Scientists at The Ohio State University and the University of Houston have received two grants from the National Institutes of Health totaling $25 million to test daily drops of atropine as a nearsightedness preventive therapy in children age 6-11 years old.

“The more nearsightedness you have, the more at risk you are as an older adult of sight-threatening complications – retinal detachments, atrophy at the back of the eye, glaucoma and macular degeneration,” said Jeffrey Walline, co-principal investigator on the grants and professor of optometry at The Ohio State University. “So anything we can do to reduce the amount of myopia reduces your risk of those complications. And that’s our goal, ultimately.” 

Walline is co-leading the study with David Berntsen, Golden-Golden Professor and chair of clinical sciences at the University of Houston College of Optometry, and Lisa Jordan, director of the Data Coordination and Analysis Center at Ohio State. 

Previous studies in the United States and Asia have suggested atropine can slow the progression of nearsightedness after its onset. This new study aims to administer the drug before diagnosis in children deemed at highest risk for myopia, or nearsightedness, based on their school vision screening outcomes. 

People are born farsighted, and previous research has suggested that kids whose farsightedness has decreased to a specific measure by third grade are at the highest risk – with almost 90% accuracy – for developing nearsightedness by eighth grade. Those children will be recruited to join the study. 

The clinical trial will be conducted at Ohio State, the University of Houston, and 12 additional centers across the United States. Researchers plan to enroll over 600 children who will be randomized to receive nightly drops of either 0.05% low-concentration atropine or a placebo for two years. 

The timing of the onset of nearsightedness in children receiving the drug will be compared to those who receive the placebo. Any children in the placebo arm of the trial who are diagnosed with myopia during the study will begin receiving the atropine drops. All children who become nearsighted will also receive an annual voucher for corrective lenses, Walline said. 

The eye grows fastest just before the onset of myopia, which tends to begin between the ages of 8 and 10 and progresses up to about age 16. After that, the eye might continue to grow but does not become more myopic in most people.  

The researchers predict the atropine drops will reduce the proportion of children who become nearsighted from 20% in the placebo group to 10% in the treatment group, and that atropine will slow pre-myopic eye growth by 30% over the course of the study. 

Myopia affects at least one-third of adults in the United States, and is becoming more prevalent – because, the scientific community believes, children are spending less time outdoors now than in the past. 

In decades past, myopia hasn’t been thought of so much as a disease than as a nuisance condition. But in the past 10 years, optometry research has advanced beyond alleviating symptoms to better understand and address the mechanisms of nearsightedness with an eye toward lowering the risk for vision loss in adulthood, Walline said. 

Walline, Berntsen and Jordan previously co-led studies showing that contact lenses can effectively slow the progression of nearsightedness. The research team reported in 2020 that multifocal contact lenses with the strongest reading power dramatically slowed further progression of myopia in nearsighted kids as young as 7 years old, and in 2025, they reported that those benefits lasted after the treatment ended. 

“We’ve shown that kids can handle treatments from a very young age, and so we’re just applying a different treatment now,” Walline said. “If they become nearsighted during our study, we will also give them the option of wearing contact lenses.” 

In addition to the health ramifications of myopia, correcting the condition is expensive, costing an estimated $4 billion to $7 billion annually in the United States. And high myopia not only threatens vision, but limits the options for refractive surgery, contact lenses and glasses – all factors that point to the importance of getting ahead of the diagnosis, Walline said. 

“Myopia affects such a large number of people, and even if the effects for given individuals aren’t particularly bad, if we can save the sight of just a few people, I think it’s ultimately very important,” he said. “This affects one out of every three people in the United States. We can make a big difference.”

The study is a follow-up to a clinical trial published in 2020 showing that soft multifocal contact lenses with a heavy dose of added reading power dramatically slowed further progression of myopia in kids as young as 7 years old. Researchers wondered if discontinuing that treatment might cause a rebound of faster-than-normal eye growth that wipes out the benefit. 

In the new trial, nearsighted kids wore high-add bifocal lenses for two years followed by one year with single-vision contact lenses. Results showed no evidence that the treatment effect declined, and myopia progression then continued at age-expected rates. 

“We want doctors to understand that you don’t lose the benefits that you gain with this treatment,” said senior author Jeffrey Walline, professor of optometry at The Ohio State University and chair of the project, known as the BLINK (Bifocal Lenses in Nearsighted Kids) Study. 

“But more importantly, what we want to do with this research is give patients healthier eyes at a lower cost with more options. And then in adulthood, we want them to be able to function fully and with clear vision.” 

The new follow-up study, known as BLINK2, is published today (Jan. 16, 2025) in JAMA Ophthalmology. Both trials were conducted at Ohio State and the University of Houston. 

In nearsightedness, or myopia, the eye grows and is stretched into an elongated shape. This abnormality increases the risk for cataracts, detached retina, glaucoma and myopic macular degeneration, all of which can lead to loss of vision, even when wearing glasses or contact lenses. 

