Lions Eye Institute

The Lions Eye Institute (LEI) in Perth, Western Australia, is the largest eye research institute in the southern hemisphere. It is a limited liability company, with not-for-profit and tax-exempt gift recipient status, overseen by a Board of Directors. The directors are David Eiszele (Chairman), John Atkins, William Bloking, Professor Ian Constable AO, Michele Dolin, and Brian King AM MBE,

Overview
Each year, LEI provides specialist clinical services to over 40,000 patients from throughout Australia and the world. Its surgeons perform around 3000 complex eye operations annually. Since 1983 the Lions Eye Institute has supported community services aimed at early detection and prevention of major blinding eye disease. Foreign ophthalmologists (especially from south-east Asia) seek specialty medical training at LEI. They parcipate in the program and return to their region with a higher level of skill.

Main research activities
LEI's laboratory-based and clinical research teams investigate all major untreated causes of blindness including cataracts, diabetes related eye disease, glaucoma, retinal degenerations, corneal, and immune-based diseases. More than 70 scientists at LEI use a range of technologies to develop treatments for blinding diseases, including gene therapy and telemedicine; have several major international collaborations and partnerships with a wide range of Australian and international institutions; and collaborate with industry in joint research and development projects.

Practical applications
LEI has developed and licensed the rights to its artificial cornea and orbital implant technologies; developed the first transgenic mouse model for age-related macular degeneration; pioneered gene therapy treatments for reversal of blinding retinal dystrophy, developed the world's first dissoluble glaucoma tube for microsurgery; and progressed the use of telemedicine in diagnosing eye disease.

Trivia
The Institute's staff come from nearly 30 nationalities; one of its scientists previously studied genetically based disease in the British royal family and the molecular ophthalmology group has reversed blindness in dogs and mice and plans to embark on human trials in the near future.

Funding
The bulk of LEI's funding comes from scientists winning highly-competitive peer reviewed research grants from organisations like the National Health and Medical Research Council and the Juvenile Diabetes Research Foundation. It also is fortunate to have earned the support of individual donors and benefactors.

Major supporters/partners
National Health and Medical Research Council, Australian Research Council, Juvenile Diabetes Research Foundation, Medical and Health Infrastructure Fund of W.A., the University of Western Australia, and Lions Save Sight Foundation of Western Australia.

Future ambitions
To find cures for blinding eye diseases.

Ophthalmologists

 * Professor Ian Constable AO
 * Sub-specialties: Vitreoretinal Surgery, Retinal Vascular Disease, Diabetic Retinopathy, Macular Degeneration
 * Ian Constable is the immediate-past President of the Asia-Pacific Academy of Ophthalmology which serves 56 per cent of the world population and a greater percentage of the world blind.


 * Associate Professor Graham Barrett
 * Sub-specialties: Cataract surgery, keratorefractive surgery, corneal and anterior segment disorders
 * Graham Barrett is the first Australian ophthalmologist to win, in one year, the prestigious Binkhorst, Ridley, Susruta and Choyce Awards.


 * Associate Professor Geoffrey Crawford
 * Sub-specialties: Corneal disorders and surgery, Keratorefractive Disorders, Ocular Plastic, Orbital Surgery
 * Geoff Crawford was instrumental in the development of the Alphacor™ and the first surgeon to perform LASIK in Western Australia.


 * Associate Professor Ian McAllister
 * Sub-specialties: Vitreoretinal Surgery, Retinal Vascular Disease, Diabetic Retinopathy, Macular Degeneration, Ocular Trauma
 * Ian McAllister has pioneered a novel surgical bypass technique for treatment of retinal vascular occlusive disease.


 * Dr. William Morgan
 * Sub-specialties: Glaucoma
 * Bill Morgan is establishing Western Australia's first population health data base in glaucoma.


 * Dr. Mei-Ling Tay Kearney
 * Sub-specialties: Opportunistic infections of the eye, Uveitis and Inflammatory disorders of the eye
 * Mei-Ling Tay Kearney delivers workplace safety education to companies in north-west Western Australia.


