Clinical researchers in the Division of Neuro-Ophthalmology are leaders in the fields of vision and eye movement research. We focus on understanding how the eye is integrated with the brain, how visual and eye movement disorders clarify how the brain works, and advancements in treatment of vision and eye movement disorders.
For example, advanced eye imaging techniques such as optical coherence tomography can help to detect subtle vision involvement in disease. These images are used to assess the rate of disease progression and response to treatment. Our eye movement laboratory uses a high-resolution camera that records eye movement up to 1,000 times per second. These data can be used to quantify eye movements and aid in differential diagnosis, assessing treatment responses, and understanding of disease mechanisms.
Vision and Multiple Sclerosis
Our physician–scientists conduct pioneering research on vision problems in people with multiple sclerosis (MS), including diminished visual acuity, low-contrast vision, and the impact of visual deficits on quality of life. Laura J. Balcer, MD, MSCE, and Steven L. Galetta, MD, lead multicenter collaborative research efforts to improve visual function assessment and ocular imaging with optical coherence tomography (OCT) for MS clinical trials.
Dr. Balcer and Dr. Galetta have led an international clinical trial of a neurorepair agent for MS, using acute optic neuritis as the model for structure–function correlations. They are also involved in testing vision-based methods as sideline tools for the assessment of sports-related concussion.
Eye Movement Testing
Janet C. Rucker, MD, studies eye movement in detail to assist in diagnosis of illness and define abnormal eye movements in different conditions. The laboratory team includes co-investigator John Ross Rizzo, MD, and computational neuroscientist Todd Hudson, PhD, from NYU Langone’s Rusk Rehabilitation.
Quantified eye movement recording allows for more accurate identification of types of abnormal motion of the eyes that cause jumpy vision and significant disability. Examples of such eye movement disorders include various forms of nystagmus and fast eye movements called saccades that lead to disruption of visual stability. Collecting eye movement recordings from patients with these clinical disorders allows us to more accurately determine treatment responses and improves efforts to identify new treatments.
We also collect quantified eye movement recordings in the laboratory from patients with concussion, multiple sclerosis, and movement disorders in order to provide added value in terms of diagnosis, symptom management, and prognosis.
Vision and Concussion
Our team investigates what happens to the brain during and after a concussion. We are also involved in research towards the goal of validating vision tests for use in concussion detection on the sidelines of sport.
An example of such ongoing research in youth and collegiate sports is a large-scale study of head impact with an NYU Langone team–created test of rapid picturing naming called the Mobile Universal Lexicon Evaluation System (MULES test). With this test, we time athletes and concussed individuals as they name a series of common animals, objects, and fruits. We collect both baseline preseason measures and repeat testing after head impact. To date, data suggest that concussion results in slowed reading times. Dr. Rucker’s eye movement team adds to this research effort by studying eye movements during the MULES test to better understand the underlying brain deficits in concussion.
Idiopathic Intracranial Hypertension Multicenter Study
Cinthi Pillai, MD, is the NYU Langone site primary investigator for a multicenter study on idiopathic intracranial hypertension. This study is funded by the National Eye Institute and is run by the Neuro-Ophthalmology Research Disease Investigator Consortium. The current study, called the Surgical IIH Treatment Trial, will compare medical treatment and two different surgical treatments for this condition.