As a result of NEI-sponsored laboratory and clinical research trials, researchers have discovered that:

• Laser surgery can safely and effectively treat diabetic retinopathy, a potentially blinding disease of the retinal blood vessels. Diabetic retinopathy affects between 40-45 percent of the 10.5 million Americans who have been diagnosed with diabetes. With timely laser surgery and appropriate follow-up care, people with advanced diabetic retinopathy have a 90 percent chance of maintaining vision.

• Laser surgery is a safe and effective alternative to eye drops as a first-line treatment for newly-diagnosed primary open-angle glaucoma, a disease that affects three million Americans, half of whom do not know they have it.

• New medical therapies effectively treat glaucoma while greatly reducing the number of adverse side effects.

• A potentially blinding eye disease in premature infants - retinopathy of prematurity - can be significantly reduced by briefly freezing the outer part of the retina, a treatment called cryotherapy.

• Laser surgery can slow vision loss in some people with the "wet" form of age-related macular degeneration (AMD), the leading cause of blindness in older Americans. Prior to this finding, this form of AMD was considered untreatable.

• An oral antiviral drug significantly decreases the recurrence of herpes of the eye and reduces the rate of return of stromal keratitis, the more severe form of the disease.

• Certain forms of uveitis - potentially blinding inflammations of the inside of the eye - respond to drugs that are safe and effective.

• A purified protein, called retinal S-antigen, when taken orally, allows people with certain forms of uveitis to eliminate or reduce the need for powerful drugs. These drugs, while often effective, can cause decreased kidney function, cataracts, glaucoma, and brittle bones.

• Ganciclovir implants are effective in treating cytomegalovirus (CMV) retinitis, a potentially blinding eye disease that affects people with AIDS. The implant significantly improves the quality of life for AIDS patients with CMV retinitis.

• A combination of protease inhibitors and other anti-HIV drugs used to treat people with AIDS can prevent or delay the progression of CMV retinitis.

• Improved selection and handling of donor eyes, improved preservation, and better surgical techniques lead to an overall higher success rate for corneal transplants.

• The growth of the eye, which affects the development of myopia, or nearsightedness, is guided by visual feedback during early life. This means that scientists may be able to develop treatments for young children that can prevent or lessen this condition.

• Ambient light reduction has no effect on the development of retinopathy of prematurity in very low birth weight infants.

• Steroids given orally are ineffective in treating optic neuritis and may actually increase a person's risk for future attacks. Doctors had long used oral steroids to treat this debilitating disease that each year strikes about 25,000 Americans, primarily women.

• A surgical procedure for nonarteritic ischemic optic neuropathy, a potentially blinding condition, is ineffective and could be harmful to a person's vision. This led to a recommendation that doctors stop performing this procedure, called optic nerve decompression surgery.

Also, NEI-sponsored scientists have identified:

• A gene for juvenile primary open-angle glaucoma, which develops in late childhood or teenage years. This discovery opened up a new approach to understanding glaucoma in all its forms.

• The first gene associated with a form of macular degeneration.

• A number of gene mutations suspected of causing retinitis pigmentosa (RP). RP is a group of inherited, blinding diseases that affect 100,000 Americans. These findings provide the first step in developing new strategies to prevent or control RP.

• The gene that causes retinoblastoma, a rare form of eye cancer. The gene has been isolated, cloned, and sequenced. This research has implications not only for eye cancer, but also breast cancer and prostate cancer, and may one day lead to the development of better treatments for these types of cancer.

• Mutations in the Pax-6 gene that cause aniridia, a congenital malformation of the eye that occurs in 1.8 per 100,000 births. The Pax-6 gene is the first gene discovered to be essential for normal eye development.

• A "critical period" in the early visual development of cats and monkeys. This discovery has led to an understanding of how to treat and prevent amblyopia and similar visual problems in human infants.

Technological development supported by the NEI has contributed to major advances in diagnosing and treating eye disease. This includes:

• Medical lasers to diagnose and treat patients with diabetic retinopathy, age-related macular degeneration, and other eye diseases; and for correcting refractive errors of the eye, such as nearsightedness.

• A safe and effective technique to photograph the retinal blood vessels in the eye. Called fluorescein angiography, this technique allows doctors to pinpoint abnormal blood vessels that cause diabetic retinopathy. These abnormal blood vessels can then be treated with laser therapy.

• "Imaging" devices that allow doctors to more closely examine the interior of the eye. This technology permits doctors to more completely diagnose eye diseases and disorders, and gives scientists a better understanding of how eye diseases develop and progress. These include devices built on technology known as "adaptive optics," first proposed by astronomers in 1953 and developed later by the U.S. to clear up satellite images.

• Noninvasive imaging technologies, such as positron emission tomography (PET) and functional magnetic resonance imaging (fMRI), that allow researchers to peer inside the brain and assess visual function.

• Major advances in microsurgical instruments and surgical techniques for treating retinal detachment, retinal hemorrhages, and other retinal disorders.

• A better understanding of how the brain processes visual information. More technically, this understanding involves the capture of light by photoreceptor cells and the initiation of electrical signals utilized by the brain.

• Progress in establishing the scientific basis for transplanting healthy cells into the retina. Further development of this technique could lead to new treatments for people with blinding diseases, such as age-related macular degeneration and retinitis pigmentosa.

Link to Related News Release: National Eye Institute Director Dr. Carl Kupfer Steps Down After 30 Years at NIH