Research & Innovation | Overview
Our clinicians and researchers interact to advance pediatric ophthalmology and strabismus and to bring these advances to patients in need. The focus of our basic research is on the major causes of vision loss in children, including retinopathy, amblyopia and strabismus and retinal degeneration, as well as to the promise of vision rehabilitation, including visual object recognition.
Some of our recent research includes:
Preventing Retinopathy of Prematurity
A promising investigation is underway on a method to prevent retinopathy of prematurity, a disease that occurs in many premature babies that without intervention, can lead to blindness. Currently, laser surgery is the only hope for babies born with this condition, and surgery is not always successful in resolving it. Researchers at Boston Children's have shown in animal models that doses of growth factor can prevent ROP.
New methods for early detection of misaligned eyes
Sometimes when a child's eyes cross, the problem is obvious. Other times, when the eye alignment is only slightly off, strabismus can go undetected because it is difficult for pediatricians to detect small angles of misalignment. Yet if the misalignment goes undetected, the brain doesn't learn how to see properly from the misaligned eye and a child can develop subnormal vision, a condition known as amblyopia (lazy eye). It is estimated that up to 500,000 preschool children with this condition remain undiagnosed and untreated. In these difficult to detect cases, new methods for early detection are essential.
Researchers at Children's have developed remote sensing scanners that can screen children as young as 2 years old, and detect even slight misalignment of the eyes. Perfecting this technology will allow pediatricians across the country to perform a quick screening exam while the child, unaware of testing, gazes at a winking smiley face for a few seconds.
Genetic testing for congenital fibrosis and Duane syndrome
Congenital fibrosis and Duane syndrome are particularly devastating forms of strabismus in which several or all the eye muscles malfunction, causing profound misalignment. Surgery to correct the condition often fails.
Researchers at Children's have identified several of the genes mutated in these disorders. Clinical trials are being planned to advance the understanding of these genes. Using powerful MRI scanners researchers are also developing an orbital imaging center to map the pathway of nerve to muscle. For more information about these studies and how to participate, see the Engle Laboratory.
Amblyopia Treatment Study
The Department of Ophthalmology is a designated research site for the Pediatric Eye Disease Investigations Group (PEDIG), a collaborative network funded by the National Eye Institute that facilitates multicenter clinical research in eye disorders that affect children. The department is currently investigating the efficacy of patching therapy to treat children between the ages of 7-13 years who have amblyopia (lazy eye) which results in decreased visual acuity.
Patching therapy is a method of occlusion of the "good" eye with a goal of improving the acuity in the fellow eye. It is widely known that visual acuity can be improved by this method in young children with amblyopia, but opinions differ as to whether it is useful in children between the 7-13 age group, when children reach a certain point of ophthalmic maturity. The Amblyopia Treatment Study is looking at large volumes of children at numerous sites throughout the country to determine definitively whether patching can be used as a method of treatment for older children. More information from the Pediatric Eyes Investigator Group.
Babies with cataract
Boston Children's Hospital's Ophthalmology Department is part of a multi-eye center study to determine how best to treat infants once the cataract is removed with the goal of attaining normal vision: contact lenses or surgical placement of a plastic lens called intra-ocular lens. The Infant Aphakia Treatment Study aims to determine which of these two methods is the best method to focus the eyes of babies following cataract surgery. The study will follow infants between the ages of 4 weeks and 7 months who were treated for cataracts for five years.
Research
Boston Children's Hospital's Department of Ophthalmology is involved with numerous research projects designed to improve methods of diagnosis and treatment for a host of vision problems. For more information on research initiatives, visit our research site: www.infantvision.org.