Article

A Tribute to Brien Holden

Vision for Everyone…Everywhere: Professor Holden’s legacy lives on.

IN MEMORIAM

A Tribute to Brien Holden

Vision for Everyone…Everywhere: Professor Holden’s legacy lives on.

By Edward S. Bennett, OD, MSEd, FAAO, & Jason J. Nichols, OD, MPH, PhD, FAAO

If we are lucky in life, we are blessed to be surrounded by great leaders and visionaries who positively impact our lives and the lives of those around us. In rare instances, these individuals can use their vision and unparalleled influence to not only do their jobs, but to bring about a greater good. On July 27, 2015, the eyecare profession lost such an icon and perhaps its greatest leader. With the sudden passing of Professor Brien Holden in Sydney, Australia, the world lost a champion for the cause of worldwide vision care for millions of in-need people.

In speaking about greatness, it is often challenging to determine whom is/was the greatest in any given category. It is generally agreed that Jerry Rice was the greatest wide receiver in the National Football League. In Major League Baseball, Rickey Henderson is widely accepted as the greatest leadoff hitter. In the soccer world, Pelé is universally considered the best player of all time. The cornea and contact lens profession has had great visionaries, such as Newton Wesley, and brilliant minds and innovators, such as Dr. Irvin Borish, Dr. Donald Korb, and Dr. Morton Sarver. However, no one has defined all of these qualities better than Brien Holden has.

Pursuing Education

Brien Holden received his Bachelor’s degree in 1964 from the University of Melbourne. After briefly working in an optometry practice, he traveled to London to complete a Diploma in Contact Lens practice program. Ian Bailey, who at that time was a research student at the City University of London, convinced Brien to consider research. As a precursor of future events, his doctoral thesis (which resulted in the awarding of his PhD in 1971) actually pertained to corneal reshaping and was titled: “A study of the development and control of myopia and the effects of contact lenses on corneal topography.”

Upon completing his PhD, Brien returned to Australia where he accepted a position at the University of New South Wales in Sydney. While there, he established the Cornea and Contact Lens Research Unit (CCLRU) in 1976. In 1985, the Institute for Eye Research was established by the founders of the CCLRU as an independent, but still university-affiliated, research organization. The Institute for Eye Research was appropriately renamed the Brien Holden Vision Institute (BHVI) in 2010. Primarily through his efforts and leadership, BHVI quickly became the global leader in eyecare and vision research.

Brien Holden in his early years as a researcher.

At the Cornea and Contact Lens Research Unit, 1978.

Soweto, South Africa stop of the Drive for Sight tour, World Sight Day, 2012.

BHVI has now trained more than 150 doctoral and graduate students, and it currently supports more than 40 postgraduate researchers. This has included a literal “Who’s Who” in cornea and contact lens research, including Dr. Steven Zantos, Ian Cox, Helen Swarbrick, Deborah Sweeney, Arthur Ho, Eric Papas, Nathan Efron, and Cristina Schnider, among many others. These noted researchers—in addition to important members of his prolific research team, such as Dr. Mark Willcox, Dr. Fiona Stapleton, and Dr. Nicole Carnt—have contributed significantly to his remarkable publication record of more than 270 peer-reviewed articles, 462 published abstracts, and 26 book chapters and monographs.

Professor Holden and BHVI have also welcomed nearly 100 visiting research scientists over the years, including renowned researchers such as Dr. Earl Smith, Dr. Kelly Nichols, Dr. Jason Nichols, Dr. Suzanne Fleiszig, Dr. Kathy Dumbleton, Dr. Lyndon Jones, Dr. Noel Brennan, Dr. Jerry Lowther, Dr. Irving Fatt, Dr. Kenneth Polse, and Dr. Desmond Fonn, in addition to countless others.

As if his influence required any further evidence, he has provided more than 120 keynote addresses in 25 different countries. The lasting memory that many of us will have of Brien pertains to two of his final lectures—at the Global Specialty Lens Symposium (GSLS) in January and for the British Contact Lens Association (BCLA) in May—in which he dynamically and powerfully communicated the message about worldwide prevention of myopia.

Awarding Excellence

Brien has received nearly every conceivable award in our field—more than 45 in all. This includes practically every significant award given by the American Academy of Optometry (i.e., The Glenn A. Fry Lecture Award, The Carel C. Koch Memorial Award, the Max Schapero Memorial Lecture Award, and, in 2014, the prestigious Charles F. Prentice Medal). He has also received the Medal of the Order of Australia for outstanding contributions to eyecare research and education, the BCLA Medal, the Dr. Josef Dallos Award from the Contact Lens Manufacturers Association, the Dr. Leonard Bronstein Memorial Award, the GSLS Award of Excellence, and the World Council of Optometry (WCO) Distinguished Service Award. Professor Holden was also inducted into the U.S. National Optometry Hall of Fame.

A Man of Conviction

Brien Holden was very forceful in his opinions, sometimes to the consternation of those he was addressing. One might say that in the color spectrum, he did not recognize gray. However, every great leader has both a vision, and the ego and passion to be able to implement that vision—and that defined Brien Holden. This was very evident in the contact lens industry where his impact was enormous.

