Future Vision Foundation Chairman, A/Prof Tim Roberts, has announced the recipients of 2023 funding by the non-profit eye research charity.

In a positive sign for the Foundation, the momentum from 2022 has continued with another strong showing of applications. A total of 18 groups submitted applications, ranging from optimised protocols for post-operative patient care, the role of computation in improving imaging and diagnosis, and the potential impact of microplastics in the eye.

Of these, Future Vision Foundation funding has been approved for 13 projects (further details below).

 

Unique research opportunities

A/Prof Roberts is particularly encouraged by the number of applicants who are interested in research but are not experienced with the process.

‘We are seeing orthoptists, nurses, optometrists and practice managers keen to get in and have a go – which is exactly what Future Vision Foundation was set up for,’ he says.

‘Maximising the benefits from research and innovation requires bigger-picture thinking and opportunities beyond typical pathways such as postgraduate research.

‘Each and every staff member at Vision Eye Institute has unique interactions with patients based on where they sit within the organisation. It’s these insights that we want to tap into and explore in relation to improving clinical outcomes and experiences, and even business and workforce sustainability, within a quick timeframe.’

Up-and-coming researchers, who can also come from external organisations such as universities, gain valuable experience, says A/Prof Roberts. ‘It’s not just the project outcome but also the dissemination of research experience that makes Future Vision Foundation unique.

‘Each submission must include at least one Vision Eye Institute doctor partner to be accepted. For newer researchers, it’s knowing they will have others to help guide them – including our postdoctoral Clinical Research Coordinator, Dr Chris Hodge – that gives them the confidence to move from having an idea to applying for a grant.’

Successful grant applications for 2023

  • Early intraocular pressure (IOP) rise in Deep Anterior Lamellar Keratoplasty (DALK) surgery for keratoconus: using technology to increase our understanding

    Prof Rasik Vajpayee,1 Dr Abi Tenen,1 Dr Alex Ioannidis,1 

    The main aim of this research is to understand the anterior chamber morphology changes in keratoconus or corneal ectasia patients undergoing DALK transplantation surgery to determine the impact on IOP post-surgery.

    Secondary aims include determining preoperative and intraoperative characteristics or variables for increased risk of IOP-related complications and providing a greater understanding of anterior chamber morphology for surgeons in these patients.

    This study may provide important information in understanding the origin of a significant potential surgical complication. It would be expected that a greater understanding of anterior morphology changes in DALK surgery may represent a key part of the decision to offer surgery if preoperative findings are suggestive of increased risk. Further, this may lead to a paradigm shift in the way surgeons assess patients at both pre and post-surgery visits.

    1Vision Eye Institute Blackburn South

  • Analysis of toric intraocular lens rotation calculations for residual astigmatism post cataract surgery

    Dr Lydia Zhou,1 A/Prof Tim Roberts,2 A/Prof Michael Lawless,2–4 Prof Gerard Sutton,2 Dr Simon Chen2,3

    The aim of this research project is to investigate the ability to improve unaided vision following cataract removal and intraocular lens implantation (in cases of toric IOL use for astigmatism).

    If an IOL has rotated from the expected axis following surgery, this may result in residual astigmatism. An option in this scenario is to rotate the IOL to the optimal axis. This procedure can be done with minimal intraocular involvement, thereby reducing additional risks.

    Calculation of the optimal IOL axis is completed through the use of an online program (www.astigmatismfix.com). Although the creators have published data on the patient characteristics leading to IOL rotation, no current evaluation of the program currently exists in the literature.

    This study will provide a novel analysis of the accuracy of IOL rotation for residual astigmatism.

    1Registrar, Royal North Shore Hospital
    2Vision Eye Institute Chatswood
    3Vision Eye Institute Bondi
    4Vision Eye Institute Hurstville

  • Microplastics in the eye

    Dr Alex Ioannides,1 Dr Sheng Hua PhD,2 Dr Chris Hodge PhD3

    The aim of this project is to analyse aqueous and vitreous humour samples obtained through routine cataract surgery to determine the presence of microplastics.

    Microplastics have been identified in blood samples and having crossed the blood-brain barriers and subsequently identified as possible risk factors to disease through cytotoxicity, inflammation and oxidative stress.

