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fire pit in research lab

Following the devastation of the 2019-20 Black Summer bushfires, the volume of patients with bushfire smoke related eye problems pushed Suki Jaiswal, an optometrist in metropolitan Sydney, to take the opportunity to better understand the impact of bushfire smoke on the ocular surface and find evidence-based treatments.

Suki’s research is both innovative and a strikingly understandable subject to pursue from the perspective of any Australian who has lived through a bushfire crisis. Her current investigations are centred around how exposure to bushfire smoke can cause ocular surface disease, an underreported side effect for the local communities that endure these natural disasters. Given the prevalence of bushfires in Australia and the current limitations of published literature concerning the ocular impacts of bushfire smoke, Suki’s research will provide valuable knowledge on how smoke can interfere with the delicate mechanics of the ocular surface microenvironment resulting in a range of ocular discomfort symptoms. She is developing novel methods to study how ocular surface immune cells respond when exposed to smoke, paving the way for clinical trials to develop guidelines to treat smoke induced ocular surface disease, which has been her goal from the beginning.

Having identified this gap in knowledge, Suki set out to first understand the problem. Current bushfire-related literature largely addresses the impact of bushfire smoke exposure on the airways and blood vasculature, despite research from population studies in bushfire-affected regions showing eye symptoms are one of the most commonly experienced symptoms during bushfire crises. She also discovered that people with respiratory problems such as asthma may be at greater risk of ocular surface disease when exposed to bushfire smoke, with research showing eye symptoms are more prevalent in these people than the general public.

During the devastating bushfires in December 2019, there was a surge in ocular surface disease cases for a variety of reasons, though they all linked back to the same source; Suki explained that smoke contains fine and coarse particles as well as noxious gases that can affect the ocular surface in numerous ways. Particles can embed into the cornea and cause constant irritation when blinking, or they can deposit in the tear film and irritate the highly-sensitive mucous membranes of the ocular surface and cause allergy-like reactions, which can affect vision and disrupt daily tasks. People in affected regions, particularly firefighters on the front lines, are vulnerable to many eye conditions, and we are yet to understand the true pathological mechanisms occurring at the ocular surface and what the best treatment and eye protection options are.

To this end, Suki and the UNSW team are currently attempting to simulate bushfire conditions in a controlled environment to directly study the effects such conditions can have on eyes and contact lenses with varying levels of exposure. This is with the hopes of providing a head start on preventative care.

suki's team running bushfire condition tests at university
Meagan Porter (left) from FireLab3 at the Fire Research Centre Hub at the University of Tasmania simulates bushfire conditions for research with Suki Jaiswal (right).


‘In the long term, we want to adapt eye care to Australia’s changing climate and anticipate needs going into the future in a sustainable manner. For instance, how should patients handle contact lenses during smoke; do you take them out, or leave them in? Which action will result in less irritation? We’re also investigating if smoke treatments conflict with lenses. As an optometrist, it’s both fascinating and necessary to know,’ Suki said.

Alongside this exciting research, Suki is also driving a separate epidemiological arm of this project. Recognising that Black Summer was up to this point in time a unique event, Suki wants to understand how the extremely poor air quality during those weeks affected Australians that were exposed.

‘We know that there is high likelihood that we will unfortunately have more Black Summers, so we need to be prepared. We need to analyse data from 2019-2020 to prepare health care practitioners, including optometrists, on what eye problems they can expect their patients to present with and how to manage them,’ she said.

To achieve this, Suki is seeking to collect clinical data from optometry practices.

‘With a large volume of de-identified data, I would be able to check which parts of the ocular surface were most affected, which eye conditions were diagnosed, understand how needs differ between demographics, and understand how it was treated on a wide scale. That would begin to inform a model for how we could better treat similar cases in the future,’ she said.

Suki’s goal is to partner with at least 10 practices in New South Wales, and Optometry Australia is calling on member optometrists in relevant areas to get involved.

Suki and her research
Suki Jaiswal at the AFAC fire and climate conference, where she presented her findings so far.


‘The data we are collecting is completely de-identified, meaning all we’re looking at are a comprehensive set of conditions and treatments with no names or date of births. We’re adhering to data collection techniques widely used in clinical research, which means it is impossible to identify which patient any piece of data has come from. It’s also important to make it clear that the data collection procedure will not interrupt practice flow. I will simply come in for a few hours at a time that suits the practice, to collect data from practice records.

‘If we do that with enough practices, we will have the comprehensive data set we need to make progress towards better outcomes for bushfire-affected patients,’ she said.

The project has obtained ethics approvals from UNSW’s Human Research Ethics Committee, which legally has the authority of the National Health and Medical Research Council to approve such projects, and all participating practices will be acknowledged for assisting research that may revolutionise how we treat bushfire-related conditions.

‘If we make progress now, then the next time a large bushfire event occurs, we’ll be better prepared,’ said Suki.

If you are you a practice owner and want to get involved in Suki’s research, contact her at

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