THIS MONTH’S FOCUS is on the National Eye Institute (NEI). CLS recently had the pleasure to hear from NEI director Michael F. Chiang, MD.

MICHAEL F. CHIANG, MD

PLEASE TELL US ABOUT THE NATIONAL EYE INSTITUTE.

The National Eye Institute is one of 27 institutes at the National Institutes of Health [NIH]. We were founded in 1968 by Congress and President Lyndon B. Johnson as the branch of the NIH that manages national efforts in vision science.

The reason that we exist is because of the impact of vision on quality of life. There’s a lot of amazing science that occurs in the visual system. I didn’t know until I started this position that we’ve funded the work of eight Nobel Prize winners. A lot of fundamental innovations have occurred first in the visual system because it’s such an accessible system for doing research that then gets generalized to other parts of the body. That phrase, “The eye is the window to the soul…the window to the brain,” is really kind of true in terms of the way that we do science.

[The NEI] provides leadership in four areas: we drive innovative research; we foster collaboration; we recruit, inspire, and train a talented and diverse group of people; and we educate people about what we do and why it’s important.

TELL US ABOUT ANY NEW DEVELOPMENTS IN WHICH THE NEI IS INVOLVED.

Of course, there are some [myopia] treatments that have been quite successful. But it’s clear that we don’t understand the mechanisms of what causes myopia, and we don’t understand ways to disseminate screening and management on a large scale—even in [the U.S.].

We’ve been working with the National Academies of Sciences, Engineering, and Medicine to do a study that really addresses how to look at environmental factors, risk factors in children, socioeconomic barriers toward delivering care to underserved populations, mechanistic factors of disease, and, ultimately, how we can best target research efforts in ocular development in myopia and get the community to galvanize around this.

Another thing is, a few years ago, we put together a family of projects called the Anterior Segment Initiative to try to stimulate research that’s targeted in areas involving the anterior segment that we identified as gaps.

One of them has recently gotten underway: a consortium about a neurocircuitry in the anterior segment—specifically, what are mechanistic drivers of things like ocular pain and itch? It’s a consortium of multidisciplinary, collaborative research projects looking at this question of the innovation of the ocular surface—the neurological, molecular basis of things like corneal pain and tearing reflex. There are many areas where I hope that’s going to be relevant: dry eye, Sjögren’s, and neuropathic ocular pain. I’m excited about the fact that these teams are working together to try and solve these problems in a coordinated way.

PLEASE SHARE YOUR VISION FOR THE EYECARE FIELD.

Our mission is to eliminate vision loss and improve quality of life. I think that 21^st century science is going to be more about data and collaboration than ever before. We’re going to have to attract the best scientists into the vision field to work with ophthalmologists and optometrists to develop methodological advances that are going to lead to better treatments of disease.

The pandemic has exposed that we really don’t have equal access to care in this country. The best research and the best care aren’t quite as useful if not available, especially to people who need it most. There’s a lot of work to do in terms of not only making these advances but figuring out how to make sure that everybody has access to them. CLS