Overview
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Generally, HP is considered to obtain ‘Input’ from different stakeholders among the society in multiple aspects, proving the feasibility, legitimacy, demand and impact of our project with professional opinion, general public review and data analysis.
Driven by the goal of soothing glaucoma, HK-HCY-PCMS iGEM team’s project is shaped with regards to social and ethical values. Long-term communications, conferences and collaborations with glaucoma patients, general public, synthetic biologists and experts in various fields not only lead us to improvement of the project, but also navigate us to balance needs and expectations of stakeholders. Per the official iGEM Human Practice goal, the HP department demonstrates how the world affects this project, as well as how we affect them.
Critical reflection on our human practices engagements has been fundamental to our project's development. Through systematic stakeholder engagement , we have gained mutidimensional insights that both validated and enhanced our research direction:
- By listening to glaucoma patients, we gained profound insights into the disease's life-altering impacts, which reinforced our commitment to this research.
- Learning from glaucoma specialists, we are able to solve provocations in our process of modelling and wet lab.
- From interviewing bioethicists, we are able to plan our future project development ethically.
- From consulting drug manufacturers, we understand the procedure of launching our product into the market.
We listen, we communicate, we perform research and we implement. By performing extensive research in terms of how our project addressing real-life issues, we believe that being involved in iGEM doesn’t mean we only conduct scientific research in theory, instead, we are also responsible for making a difference in this world.
Background Research
Primary Open-Angle Glaucoma (POAG), the most prevalent and insidious form of glaucoma, poses a significant threat to global vision health. This condition develops when impaired drainage of aqueous humor leads to elevated intraocular pressure (IOP) in the anterior chamber. The increased IOP exerts damaging pressure on ocular tissues, ultimately causing irreversible damage to retinal ganglion cells (RGCs) and progressive vision loss.
Insufficient drainage of aqueous humour leads to high IOP
Granted use from Prof. Edward Ryan Collantes.Global Prevalence
Glaucoma has gained its prevalence across the globe, especially in China. Its population has increased by roughly 20 millions in 10 years. It is crystal-clear that Glaucoma is a disease that must be addressed. This piece of infromation serves as a backbone for our research, with urgent need to provide a holistic, multipathway solution for this disease.
There are 80 million glaucoma cases in 2020
Varma, Rohit & Lee, Paul & Goldberg, Ivan & Kotak, Sameer. (2011). An Assessment of the Health and Economic Burdens of Glaucoma. American journal of ophthalmology. 152. 515-22. 10.1016/j.ajo.2011.06.004.It is urgent for us to address the global prevalence of Glaucoma with Project Opthera.
Glaucoma population is expected to rise to over 111 million in 2040.
Tham, Yih-Chung & Li, Xiang & Wong, T-Y & Quigley, Harry & Aung, Tin & Cheng, Ching-yu. (2014). Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040 A Systematic Review and Meta-Analysis. Ophthalmology. 121. 10.1016/j.ophtha.2014.05.013.
Symptoms
Glaucoma, though difficult to notice, identify and diagnose, leaves permanent damage on patients' vision. Beginning from the peripheral areas, this disease can cause full blindness if untreated. It also brings an array of suffering symptoms to the patients, including acute eye pain, headache, insomnia, etc.
Progressive damage of vision
Granted use from Prof. Edward Ryan Collantes.Societal Awareness
Despite being a chronic disease with high population worldwide, Glaucoma remains relatively unnoticed in the society. Elders, with the risk factor of high age, are particularly poorly informed due to their poor digital literacy. It is crucial for us to address this issue through our project outreach activities.
Up to 50% of Blind individuals due to Glauocma are unaware of the cause
World Health Organization and World Glaucoma Association, 2016.
More than 65% of 452 survey participants do not have a habit of yearly eye checkup
From our Street Interview (Stage I)It is our mission to spread glaucoma awareness and knowledge through our educational activities.
Bioethical Reflection
Reflection in iGEM Human Practices means a conscious, iterative process of considering the motives, benefits, impacts and implementation of our project. In Project Opthera, we have succeeded in:
- Examining the social and scientific feasibility of a dual-targeting treatment over traditional pathway.
