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(L-R) Dr Sivaraman Balasubramanian, Associate Professor David Pye and Professor Mark Willcox   Photo: UNSW Australia

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By Helen Carter
Journalist

 

Authors of a paper on eye rubbing and keratoconus have received the 2016 J Lloyd Hewett Award for the best article published in Clinical and Experimental Optometry in the past three years.

The authors are Honorary Associate Professor David Pye and Professor Mark Willcox from the University of New South Wales School of Optometry and Vision Science, and visiting academic Dr Sivaraman Balasubramanian, a clinical research fellow with the Doheny Eye Institute, Los Angeles.

The article, ‘Effects of eye rubbing on the levels of protease, protease activity and cytokines in tears: relevance in keratoconus’ was published in the journal’s special issue on keratoconus in March 2013. The article has free access.

Apart from being judged by the journal’s editorial board as the most meritorious article for 2013–2015, it is also one of the highest cited articles in the keratoconus issue and the highest cited article in the journal overall in 2015. Other researchers have cited the article 19 times.

‘We are delighted to receive the J Lloyd Hewett award,’ Dr Balasubramanian told Australian Optometry. ‘It is a surprise and great thrill for all of us.’

‘Lloyd was an eminent and enthusiastic clinical optometrist who believed in the advancement of the profession through published works, and his dedication to the Australian Journal of Optometry, the former name for Clinical and Experimental Optometry, as editor over many years was exemplary.

‘We were among the first to consider investigating the constituents of the tear film to see if there was a link between certain tear film components and keratoconus.

‘In this study published in Clinical and Experimental Optometry, we reported on how eye rubbing in normal subjects significantly increased the concentration of proteases, protease activity and inflammatory mediators in the tear film. We then proposed how frequent eye rubbing by keratoconic patients may contribute to the development of the condition.

‘From a broad perspective, this article is an excellent example of translational research bridging the gap between basic science and clinical relevance,’ Dr Balasubramanian said.

The authors sought to determine the influence of eye rubbing on protease expression and activity, and concentration of inflammatory molecules in tears.

They collected basal tears from normal volunteers before and after experimental eye rubbing and found that eye rubbing for 60 seconds increased the level of tear matrix metalloproteinase and tumour necrosis factor (TNF)-alpha in normal study subjects.

‘This increase in protease, protease activity and inflammatory mediators in tears after eye rubbing may be exacerbated even further during persistent and forceful eye rubbing seen in people with keratoconus and this in turn may contribute to the progression of the disease,’ they concluded in the paper.

The editorial board of Clinical and Experimental Optometry established the award in 1980 as a tribute to Sydney optometrist J Lloyd Hewett, who was editor of the journal from 1962 to 1979, and a leading practitioner and clinical teacher.

Recipients each receive a framed certificate and a letter of congratulations.

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