National Alliance for Eye and Vision Research (NAEVR) Fact Sheet
NATIONAL EYE INSTITUTE (NEI) LEADS IN EYE AND VISION RESEARCH; ENGAGES IN COLLABORATIVE RESEARCH WITH OTHER NIH INSTITUTES AND FEDERAL ENTITIES AND THE PRIVATE SECTOR
In 1968, Congress passed the National Eye Institute (NEI) Act, which was signed into law by President Johnson on August 16, 1968 (PL 90-489), with the NEI holding the first meeting of its National Advisory Eye Council on April 3, 1969.
The legislation created a free-standing Institute, separate from the then-National Institute of Neurological Diseases and Blindness (NINDB). Previously, the budget for eye research was less than 20 percent of the NINDB budget. Simply stated, if eye research had remained as part of the NINDB, the American people would not have benefited from the treatments and therapies for eye disease that have emerged from NEI-led and funded research, training and education.
The NEI is a well-managed and efficient Institute that maximizes funding by devoting 85 percent of its budget to extramural research that addresses the breadth of eye disorders, including “back of the eye” retinal disease and “front of the eye” diseases, such as corneal, lens and cataract, glaucoma, refractive errors and low vision. This research is more timely and valuable than ever since:
- Americans have consistently identified fear of vision loss as second only to fear of cancer in public opinion polls conducted over the past 40 years.
- Vision impairment and eye disease is a major public health problem. Currently,
38 million Americans age 40+ experience blindness, low vision or an age-related eye disease, and this number is expected to grow to 50 million by year 2020.
- Vision impairment and eye disease costs the United States $68 billion annually in direct healthcare costs, lost productivity and diminished quality of life. This is expected to increase dramatically with the aging of the population.
- NEI-sponsored research results in therapies and treatments that can delay, save and prevent healthcare costs, especially to the Medicare and Medicaid programs.
NEI’s mission to protect and prolong the vision of the American people has resulted in research to advance our knowledge of both eye health and disease. Most recently, and post NIH-budget doubling, NEI-sponsored research has:
- Identified key genes associated with age-related macular degeneration (AMD), the leading cause of vision loss in older Americans, which can now lead to potential therapies and prevention.
- Demonstrated that nutritional supplements such as zinc and antioxidant vitamins can reduce vision loss in people at high risk of developing advanced AMD, thereby identifying a cost-effective preventive treatment.
- Demonstrated that pressure-reducing eye drops can delay or prevent the onset of glaucoma, an especially important finding for African Americans, who experience this blinding disease at a rate three times that of White Americans. All of the new drug therapies and procedures for glaucoma introduced in the last decade have emerged from NEI-funded research.
- Demonstrated through the Los Angeles Latino Eye Study (LALES), the largest eye health epidemiological study on Latinos, that this fastest-growing segment of the US population has a higher incidence of diabetic retinopathy, glaucoma and low vision than other segments. One in five individuals with diabetes was newly diagnosed during the clinical exam, and 25 percent were found to have diabetic retinopathy.
NEI’s status as a free-standing Institute has enabled it to pursue numerous clinical trials (more than 60 date) not previously considered a priority when eye research was part of the NINDB and to collaborate with seemingly unrelated Institutes. These collaborations have resulted in measurable health improvements and cost-effective treatments, such as therapies that have enabled individuals to see that didn’t see before, as well as substantial progress in the professional practice of vision care. Two dramatic examples include:
- NEI’s initial Diabetic Retinopathy Study established the efficacy and value of laser treatments. NEI collaborated with colleagues at the National Heart, Lung and Blood Institute (NHLBI) on trial design and with the National Institute for Diabetes and Digestive and Kidney Disorders (NIDDK), since retinal vessels respond differently to diabetes than do brain vessels. The subsequent NEI-sponsored Diabetic Retinopathy Clinical Trial Network helped to determine the best treatment strategies through diabetes control (in conjunction with NIDDK) and laser photocoagulation. As a result, these treatments that delay or prevent the disease are effective and save an estimated $1.6 billion per year in costs of blindness and vision impairment to the federal government.
- NEI has funded research, along with that of the National Cancer Institute (NCI) and the NHLBI, into factors that promote new blood vessel growth (such as Vascular Endothelial Growth Factor, or VEGF). This has resulted in anti-VEGF factors that have been translated into the first generation of Food and Drug Administration (FDA)-approved ophthalmic drugs to inhibit abnormal blood vessel growth in “wet” AMD, thereby stabilizing vision loss. Current research is focused on improving vision that has already been lost in AMD, as well as applying these drugs to treatment of diabetic retinopathy.
The NEI has been an important participant in the NIH Roadmap (leading the Nanomedicine initiative) and the trans-Institute Neuroscience Blueprint, since eye research is at the cutting edge of scientific discovery. NEI is engaged in various forms of collaborative research with most other NIH Institutes and Centers, since:
- Eye diseases affect Americans of all ages and races, are most often chronic diseases and can be a co-morbidity of another disease.
- The eye can often be used as a diagnostic tool for disease. As noted in the previously-cited LALES study, many individuals are initially diagnosed with diabetes only after an eye care professional detects retinal damage associated with diabetic retinopathy.
- The eye is a unique site to study cellular mechanisms and pathways, as it offers accessibility and an organ in which to measure an effect of a treatment.
- Most blinding eye diseases require research expertise from a wide range of fields, including neurobiology, genetics, physiology, cellular mechanisms, biophysics, membrane transport, microbiology, virology, immunology, bacteriology, parasitology and optics.
Additionally, because the NEI staff has a thorough understanding of the eye and works closely with a large community of support for eye research, including other federal entities, academic institutions, ophthalmic and optometric professional societies, private research organizations, patient advocacy organizations and industry, it can fully leverage federal research dollars with the private sector. Examples of two groundbreaking public-private relationships include:
- Bioengineering research partnerships, one of which is engaging the National Science Foundation, Department of Energy, an academic institution and private companies in developing a retinal chip implant that has enabled individuals who have been blind for decades to perceive visual images.
- A collaborative research program with Foundation Fighting Blindness, a privately funded research organization, conducting a human gene therapy clinical trial in individuals with Leber Congenital Amaurosis (LCA), a rapid retinal degeneration that blinds infants in the first year of life. In 2008, researchers demonstrated measurable vision improvement even within the initial safety trials.
NEI is a leader in eye and vision research that is taking full advantage of productive collaborations with other NIH Institutes and federal entities, as well as with the private sector. This is resulting in new treatments and therapies to not only stabilize vision loss but to restore it, or ultimately prevent the onset of eye disease. Our nation’s investment in the NEI is cost-effective, as the treatments emerging from its research can reduce healthcare costs, improve productivity and ensure quality of life.
For more information, contact:
James Jorkasky, NAEVR Executive Director