An Australian researcher who has spent nearly 50 years studying the cornea, the requirements and solutions for safe and comfortable contact lens wear, surgical vision technologies, the major causes and solutions to blindness and impaired vision from refractive error and the global epidemic of myopia, has been rewarded with optometry's highest scientific honour at the annual American Academy of Optometry meeting in Denver, US on 14 November.
Professor Brien Holden, from University of New South Wales (UNSW), Australia, and CEO of Brien Holden Vision Institute, who has been a global leader in research and innovation in the measurement, correction, management, treatment and social and economic impact of vision correction and blindness prevention, received the Charles F. Prentice Medal (established in 1958) in recognition of a career-long record of advancement of knowledge in vision science.
From his PhD research on myopia control and corneal re-shaping with orthokeratology, to corneal endothelial changes with soft contact lenses, to the definition of the oxygen needs of the eye to avoid corneal edema, and the effects of long-term extended contact lens wear on the cornea, Holden has been at the forefront of research that underpinned the huge growth in soft contact lens wear globally. More recently his focus has been on development of new methods to control the progression of myopia, to help meet the growing threat of blindness associated with high myopia, which is increasing in prevalence globally.
“Research began for me nearly 50 years ago,” said Professor Holden. “In 1971, I returned to Australia from London to take up a position as lecturer at UNSW Australia. This proved to be an incredibly fertile research and educational environment in the early 1970s.”
It was here that a group led by Professor Holden began to quickly develop expertise in soft contact lenses – a new modality for vision correction.
“At that time, contact lenses were hard, uncomfortable, oxygen impermeable and compromised ocular health with attendant side-effects including distortion, ocular oedema, mechanical damage, infection and corneal exhaustion.
“In 1973, alongside several postgraduate students, I began research to determine what was needed in contact lenses to maintain eye health. Our group managed to attract the interest of other researchers, expanding beyond the original goal of understanding the effects of contact lenses on the cornea to include all aspects of contact lenses – from lens design, material properties and performance to the effects of a wide range of ocular devices, procedures and contact lens solutions on the eye.
“By 1976, as part of the Cornea and Contact Lens Research Unit (CCLRU), the development of this group had grown to over 30 people, the largest in the world engaged in this area of research. It went on to make significant contributions to the world of contact lenses–understanding the eye’s needs, developing toric soft contact lenses and setting the agenda for clinical care of contact lens wearers.”
In 1991, Holden’s group established the Cooperative Research Centre for Eye Research and Technology (CRCERT), with funding support from the Australian Government. This extended the collaborative links, leading to the development of the first silicone hydrogel contact lenses. Apart from the product advances, Holden’s research continued to focus on inflammation and infection associated with contact lenses, treatments for ‘dry eye’, as well as ambitious projects such as an ‘accommodating gel’ for cataract patients and presbyopes and ‘intelligent retinal imaging’. In particular the area of myopia control is now in his sights.
“Myopia has traditionally been considered an East Asian health issue but the incidence and prevalence of myopia is increasing globally. For example, the USA has seen a rise in the adult population from 26% to 42% between 1971 and 1999. Currently, 1.7 billion people have myopia and this number will likely increase to 2.4 billion by 2030.
“Our myopia control products are being developed to tackle this issue head on and the Brien Holden Vision Institute is now accelerating its efforts to deliver advanced products to the market through its own companies and through other corporations.”
Professor Holden has also made a major contribution to the next generation of researchers, through opportunities provided by the Brien Holden Vision Institute and UNSW Australia, to over 160 postgraduate students.
Upon receiving the award, Professor Holden said, “This award is a tribute to my outstanding research colleagues at Brien Holden Vision Institute worldwide, and my global collaborators. Since the early 1970s, along with colleagues at UNSW Australia, Sydney, I have been very fortunate to work with innovative, dedicated and talented people with a shared goal of providing vision for everyone… everywhere."