Neuro-Ophthalmology Clinical Research
Visual Outcomes in Multiple Sclerosis, Alzheimer’s Disease, and Other Neurologic Disorders
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 has been previously funded by the National Multiple Sclerosis Society and the National Eye Institute, part 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 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 working on other opportunities in this regard.
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 Rusk 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 our 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 toward 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.