Myopia is also common, affecting at least one-third of adults in the United States, and is becoming more prevalent – because, the scientific community believes, children are spending less time outdoors now than in the past. Nearsightedness tends to begin between the ages of 8 and 10 and progresses up to about age 18, when the eye might continue to grow but not become more myopic in most people. 

Multifocal contact lenses for nearsighted patients correct for clear distance vision and include focal power that allows middle-aged eyes to read near work clearly. 

In the original study, 294 nearsighted children aged 7-11 years were randomized into one of three groups of contact-lens wearers. Those who wore the lenses with the highest added power, 2.50 diopters, had shorter eyes and slower rates of myopia progression than the kids in the other two groups after three years. 

Of the original participants, 248 continued in BLINK2, during which all – then aged 11 to 17 years – wore the high-add lenses for two years followed by single-vision contact lenses for the third year, a method used to see if the benefit remained after discontinuing the bifocal treatment. 

At the end of BLINK2, eye growth returned to age-expected rates and there were no signs of faster-than-normal eye growth. Participants who had been in the original BLINK high-add group continued to have shorter eyes and less myopia at the end of BLINK2, meaning those who started high-add bifocal lenses in BLINK2 did not catch up to those who received the treatment when they were younger. 

“After the children discontinue using the contact lenses, their myopia progression increases, but just to normal standards you would expect if you hadn’t treated them. And that happens no matter what age they are when they stop wearing the bifocal lenses,” said Walline, also acting dean in Ohio State’s College of Optometry. 

This research and other studies have led to advances in the treatment landscape for nearsighted children: Options include multifocal contact lenses, contact lenses that reshape the cornea during sleep called orthokeratology, and atropine eye drops. 

“This is a burgeoning area,” Walline said. “The standard of care has switched from providing kids with single-vision glasses or contact lenses to things that slow down the progression of myopia, or the growth of the eye.” 

Walline and his colleagues are now pursuing funding for a clinical trial to see if it’s possible to delay the onset of myopia in young children by administering atropine eye drops before nearsightedness is detectable. 

“What we know is that the earlier you become myopic, the more myopia you’re expected to have as an adult. So if we can delay the onset, then we can make a big difference,” he said. 

BLINK was funded by the National Institutes of Health’s National Eye Institute and supported by Bausch + Lomb, which provided contact lens solutions. 

David Berntsen, Golden-Golden Professor and chair of clinical sciences at the University of Houston College of Optometry, was the first author of this study. Additional co-authors were Anita Tićak and Amber Gaume Giannoni of the University of Houston, and Danielle Orr, Loraine Sinnott, Donald Mutti and Lisa Jones-Jordan of Ohio State.

The three-year study found that a daily drop in each eye of a low dose of atropine, a drug used to dilate pupils, was better than a placebo at limiting eyeglass prescription changes and inhibiting elongation of the eye in nearsighted children aged 6 to 10.

That elongation leads to myopia, or nearsightedness, which starts in young kids and continues to get worse into the teen years before leveling off in most people. In addition to requiring life-long vision correction, nearsightedness increases the risk for retinal detachment, macular degeneration, cataracts and glaucoma later in life – and most corrective lenses don’t do anything to stop myopia progression. 

“The idea of keeping eyeballs smaller isn’t just so people’s glasses are thinner – it would also be so that in their 70s they don’t suffer visual impairment,” said lead study author Karla Zadnik, professor and dean of the College of Optometry at The Ohio State University.

“This is exciting work for the myopia research community, which I’ve been part of for 35 years. We’ve talked about treatment and control for decades,” she said. “And it’s exciting to think that there could be options in the future for millions of children we know are going to be myopic.”

The results of the CHAMP (Childhood Atropine for Myopia Progression) trial are published today (June 1, 2023) in JAMA Ophthalmology. 

About one in three adults worldwide is nearsighted, and the global prevalence of myopia is predicted to increase to 50% by 2050. Though one federally approved contact lens can slow progression of nearsightedness, no pharmaceutical products are approved in the United States or Europe to treat myopia. 

Animal studies years ago hinted at atropine’s ability to slow the growth of the eye, but the full-strength drug’s interference with near vision and concerns about pupil dilation hindered early considerations of its potential as a human therapy for myopia. More recent research has suggested a low dose of atropine might be the ticket. 

This new double-masked, randomized phase 3 trial assessed the safety and effectiveness of two low-dose solutions, with atropine concentrations of either .01% or .02%, versus placebo. Treatment for each of the 489 children aged 6 to 10 assessed for the drug’s effectiveness consisted of one daily drop per eye at bedtime, which minimized the disruption of any blurring effects atropine might have on vision. 

Researchers were a bit surprised to find that the most significant improvements at all time points compared to placebo resulted from the solution containing .01% of atropine. Though the .02% atropine formulation was also better at slowing progression of myopia than placebo, the results were less consistent. 

