- Category: Who we are
Professor Brien Holden (6 January 1942 - 27 July 2015) was a leading champion for research and the development of new and better vision care technology and products.
His contributions extended across research, education, public health and social enterprise. He was awarded: an Order of Australia Medal for his work in eye health and vision science; the Schwab Social Entrepreneur Award for Africa 2010 at the regional World Economic Forum; the Charles F. Prentice Medal (optometry's highest scientific honour) and seven honorary doctorates from universities in Canada, South Africa, UK and the US.
He generated over $1.3 billion in research, education and humanitarian funds over the last 20 years and was described by Professor Earl Smith at the award of his Honorary Doctorate in Humane Letters at the University of Houston as, "the most influential optometrist of our generation."
His contributions have been acknowledged through a host of other national and international awards and honours, such as in 2010 the renaming of the Institute for Eye Research to the Brien Holden Vision Institute.
The early years
Following the completion of his optometry training at Melbourne University in 1964, Brien Holden embarked on an impactful journey by boat to the UK with his new wife. Seeing the poverty and hardship at several port stops along the way stimulated a lifelong interest in humanitarian pursuits and social justice.
After completing his PhD in corneal and contact lens research in the United Kingdom at the City University London in 1971, Brien returned to Australia to take up a position as Lecturer at the University of New South Wales (UNSW) in Sydney. This proved to be an incredibly fertile research and educational environment in the early 1970s.
It was here that a group led by Brien Holden began to quickly develop expertise in soft contact lenses – a new modality for vision correction. Brien's influence was not only felt in contact lens studies and research, but also in teaching diagnostic drugs. His UK qualifications enabled him to be both the first person to be registered in optometry to use diagnostic drugs and the first teacher of the subject in Australia.
In 1973, Brien and several postgraduate students began research to determine what was needed in contact lenses to maintain eye health. This group managed to attract the interest of other researchers to work with them, 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.
Building organisations and creating breakthrough research
The Cornea and Contact Lens Research Unit (CCLRU) was established in 1976 by Brien to develop the specialty within what was then known as the School of Optometry at UNSW (it later became the School of Optometry and Vision Science). This CCLRU became the basis for the phenomenal growth in research activity within the School of Optometry in subsequent years. By this time the 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.
The CCLRU quickly grew, along with its reputation, attracting industry interest and funding. By the end of the 1970s its staff included optometrists, biologists, physiologists, biochemists, microbiologists and biostatisticians. It began to develop a postgraduate research programme as well as expertise in continuing education, delivering contact lens education to thousands of practitioners and educators throughout Asia. Key world leaders in the field were attracted to Sydney to help develop the international reach of the group.
The CCLRU expanded its operations to become the major organiser of contact lens related clinical trials around the world, collaborating with what is now one of the world’s leading eye research Institutes and hospitals, the LV Prasad Eye Institute (a long-time research partner).
The success of the CCLRU spurred Brien Holden onto further challenges. Brien and colleagues saw the need for an independent, but university-affiliated, Australian institute to promote and develop eye research and education. In 1985, Brien and colleagues established the Institute for Eye Research as a non-profit Approved Research Institute.
The Institute undertook a range of both applied and basic scientific and clinical research projects dedicated to advancing knowledge of the eye and vision system and to create innovative vision correction products. It managed this by employing a policy of engagement with external organisations as a way to draw on expertise from around the world to create inventive solutions to some of the major challenges facing the field. The Institute forged long-standing associations with organisations through the CRC program such as the LV Prasad Eye Institute and the University Hospital in Helsinki.
When the Australian Government established the Cooperative Research Centres (CRC) Program in 1991, Brien immediately saw an opportunity to create new breakthroughs through the relationships between research and industry that the Program promoted. The Cooperative Research Centre for Eye Research and Technology (CRCERT) was established in 1991 and through this program with Brien as Director, developed collaborations with Bascom Palmer Eye Institute, CSIRO, University of western Sydney, Queensland University of Technology, the Optometric Vision Research Foundation and later the University of Houston and the Centre for Eye Research Australia among many others.