- Considering who most benefits from such innovations, and who might be left behind by the current system, we address their needs through engagements and connections with elders, patients and the public.
- Comparing the approach with alternative, surgery procedures and more invasive treatment types through engagements with doctors and professors of related fields.
- Continuously revisiting design goals with patient feedback, emerging risks, and the dynamic context of therapy environments, through our IOP reflection cycle.
This reflection process was built into the project workflow, from start to finish, to ensure that we are responsible for our development and adhere to the principles of bioethics.
HP Development Stages
Stage I: Laying the Fundamentals
In this section, we outline our HP development process, as well as our span of different groups of opinions. We conducted brainstorming sessions, research, and outline designs to facilitate our upcoming stages of HP activities.
Analysing Potential Stakeholders
Outlining Event Approach
We have identified a number of stakeholders that we plan to engage, which provides realistic information for our project development, both scientifically and sociologically.
Applications
By accessing the impact of our project, we can get a better understanding of how our project changes the lives of others, not only by direct beneficiaries of the product but also by the ripples we make along this iGEM journey. We are inspired to enhance the overall environment for glaucoma patients, making their lives more convenient and inclusive by promoting awareness and inclusiveness for eye diseases such as glaucoma.We aim to exert a positive influence and impact on different stakeholders of the community - glaucoma patients (individuals, public medical services, nursing homes), optometrists (professional opinion on whether our project is beneficial to the patients) and social authorities (to obtain the view of our impacts in a macro scale on the society).
We can connect with patients, ophthalmologists, nurses, nursing homes, general public and social authorities.
Feasibility
Our project must be realistic and favourable in real-world conditions. It is important to stay collinear with real-world conditions by adapting to different environmental, scientific and social circumstances. Thus, we have to make sure our project is feasible in every aspect involved in the development of a synbio drug, from design to commercial processes.
For scientific feasibility, we can connect with professors of related fields and ophthalmologists.
For Sociological feasibility, we can connect with patients, medicine manufacturers and pharmacies.
Stage II: Understanding Realistic Needs
In this section, we obtain the view and needs of different stakeholders in the society. We will mainly analyze the interviews we have done, and focus on glaucoma patients’ needs and social authorities’ demands, aiming to create a down-to-earth and realistic project according to different stakeholders’ needs. We would like to send out google forms to the general public, in addition, interview social authorities, patients and opthalmologists.
Interviewing patients in HKBU
Interviewing opthalmologist Dr. Jasper Wong
Our goal in this stage is to try making our project adhere to the realistic needs of stakeholders in this society, including the side effect profile, interval of drug intake, etc.
Opthalmologists
Ophthalmologists seek innovative drugs that address the multifaceted nature of eye diseases, particularly favoring multi-targeting approaches that simultaneously hit multiple biological pathways for enhanced efficacy. For instance, in treating conditions like glaucoma, where elevated intraocular pressure arises from issues such as impaired outflow, excessive aqueous humor production, and neuronal damage, a single-target drug often falls short, necessitating combinations or polypharmacological agents to achieve better control and neuroprotection. They prefer these multi-targeting drugs because many ocular disorders involve complex, interconnected mechanisms—including inflammation, vascular proliferation, and oxidative stress—that no solitary compound can fully mitigate, leading to synergistic effects, improved patient outcomes, reduced dosing frequency for better compliance, and minimized side effects compared to traditional monotherapies. This strategy ultimately allows for more tailored and effective management of chronic eye conditions, aligning with the goal of preserving vision with fewer interventions.
Opthalmologists seek drugs with multi-targeting nature, reliability, and low dosage frequency.
Patients
Patients with ocular conditions want newly developed drugs that provide effective symptom relief, minimal side effects, and easy administration to enhance their quality of life. They prioritize treatments that are convenient, such as once-daily eye drops or sustained-release formulations, to simplify adherence and reduce the hassle of frequent dosing. Patients also value therapies with a low risk of adverse effects, like eye irritation or systemic issues, to ensure comfort and safety. Above all, they seek affordable, accessible drugs that effectively preserve vision while integrating seamlessly into their daily routines.
Patients seek drugs with low side effects, low dosage frequency, and high instantaneous relief.