“The .01% story is clearer and more obvious in terms of significantly slowing both the growth of the eye as well as then resulting in a lower glasses prescription,” Zadnik said.

Including a measure of the eye’s growth was a key component of the study because “the field is actually moving toward axial elongation being as important as, or more important than, the glasses prescription in terms of the most meaningful outcome,” she said. “If we’re trying to slow eye growth to prevent bad outcomes for people in their 80s, measuring the eye growth directly is really important.” 

The drugs’ safety was assessed in a larger sample of 573 participants that also included children as young as 3 and up to age 16. Both low-dose formulations were safe and well tolerated. The most common side effects were sensitivity to light, allergic conjunctivitis, eye irritation, dilated pupils and blurred vision, although reports of these side effects were few. 

The CHAMP trial was the first study of low-dose atropine to include placebo controls for three years and to involve a large, diverse population recruited from 26 clinical sites in North America and five countries in Europe. In a second section of the trial, researchers are evaluating how the eyes respond when the treatment is over. 

The experimental drug is made without preservatives and, if federally approved as a therapy, would be distributed in single-use packaging for convenience and to prevent contamination. Off-label low-dose atropine that can currently be obtained at compounding pharmacies may contain preservatives that can lead to dry eye and corneal irritation, researchers noted.

The experimental product studied in the CHAMP trial is manufactured by Vyluma, a New Jersey development-stage biopharmaceutical company with a focus on pharmaceutical treatments for refractive errors of the eye. A subsidiary of Nevakar Inc., Vyluma sponsored the trial, has submitted a New Drug Application to the FDA to seek approval in the U.S. and has partnered with two companies to commercialize the product outside the United States. 

Zadnik led the study as a paid expert consultant to Vyluma. Jennifer Fogt, assistant professor at Ohio State, also worked on the trial. Additional co-authors Erica Schulman of SUNY College of Optometry; Ian Flitcroft of the Center for Eye Research in Dublin, Ireland; Louis Blumenfeld of Eye Physicians of Central Florida; and Tung Fong, Eric Lang, Houman Hemmati and Simon Chandler of Vyluma represented the CHAMP trial group investigators. 

The College of Medicine, College of Nursing, College of Optometry, College of Public Health and College of Veterinary Medicine were recognized for demonstrating an outstanding commitment to diversity and inclusion. Ohio State is the only academic institution in the country to have five colleges honored with the Health Professions HEED award.

“This recognition is meaningful and reflects the outstanding work of these five colleges to further diversity and inclusion,” said Melissa Gilliam, executive vice president and provost at Ohio State. “By fostering a culture of inclusive excellence, the entire university community benefits through a greater sense of belonging.”

INSIGHT Into Diversity magazine evaluated academic institutions on leadership support for diversity, recruitment and retention of students and employees, and other aspects of campus diversity and inclusion. Ohio State diversity and inclusion efforts include:

College of Medicine: The College of Medicine has adopted curriculum and training procedures to explore racial disparities in medicine with the goals of dispelling myths and becoming aware of and rectifying any subconscious bias. Coupled with the classroom education are opportunities to apply learnings in the clinical skills lab through the use of manikins of color and melanated suture pads.

College of Nursing: The Summer Institute for Future Nurses introduces diverse groups of high school students from around the country to nursing. Offered in a hybrid format, students participated in mock clinical skills training sessions on campus and virtual presentations. More than 20 previous attendees of the Summer Institute have graduated from the College of Nursing with a Bachelor of Science in Nursing degree. 

College of Optometry: BuckEye Launch is an immersive five-day program for first-year students that provides strategies for academic success and creates a sense of community among students, faculty and staff. Major themes include effective learning and test taking strategies, self-care and personal wellness, and time management.

College of Public Health: The College of Public Health dean’s administrative leadership team and extended staff applied for and were chosen to be part of the inaugural class of Ohio State’s Office of Diversity and Inclusion’s new Inclusive Excellence Team Certification Program. The nine-month intensive learning and project development opportunity is designed to ensure that each participating faculty and staff member receives the same inclusive excellence education and tools to build a diverse, equitable and inclusive workplace. It includes a capstone project designed to advance the college’s goals around diversity, equity and inclusive excellence in the long term.

College of Veterinary Medicine: Diversity, equity, inclusion and belonging (DEIB) is incorporated as a foundational principle in each of the six goal areas of the College of Veterinary Medicine’s Be The Model® strategic plan. The formation of a new student leadership group, Student Leaders for Inclusive Excellence, is one example of many initiatives designed to support DEIB in the college community. Comprised of student leaders representing the college’s affinity groups and student chapters supportive of DEIB, this group provides mentorship and support to student affinity groups and student organizations that are supportive of diverse populations. The goal is for all student organizations to work together to create a sense of belonging with one another and to develop leadership skills as they plan DEIB educational events for the entire college community. 