    As inflammation and oxidative stress represent the causative factors in several eye diseases, the presence and impact of microplastics within the eye deserve consideration.

    1Vision Eye Institute Blackburn South
    1Save Sight Institute, University of Sydney
    2Vision Eye Institute

  • Feasibility of portable perimeters in an Eye Emergency Department Setting and survey of patient perception of these devices

    Dr Neera Jain,1 Dr Jessica Li,2 Dr Jason Cheng3

    The aim of this research project is to examine patient and clinician experiences with three portable perimeters over a period of one month each at the Sydney Eye Emergency Department.

    This study will provide insight into the feasibility of integrating portable perimeters into the workflow of patient assessment within the Emergency Department. It will also highlight further areas of inquiry in using these devices in broader settings, such as in patients’ homes, at the optometrists, by other clinicians in the hospital or community, and in regional settings where visual field machines may not be available.

    It would potentially be used with glaucoma patients to improve workflow, reduce HVF-associated manpower, reduce clinic wait times and improve patient experience, or used in the co-management of glaucoma patients with optometry partners.

    1Registrar, Sydney Eye Training Network
    2Medical Officer, Liverpool Hospital
    3Managing Partner, Vision Eye Institute Hurstville

  • Quantifying outer retinal curvature to predict progression to late AMD

    Dr Lisa Nivison-Smith PhD,1 Ms Rene Cheung,2 Dr Simon Chen,3–5 Dr David Ng,4,5 Dr Jeff Friedrich,4 Dr Gary Schiller5

    The aim of this research project is to support a retrospective, longitudinal study to determine if ‘sinuosity’ (a metric traditionally used in environmental science) can be repurposed as an optical coherence tomography (OCT) biomarker for age-related macular degeneration (AMD).

    Accurately predicting when an individual with the early stages of AMD will progress to the sight-threatening, late stages of AMD is a fundamental challenge in clinical practice with AMD prognosis currently limited to manual inspection of retinal images for lesions.

    This proposal aims to assess the predictive power of sinuosity from eyes that have/have not progressed to late AMD and subsequently develop an automated method that would help translate the metric into the clinic – as an automated tool to assist clinicians in assessing the AMD patient’s prognosis and making appropriate management decisions.

    1Centre for Eye Health, University of New South Wales
    2PhD Candidate, Centre for Eye Health, University of New South Wales
    3Vision Eye Institute Bondi Junction
    4Vision Eye Institute Chatswood
    5Vision Eye Institute Hurstville

  • Perceptions of perimetry performed at home prior to ophthalmology appointments in patients with glaucoma

    Dr Jessica Li,1 Dr Neera Jain,2 Dr Jason Cheng3

    The aim of this research project is to investigate patient attitudes towards at-home perimetry testing in preparation for ophthalmology consultation.

    Humphrey visual field testing is central in monitoring patients with glaucoma and is a necessary but resource-intensive investigation when carried out in the hospital setting. At-home perimetry may be an acceptable, timesaving and cost-saving alternative to the current standard of practice for perimetry testing in ophthalmology clinics.

    1Medical Officer, Liverpool Hospital
    2Registrar, Sydney Eye Training Network
    3Managing Partner, Vision Eye Institute Hurstville

  • Post-surgery automated text follow up program: characteristics, acceptability and role in cataract patient care

    Ms Gabriela Kalofonos,1 Kylie Bennett,2 Dr Jason Cheng,3 Ms Elena Binios,4 Ms Shih Shih Ta5

    The aim of this research project is to understand the patient acceptability and usability of a nurse-led, automated, digital post-discharge follow-up program (via the use of text messaging) following routine cataract surgery.

    A secondary aim is to understand the incidence and correlation of clinical signs to patient subjective responses. This project is a novel investigation into patient follow-up care within ophthalmology and will provide a platform for potentially streamlining patient care following cataract surgery.

    1Director of Nursing, Forest Road Day Surgery
    2National Quality and Risk Manager, Vision Eye Institute and Vision Hospital Group
    3Managing Partner, Vision Eye Institute Hurstville
    4Orthoptic Team Leader, Vision Eye Institute Hurstville
    5Digital Transformation Manager, Vision Eye Institute and Vision Hospital Group

  • Predicting Future Vision of Patients with Age-related Macular Degeneration

    Dr Matt Trinh PhD,1 Dr Angelica Ly PhD,1 Dr Jeff Friedrich,2 Dr Simon Chen,2 Dr David Ng2

    The primary aim of this research project is to examine which retinal imaging biomarkers, systemic disease, medications, and smoking and lifestyle factors may predict the risk of progression to late AMD.

