Glaucoma is the second leading cause of blindness in the developed world and causes progressive loss of the peripheral visual field. While visual loss caused by glaucoma is currently irreversible, clinical intervention is most effective if the disease is caught at an early stage, when catastrophic field loss can be averted. Unfortunately existing screening techniques can only detect glaucoma once significant visual impairment has occurred. Although visual deficits in glaucoma are thought to be attributable to programmed cell death (apoptosis) of retinal ganglion cells (RGCs) it is now clear that cell-death is the endpoint of a gradual deterioration in RGC-function. Effective diagnostics cannot wait for cell death, but must measure a behavioral impact of RGC dysfunction. When screening fails, the clinician is particularly reliant on the patients self-diagnosing. Unfortunately more than 50% of people who have diagnosable glaucoma are unaware of it. This, along with poor screening sensitivity has long-term implications for the effective management of an increasingly prevalent disease. This proposal assesses a more efficient and more sensitive motion screening technique that may help detect RGC dysfunction earlier, facilitating prompt clinical intervention to slow the progression of glaucoma. We examine binocular vision, filling-in and compensatory eye movements that may obscure detection of progressive visual impairment and prevent patients from self-diagnosing at an earlier stage of the disease. The overall aim of this proposal is to identify signs of glaucoma that may help bring patients to clinic before catastrophic glaucomatous visual field loss has occurred. Such early intervention allows clinical management of glaucoma to be most effective and so relieves the burden of visual impairment.
Glaucoma is the second leading cause of blindness in the developed world and its incidence is set to rise as the population ages. While visual loss caused by glaucoma is currently irreversible, clinical intervention is most effective if the disease is detected and treated at an early stage, when catastrophic field loss can be averted. The proposed program of research develops new diagnostics that are sensitive to the early stages of neuro-degeneration in glaucoma.
|Harrison, William J; Bex, Peter J (2014) Integrating retinotopic features in spatiotopic coordinates. J Neurosci 34:7351-60|
|Feke, Gilbert T; Bex, Peter J; Taylor, Christopher P et al. (2014) Effect of brimonidine on retinal vascular autoregulation and short-term visual function in normal tension glaucoma. Am J Ophthalmol 158:105-112.e1|
|Bogfjellmo, Lotte-Guri; Bex, Peter J; Falkenberg, Helle K (2014) The development of global motion discrimination in school aged children. J Vis 14:|
|Wallis, Thomas S A; Taylor, Christopher Patrick; Wallis, Jennifer et al. (2014) Characterization of field loss based on microperimetry is predictive of face recognition difficulties. Invest Ophthalmol Vis Sci 55:142-53|
|Dorr, Michael; Bex, Peter J (2013) Peri-saccadic natural vision. J Neurosci 33:1211-7|
|Bogfjellmo, Lotte-Guri; Bex, Peter J; Falkenberg, Helle K (2013) Reduction in direction discrimination with age and slow speed is due to both increased internal noise and reduced sampling efficiency. Invest Ophthalmol Vis Sci 54:5204-10|
|Gepshtein, Sergei; Lesmes, Luis A; Albright, Thomas D (2013) Sensory adaptation as optimal resource allocation. Proc Natl Acad Sci U S A 110:4368-73|
|Dorr, Michael; Lesmes, Luis A; Lu, Zhong-Lin et al. (2013) Rapid and reliable assessment of the contrast sensitivity function on an iPad. Invest Ophthalmol Vis Sci 54:7266-73|
|Elze, Tobias; Taylor, Christopher; Bex, Peter J (2013) An evaluation of organic light emitting diode monitors for medical applications: great timing, but luminance artifacts. Med Phys 40:092701|
|Greenwood, John A; Bex, Peter J; Dakin, Steven C (2012) Crowding follows the binding of relative position and orientation. J Vis 12:|
Showing the most recent 10 out of 22 publications