Ohio State will be featured in the December 2022 issue of INSIGHT Into Diversity magazine.

The College of Medicine, College of Nursing, College of Optometry, College of Public Health and College of Veterinary Medicine were recognized. Ohio State is the only academic institution in the country to have five colleges honored with the award.

“The recognition bestowed upon these five colleges is a testament to our collective commitment to diversity and inclusion,” said Melissa Gilliam, executive vice president and provost at Ohio State. “The entire university community benefits from this recognition as we strive to live up to our land-grant university values.”

The Health Professions HEED Award process consists of a comprehensive and rigorous application that includes questions relating to the recruitment and retention of students and employees, leadership support for diversity, and other aspects of campus diversity and inclusion. Ohio State diversity and inclusion efforts include: 

College of Medicine: The College of Medicine is executing an anti-racism action plan that includes a review of medical curriculum to remove racism and bias. In addition, the college appointed vice chairs of diversity, equity and inclusion in all 26 departments and implemented best practices for inclusive faculty searches, which includes creating a standing search committee within each department whose members will complete implicit bias mitigation training.

College of Nursing: In May 2021, the Office of Diversity, Equity and Inclusion at the College of Nursing held virtual graduate entry welcome panels for incoming graduate entry students of all backgrounds. The panels were designed to enhance incoming graduate students’ understanding of psychosocial, academic, clinical, professional practice and research aspects of the nursing student experience.

College of Optometry: With an aim of cultivating interest in optometry as a career and creating a pipeline of students who exhibit inclusive thinking and behavior, the College of Optometry offers the I-DOC – Improving Diversity in Optometric Careers – summer program for underrepresented diverse students. During this program, students learn about health disparities in optometry, explore different careers in optometry and review how to be successful learners and applicants. 

College of Public Health: In 2020, the College of Public Health launched a trio of scholarships designed to increase diversity and equitable access to public health education: the Ruth Ella Moore, Dr. Amy Acton Future Leaders of Public Health and the Multicultural Public Health Hood scholarships. The scholarships will be awarded annually with the intention of championing those who are first-generation or trailblazing students, those who have overcome significant challenges and those students who seek to advance Black Americans. 

College of Veterinary Medicine: The College of Veterinary Medicine has a strategic focus on recruiting underrepresented minorities and first-generation students by reducing barriers to enter the profession, providing engaging learning opportunities and creating an academic community that fosters inclusion. This includes the creation of several new scholarships and the use of a virtual recruitment platform that provides an opportunity to connect with historically Black colleges and universities for virtual admissions sessions.

Ohio State will be featured in the December 2021 issue of INSIGHT into Diversity magazine. 

A review of the few film- and lab-based studies on the subject suggests that yes, indeed, batters’ eyes are watching the pitched ball. But they’re moving their heads, and not their eyes, to direct their gaze.

And then, with little time to spare, some batters in studies shifted their gaze toward home plate, a move that researchers suspect is related to trying to anticipate where the ball will be when it is in batting range. But not all batters made this move to briefly take their eye off the ball.

After examining previous studies on head and eye movements in baseball batters, Ohio State University researchers concluded that there is no consensus on which head and eye movements are most likely to improve batting performance – but further investigation could get the sport to the point at which eye gaze-based batting training is feasible.

“One question we had was whether batters actually keep their eye on the ball, and if they do, does that lead to some advantage?” said Nick Fogt, professor of optometry at Ohio State and co-author of the review.

“What we’ve found, and it’s been replicated several times, is that they do keep their eye on the ball, but they don’t turn their eyes – they turn their head, which is fruitful in terms of a scientific question: Is there some reason why you would do it this way?

“Presumably there is, but we don’t quite have that nailed down yet.”

Fogt co-authored the paper with Andrew Toole, associate professor of clinical optometry at Ohio State. The review is published in the July issue of Optometry and Vision Science.

Despite the pending questions, one thing is certain: During the half-a-second journey of a pitched ball to home plate, batters are negotiating a lot of visual and neural signals – some of which contradict each other.

Given the time pressure, it could be that batters move their head to reduce the complicated calculations needed to get the bat to the right place at the right time. But head movement requires that batters suppress a finely tuned vision-related system, Toole said.

By keeping their head and eyes toward the ball, batters are essentially canceling out what is known as the vestibular ocular reflex (VOR), which allows us to see a stable world as our heads move around.

“The VOR helps us maintain our gaze toward where we’re looking in space,” Toole said. “When it comes to something like batting, when I’m rotating my head to follow the ball, the VOR is telling my eyes to go in the opposite direction. … So that VOR has to be canceled if the eyes are going to stay on the ball.”

In the paper, Fogt and Toole trace the history of eye and head movement studies in baseball batters, the first two of which were published in 1954 and 1984, and more recent studies conducted within the last decade.

