Division of Neuro-Ophthalmology Research
Clinician–researchers in the Department of Neurology’s 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, understanding how visual and eye movement disorders clarify how the brain works, and identifying 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 systemic disease. These images are used to assess the rate of disease progression and response to treatment. Our eye movement laboratory uses a state-of-the-art high-resolution camera that records eye movements up to 1,000 times per second. These data can be used to quantify eye movements and aid in differential diagnosis, assessment of 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. This work is funded by the National Multiple Sclerosis Society and the National Eye Institute of the National Institutes of Health (NIH), including an NIH K24 grant for mentoring residents and fellows in patient-oriented research.
Dr. Balcer and Dr. Galetta also lead an international clinical trial of a neurorepair agent for MS, using acute optic neuritis as the model for structure–function correlations. They are also testing vision-based methods of assessment as sideline tools for sports-related concussion.
Eye Movement Testing
Janet C. Rucker, MD, studies eye movements 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 the Department of Physical Medicine and Rehabilitation. Quantified eye movement recording (eye tracking) allows for 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 diagnosed with concussion, MS, and movement disorders in order to provide added value to diagnosis, symptom management, and prognosis.
Vision and Concussion
Our team investigates what happens to the brain during and after a concussion. We are involved in research towards the goal of validating vision tests for use in concussion detection on the sidelines of sport. Examples of such ongoing research in youth and collegiate sports are large-scale studies of head impact with NYU Langone-created tests of rapid picture and number naming called the Mobile Universal Lexicon Evaluation System (MULES) test and the Staggered Uneven Number (SUN) test.
With the MULES test, we time athletes and concussed individuals as they name a series of common animals, objects, and fruits. We collect baseline preseason measures and repeat testing after head impact. To date, data suggest that concussion results in slowed reading times. The eye movement team adds to this research effort by studying eye movements during these tests to better understand the underlying eye movement and cognitive effects of in concussion.