Stage III: Improvements of this Project
In this section, from the interviews with synthetic biology and medical experts, we seek improvement on this project - both Socially and Scientifically. Our team has set our focus on experts related to synthetic biology and community health. This stage is also the most time-consuming and restless, as we constantly refine our projects to a higher level of scientific rigor.
Visiting lab facilities of BioTech startup in ShenZhen
Interviewing Prof. Wai-Kit Chu from CUHK
Through different interviews, we have obtained pragmatic insights on how to improve our project research and experiement, and refining our pathway to a more scientifically feasible approach.
Reflective Action Research
In the span of 10 months, we constantly seek professional opinions to improve our project. Here are some of the key points of what we altered & modified in our project, thanks to the valuable insights of different esteemed professionals.
- We refined our scope from a diagnostic and therapeutic approach to focus solely on relieving the situation of glaucoma.
- We will utilize cell lines to test protein function instead of experiments with primary mouse cells.
- Our multi-target eye drop addresses both elevated intraocular pressure and retinal ganglion cell apoptosis.
- We prioritize preventing retinal ganglion cell death, with IOP regulation as a parallel side project.
- We are utilizing TAT-functionalized liposomes as nanocarriers to enhance permeability through ocular barriers.
- We will use ligands specific to RGC and trabecular meshwork receptors to improve targeting precision.
Stage IV: Commercialization
In iGEM 2025, we work beyond our scope, performing extensive research in the commercial, social and ethical side of drug development. As a potential startup, we deeply value the holistic planning of marketing and bioethics. In this session, we conduct interviews and research on how the public and professionals percieve the topics of bioethics, and also consulting marketing professors for future marketing plans of a pharmaceutical startup.
Interviewing Bioethics Professors Prof. Yat-Nork Chung @CUHK Centre for Bioethics
Interviewing glaucoma tech entrepreneur Dr. Russel Tait
The purpose of this stage is to reflect on the moral side of the project, as well as consider the future directions beyond the iGEM competition.
Bioethics
An ethical approach ensures the transparency, inclusivity, and responsibility of our team regarding our innovations. Beyond striving for technical proficiency, our team also wishes to leverage a more socially and ethically conscious practice. This means engaging openly with stakeholders, including experts, communities and end-users to align our project with real-world needs and values. Our team explores the ethical difficulties and concerns throughout the process of creating a drug. We aim to address these challenges by presenting our ideas not only innovatively, but also respectfully and morally. By integrating ethical aspects into our project, we are committed to contribute meaningfully to a safer, more equitable and sustainable future for all.
We can interview bioethics professors on the multifaceted topic.
Market
Beyond participating in the competition, our team hopes to turn our creation into a product which is accessible to the general public to help those in need. In hopes of popularizing our product, we extended our research beyond its core technical development, and towards the marketing processes, strategies and drug commercialization. We’ve delved into different stages of the marketing of a product, stretching from preclinical studies, clinical trials to manufacturing and distribution. By pivoting around the business aspects, we gained invaluable insights which ensures our product not only excels scientifically, but also commercially for widespread accessibility and societal benefits.
We can interview professors, business owners, entrepreneurs, drug developers and manufacturers to get a more holistic perspective on the marketing of drugs.
IOP Reflection Cycle
The IOP reflection cycle is a standard procedure for systematically organizing information obtained from interviews with different stakeholders. This provides us a clear, sorted perspective on what we obtained from the interview, what we will do or have done in our interviews, as well as what we can do to further maximize the impact of our project.
Inspiration
From interviews with experts and patients, we receive pragmatic advice and inspirations on improving our project in different aspects. Their inspiration provides us insights on what to improve and alter in our project by reforming decisions and tweaking different aspects and elements of our project. We ask ourselves: What inspirations and advice did we receive, enlightening us to opt for changes?
Operation
As we organized the inspirations in previous stage, the next stage is to arrange actualmodifying operations and changes according to the inspirations. We incorporate many suggestions to improve scientific robustness and accuracy, as well as a more sophisticated pathway and effect. Their inspirations are fundamentals for us to perform modifying operations and changes to our project according to their valuable opinions. In this session, we ask ourselves: What specific actions can we take to improve our project based on the interview?