The findings consistently showed that baseball players at all levels kept their eye on the pitched ball with similar head movements, and also suggested that the process of swinging the bat doesn’t seem to influence what the eyes and head are doing.

But less clear is whether some batters’ flicker of the eye away from the ball, gaze changes called “anticipatory saccades,” affect overall batting success.

“The question is, do batters try to keep following the ball all the way to the plate or do they take their central vision off of it and look to where it’s going to go?” Fogt said. “That’s an important question, because if you’re going to teach somebody what to do, we need to know if that’s a strategy employed regularly and whether it’s helpful.”

Toole said he and Fogt are currently exploring this component of batting vision, studying how quickly batters make predictions about the ball’s trajectory and how accurate those predictions are. They also said larger studies under game conditions are needed to determine which gaze strategies are most beneficial for baseball batting.

If the steady stream of inquiries from professional leagues at a variety of levels is any indication, there appears to be interest in this line of research, the scientists say.

The lessons to be learned about vision concerns encountered in baseball may apply to everyday life as well – and vice versa, Toole and Fogt noted. In tasks as simple as pouring a glass of milk or as complicated as driving in heavy traffic, there’s a lot to consider: How do we organize our thinking when we’re pressed for time? Should we fix our gaze on the focus of our attention or make predictions about how things will play out based on past experiences?

“We’re using baseball batting as a model, but these questions are more generalizable than just to baseball,” Fogt said. “Ultimately, once we understand how and why the hand, eye and head are coordinated in a certain way, then training these patterns is the next step. And those are questions that I think this research can underpin.”

These four programs have again received the INSIGHT into Diversity magazine 2020 Health Professions Higher Education Excellence in Diversity (HEED) Award. INSIGHT into Diversity magazine is the oldest and largest diversity-focused publication in higher education.

This is the second consecutive year that all four programs have been named as a Health Professions HEED Award recipient. Ohio State is the only academic institution in the country to have four colleges receive the 2020 Health Professions HEED award. The colleges of nursing, medicine and veterinary medicine have received the award in previous years as well.

“Our standards are high, and we look for institutions where diversity and inclusion are woven into the work being done every day across their campus,” said INSIGHT Into Diversity publisher Lenore Pearlstein.

The award recognizes the university’s efforts in recruitment and retention of students and employees, continued leadership support for diversity, and other aspects of campus diversity and inclusion.

“Ohio State’s colleges are focused on diversity and inclusion as essential components of our mission,” said Executive Vice President and Provost Bruce A. McPheron. “By fostering these values in the health sciences, our students, faculty and staff are prepared to serve Ohioans well in the future.”

Each of the health sciences colleges incorporates diversity and inclusion throughout its student recruitment, teaching, research and service, including the creation and implementation of an Anti-Racism Action Plan that creates a foundation for structural and systemic change.

“I am extraordinarily proud of the continued advancements in diversity and inclusion that led INSIGHT Into Diversity to recognize Ohio State’s health science colleges. Much has been accomplished, but there is undoubtedly more to do,” said Dr. Hal Paz, executive vice president and chancellor for health affairs at Ohio State and CEO of Ohio State Wexner Medical Center. “As educators, researchers and caregivers, we are committed to improving health and building a culture of equity to better care for the communities we serve.”

Below are highlights of the colleges’ diversity and inclusion efforts.

College of Medicine – There is a history of recruiting and supporting under-represented minority students – 24% of students are underrepresented minorities. The college also follows a holistic admissions process, and everyone on the selection committee receives Implicit Bias training. There is diversity among the faculty and college leadership. The college requires a diverse pool of applicants in the hiring process and requires search firms it uses to include diverse candidates in the final pool of all candidates.

College of Nursing – The Ohio State College of Nursing earned its fifth consecutive HEED award, in part because of its ability to build on progress made in academics, research, student engagement and community impact. Several College of Nursing faculty have current research focused on reducing health disparities; the college’s population of underrepresented students increased across academic programs; and the college leveraged technology to host a five-week virtual Summer Success Series that aimed to help develop soft skills in under-represented undergraduate students. The college also formed the affinity group Nursing Students of Color to retain and support students as they move toward graduation, and continued its Health Resources and Services Administration grant-funded work to support the education and development of community health workers to improve the health and well-being of their own neighborhoods.

College of Optometry – The College of Optometry focused on several key initiatives to foster diversity and inclusion in 2020, including: reimagining the role of the college’s chief diversity officer to be more broadly integrated into the structure of the college; enhancing the admissions process for diverse underrepresented students by employing mitigation strategies against implicit bias and searching for inclusive behaviors in all applicants; educating all faculty, staff and students on implicit bias and anti-racism; engaging in purposeful relationship-building between our diverse students and diverse alumni; integrating diversity, equity and inclusion in the policy documents that govern the college; and developing a pathway for diverse underrepresented students to become faculty. The college also updated its Improving Diversity in Optometric Careers program this year to be virtual, ensuring that this annual summer program continued its mission to attract underrepresented minority undergraduate students from across the U.S. to learn about optics, eye anatomy and vision disorders as well as the College of Optometry admissions process.

