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Children’s Vision Researchers Educate Capitol Hill about Latest Studies to Diagnose and Treat Vision Impairment and Eye Disease

On June 28, the Alliance for Eye and Vision Research (AEVR) hosted a Congressional briefing that described the impact of the past investment in children’s vision research conducted by the National Eye Institute (NEI) within the National Institutes of Health (NIH). "Most of the NEI-funded research into the diagnosis and treatment of vision impairment and eye disease in children would not have happened without the NIH budget-doubling that occurred from Fiscal Years 1998-2003," said AEVR Executive Director James Jorkasky, who added that the renewal of several major studies depends on adequate future funding. In addition to the many characteristics of NEI-funded children’s vision research cited by Jorkasky—engaging ophthalmic and optometric researchers nationwide, many of whom are associated with community-based health centers, recruiting multi-ethnic patients, and reflecting trans-NIH, collaborative funding—it also represents the 21st century paradigm for research as defined by NIH Director Dr. Elias Zerhouni, specifically that which is preemptive/preventive, predictive, personalized, and participatory. Featured speakers included Lynn Cyert, Ph.D, O.D. (Northeastern State University/Oklahoma College of Optometry) and Michael Repka, M.D. (Wilmer Eye Institute/Johns Hopkins University School of Medicine).

Dr. Lynn Cyert and Cong. Gene Green (D-TX), co-chair of the Congressional Vision Caucus
Lynn Cyert and Cong. Gene Green (D-TX), co-chair of the Congressional Vision Caucus
Dr. Michael Repka addresses the crowd of 70 attendees
Michael Repka addresses the crowd of 70 attendees

Cyert, a principal investigator in the NEI-funded Vision in Preschoolers (VIP) Study, described the study’s goal to evaluate vision screening tests to determine which are best for identifying preschoolers with ambylopia (lazy eye), strabismus (misaligned eyes), and refractive error (farsightedness and astigmatism) who need referral to an eye care practitioner for a complete eye evaluation. Although primary study results are in, researchers are seeking additional NEI funding to expand the research into whether having preschoolers with refractive error wear eyeglasses improves their school readiness and educational achievement later on. "Will eyeglasses help their readiness? Eye care practitioners generally use their intuition instead of real proof that these young children benefit from eyeglasses," she said, adding that, "We want to find out if it is worth the effort and expense to put them in glasses at such a young age." She also spoke briefly about the challenges presented by the disproportionate incidence of diabetic retinopathy in the Native American population since she also provides eye care services to the Cherokee Nation Early Childhood Program.

 

Repka, co-chair of NEI’s Pediatric Eye Disease Investigator Group (PEDIG), described the study’s goal of determining optimal treatments for vision problems that exist in pediatric populations. He is pursuing evidence-based medicine in order to separate "intuition from fact" and to standardize treatment for patients. PEDIG, which now includes 244 eye care practitioners with access to thousands of patients, has demonstrated that in patients with ambylopia—where a daily eye patch has been the standard treatment—two atropine eye drops each week work just as well, and older children can benefit from treatment, too. Ongoing studies are looking at improving outcomes further.

Hanna Doerr from the office of House Speaker Nancy Pelosi (D-CA) and AEVR’s James Jorkasky
Hanna Doerr from the office of House Speaker Nancy Pelosi (D-CA) and AEVR’s James Jorkasky
The researchers are joined by their colleagues in attempting to answer a very basic question, "What is the prevalence of eye disease among children in this country?" Two ongoing NEI-funded projects will help find the answer, including the Baltimore Pediatric Eye Disease Study (BPEDS), looking at 5,000 preschoolers, and the Multi-Ethnic Pediatric Eye Disease Study (MEPEDS) at the University of Southern California, enrolling 15,000 children in the same age group. Combined, this research ranges from evaluation of populations and the tools to measure and diagnose eye disease to treatments and the associated tools necessary to adequately evaluate those treatment outcomes.

In closing, Repka also discussed retinopathy of prematurity (ROP) and the potential impact of the recently released NEI-funded research on the protective effect of omega-3 polyunsaturated fatty acids, as demonstrated in mice. ROP, in which abnormal blood vessels grow in the retina (light- sensitive back of the eye) causing it to scar or detach, blinds about 500 children yearly in the United States. NEI plans to lend further support to allow clinical testing of the protective effect of the omega-3 supplement in premature infants, and research also suggests a protective effect in diabetic retinopathy and age-related macular degeneration (AMD), the leading cause of vision loss in seniors. Commenting on this finding, AEVR’s Jorkasky stated that "With research ranging from ROP in premature infants to AMD in seniors, the NEI affects and benefits the vision health of Americans at all stages of life."