To say that the Dana Center for Preventive Ophthalmology at Wilmer is a World Health Organization (WHO) collaborator is a powerful statement in its own right. But to say the Dana Center is the only WHO collaborating vision center in the United States puts the impact of the center in an even more notable light.

The two organizations have partnered to take on several of the main causes of preventable eye diseases around the world: cataracts, glaucoma, nutritional deficiency, onchocerciasis (river blindness) and trachoma (see sidebar). The Dana Center guides many evidence-based programmatic activities around the globe and educates public health leaders on how to alleviate avoidable blindness worldwide.

“We take a public health approach to fighting these diseases,” says David Friedman, M.D., Ph.D., M.P.H., director of the Dana Center and Wilmer’s Alfred Sommer Professor of Ophthalmology. “Our team includes ophthalmologists, of course, but also epidemiologists, statisticians, programmers and project coordinators.”

From its inception, the Dana Center’s mission has been to bring together the strengths of Johns Hopkins’ schools of public health and medicine to counteract preventable eye diseases.

It was on a visit to Wilmer in 1980 that Charles A. Dana Jr., chair of the Dana Foundation, brought into being a vision of preventing blindness on a worldwide scale. With $1 million staked by the Dana Foundation, the Dana Center for Preventive Ophthalmology launched the same year, headed by Wilmer ophthalmologist and epidemiologist Alfred Sommer, M.D., M.H.S., (who would go on to head the Johns Hopkins Bloomberg School of Public Health as dean from 1990–2005).

Sommer had gained international recognition while doing fieldwork in Indonesia in the late 1970s by showing that small doses of vitamin A given twice a year could both prevent and cure eye disease—and also reduce childhood mortality by one-third.

Returning to the United States in 1980, Sommer became the Dana Center’s first director. He immediately began recruiting faculty members from the schools of medicine and public health. Sommer was every bit as much an epidemiologist as an ophthalmologist. He was interested in better understanding who, why and how many people get diseases like glaucoma, cataracts and trachoma in order to diagnose and treat them sooner. A veteran of overseas assignments, Sommer recalls seeing the Dana Center’s mission from the outset as “half domestic and half international.”

“Our job was to build a field from scratch, and we did that,” Sommer says.

The emphasis on research and training that defined the Dana Center’s mission from its start remains today. In a recent example of the sort of research the Dana Center conducts, Bonnielin Swenor, Ph.D., M.P.H., has been studying aging and vision, and has shown cognitive decline in people with worsening vision.

The relationship works in both directions, Swenor says. Mental decline can precede visual decline as well. “But we found the strongest driver is worsening vision predicting cognitive decline. That finding can help us in our medical decisionmaking,” she says, and could lead to programs to help older people maintain good vision as they age.

Swenor’s research proved so compelling that Jane Kroger, a noted psychologist and retired professor, who had witnessed a similar decline in a close family member, decided to support the study financially.

“I’d seen macular degeneration lead to cognitive impairment, and when I heard about some of these amazing science fiction-type projects that are going on at the Dana Center, it really caught my attention,” Kroger says.

The Dana Center works close to home too. A Dana Center-sponsored program called Vision for Baltimore is striving to improve academic performance by providing glasses to Baltimore students. Another program funded by the Centers for Disease Control and Prevention,

SToP Glaucoma, has screened the vision and eye health of over 6,000 inner-city individuals and provided free glasses and access to a free exam if needed. Internationally, there is work on diabetic retinopathy screening and treatment, and a project in sub-Saharan Africa to improve cataract surgery outcomes and volumes. The list of projects goes on and on.

Likewise, the Dana Center works to educate the next generation of public health ophthalmologists by mentoring doctoral, master’s and medical students in short- and long-term training opportunities. Many leaders in the global eye health community have studied at the Dana Center. And the final piece of the puzzle, Friedman says, is the work the Dana Center does to raise awareness of preventable eye conditions and what people can do to avoid them or lessen their impact.

“I think Dr. Swenor's research is very much in line with that aspect of our mission,” Friedman notes. The connection between vision and mental acuity is not one many people naturally put together, he says. Simply drawing attention to the correlation should encourage more older people to seek eye care as they age.

“Cognitive decline is one of the most important concerns in aging populations. We really should be putting effort into preventing vision loss in older people,” Friedman says.