College of Veterinary Medicine – The College of Veterinary Medicine is focusing on recruiting underrepresented minorities and first-generation students by reducing barriers to enter the profession, providing engaging learning opportunities, and creating an academic community that fosters inclusion. An increase in scholarship awards helps alleviate some of the debt burden many students face. Be Well programming teaches a foundation of health and well-being skills before students enter their professional career. Outreach and engagement opportunities such as the Pet Owner and Pet Care Program and the Veterinary Medicine Outreach Program provide care to underserved populations and unique service-learning experiences for students.

His minimal vision loss tells some of the story, but a high-resolution optical imaging device developed by Ohio State University researchers showed in stark detail that cells in the boy’s retinas are missing – “blasted away” by the laser, his ophthalmologist explained.

This area of the eye is home to photoreceptors, light-sensitive cells (often referred to as rods and cones) that allow us to “see.” These cells are most dense in the center of the retina and give us the perception of vision and color.

“There’s just nothing left there,” said Frederick Davidorf, professor of ophthalmology and visual science at Ohio State and co-author of a paper describing the case. “The affected areas are devoid of cones.”

Only with the optical scanning system, engineered by Nathan Doble, associate professor of optometry at Ohio State, could scientists count individual cells to see precisely what had happened to the teen’s eyes. Both eyes were damaged, the right more extensively.

The case study is published online in the journal Retinal Cases & Brief Reports and will appear in a future print issue.

The case serves as a cautionary tale about the risk of staring at laser pointers, which both Doble and Davidorf noted often pack much more power than advertised.

It is also the first published report of laser eye damage captured by this specific imaging system, showing how valuable this research equipment can be in understanding the exact extent of damage caused by the laser.

The imaging system can be thought as a powerful microscope that can magnify the view of retinal cells that are equal in size to about 1/20th the width of a human hair. One of the main research goals in Doble’s lab is to utilize such high-resolution imaging systems to detect and monitor various eye diseases such as age-related macular degeneration, diabetic retinopathy and glaucoma.

“It has been described as looking at the retina through a straw,” said Doble, a lead author of the paper. “We can see much more detail than you would see with standard clinical imaging. We do not image large areas of the retina, but the areas we do image are at a much higher level of resolution.”

The 14-year-old boy, not identified in the article, and a friend were playing with pet laser pointers when he stared directly at the laser for several seconds. He described the initial effect as a bright light that limited his vision for several minutes.

By the time he saw Davidorf five months later, the patient said that if he were looking at text with only his right eye, a single letter would be missing, but with both eyes he could not detect any problems. Though he otherwise had 20/25 and 20/20 vision, a standard clinical exam showed lesions in both eyes that were diagnosed as macular laser burns.

The damage came into clearer view when Doble imaged the retinas with his device, called an adaptive optics-optical coherence tomography-scanning laser ophthalmoscope: The two lesions in the right eye and one in the left eye appear as black gaps in a sea of individual cells.

The scope is equipped with a specialized mirror that has been deformed “almost like a funhouse mirror,” Doble said, correcting for the slightest motions – even motion related to the patient’s heartbeat – as the researchers shine light into the eye.

“The mirror allows us to bypass the optics of the aberrations or distortions in your eye and gives us the really sharp image of the back of the eye,” Doble said. Each individual image covers only a small field of view, so the researchers “stitch” images together to see the entire target area of concern.

The high-resolution images are similar to what scientists can see when they view a slice of tissue under a microscope – only in this case, the tissue doesn’t have to be biopsied to be seen up close.

Doble, also an associate professor of ophthalmology and visual science, doesn’t intend to market the scope or make it widely available – it is one of only five known custom-built devices of its kind in the United States. As an optical engineer, his emphasis is producing images that can help increase understanding of eye diseases as they progress.

Most recently, his lab published images of retinal cells called ganglion cells from patients with glaucoma, a disease that damages the optic nerve.

“The ganglion cells are some of the first cells affected by glaucoma, so potentially counting these cells might be a very sensitive measure for this condition,” Doble said. “We can also follow the same patient over time so the potential of new stem-cell or genetic therapies can be evaluated objectively by counting the number of individual cells as the disease progresses.”

In this case study, the researchers scanned the teen’s eyes twice, 11 and 20 months after the injury, and found slight decreases in the size of the lesions over that time period.

“But it’s never going to fully heal,” Davidorf said. “There will always be scarring there.”

Other Ohio State co-authors of the study include Carol Vitellas, Elaine Wells-Gray, Nayanika Challa and Stacey S. Choi.

In the three-year clinical trial of almost 300 children, a bifocal contact lens prescription with the highest near-work correction slowed nearsightedness progression by 43 percent when compared to single-vision contact lenses.