CRCERT received grants of $37 million over 13 years and provided the basis from which the Vision CRC was established in 2003 and a Vision CRC extension granted in 2009 – a total of $85 million in CRC funding over 25 years. This level of government support attracted over $800 million in industry and partner investment in the CRCs.
These organisations achieved their goals of delivering breakthrough research and innovative products, with products delivering over a $1 billion a year in sales and $300 million in total royalties. The CRCs have also made important contributions in the areas professional education and vision care delivery.
Brien Holden’s research focus was in the area of ocular health and vision with all forms of vision correction including contact lenses and surgery. He was the driving force behind the development of a number of products. Most notably, the creation of a new generation of soft lenses to correct astigmatism and the co-developer of the breakthrough highly oxygen permeable silicone hydrogel lenses with CIBA VISION, which have revolutionised the contact lens market.
Institute researchers developed the technology that resulted in the development soft toric contact lenses for the correction of astigmatism. These lenses were successfully launched worldwide in 2002 and rapidly became one of the most successful toric designs ever launched.
The invention of the silicone hydrogel contact lens solved the problem of supplying high enough levels of oxygen to the cornea to overcome the problem of hypoxia and has earned billions in product sales for industry.
Most recently collaborators through the Vision CRC created a US based for-profit company Adventus Technology Inc and an Adventus Technology (Australia) subsidiary to take to market a revolutionary technology (Accommodating Gel) that could potentially provide full visual rehabilitation for those with presbyopia and cataract.
Brien Holden and a team of Australian researchers also recently received high praise for their work in developing an innovative new spectacle lens that will help address the explosion in the number of people with the eye condition myopia worldwide.
There are an estimated 1.45 billion myopes around the world, of which 3.5 million are Australians, and research indicates that the prevalence is growing rapidly.
The myopia work was done in collaboration with the University of Houston School of Optometry and industry partners through Vision CRC.
Developed by the Vision Cooperative Research Centre (Vision CRC) based in Sydney, the spectacles are the first to demonstrate an ability to slow the progression of myopia in children. The spectacle design, released in 2010 as the MyoVisionTM lens by industry leader Carl Zeiss Vision, won the 2011 Excellence in Innovation Award from the Cooperative Research Centres Association.
During the 1980s, there was a strong growth in the use of contact lenses for vision correction in the Asia-Pacific region. Despite this growth there was a lack of regulation both of contact lens practice and products and a lack of training and education throughout the region.
In many Asian countries minimal opportunities existed for contact lens practitioners to acquire initial or continuing professional education and it was common for contact lens fitting to be carried out by people without formal contact lens education. As a result, the standards of care available varied considerably. Patients were often fitted and managed on a trial and error basis.
In 1990, Brien Holden and colleagues from the Cornea and Contact Lens Research Unit instigated the Asia Pacific Contact Lens Education Programme (APCLEP) as a way to educate contact lens practitioners in countries across the Asia-Pacific and improve eye care, contact lens education and contact lens fitting. This included raising sponsorship from the ophthalmic firm Bausch & Lomb, which helped support the programme. Its first series of lectures were held in China and over the next 10 years APCLEP reached over 20 000 practitioners.
Brien Holden was also involved in the establishment of the International Association of Contact Lens Educators (IACLE), which developed educational infrastructure and resources specifically targeting hundreds of contact lens educators throughout the world. IACLE programs now exist in over 60 countries. Similar programs were initiated for educator and practitioner training in refraction and progressive spectacle dispensing in association with Essilor through the Institute.
Brien Holden has also made important contributions, especially in the area of post graduate academic education, through his involvement with the School of Optometry and Vision Science at UNSW where he evolved from Lecturer in 1971 to Scientia Professor in 2001. He had visiting appointments at universities across the globe, including the United Kingdom, Finland, United States, Canada and China.
