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Saving sight. Changing lives.

Population Health and Health Services Research

Affiliated with the University of MelbourneUniversity of Melbourne Logo

CERA’s population health and health services research is focused on understanding health and eye disease in the community, and improving health and well-being by addressing the differences in eye health conditions between social groups.

Lead Researcher: Professor Mingguang He

Professor Mingguang He is the Professor of Ophthalmic Epidemiology at the University of Melbourne. Professor He’s research interests include: clinical and epidemiological research, randomized clinical trials, twin studies and imaging technology and he has led a series of studies to help understand the prevalence, clinical characteristics, natural history and risk factors for important eye diseases such as glaucoma, myopia and retinal diseases. Professor He began his appointment in October 2014 and will work on population health research.

Lead Researcher: Dr Peter Van Wijngaarden

Current research

  • A Diabetes Blindness Prevention Program for Australia
  • The influence of diet on repair of the brain and spinal cord in Multiple Sclerosis
  • Energy supply in glaucoma: one cell’s trash is another cell’s treasure

A Diabetes Blindness Prevention Program for Australia

Diabetic retinopathy (DR) is the leading cause of blindness in working-age adults in Australia. The majority of diabetes-related vision loss can be prevented with early detection and timely treatment. The implementation of systematic eye screening programs has been proven to dramatically reduce severe vision loss and blindness from diabetes. Unfortunately, Australia lacks a nationwide DR screening system to prevent avoidable vision loss and blindness, and the current ad hoc approach to early detection of DR is failing Australians with diabetes.

We are working closely with Vision 2020, Diabetes Australia and representatives of the eye health and vision sector to develop a framework for a national diabetes blindness prevention program. This program has the potential to revolutionise eye care for the 1.7 million Australians living with diabetes.

The influence of diet on repair of the brain and spinal cord in Multiple Sclerosis

Multiple Sclerosis (MS) is a disease characterised by recurrent episodes of inflammatory damage to the insulating layer that surrounds nerves in the brain and spinal cord. A group of stem cells that are scattered throughout the central nervous system play important roles in repairing this damage and are key to the functional recovery that is often seen early on in the disease. Unfortunately, the ability of these stem cells to undertake repair declines with age and failure of repair is a key contributor to disability in MS.

Emerging evidence suggests that diet can have a major influence on ageing and age-related disease. We are testing whether diet can alter the efficiency of repair.  Our ultimate goal is to develop treatments to improve repair and to promote the recovery of function in MS.  This work builds on an established collaboration with Professor Robin Franklin at the University of Cambridge.

Energy supply in glaucoma: one cell’s trash is another cell’s treasure

Glaucoma involves the progressive loss of nerve cells in the eye. These cells need a constant supply of energy to survive. Recent studies have identified an energy recycling system in the brain in which waste products from neighbouring cells are used by nerve cells as fuel. We hypothesise that this energy recycling system is important for vision, and that disruption of this supply chain contributes to glaucoma. This project aims to shed new light on what causes glaucoma.

Lead Researcher: Dr Robert Finger

Current research

Access to treatment for neovascular age-related macular degeneration

The aim of this study is to assess the barriers to accessing anti-VEGF treatment for neovascular age-related macular degeneration (AMD) in Australia. Only timely and regular anti-VEGF treatment can maintain or improve vision which is otherwise lost. Currently, fewer than expected persons are treated for nevoascular AMD when going by PBS/Medicare numbers, and we will assess the extent of this gap as well as barriers to accessing this treatment with the goal of improving access and thus long-term treatment outcomes for neovascular AMD.

Physical activity and age-related macular degeneration

A growing but inconclusive body of evidence links physical activity not only to more successful aging but also to a reduced risk of developing visual impairment and age related macular degeneration (AMD).  The impact of physical activity on AMD will be assessed in 21,000 persons participating in the Melbourne Collaborative Cohort Study, a cohort representative of older Australians.

Assessing barriers to guideline compliant referral for and uptake of diabetic retinopathy screening

Diabetic retinopathy (DR) screening is readily available in Australia, but severe vision loss due to complications can only be avoided if it is utilised. We will investigate referral pathways and patient- and provider-related barriers to DR screening referral and uptake. This will enable us to improve current DR screening referral and uptake, leading to better long-term vision, better quality of life and fewer costs associated with ocular complications and blindness in persons with type 2 diabetes in Australia.

Lead Researcher: Dr Mo Dirani

Current research

  • National Eye Health Survey (NEHS)

National Eye Health Survey (NEHS)

Dr Dirani is the principal investigator of the NEHS that aims to determine the causes and prevalence of vision impairment and blindness in Indigenous and non-Indigenous Australians aged 40 years and 50 years, respectively residing in urban, regional and rural areas across the nation.

The NEHS is a key priority area of the recently endorsed National Framework Implementation Plan (NFIP) developed by Vision2020 Australia and will contribute to the Global Action Plan (2014-2019) that calls for a reduction in avoidable blindness by 25 per cent by 2020.

A total of 4500 individuals from 30 different areas covering all remoteness regions in Australia will be examined, recruitment commenced in March 2015.

Other leading research activities include;

  • The development and implementation of an integrated diabetic eye screening program to reduce the unnecessary burden of vision loss associated with diabetes in all Australians.
  • Research to assess the relationship of cognitive impairment and retinal parameters in collaboration with the Australian National University (ANU).
  • The evaluation of a number of outreach clinical eye programs in South-East Asia, including the Sumba Eye Program and the East Timor Eye Program.
  • Evaluative research to assess the impact of eye health interventions in Australians with vision impairment or blindness in collaboration with Guide Dogs Victoria.

For general enquiries call +61 3 9929 8190 or email nehs-cera@unimelb.edu.au

Lead Researcher: Associate Professor Ecosse Lamoureux

Current research

  • Ret-Path
  • Glaucoma initial treatment study
  • Residential ocular care

Ret-Path

Most vision loss from diabetic retinopathy can be prevented by early detection. However, with no recognized eye screening procedure, up to half of Australians with diabetes do not have a regular eye check. We have successfully piloted a new eye screening model using pathology centres. In this project, we will demonstrate the overall effectiveness and economic benefits of this eye screening model in urban and rural Victoria for people with diabetes.

Glaucoma Initial Treatment Study

The main treatment of glaucoma involves the use of eye drops. However, drops are expensive, have considerable side effects, and impact negatively on daily living. Laser has recently been proposed as an alternative treatment and, in this project, we will investigate the effectiveness of laser compared to drops.

Residential Ocular Care

Elderly people living in residential care facilities have high levels of vision loss which can impact on emotional health and quality of life. Appropriate correction and cataract surgery can improve vision and, with low vision rehabilitation, can enhance quality of life. This project will assess the success and cost-effectiveness of a new model of eye care targeting vision impairment to improve residents’ daily routine, enhance their emotional well-being and quality of life; and prevent falls.