Though many adults in their 40s need time to adjust to their first multifocal contact lens prescription, the kids using the same commercially available soft contact lenses in the study had no vision problems despite the strong correction. Multifocal lenses for nearsighted patients correct for clear distance vision and include an “add” of focal power for near work that challenges middle-aged eyes.

“Adults need multifocal contact lenses because they can no longer focus their eyes to read,” said Jeffrey Walline, professor of optometry at The Ohio State University and lead author of the study.

“Kids can still focus their eyes, even though they’re wearing multifocal contact lenses, so it’s like fitting them with normal contact lenses. They adapt much easier than adults.”

The study, known as BLINK (Bifocal Lenses In Nearsighted Kids), is published today (Aug. 11) in the Journal of the American Medical Association.

In nearsightedness, or myopia, the eye grows in an uncoordinated way into an elongated shape, for reasons that remain a mystery. Animal studies clued scientists in to contact lenses’ potential to keep eye growth in check by using the reading portion of multifocal contact lenses to focus some light in front of the retina – the light-sensitive layer of tissue lining the back of the eye – to slow the eye’s growth.

“These multifocal contact lenses move with the eyes and provide more focus in front of the retina than glasses do,” said Walline, also associate dean for research in Ohio State’s College of Optometry. “And we want to slow the growth of the eye because nearsightedness is caused by the eye growing too long.”

This research and other studies have led to advances in the treatment landscape for nearsighted children, Walline said. Options include multifocal contact lenses, contact lenses that reshape the cornea during sleep called orthokeratology, a specific type of eye drop called atropine, and specialty glasses.

Nearsightedness is more than an inconvenience. Myopia increases the risk for cataracts, detached retina, glaucoma and myopic maculopathy. All of these conditions can lead to loss of vision, even when wearing glasses or contact lenses. There are also quality of life factors – less severe nearsightedness improves the chances for successful laser surgery to correct vision and is not as disabling when no correction is worn, such as upon waking in the morning.

Myopia is also common, affecting about one-third of adults in the United States, and is becoming more prevalent – because, the scientific community believes, children are spending less time outdoors now than in the past. Nearsightedness tends to begin between the ages of 8 and 10 and progress up to about age 18.

Walline has been studying contact lens use in children for years and has found that in addition to the vision benefits, contact lenses also improve kids’ self-esteem.

“The youngest nearsighted kids I’ve studied with were 7,” he said. “Not all 25-year-olds can tolerate contact lens wear. About half of 7-year-olds can adapt to contact lenses reasonably, and almost all 8-year-olds can.”

In this trial, conducted at Ohio State and the University of Houston, nearsighted children age 7-11 years were randomized into one of three groups of contact-lens wearers: single vision or multifocal prescriptions with a medium reading add of 1.50 diopters or a high add of 2.50 diopters. Diopters are a unit of measurement of the optical power needed to correct vision.

As a group, the participants’ average prescription at the start of the study was -2.39 diopters. After three years, both the degree of myopia progression and the extent of eye growth were lower in the kids who had worn the high-add lenses. On average, the three-year eye growth among kids with the high-add bifocals was .23 millimeters less than in kids wearing single-vision lenses. Medium-add lenses did not slow eye growth any more than single vision lenses.

The researchers were aware of the need to balance the reduction of eye growth with any risks associated with subjecting children to strong reading power long before they need that level of correction. When testing their ability to read gray letters on a white background, there was a two-letter difference between single-vision lens wearers and those wearing multifocal lenses.

“This was about finding a sweet spot,” Walline said. “And really, what we found was that even the high-add power doesn’t reduce their vision much at all, and certainly not in a way that is clinically relevant.”

The research team is continuing to follow the same participants, treating them all with the high-add bifocal lenses for two years and then switching them all to single-vision contact lenses.

“The question is, we have slowed the growth of the eye, but what happens when we take them out of the treatment? Will they go back to where they were preprogrammed to originally? The permanence of the treatment effect is what we’ll be examining,” Walline said.

This study was funded by the National Eye Institute, part of the National Institutes of Health, and supported by Bausch + Lomb, which provided contact lens solutions.

Co-authors included Donald Mutti, Lisa Jones-Jordan, Loraine Sinnott, Katherine Bickle, Alex Nixon and Gilbert Pierce from Ohio State; and Maria Walker, Amber Gaume Giannoni, Krystal Schulle and David Berntsen from the University of Houston.

Ohio State will seek approval for the $155.9 million health sciences center during next week’s Board of Trustees meeting. Funding sources are to be determined. The project is poised to benefit colleges, including medicine, dentistry, nursing, optometry, pharmacy, public health and veterinary medicine, and strengthen the interdisciplinary curriculum of Ohio State.

“A healthier future demands health care leaders who are prepared to work together to address health challenges,” said Bruce A. McPheron, Ohio State’s executive vice president and provost. “Ohio State’s new health sciences education building is the place where students will become those leaders.”