Brien also created many opportunities for postgraduate research students through the organisations he was been involved with. The CCLRU, Institute for Eye Research, CRCERT, Vision CRC and Brien Holden Vision Institute have all possessed strong student programs and many graduates have become some of the finest professionals, researchers and educators in their fields.
These organisations have educated more than 180 PhD and MSc students.
Global and Indigenous eye care
Brien's postgraduate education began in 1965 in the United Kingdom and the lengthy journey by boat included several port stops along the way. At locations such as New Guinea and Sri Lanka he observed the conditions of poverty that many people there at the time were forced to survive in. The experience had a major impact on Brien's future activities, inspiring a commitment to engage the optometric community to increase efforts to help those in need.
With colleagues Brian Layland, David Pye, Debbie Sweeney and Frank Back he established VisionCare NSW in 1992 to manage the NSW Government Spectacle Program, which delivers subsidised eye care to those in need. VisionCare NSW supplied over one and a half million pairs of spectacles to financially disadvantaged people in NSW from 1992 to 2014.
In 1998, he co-founded the International Centre for Eyecare Education (ICEE) (now Brien Holden Vision Institute, Public Health) to establish eye care services in developingcommunities throughout the world. The Public Health Division now delivers self-sustaining education programs and ensures the necessary supporting infrastructure and supplies of spectacles and equipment exists to ensure these services are sustainable. The programs continue to build eye care services for Indigenous Australians and other communities throughout the world.
Brien Holden has also made a strong contribution to global initiatives to address avoidable blindness and vision impairment through his involvement with the peak global bodies - the International Agency for the Prevention of Blindness (IAPB) and the World Health Organization (WHO) Refractive Error Working Group.
Along with colleagues Dr Gullapalli ‘Nag’ Rao and Dr Serge Resnikoff, Brien made important representations to have refractive error recognised as the main cause of blindness and impaired vision by the WHO. This is now a key theme for Vision 2020, the global initiative of the IAPB and WHO to eliminate avoidable blindness.
The Institute instigated the inaugural World Congress on Refractive Error in 2007 which has further promoted global efforts in this area Brien Holden was appointed Chair of the WHO’s Refractive Error Working Group since 2001 and a Member of the Board of Trustees of the IAPB since 2004. As a critical part of this initiative Brien and colleagues developed the epidemiological data on the global size of the problem. This assisted in the development of a global plan of action to eliminate uncorrected refractive error by the year 2020.
Brien and colleagues from the Public Health Division, CBM, Fred Hollows and Vision 2020 Australia were instrumental in developing the proposal that resulted in an allocation from the Australian Government of $67 million over four years to eliminate avoidable blindness and impaired vision in the Pacific region.
BBrien's commitment to this issue saw him address the National Press Club in 2005, where he alerted the audience of the enormous need for vision correction to address a problem that impacts on the health, quality of life, education and economic opportunities of so many. In the following years he continued to emphasis the link between avoidable vision impairment, disability and poverty.
Involvement with Australia-India Council and signing of Delhi Declaration
Professor Holden’s association with India began in the mid-1980s through a friendship with Dr Gullapalli 'Nag' Rao, founder of the LV Prasad Eye Institute, now one of India's leading eye care, research and teaching hospitals. Through his involvement in the Australia-India Council, Brien joined Indian and international optometry leaders to initiate the necessary regulatory, infrastructure and education change to transform the eye care landscape in India.
To date, these organisations include the Indian Optometry Federation, India Vision Institute (joint initiative of the Brien Holden Vision Institute and LVPEI) and the Optometry Council of India.
With 456 million people needing vision correction and an estimated 133 million blind or vision impaired because they don’t have access to an eye examination and a pair of glasses – including 11 million children – India faces a huge task in addressing this need.
If it is to further develop into a regulated profession in India, it is estimated that the country will need at least 100 schools of optometry over the next few decades to meet the demand for fully qualified optometrists. Ensuring that quality education is delivered in all these undergraduate programmes would require the development of a minimum of 1000 optometric educators who are capable of facing the challenges ahead to help produce around 5000 optometry graduates per year.
