Macular Degeneration Trigger Enzyme Discovered

The discovery of a crucial trigger for dry macular degeneration (AMD) – an enzyme called cGAS – could lead to the development of a drug to prevent disease progression. 

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This discovery, at the University of Virginia School of Medicine, was a surprise. Drs. Jayakrishna Ambati and Nagaraj Kerur had determined that cGAS plays an important role in the body's immune response to infections detecting foreign DNA, but its role in dry AMD was unexpected. 

“It's really surprising that in macular degeneration, which, as far as we know, has nothing to do with viruses or bacteria, cGAS is activated, and this alarm system is turned on,” said Dr. Ambati. “This is what leads to the killing of the cells in the retina, and ultimately, vision loss.” 

cGAS may also be an alarm for other problems that warrant responses from the immune system, and may play important roles in conditions like diabetes, lupus and obesity. “Because the target we're talking about is an enzyme, we could develop small molecules that could block it,” said Dr. Kerur. “There are many drugs already on the market that target specific enzymes, such as the statins.” 

A drug to inhibit cGAS will take several years to develop. Researchers also hope to find a way to detect enzyme levels in patients' eyes, and determine when best to administer a treatment that blocks cGAS. “This is really precision medicine at the single-molecule level,” said Dr. Ambati.

The findings were published in Nature Medicine.

Advanced Glaucoma Training

Currently Claire is one of four optometrists completing Advanced Glaucoma Training with the University of Auckland. The course is designed to give experience in glaucoma management and collaborative care with ophthalmologists (eye specialists).

 Medmont Visual Field Results

Medmont Visual Field Results

Claire is authorized to prescribe glaucoma medications. This expanded scope for optometrists has been in place since 2013. Claire says “in our community with a high proportion of people over 65 years of age this is valuable. Prevalence of glaucoma increases with age.”
Planning is underway for Auckland District Health Board to involve optometrists in glaucoma management and care. This will be particularly helpful for us here in Warkworth; it will reduce the burden of travel to either Greenlane Eye Clinic, or Waitakere Eye Clinic.
The initiative is designed to reduce the waiting time for appointments and glaucoma is a condition which needs ongoing check ups.

Slowing Myopia - OrthoK Case Notes

Fitting children with hard contact lenses which they will wear while sleeping at night may seem like a big undertaking, but the outcomes
continue to impress us. From the first morning these children see massive improvements in their vision - one of the most rewarding
aspects to this work.
When we met Jack* he was 6 years old, an outdoors boy who loved to read, struggling to see the whiteboard at school. Jack’s Mum is
highly short-sighted (-9.00D myopic), and his dad is moderately short-sighted (-2.50D myopic). Jack’s first prescription in December
2015 was -1.00D.
Jack also had poor visual efficiency, a risk factor for becoming more myopic. The first step was a behavioural optometry assessment
and vision therapy to improve his binocular vision. This was successful, but his distance vision remained blurred.

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At the end of 2016 Jack got his first pair of glasses. To start he only wore his glasses a couple of times a week at school. Over a 6
month period, Jack’s vision got worse, by -0.50D. If he continued at this rate, by 18 years old his prescription could track towards -
11.00D increasing the risk of serious future eye problems (retinal detachment, glaucoma and maculopathy).
This year we have fitted Jack with custom made Ortho K contact lenses to wear while sleeping. This gives him clear vision the next day
once he takes out his contacts. Importantly, wearing these contact lenses can significantly slow down his myopia progression.
When we checked Jack after his first night wearing his contacts, he commented “I can see great” and his vision was 6/6 (equivalent to
20/20). He managed to take out his lenses solo on the second morning. There are more firsts; he was able to see his parents in the
back row of assembly when he won an award at school. His family report “we are so impressed with these lenses, Jack is really excited
to be able to see clearly and positive about the process.”
Jack will have follow-up checks every 6 months to monitor his vision. So far, after 2 months of treatment his vision has not changed at
*name changed for privacy

MiSight® Daily Contact Lenses for Myopia Control

We now have MiSight® Daily Contact Lenses as another option for myopia control. This year at the British Contact Lens Association
(BCLA) meeting some promising results were announced from a three-year study for MiSight®. The results indicate MiSight® dual-
focus contact lenses which have alternating visual correction and treatment zones - are effective in slowing myopia progression in
children by 59%. CooperVision, MiSight® manufacturer, reported data from its Clinical  Contact Lens Study showing these lenses
slowed myopia and eye elongation. 

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The prevalence of myopia is projected to increase from approximately two billion people worldwide in 2010 to an alarming five billion
people in 2050, bringing with it both short  and long-term health challenges. “Myopia’s growth has been dizzying and now affects the
vast majority of young adults in some countries, especially in East Asia,” said Arthur Back, from CooperVision. “Not only does it create
blurred vision, but also increases the likelihood of serious and blinding eye conditions later in life.
“Early intervention by parents, in partnership with optometrists, is essential for the short and long-term health and well being of their


The prospective, multi centre, double masked, randomised study enrolled 144 myopic children aged 8-12 years from Singapore,
Canada, England and Portugal. MiSight® was well accepted by the children who continued their daily activities such as school work,
reading, playing outside and computer use while wearing the lenses.  
Parents of participants gave a very positive response, noting that before the study, many were concerned about their children wearing
contacts.  After their children had worn MiSight® 1 day contact lenses for three years, almost 9 out of 10 parents rated their children
‘extremely happy’ with the overall experience. Children could mostly manage their lens wear independently.

McDonald Adams Science Scholarship Rodney College

Sally Adams was at Rodney College prizegiving to present our annual McDonald Adams Science Scholarship. The winner this year was Lachlan Campbell. Lachlan plans to attend the University of Auckland, studying towards a Bachelor of Engineering with Honours. At this stage he thinks he may do Mechatronics or Engineering Science.

 Sally Adams presenting Lachlan Campbell with his Scholarship

Sally Adams presenting Lachlan Campbell with his Scholarship