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The Sight Loss and Vision Priority Setting Partnership

Priorities for eye research

The Sight Loss and Vision Priority Setting Partnership (PSP) was led by a Steering Group headed by representatives from Fight for Sight, the College of Optometrists, Vision UK, and the NIHR Biomedical Research Centre at Moorfields Eye Hospital. It also included representatives of patient/service user groups and healthcare professionals from ophthalmology, optometry, orthoptics, ophthalmic nursing and social care.

Background information relating to the creation of the Sight Loss and Vision Priority Setting Partnership can be found here.

The Sight Loss and Vision Priority Setting Partnership Survey in 2012 asked patients, carers and eye health professionals to identify unanswered questions about the prevention, diagnosis and treatment of sight loss and eye conditions that they wished to see answered. 2,220 people responded to the survey generating 4,461 questions.

The questions were checked and both duplicates and those not relating to sight loss and vision were removed. Those remaining were then allocated to 12 different eye disease/condition categories and similar submissions were combined.

At workshops held in April and May 2013 the top priorities for each category were agreed. Since then, a significant number of grants aimed at a wide range of priorities have been funded in the UK.

The results in detail

Priorities by condition

  • Age-Related Macular Degeneration (AMD)

    At a workshop held on 30 April 2013 attended by patients and eye health professionals the following top 10 priorities for AMD research were identified:

    Priorities

    1. Can a treatment to stop dry AMD progressing and/or developing into the wet form be devised?
    2. What is the cause of AMD?
    3. How can AMD be prevented?
    4. Are there ways of restoring sight loss for people with AMD?
    5. Can the development of AMD be predicted?
    6. What is the most effective way to detect and monitor the progression of early AMD?
    7. What factors influence the progression of AMD?
    8. Can a non-invasive therapy be developed for wet AMD?
    9. Can dietary factors, nutritional supplements, complementary therapies or lifestyle changes prevent or slow the progression of AMD?
    10. What are the best enablement strategies for people with AMD?

  • Cataract

    At a workshop held on 10 April 2013 attended by patients and eye health professionals the following top 11 priorities for Cataract research were identified:

    Priorities

    1. How can cataracts be prevented from developing?
    2. Can the return of cloudy or blurred vision after cataract surgery known as posterior capsule opacity (PCO) or secondary cataract be prevented?
    3. How can cataract progression be slowed down?
    4. What alternatives to treat cataracts other than cataract surgery are being developed?
    5. What is the cause of cataract?
    6. How can cataract surgery outcomes be improved?
    7. How safe and effective is laser assisted cataract surgery?
    8. Should accommodative lenses be developed for cataract surgery?
    9. What is the best measure of visual disability due to cataract?
    10. Can retinal detachment be prevented after cataract surgery?
    11. What are the outcomes for cataract surgery among people with different levels of cognitive impairment (whatever the cause but including dementia, stroke, neurological conditions, head injuries)?

  • Childhood Onset Disorders

    At a workshop held on 13 May 2013 attended by patients and eye health professionals the following top 10 priorities for childhood onset disorder research were identified:

    Priorities

    1. How can cerebral visual impairment be identified, prevented and treated in children?
    2. How can treatment for visual pathway damage associated with pre-term birth be developed?
    3. How do we improve screening and surveillance from the ante-natal period through to childhood to ensure early diagnosis of impaired vision and eye conditions?
    4. Can the treatment of amblyopia be improved to produce better short and long term outcomes than are possible with current treatments?
    5. How can cataract be prevented in children?
    6. What are the causes of coloboma and microphthalmia/anophthalmia and how can they be prevented?
    7. Can vision be corrected in later life for people with amblyopia?
    8. How can retinoblastoma be identified, prevented and treated in children?
    9. Can better treatments for glaucoma in children be developed?
    10. Can a treatment be developed to improve vision for people with albinism?

  • Corneal and External Eye Conditions

    At a workshop held on 24 April 2013 attended by patients and eye health professionals the following top 11 priorities for corneal and external eye conditions research were identified:

    Priorities

    1. Can new therapies such as gene or stem cell treatments be developed for corneal diseases?
    2. What is the most effective management for dry eye and can new strategies be developed?
    3. Can treatments to save eye sight from microbial keratitis be improved?
    4. How can the rejection of corneal transplants be prevented?
    5. Can the outcomes of corneal transplantation be improved?
    6. What causes keratoconus to progress and can progression be prevented?
    7. Can non-surgical therapy be developed for Fuchs' corneal dystrophy?
    8. Can corneal infections be prevented in high-risk individuals such as contact lens wearers?
    9. What is the cause of keratoconus and can it be prevented?
    10. What is the most effective management of ocular complications associated with Stevens Johnson Syndrome?
    11. Can severe ocular surface disease in children, such as blepharokeratoconjunctivitis and vernal keratoconjunctivitis be managed better?

