Given that many children with complex needs will also have a visual Impairment, would the provision of enhanced visual awareness training to multidisciplinary healthcare teams improve outcomes for these children?

Given the prevalence of visual impairment among children with complex needs, the question arises: could providing comprehensive visual awareness training, including the use of Virtual Reality visual simulators, to multidisciplinary healthcare teams enhance outcomes for these children? The 2021 census recorded 1,491 individuals aged 0-14 with blindness or partial sight loss. However, Vision 2020 notes that registered cases may under-represent the true numbers, as not all eligible children and young people are registered. Bassett’s findings in 2010 indicate that around 50% of children and young people with vision impairment also have additional special educational needs and disabilities. Moreover, Rahi and Cable’s research in 2003 reveals that two-thirds of vision impairment is either present from birth or diagnosed within the first year of life. Hewett and Keil’s study in 2016 adds another layer to the issue, reporting that 38% of 16-25-year-olds with vision impairment are not in employment, education, or training. The impact of these statistics underscores the necessity for correct early intervention by trained professionals across various disciplines, such as physio, speech, and occupational therapists.

How important is it to you as a researcher/academic to include lived experience in your research? How do you build meaningful PPIE into the research process which is representative of society as a whole, whilst understanding the impact of the ask to the participants?

How/ what can you do to ensure that research undertaken and treatment/ drug development is inclusive of people and communities who aren’t typically represented in research, and that research participants come from a range of diverse backgrounds and experiences. The involvement of lived experience is important across all stages and areas of research and increasingly sought after by funders.
Given that the research that is carried out, ultimately could be their treatment down the line, and be the day to day that they have to live with, how important is it to you as a researcher/ academic to consider this? Have you considered timing, methods of involvement, impact of time and expertise being voluntary?

How/ what can you do to ensure that research undertaken and treatment/ drug development is inclusive of people and communities who aren’t typically represented in research, and that research participants come from a range of diverse backgrounds and experiences.

The involvement of lived experience is important across all stages and areas of research. Treatment options that come from research are potentially the day to day treatment for people living with illnesses and conditions but much research still remains narrow in the diversity of it’s participants. Treatments will be for everyone and given lived experience and considerations of diverse backgrounds are becoming increasingly important in research, how does research represent the people and communities it will be for in the future.

As the aging population expands, what solutions are required to support earlier recognition, referral and treatment of age-related eye diseases?

What role do public health agencies and novel technologies have alongside healthcare teams in raising the awareness of strategies for prevention of these conditions?

Studies suggest that the due to the aging population, visual impairment has become a public health concern. Eye diseases including Cataract, Glaucoma, Age-Related Macular Degeneration and Diabetic Retinopathy prevalences are high for people over the age of 75 . In Northern Ireland, AMD accounts for over 50% of the sight impairment/severe sight impairment registration, followed by Glaucoma and Diabetic Eye Disease.
Considering this rising prevalence in the population, could widespread Visual Impairment education using tools such as a Virtual Reality Headset bring prevention (through lifestyle changes and drug adherence), earlier recognition and even better overall support to people with a visual impairment?

To what extent do age, neurodegenerative conditions, multimorbidity, polypharmacy and chronic conditions such as diabetes, influence the dry eye disease demographic?

We are developing a device to alleviate dry eye symptoms caused by lagophthalmos and believe that this condition underpins a significant amount of dry eye disease symptoms

Learnings are requested on how best to embed novel medical devices within the treatment or care pathways of patients with Diabetic Retinopathy?

In 2023 it was shown, that the HIF pathway is triggered not just by hypoxic episodes, but also by sudden drops in blood sugar glucose levels. Should nocturnal light treatment be added to healthcare pathways i.e. should it be used during treatments which intentionally result in rapidly lowering blood glucose, in order to combat the nocturnal hypoxia contribution to HIF accumulation and reduce adverse effects of VEGF and ANGPT2 on Diabetic Retinopathy development.

Whilst maintaining blood glucose within a normal range is advised in order to reduce the risk of Diabetic Retinopathy, if a person with Diabetes reduces their blood sugar levels too rapidly, they can increase their risk of developing eye complications. Rapid reduction in blood sugar levels can occur when normal levels of blood glucose drop to hypoglycaemic states (common during pregnancy) and also could occur during a rapid drop from chronically high blood glucose levels down to normal levels when a type 1 first implements the closed loop continuous glucose monitoring system (CGM). It may also be relevant when people with type 2 diabetes embark on an ultra low calorie diet in order to rapidly lose weight and put their type 2 diabetes into remission. There is currently no method of managing excessive accumulation of HIF and sudden drops in blood glucose are an inevitable part of these events. Should other methods of oxygen management and retinal hypoxia avoidance through control of retinal metabolism be considered such as the suppression of dark adaptation with Noctura 400. Use of such a device during the period of rapid sugar reduction could reduce the hypoxia contribution to HIF and the development of retinopathy at this time.

What are the future demands of retinal imaging? What hardware and software development do you expect from the imaging industry?

With an aging population and increased number of patients, the process of diagnostics, treatment follow up needs to be more accurate and less time consuming. What additional tools, functions, software, will be needed to speed up and improve the process of retinal imaging?

How can academia and industry work together to develop more patient-centric outcomes in clinical trials?

For example – moving away from best-corrected visual acuity (BCVA) in retina studies, which is a poor measure of a patient’s overall experience of functional vision.

How can we work together to balance the need for innovative new treatments with a UK healthcare environment which encourages generic and biosimilar medicines?

All ideas and further discussion welcome.

How will the development of AI analysis of fundus and OCT images change the scope of community and optometric healthcare? How will this impact on practices as well as patient pathways?

As we see further development of AI analysis of images for ocular and systemic disease risk factors, will this present further challenges to the expected level of care that HCPs provide?