A staunch advocate for quality education, Professor Holden explained; “Australia can assist by sharing lessons learned from the academic, professional and legislative pathway that we have followed over the last 80 years to become an effective health care profession. Optometry in Australia is now a very well defined profession and makes a significant contribution to the country’s welfare”.
New research & education partnerships with China
Refractive error includes conditions such as myopia, presbyopia and hyperopia which affect the vision of billions worldwide. Myopia alone affects more than 600 million Chinese people.
Brien Holden was one of the driving forces behind the recent establishment of the Australia China Centre for Optometry Research and Development (ACCORD) in Guangzhou, China in 2012.
This joint initiative between Brien Holden Vision Institute and the Zhongshan Ophthalmic Centre of Sun Yat-sen University, Guangzhou, China, resulted in the signing of a Memorandum of Understanding (MOU) that will encourage future cooperation in clinical and fundamental research into refractive error, particularly in the Asian context.
All of Brien Holden’s career activities and achievements are a result of collaborative partnerships he has established with colleagues and organisations in Australia and around the world. With long-time colleague Emeritus Professor Brian Layland, and importantly under the direction of Sandra Bailey, CEO of the Aboriginal Health and Medical Research Council, they have achieved the recognition and service of optometry to community controlled eye care for Aboriginal people all over Australia, particularly in New South Wales and the Northern Territory.
Other major collaborators include Dr Antti Vannas, an outstanding researcher and surgeon, who opened up the world of ophthalmology research for Brien and Professor Debbie Sweeney, enabling them to realise the potential for improved vision correction that could result from understanding the cornea and its response to surgery.
Nag Rao, founder of the LV Prasad Eye Institute in India, has been a long-term partner in both vision correction research and efforts to address avoidable blindness and vision impairment worldwide. He has also been an important figure in the development and successes of organisations such as the Brien Holden Vision Institute. Cooperation between ophthalmology and optometry through partnerships with Antti Vannas, Nag Rao, Hugh Taylor and, later, Serge Resnikoff, was an enlightening and empowering experience for Brien.
Brien Holden’s contributions to the L V Prasad Eye Institute were acknowledged by LVPEI when it named its centre investigating the causes and treatments of eye conditions, the Professor Brien Holden Research Centre.
Over the course of his career, Brien Holden received over 30 national and international awards from organisations around the world for his contributions to research, eye care and health, including seven honorary doctorates from the U.S., U.K., South Africa and Canada. He delivered more than 90 Keynote Addresses, authored more than 220 refereed papers, 26 book chapters and 380 refereed abstracts.
Brien served as a member of government licensing, advisory and registration bodies, several boards of management and acted in an editorial capacity and as referee on a range of international academic journals.
In 1997, Brien Holden received the Medal of the Order of Australia for outstanding contributions to eye care research and education.
1986 The Ruben Gold Medal from the International Society for Contact Lens Research for outstanding contributions to contact lens research
1997 Medal of the Order of Australia (OAM) for outstanding contributions to eye care research and education
1997 British Contact Lens Association Medal for outstanding contributions to contact lens research and education
2001-2007 Scientia Professorship, University of New South Wales for outstanding research performance
2002 Inducted into the USA National Optometry Hall of Fame, which recognises persons whose lifetime achievements have advanced the profession of optometry
2004 Inaugural International Award from the American Academy of Optometry, for an individual or organisations whose direct efforts and contributions have resulted in unquestionably significant and extraordinary advances in optometry and eye care internationally
2010 Schwab Social Entrepreneur Award for Africa 2010, at the regional World Economic Forum – joint award with Dr Kovin Naidoo, Brien Holden Vision, Public Health Division Africa
2014 Charles F Prentice Medal from the American Acadey of Optometry in recognition of a career-long record of advancement of knowledge in vision science