Promotion
For outreach, we think of ways to maximize our project’s reach to different audiences. From the data and information gathered in the interviews, we gain more insights on how, and in what scale does our project make a difference in this world. We also come up with innovative ways to communicate to different audiences and stakeholders. In this session, we ask ourselves: How do we amplify the promotions and reach of our project, make a more significant difference to this world?
Full timeline (Click to expand)
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*As one interview may involve multiple stages, duplication of blocks across different stage is normal. All photos displayed have gotten verbal or written consent.
Street Interview (Stage I) in Mong Kok, Hong Kong
In February, we conducted a street interview with 452 members of the public, obtaining more insights on how the public views Glaucoma and its treatments. In the span of 4 days, we have collected 452 responses with diverse age and societal background, providing us a broad and macro view on the public's point of view on our project.
Date: February 2025
Participants: 452 Members of the Public
The general public lacks awareness and knowledge towards Glaucoma.
Inspiration
We obtained a wide range of statistics on publics’ views on glaucoma, and their familiarity with this disease, as well as its treatments. From the data, we know that most of the public members do not have a habit of regular eye checkups, let alone glaucoma checkups. They also do not have proper consciousness on glaucoma and potential severity of glaucoma. This inspires us to host campaigns to educate the public about glaucoma to boost its awareness. On the other hand, respondents show interest in knowing more of drugs to slow down glaucoma deterioration. This proves that our project is in demand of the general public.
Operation
This interview gives us substantial insight in basic understanding of publics’ view on our project and glaucoma. Through the project, we confirm our targeting of the general public’s awareness towards treatments, symptoms, and preventive measures of this disease, which define the scope of our educational activities. In the future educational activities and media content for the general public, we are incorporating glaucoma symptoms, its societal impact, and severity into our content. In minifilms, we will include the content mentioned above, and also implement related information in our social media posts.
Promotion
This interview allows us to more accurately resonate with the general public, communicating with them more effectively and engagingly. This sets the tone for the rest of our iGEM journey, amplifying our messages and impact on the world.
Patient Mr. Kwok, a member of Hong Kong Blind Union
Kwok Kai Fung, diagnosed with glaucoma in 2023, experienced rapid vision loss post-diagnosis. He manages his condition with subsidized eye drops (HKD$300/month) and quarterly hospital check-ups. We are aware of the need of our project to be down-to-earth and align with patients’ needs. Thus, we are launching a series of interviews with patients, in order to collect real-life needs of patients.
Date: February 2025
Patients are not well-informed in knowledge of Glaucoma.
Inspiration
Kwok was diagnosed with glaucoma in 2023, experiencing rapid vision loss post-diagnosis. He manages his condition with subsidized eye drops (HKD$300/month) and quarterly hospital check-ups. Despite the convenience and effectiveness of the drops in regulating eye pressure, they fail during occasional severe pain. Kwok’s experience is really inspiring. In this interview, we learnt the hardships patients have to face in their daily lives, including sensory adaptation and tweaks of life routines. He also mentioned the hindrance and difficulties of current treatments, checkups and medications. This inspired us to solve specific problems of patients with our product, with information given by Kwok.
Operation
We have taken advice from Kwok and conducted a number of operations accordingly. Science wise, as Kwok expressed difficulties of some patients in affording the drugs, we have started researching on commercial ways to lower the product price (Stage IV: Commercialization), as well as planning for simulated experiments to simulate our product’s IOP decrease ability, compared to commercially available drugs. In our education programmes, we have also taken a lot of advice from Kwok. In our courses (PCMS & HKPA), we had extensive courses and lessons on the hardships of glaucoma and visually impaired patients.
Promotion
Through this interview, we found out that the current market really needs a drug that patients can experience the drug’s efficiency during the treatment. Besides, we realised that patients in Hong Kong are generally not well and holistically supported. Even if the systematic factors are well supported (medication price, check-up waiting time), they still severely lack a sense of support and inclusivity in our society. This encourages us to host a series of seminars and workshops to maximize our impact in making a difference in our society, fostering a more inclusive and caring environment for the visually impaired individuals.
Glaucoma Patients-Members of the HKGPA
For understanding patient’s needs realistically, we have organised a meeting with the Hong Kong Glaucoma Patient Association. In this meeting, we hope to know more about what the users care about such as the package of the product, frequency when using the product. We also aim to collect information about distribution channels of the product in order to ideate our entrepreneurship plan in the meeting.
