear film exceeds that
of the epithelial cell. It occurs as a consequence of reduced lacrimal secretion and/or excessive tear
evaporation and is a key pathogenic mechanism in dry eye disease. While tear osmolarity measures
have been suggested to be the single best clinical indicator of dry eye severity, tear osmolarity
values tend to correlate poorly with many traditional dry eye diagnostic tests, including symptom
scores, and measures of tear stability and production. Recent investigations undertaken in the
Downie ‘Anterior Eye, Clinical Trials and Research Translation’ unit has focussed upon furthering
scientific understanding into the clinical significance of tear hyperosmolarity in dry eye disease.
This work has identified several novel clinical associations between tear hyperosmolarity and
alterations to tear pro-inflammatory cytokines, tear film integrity (measured using a novel noninvasive marker) and corneal structural integrity (quantified using anterior segment optical
coherence tomography). These parameters show promise as potential new biomarkers for ocular
surface inflammation in individuals with dry eye disease.
Ally Xue, PhD student in Department of Ophthalmology
The Analysis of Self-reported Dry Eye Practices amongst New Zealand Optometrists
Brief Abstract: Dry eye causes chronic discomfort and impaired vision for approximately 20% of
the adult population, it is the most common ocular dysfunction encountered by primary eye care
practitioners. However, no previous studies have examined the dry eye practices of NZ optometrists
compared to internationally recognized guidelines. NZ optometrists (n=614) were sent an online
survey in order to anonymously provide information about their preferred diagnostic and treatment
strategies, practice modality, optometric experience, and dry eye interest. This study indicates that
there is inconsistent adoption of evidence-based guidelines, which has created a lack of
standardized diagnostic and treatment protocols. The results highlight the potential to improve
dissemination of dry eye research evidence into New Zealand optometric practice.
Friday, 5th February 2016, 4.00 – 5.00 pm
Lecture Theatre 501-110