A keen eye for science

Through her research at the Save Sight Institute (SSI), Pauline is working to improve the diagnosis and treatment of corneal infections, specifically an infection called microbial keratitis. The infection occurs in the cornea, the thin, clear part of the eye that covers the front of the eye including the pupil and iris. When the cornea is infected it can cause pain, irritation, and redness.

“In the earlier stages of infections symptoms are mild and can be managed with effective treatment.

"It’s important that patients get the right treatment as soon as possible so that the infection doesn’t worsen and cause complications. If the infection isn’t diagnosed in time or if it goes untreated it can spread to other parts of the eye.

"In severe cases, the infected eye may need to be removed as further treatment would no longer stop the infection.”

To help improve the diagnosis of corneal infections Pauline produced an educational resource for medical professionals, which can be viewed below. She developed a video on the best practices for obtaining a sample of infected tissue from a "corneal scrape."

Pauline is also involved with data collection and analysis to help better identify the organisms responsible for infections.

“The organisms responsible for microbial keratitis differ from place to place, even within New South Wales.”

"I’m part of a team that’s investigating the geographic variations of the bacteria responsible for corneal infections in Sydney so that doctors can more easily identify the cause of infection, and the best course of treatment based on recent data.

"Typically, doctors will empirically treat corneal infections – this means they provide a treatment based on clinical examination, patient history, and the symptoms they have, without knowing the exact cause (i.e., causative organism). This is so the infection does not worsen.

"We’ll be including our data in an annual report to help doctors narrow down the appropriate treatment for the specific cause of infection. This will become increasingly important as rates of antimicrobial resistance increase. These data will help doctors respond to treatment-resistant infections.”

Working at SSI also presented Pauline with the opportunity for further study. Thanks to her interest in research and a discussion with her manager Pauline decided to complete her PhD.

“My parents own an optical store, so I’ve always had an interest in eye research. I did a Bachelor of Science (Vision and Pharmacology) and thought about being an optometrist, but it wasn’t for me.

“During my undergraduate years I undertook research projects in the summer holidays and an honours year and realised research was better suited to me. A year into my role at SSI I spoke to my manager, Professor Stephanie Watson, who is now one of my PhD supervisors. She asked where I wanted to be in five years, so I thought more seriously about taking on a PhD.”

Pauline’s PhD focuses on ways to improve outcomes for patients with dry eye disease. This is a condition that occurs when the eyes don’t produce enough tears or produce poor quality tears which leads to inflammation and can damage the eye’s surface. Currently, there is no patient registry that tracks “post-market surveillance” for dry eye disease, that is, how well treatments work in the long-term following a clinical trial.

“A treatment might work well in a clinical trial, but patients enrolled in a clinical trial are only a subset of the general population. In dry eye disease, we do not have clear definitions to assess disease severity, and treatment and patient outcomes. Also, there is a lack of data on the long-term effects of dry eye treatments. This makes it difficult to compare treatments to one another, and meaningfully assess their impact.”

To overcome this, Pauline - with the assistance of international and domestic dry eye experts - developed a dry eye module that is part of the Save Sight Registries (SSR), a web-based tool that allows clinicians to track, analyse and report on “real world” patient treatment outcomes. The international, collaborative project allows clinicians and researchers to compare dry eye treatments and find out what works best.

Although completing a PhD while working can be tough, Pauline says her support system, and her passion for eye research helped her stay on track.

“I’ve definitely been kept busy by working while completing my PhD. But I’m lucky to have a supportive team behind me, including my supervisors, Professor Stephanie Watson and Professor Fiona Stapleton.

“I’m hoping to submit my PhD this year, which I’m very excited about. Ideally, I would like to continue researching in this field, but a PhD provides you with an ample amount of skills that are transferrable to other fields.

“People forget that the eyes are so important, and that blindness can come on suddenly – 80% of what we perceive comes through our sense of sight.

“My work has been a constant reminder of this, and it’s helped me stay driven and will no doubt help motivate me in my future work.”