Date: August 2025
Focus on content creation and events to inform others of glaucoma patients’ needs and struggles.
Inspiration
In this meeting with glaucoma patients, we have known that patients are always annoyed by the frequency of taking eye drops. They may need to drip eyedrop almost six times a day. After questioning and understanding every patients’ needs, the modest frequency of using eye drops for patients is twice a day, once in the morning and once before bed as this frequency of using eye drops wouldn’t interrupt the patient’s daily schedule. On the other hand, our team members have also asked questions about the package of eyedrop. Several patients reported that the design of the cap that requires the patient's screw to open is not convenient for patients. Furthermore, some patients told us that sometimes they would waste some eye drops as they may not aim their eye perfectly.
Operation
After the interview with glaucoma patients, our team members have done a lot of tests to ensure the low side effect profile. Including allogeneicity, protein toxicity tests for computational modelling. We also are reminded, through this interview, to investigate the eyedrop intake interval of our product.
Promotion
This interview is a sobering reminder that patients’ needs are often overlooked. In the aspects of doctors appointment waiting time, glaucoma education, information about glaucoma treatment types, are all poorly transmitted to patients. This allows us to outline our future education activities, with focus on creating content and events to promote the above-mentioned aspects in the life of patients. Subsequently, we strive to create a more inclusive and kind society to the blinds. This interview gave us specific scope to achieve so.
HKGPA Social Workers
Mr. Yiu is a social worker who has worked for Hong Kong Glaucoma Patient Association(HKGPA) for more than twenty years. Ms. Chan is a social worker in Hong Kong Glaucoma Patient Association(HKGPA). She is in charge of providing mental support services for glaucoma patients. Ms. Chan, herself, is a glaucoma patient. Hoping to collect advice from social workers, we organized this meeting with HKGPA’s social workers.
Date: March 2025
Focus on educating/engaging with patients, especially the elderly, for them to make informed medical and daily decisions.
Inspiration
In this interview with HKGPA’s social workers, we have understood that patients association often invite ophthalmologists and glaucoma specialist to their centre to give talks. Ms. Chan mentioned that these talks indeed can provide updated informations to patents but the scale of the these activities is too small, so only patients can be benefitted. Mr. Yiu said that the general public is lack of the information about glaucoma. He said a lot of patients, especially those who are only diagnosed a short period are shocked by the speed at which this disease can deteriorate. Lack of public awareness is the main reason why the number of diagnosed patients has kept on increasing in recent years. There are not enough opportunities for the general public, no matter children, adults or elderly, to receive information about glaucoma and alternatively cannot understand how glaucoma can affect one’s life.
Operation
After this interview, we realized that increasing public awareness is a mission for our outreach team. We decided to organize small scale educational activities first and conduct some questionnaires in order to collect advice and improve our activities next time. We first started from local students such as holding game booths, making board games and joining volunteering activities to teach students from 5 years old to 18 years old of ways to prevent glaucoma. After these activities, we plan to upscale the activities so the process can be more effective.
Promotion
Social workers Miss Chan and Mr Yiu both mentioned the knowledge difference between patients, elders, and the general public. It seems that elders and patients have a less sophisticated channel to receive information regarding glaucoma and SynBio. This encourages us to focus more on engaging with patients and elders, narrowing the knowledge difference between them and the rest of the world. In this interview, they both mentioned that it is extremely crucial for patients and elders to be more informed , so that they can be empowered to face this disease and make informed medical and daily decisions.
Conclusion
Our Human Practices efforts were instrumental in shaping Project Opthera, ensuring our work remained grounded in real-world needs. Direct exchanges with ophthalmologists, researchers, and patients provided invaluable insights. A key revelation was the critical need for public education, which motivated us to develop extensive glaucoma awareness materials alongside our scientific research. Moreover, expert feedback directly influenced our project's design, guiding our proposed treatment pathway toward greater clinical viability. This continuous cycle of engagement and refinement ensured that Opthera evolved into a holistic initiative. By integrating these perspectives, we have strived to create a project that is not only scientifically sound but also socially responsible and genuinely responsive to the community it aims to serve.