 * Dr. Steven Wiffen
 * Sub-specialties: Corneal surface disorders, Corneal surgery, Anterior Segment disorders and surgery, Keratorefractive surgery.
 * Dr Wiffen is the Chair for Eyebanks Australia and New Zealand.


 * Dr. Antonio Giubilato
 * Sub-specialty: Glaucoma
 * Tony Giubilato is the coordinator for Medical Student Teaching for Ophthalmology in Western Australia.
 * Dr. Tim Isaacs
 * Sub specialties: Vitreoretinal Specialist, Surgery, Diabetic Retinopathy, Macular Degeneration, Retinal Vascular Disease
 * Tim Isaacs has studied active Chlamydia infection rates in aboriginal children in the remote Kimberley region of Western Australia.

Research Groups at LEI

 * Molecular ophthalmology
 * Director: Professor Elizabeth Rakoczy.
 * Elizabeth Rakoczy was the first in Australia to apply molecular biological techniques in ophthalmic research. Prof. Rakoczy's group has developed gene therapy treatments for reversal of blinding retinal dystrophy in Briard dogs – the first large animal genetic blindness to be cured, and the first transgenic mouse model for ARMD.


 * Physiology and pharmacology
 * Director: Professor Dao-Yi Yu, MD PhD,
 * Dao-Yi Yu heads up a major NHMRC Centre Grant dedicated to retinal physiology, mechanisms of disease and glaucoma. His research team has created the world’s first dissoluble glaucoma tube for microsurgery.


 * Experimental immunology program
 * Directors: Dr Anthony Scalzo, PhD and Dr Mariapia Degli-Esposti, PhD
 * Tony Scalzo's scientific interest has focused on understanding the interplay between host resistance mechanisms and how viruses can subvert the host protective immune response by utilising immune evasion mechanisms.
 * Mariapia Degli-Esposti's research aims to define interactions that occur between viral pathogens and host immune effectors to determine how these interactions affect anti-viral immunity.
 * Dr Degli-Esposti recently published a definitive review of the interactions between immune cells in the prestigious Nature Reviews Immunology magazine.


 * Biomaterials and polymers
 * Director: Dr Celia Hicks
 * LEIs Biomaterials and polymers Group developed the Alphacor™ - the world's first soft artificial cornea. Alphacor represents a benchmark in the treatment of corneal disease.


 * Centre for e-Health
 * Director: Professor Kanagasingham Yogesan
 * Professor Yogesan's research, trialled in Australia and Indonesia, has led to the development of sophisticated teleophthalmology software and hardware technologies to extend to those living in remote and under serviced regions access to quality medical services.


 * Biomedical photonics
 * This group is developing scanning laser ophthalmoscope technology for diagnosis and treatment of eye disease.


 * Clinical research
 * Lions Eye Institute is acknowledged as a core academic centre suitable for substantial participation in global clinical trials of new pharmaceutical therapies and surgical procedures not yet approved by governments.

2004-2005 summary of Lions Eye Institute activities
There was a rare change at the top at the Institute: Chairman Brian King AM, MBE handed over the reins to David Eiszele. Since 1975 King held the position of Chairman, lending critical strategic guidance to the Institute’s clinical, research and medical training activities and ensuring the maintenance of highest standards of governance and public accountability. Among his many achievements, King was instrumental in establishing free screening programs throughout Western Australia: more than half a million people have been assessed for common and avoidable blinding eye diseases under this humanitarian program – the first of its kind introduced into Australia. The Chairmanship remains in very safe hands: David Eiszele is chairman of Global Carbon, director of Pearl Street Energy and a former council member of the W.A. division of the Australian Institute of Company Directors. This year has again seen the Institute's scientists win a number of highly-competitive research grants. Funded projects include advanced gene therapy research to fight diabetic retinopathy; controlling diabetes through developing a non-invasive device to measure glucose levels; and tackling viruses that affect organ transplant recipients, AIDS patients and unborn children. The funding is from the Australian Government's National Health and Medical Research Council, AusIndustry and Retina Australia, and is a tremendous vote of confidence in W.A. science and research. The Institute’s gene therapy research became one of the most-covered scientific stories in national media this year. When LEI researchers announced they had reversed blindness in dogs and mice in a gene therapy trial, and were preparing to trial the procedure on humans within the next two years, the media took an intense interest. The gene therapy involves injecting a gene into the eye, and will initially be focused on people who have lost their sight through inherited retinal dystrophies. The procedure could potentially help millions of people around the world. Another significant program this year was the formation of a partnership with BHP Billiton. The Pilbara Aboriginal Eye Health Program is an innovative two-year strategy aimed at thousands of indigenous people who suffer from diabetes and associated blinding eye diseases. The initiative will target diabetic retinopathy and cataracts – two of the major causes of blindness in our community, and especially prevalent within the Aboriginal population. It will also compile data to analyse the severity of blinding eye disease in the Pilbara and substantially help others who work to improve Aboriginal health.