The multiphase project advances Framework 2.0, the university’s long-term planning vision. It includes a 150,000-square-foot renovation of Hamilton Hall and construction of a new 100,000-square-foot building featuring flexible facilities to serve multiple disciplines. Program space will include:

• 33 interdisciplinary, state-of-the-art classrooms, each with new teaching technology, including virtual reality and enhanced anatomy and surgical practice labs
• 6,000-square-foot informal learning space
• 125-seat grand reading room

“Ohio State is in the process of creating a new model to replace the 100-year-old-plus model of academic medicine in use today,” said Dr. Hal Paz, executive vice president and chancellor for health affairs at Ohio State and Wexner Medical Center CEO. “This new academic health model takes advantage of the latest technology and brightest minds to educate professionals prepared to address the changing health needs of diverse populations. This is the key to building healthier communities.”

The Interdisciplinary Health Sciences Center will focus on inclusive work environments to create:

• Spaces for students in the health sciences to convene conversations and build team approaches to health care — a way to quickly assess patients’ needs and work with the right colleagues to design the best care plans for each individual.
• Opportunities for students to be at the forefront of innovation through modern technology — whether by using realistic virtual reality models to simulate patient care or learning how video chats, texting and other emerging “telehealth” innovations can help health care providers and patients stay in regular communication between in-person office visits.
• Warm and welcoming environments that support Ohio State’s work to build diverse communities of medical students. Research has shown that diversity in medicine — including increasing representation of women and people of color — leads to better health outcomes.

Design for the new Interdisciplinary Health Sciences Center began in August 2018. Pending board approval, construction could begin in October 2019, with completion targeted for late summer 2023.

Progress continues on a separate Health Sciences Faculty Office and Optometry Clinic at 11th and Neil avenues. The 106,000-square-foot building will be home to optometry clinics, retail spaces and faculty offices. The $35.9 million project is 60% of the way through steel work and targeting an October 2020 opening.

For more information about these projects and other major initiatives advancing Framework 2.0, visit Time and Change: Building the Future.

With this second cycle of grant funding, Ohio State will continue to provide high-quality early childhood education and services to Columbus families in low-income households through 2024.

In 2014, Congress appropriated $500 million to fund Early Head Start Child Care Partnership grants nationwide, including $16.5 million to Ohio State, with a goal of partnering with existing child care centers and family child care home providers to raise the quality of early childhood education in the most vulnerable neighborhoods with the highest rates of poverty.

Housed in the Schoenbaum Family Center, Ohio State’s partnership program, known as OSU-EHS, has gained national attention for its unique model, and was featured in January by the Bipartisan Policy Center as one of the top 12 programs in the nation.

“Our staff is passionate about this work and believe that all children, regardless of their zip code or life circumstances, deserve high-quality early education and supportive services to create a successful start in life,” said OSU-EHS director Sherrie Sutton.

The program serves 160 children in 11 child care centers and eight family child care homes. In addition, families of the children also receive comprehensive support through OSU-EHS’ network of 19 university and community agency partners.

By leveraging experts within the community, OSU-EHS is able to provide comprehensive services to address the holistic needs of families, an important two-generation approach proven to improve outcomes for young children. With 80% of the enrolled families earning $800 or less per month, social workers assist with connecting families to critical resources as well as educational and workforce development opportunities while also providing counseling and crisis intervention services.

OSU-EHS also provides significant support to the child care and home partners. In addition to enhanced funding, OSU-EHS has purchased classroom furniture and materials, curriculum and playgrounds for each center. With a focus on quality, the program offers professional development alongside practice-based coaches who work with classroom teachers. For the last three years, the home providers were sent to the National Association for Family Child Care Conference, where one attendee said, “I finally feel like I am part of something and am respected as a professional.” As the program enters the next five-year cycle, 84% of the program’s child care centers and home providers are rated in Ohio’s Step Up to Quality rating system at three stars or higher, and 55 of the teachers have advanced their education.

Reflecting on her time in Ohio State’s Early Head Start program, one mother said that she came into the program during a time when her family was facing many challenges, including homelessness.

“I am a single mother with two children, a toddler and a preschool-aged child. (My family) faced many challenges in 2017. I know that there are many other single parents facing similar challenges to those I experienced. Unfortunately, many times we slip between the cracks and don’t receive the assistance we need.

“I felt empowered because I knew that despite all of my struggles, I was able to keep (my children) in a stable learning environment. I had the peace of mind of knowing that they were receiving high-quality child care. I feel truly blessed to have been a recipient of this program and I look forward to continue watching my children flourish under their care.”

In addition to numerous community partners, Ohio State units involved in the collaborative program include the College of Education and Human Ecology, College of Nursing, College of Optometry, Speech, Language and Hearing Clinic and Nisonger Center.