The Dana Center for Preventive Ophthalmology focuses on the national and international public health prevention of blinding eye diseases.
To address the significant percentage of diabetics who do not have regular eye assessments, we hope to adapt an opportunistic screening model that has been piloted in Australia. The underlying premise is that a large proportion of persons with diabetes mellitus (DM) attend a pharmacy to receive medications for their diabetes. The plan would be to offer photographic diabetic retinopathy screening at the same pharmacies.
We are currently collaborating on a study of telemedicine approaches to screening for diabetic retinopathy, and planning a larger scale cohort study of it in Saudi Arabia.
We are developing imaging techniques with OCT that distinguish those with angle closure glaucoma, including iris and choroidal volume change. This testing is being implemented in two large studies in China and India.
We are currently collaborating with investigators at the Aravind Eye Institute in India and examining whether family members of angle closure glaucoma patients have a higher risk of having it. We are also comparing how eyes with advanced stages of angle closure differ from eyes in the benign, early disease stages. Findings will provide insights into whether screening relatives will be a useful method for identifying patients at risk of going blind from angle closure glaucoma who might otherwise remain unaware of their disease. Findings will also examine the genetic basis of angle closure glaucoma to identify new potential targets for disease treatment.
Large Database Analysis
With Dr. Gower, analysis of Medicare billing database information has yielded the volume of glaucoma care being delivered, types of interventions and tests performed, their change over the yeras 2002 to 2009, and the cost of treatment.
Current research in Tanzania is investigating approaches to reduce infection and disease in communities and to better screen and treat trichiasis in adults. We are partnering in the development of alternative diagnostic/surveillance tools for trachoma control. Read about trachoma research in the words of Dr. Sheila West.
Vision Loss and Function
These studies are focued on describing visual impairment in a variety of diseases using metrics that capture the impact of vision loss and clearly communicate them in quantitative terms. This work has drawn from several datasets, including the Salisbury Eye Evaluation, the National Health and Nutrition Examination Survey (NHANES), and data collected on patients at the Wilmer Eye Institute. A particular emphasis has been placed on “real-world” measures of disability, such as testing of physical activity in the normal routine through the use of accelerometers, testing of travel outside the home using remote tracking devices, and testing of book reading through a validated test of sustained silent reading.
Current research is investigating how vision and cognition in older individuals affect driving behaviors, using a novel Driving Monitor System to collect real time driving behaviors.