History
Now one of the most prestigious medical institutes in the world, the Institute has nine ophthalmologists who treat patients and investigate diseases such as cataract, glaucoma, diabetic retinopathy and macular degeneration. From its base in Western Australia, under the leadership of Professor Ian Constable AO, the Institute has spread its work into Asia. LEI had its roots in the hard work and goodwill of Lions Club members, who donated their time and effort to begin free glaucoma screenings in WA. “We planted a little acorn seed and a mighty oak tree grew,” says former Lions Eye Institute Chairman Brian King. Brian, a former District Governor and charter member of the Lions Club of Crawley, is the founding Chairman of the Lions Eye Institute and was also the Chairman of the Board of the Lions Save Sight Foundation for 19 years, from 1977 to 1996. He remembers the glaucoma screenings beginning in Perth just before another event in WA the same year: the British and Empire Commonwealth Games - 2004 marked the fortieth anniversary of Lions Clubs’ eye testing in Western Australia.. “The City of Perth Lions Club was in its infancy, as was The Foundation to Prevent Blindness,” Brian recalls. “We wanted to provide a free testing service to people so they could find out if they had glaucoma, and be able to give them an immediate referral to an ophthalmologist.” It was decided a mobile caravan – dubbed the Glaucoma Detection Clinic - was the way to go. “People would walk in one door, have some drops put in their eye, and lay down on one of two bunks,” says Brian. “A nursing sister would perform a quick pressure test on their eyes – then the main way of testing for glaucoma – and if there was a high pressure reading the patients would be referred to an ophthalmologist further down the caravan.” The Glaucoma Detection Clinic was extraordinary successful in capturing the public imagination: more than a quarter of a million people were tested for glaucoma in the caravan. The number of visits to the Glaucoma Detection Clinic had a profound improvement in public health: when it began, glaucoma made up more than a quarter of all cases of new blindness in WA. By the late 1970s, that had fallen to 13 per cent, halving the incidence of glaucoma-related blindness in the state. The Glaucoma Detection Clinic provided the impetus for major initiatives for eye health in Western Australia. The Lions Save Sight Foundation was formed in 1970, and then Ian Constable was appointed as the Lions Chair of Ophthalmology at the University of Western Australia in 1975. Professor Constable’s appointment led to the development of the Lions Eye Institute in 1983, and he being the founding professor of the Institute. Today, the Lions Save Sight Foundation still conducts free public screenings for glaucoma – except it’s done very differently. A hand-held teleophthalmology device can beam images of the eye to Perth, where an ophthalmologist at the Lions Eye Institute may diagnose the information. For every hundred people screened today one or two require a referral for specialist attention.

Sources: LEI Website at www.lei.org.au; LEI 2004 Annual Report; LEI-generated documents.

Work experience

LEI, despite being the largest optial institute in Australia also is one of the few major facilities that will accommodate high school work experience students. While few schools take advantage of this, it remains an important service. LEI also makes time to educate primary schools or the future scientists LEI frequently allows students into the institute to observe the latest findings or even visits the school itself. The Lions support terrific causes!