No one would argue that as a direct result of his efforts, and those of BHVI, contact lenses have continued to improve and remain a vital corrective modality worldwide. Among his notable innovations include the co-development of the silicone hydrogel lens material, corneal oxygen requirement standards, soft and GP extended wear lenses, state-of-the-art soft toric and multifocal designs, and research on contact lens adverse events and their prevention.

It’s interesting that his first publication in 1971 pertained to soft lenses and coincided with the approval of the first soft lens by the U.S. Food and Drug Administration. In fact, much of his research resulted in the continued improvement of these materials, culminating with his current work pertaining to novel soft lenses for slowing the progression of myopia in young people.

Helping Those in Need

While his prolific research record and the establishment of the most productive, successful, and influential cornea and contact lens research center are important accomplishments, Brien Holden’s legacy largely pertains to his worldwide humanitarian efforts. Many people can create something amazing, but it is a very special person who can then use that foundation as a platform to tirelessly serve others. This was initially accomplished through his involvement in the establishment of the International Association of Contact Lens Educators (IACLE) in 1979; it developed an educational infrastructure and resources that specifically targeted hundreds of contact lens educators throughout the world. In other words, he was directly involved in “teaching the teachers,” with an emphasis on underserved countries.

Receiving the 2013 Global Specialty Lens Symposium Award of Excellence.

But that was only the beginning. His interest and ultimate passion was to help the hundreds of millions of people globally who are blind or visually impaired due to uncorrected refractive error; this idea had its genesis in the 1990s as a result of the influence of his friend, Indian ophthalmologist Dr. Gullapalli (Nag) Rao. They founded an international organization—now part of BHVI—to help establish sustainable eyecare systems in developing communities. His work in this area also led to the establishment of Optometry Giving Sight (OGS) in 2003, and he served as its CEO for six years. This in itself was a major accomplishment, and he devoted the latter part of his professional career to providing services in this eyecare space. In fact, due to his work, the World Health Organization recognized uncorrected refractive errors as a major cause of visual disability. He also convinced organizations such as the International Agency for the Prevention of Blindness (IAPB) and the WCO to join with BHVI in establishing OGS.

In addition, Brien generated resources to fund public health programs that were focused on the elimination of vision impairment and avoidable blindness around the world; his efforts have raised more than $1.3 billion in research, education, and humanitarian funding. And while BHVI’s headquarters are in Australia, it also is active in Africa, the Americas, Eastern Mediterranean, Europe, South Asia, and the Western Pacific. Incredibly, BHVI has operated in 54 countries, provided optometric services and glasses to more than 2.5 million people at 429 vision centers and eyecare sites, and trained almost 50,000 eyecare personnel around the world. In 2011, Brien Holden Vision Hong Kong Limited was established to help build China’s capacity for excellent vision care through applied vision correction research, optometry development and training, and public health programs.

Continuing Influence

At the time of his death, Brien and his international team of partners were developing novel technologies in an attempt to solve the problems associated with ametropia. He has been granted nine patents with nine more pending. His recent emphasis was on novel contact lenses that exhibit the potential ability to slow myopia progression. At the 2015 GSLS, he reported that two such soft lenses had resulted in an approximate 50% reduction in myopia and 58% reduction in axial length versus conventional soft lenses over a six-month period. This serves as confirmation that his efforts show much promise for the future. That is more than appropriate, as the mission of BHVI is “to develop new solutions for vision care and eliminate vision impairment and avoidable blindness, thereby reducing poverty and suffering.”

There will never be, could never be, another Brien Holden. Will his passing leave a large void in the eyecare profession? Of course it will. However, it is more appropriate to consider what our life would be like today if Brien Holden had never existed:

• We think of the need to provide higher-oxygen-permeable materials…he co-develops silicone hydrogel lenses.

• We think of going on a vision mission trip…he thinks of—and implements—a worldwide vision education program.

• We think of how to correct a patient’s myopia…he thinks of how to prevent myopia and develops novel spectacles and contact lenses to do so.

Our goal should be to preserve his legacy and continue his efforts in eliminating uncorrected refractive error. That would be the only outcome worthy of the individual who simply wanted to improve everybody’s quality of life worldwide. Brien Holden’s enduring legacy is best summed up by American author Ralph Waldo Emerson: “Death comes to all, but great achievements build a monument which shall endure until the sun grows cold.” CLS

Dr. Bennett is assistant dean for Student Services and Alumni Relations at the University of Missouri-St. Louis College of Optometry and is executive director of the GP Lens Institute. He can be reached at ebennett@umsl.edu.

Dr. Nichols is an assistant vice president for industry research development and professor at the University of Alabama-Birmingham as well as editor-in-chief of Contact Lens Spectrum and editor of the weekly email newsletter Contact Lenses Today. He has received research funding or honoraria from Johnson & Johnson Vision Care, Alcon, and Allergan.