    The secondary aim is to examine the inter-grader reliability of the retinal imaging biomarkers for progression to late AMD.

    This research is significant because it could facilitate improved identification of patients most at risk of developing severe vision loss due to late AMD. These patients could sooner undergo altered management (e.g. increased frequency of monitoring) or potential early AMD intervention to preserve vision.

    1University of New South Wales
    2Vision Eye Institute Chatswood

  • Post-intravitreal injection endophthalmitis: a possible additional risk factor?

    Mr Stefan Siskos,1 Dr Eric Mayer2

    The main aim of this research project is to understand the incidence of IVI-related endophthalmitis in a private clinic and to elicit the odds ratio of known and further possible risk factors.

    Following an internal Vision Eye Institute review of practices in 2020, changes to technique and protocol were suggested. A change introduced was an increase in needle gauge size. Feedback and incidence results appear to be positive for further reduction of endophthalmitis rates. Further understanding the risk factors for IVI-related endophthalmitis is essential to ongoing patient care. Gauge size could represent a novel protocol change to serve as a potential limiting factor for post-IVI endophthalmitis.

    1Senior Orthoptist/Clinic Coordinator, Vision Eye Institute Box Hill
    2Vision Eye Institute Box Hill

  • Redesigning ophthalmic health care: understanding both provider and patient perspectives regarding the potential use of virtual visits and artificial intelligence

    Ms Layla Moshrif,1 Ms Kirsty Gomes,2 A/Prof Michael Lawless,3 Prof Colin Chan3

    The main aims of this research project is to understand patient awareness of new technology including, but not limited to key areas such as familiarity of technology and digital literacy, data and security concerns, use and role in clinical assessment and practice and the impact on physical interaction between patient and physician. Technology developments can be integrated into the clinical environment and support a better experience for both patients and the clinic itself. Understanding patient, clinician and administrative concerns and barriers regarding the possible benefits and barriers to clinic protocol and patient overall care is essential. This project represents a novel application within ophthalmology in Australia and will help to understand both ophthalmic provider and patient understanding of key novel technologies and the possible future use within ophthalmic care in Australia.

    1Orthoptic Team Leader, Vision Eye Institute Chatswood
    2Administration Team Leader, Vision Eye Institute Chatswood
    3Vision Eye Institute Chatswood

  • Determining the optimal keratometry reading for patients with corneal disease

    Dr Jack Kane,1 Vision Eye Institute Partners,2 Ms Kate Roberts3

    The primary aim of this research project is to determine the correlation and interchangeability of two devices measuring corneal curvature in patients with keratoconus. A secondary aim is to determine the most accurate keratometry value in keratoconus patients who underwent cataract surgery and IOL replacement. This study would help surgeons determine the most appropriate technology to aid IOL calculation prior to cataract surgery in patients with corneal disease (keratoconus). Accurate corneal curvature measurements (keratometry) in addition to other variables increases the chance of obtaining an excellent visual and refractive result following surgery.

    1Vision Eye Institute Camberwell
    small>2Vision Eye Institute
    small>3Orthoptist, Vision Eye Institute Camberwell

  • Impact of modern car headlights on night driving in older adults

    Mr Sekar Ulaganathan,1 Dr Mark Loane2

    The main aim of this research project is to examine the effects of oncoming headlight glare on nighttime driving in older adults and examine whether glare perception varies depending on the type of vehicle driven (such as small cars and SUVs).

    In general, older adults have difficulties driving at night due to constantly varying lighting conditions and their age-related deterioration in visual function. Furthermore, glare from oncoming car headlights may potentially lead to transient visual disturbances in addition to existing driving difficulties. Given that modern cars use bright LED lights, there is a need to further assess the impact of these lighting conditions on nighttime driving performance in elderly people.

    The outcome can provide potentially useful information to authorities involved in road safety and lighting standards.

    1Orthoptist, Vision Eye Institute Brisbane
    2Vision Eye Institute Brisbane