We talk to Dr Jonathan Denniss, the 2014 winner of the Neil Charman Medal for Research, about his work to improve clinical tests for glaucoma and why he thinks there aren’t enough practising optometrists involved in research. Nominations for the 2020 Research Excellence Awards are now open.
You won the Neil Charman Medal for Research. Tell us more about your award-winning research.
The work concerned the development and testing of a new way to map the optic disc to the visual field, which is useful in combining data from different clinical tests, especially in glaucoma.
Most previous studies had taken a 'one-size fits all' approach to relating optic disc regions to areas of the visual field, but we recognised that this relationship would be different in eyes with different individual anatomy. We developed a computational method that relates any part of the visual field to the optic disc according to individual eye anatomy. This method demonstrated significant variability in the relationship between disc and field, including some cases where visual field points can map to the opposite hemifield to that usually expected. We validated the method against images of retinal nerve fibre bundles in a range of different eyes with known anatomy, and then investigated the practical implementation of the method for both research and clinical practice.
How would you like to see the findings from your research impact clinical practice?
Our studies have been influential in alerting other researchers to the importance of individual eye anatomy when relating the optic disc and visual field, and have been well-cited as a result. We would like to see our methods implemented further clinically, for example, users of linked OCT and visual field devices may obtain combined structure-function reports tailored to individual eye anatomy.
What has been the biggest challenge you faced during your research career?
I think the biggest challenge for researchers working on new techniques in clinical vision science is the translation of findings into clinical practice. There are many good ideas in the literature, often with solid evidence of efficacy, that never reach mainstream clinical practice. Barriers to translation are extensive and wide-ranging, meaning that it is unfortunately common for useful developments to be consigned to the academic literature with limited benefit to patients.
How has your work progressed since you won the award in 2014?
On that particular topic, we have continued to improve the method for use in ongoing research and clinical practice. Subsequent studies showed that the method did indeed improve structure-function relationships, and that as many as one in eight people have the anatomy that means parts of the optic disc can relate to the opposite side of the horizontal midline of the visual field to what we would usually expect. My research, in general, has diversified and now includes work on visual function and eccentric viewing in AMD, as well a variety of other glaucoma-related topics. Of note, the development of en face OCT imaging techniques means that we can now visualise retinal nerve fibre bundles better than ever before, and some of our current research at the University of Bradford is looking at how we can use these images to directly map glaucomatous damage in the retina to the visual field.
What advice would you give to an optometrist in practice, interested in pursuing research?
Give it a go! There are not enough practising optometrists involved in research and I believe this holds us back as a profession. If you are interested in research or have an idea but don't know where to start, I would suggest getting in touch with an academic whose research interests seem to align with your own. Most university department websites will give you an idea of who to contact. Don't be afraid to contact someone out of the blue, most academics would be delighted to hear from you. There are many paths you could take, ranging from a small stand-alone project through to pursuing a PhD and beyond, and I would encourage you to find out more.
What did winning the Neil Charman Medal mean to you?
It was fantastic to receive recognition at this level from the College and the profession. Most research is a team effort and this was certainly no exception, so I considered it an acknowledgement of a fantastic few years working with great people.
If you would like to nominate yourself or someone else for the 2020 Research Excellence Awards, now is your opportunity. Applications and nominations are open until Monday 13 July 2020. Refer to the guidelines for more information.