  • Glaucoma

    At a workshop held on 19 April 2013 attended by patients and eye health professionals the following top 10 priorities for glaucoma research were identified:

    Priorities

    1. What are the most effective treatments for glaucoma and how can treatments be improved?
    2. How can loss of vision be restored for people with glaucoma?
    3. How can glaucoma be stopped from progressing?
    4. What can be done to improve early diagnosis of sight-threatening glaucoma?
    5. What causes glaucoma?
    6. What is the most effective way of monitoring the progression of glaucoma?
    7. How can glaucoma patients with a higher risk to progress rapidly be detected?
    8. Why is glaucoma more aggressive in people of certain ethnic groups, such as those of West African origin?
    9. How can glaucoma be prevented?
    10. Is there a link between treatment adherence and glaucoma progression and how can adherence be improved?

  • Inherited Retinal Disease

    At a workshop held on 2 May 2013 attended by patients and eye health professionals the following top 10 priorities for inherited retinal disease research were identified:

    Priorities

    1. Can a treatment to slow down progression or reverse sight loss in inherited retinal diseases be developed?
    2. How can sight loss be prevented in an individual with inherited retinal disease?
    3. Is a genetic (molecular) diagnosis possible for all inherited retinal diseases?
    4. What factors affect the progression of sight loss in inherited retinal diseases?
    5. What causes sight loss in inherited retinal diseases?
    6. What is the most effective way to support patients with inherited retinal disease?
    7. Can the diagnosis of inherited retinal diseases be refined so that individuals can be given a clearer idea about their specific condition and how it is likely to progress?
    8. What is the relationship between sight loss and mental health for people with inherited retinal diseases?
    9. Would having a treatment for an inherited retinal disease preclude a patient from having another treatment?
    10. With regard to inherited retinal disease what is the role of pre-natal and pre-implantation diagnosis in helping parents make informed choices?

  • Neuro-ophthalmology

    At a workshop held on 17 May 2013 attended by patients and eye health professionals the following top 10 priorities for neuro-ophthalmology research were identified:

    Priorities

    1. What is the underlying cause of optic nerve damage in optic neuropathies, such as anterior ischaemic optic neuropathy, Leber's hereditary optic neuropathy, optic neuritis and other optic neuropathies?
    2. What are the most effective treatments and rehabilitation for optic neuropathies, e.g. Leber's hereditary optic neuropathy and anterior ischaemic optic neuropathy?
    3. Can vision loss due to optic nerve diseases such as giant cell arteritis, Leber's hereditary optic neuropathy, optic neuritis and optic atrophy, be restored, for example through gene therapy and stem cell treatment?
    4. What rehabilitation or treatment methods are most effective for vision loss following brain damage due to stroke, brain injury, cerebral vision impairment, tumours and dementias?
    5. What is the most effective way to assess vision in patients with neurological visual impairment i.e. stroke, dementia and cerebral/cortical visual impairment?
    6. Can the early stages of optic neuropathy be detected?
    7. How can optic neuropathies be prevented, for example anterior ischaemic optic neuropathy, Leber's hereditary optic neuropathy, optic neuritis and other optic neuropathies?
    8. Can treatments be developed for visual field and ocular motility manifestations following stroke?
    9. How can electronic devices improve or restore vision for people with optic neuropathies?
    10. Can an alternative or new treatment be developed that will treat the sight loss caused by giant cell arteritis?

  • Ocular Cancer

    At a workshop held on 17 April 2013 attended by patients and eye health professionals the following top 10 priorities for Ocular Cancer research were identified:

    Priorities

    1. What can be done to help ocular cancer sufferers?
    2. Can gene-based targeted therapies for ocular cancers be developed?
    3. How can immunotherapy be used to fight metastatic ocular melanoma?
    4. What are the most effective detection and screening methods for follow-up to detect metastasis of ocular melanoma?
    5. How can follow-up for ocular complications be managed in patients with ocular melanoma?
    6. What is the best management of metastatic choroidal melanoma?
    7. What activates choroidal melanoma metastasis in the liver after the primary melanoma has been treated?
    8. Can adjuvant therapies be developed to treat ocular melanoma?
    9. What are the causes of ocular cancer and how can they be prevented?
    10. What is the most effective treatment for primary ocular melanoma?

  • Ocular Inflammatory Disease

    At a workshop held on 16 April 2013 attended by patients and eye health professionals the following top 10 priorities for Ocular Inflammatory Disease research were identified:

    Priorities

    1. What are the most effective treatments for ocular and orbital inflammatory diseases?
    2. What causes thyroid eye disease?
    3. Can the severity of ocular and orbital inflammatory disease in an individual be predicted?
    4. Is it possible to prevent further occurrences of retinal damage caused by toxoplasmosis?
    5. What causes birdshot retinopathy?
    6. Why does disease burn out in patients with ocular and orbital inflammatory diseases?
    7. Can early detection methods be developed for ocular and orbital inflammatory diseases?
    8. What medications best prevent the development of eye disease in Behcets?
    9. What causes scleritis?
    10. Can diet or lifestyle changes prevent uveitis from developing?

  • Refractive Error and Ocular Motility

    At a workshop held on 26 April 2013 attended by patients and eye health professionals the following top 10 priorities for refractive error and ocular motility research were identified:

    Priorities

    1. What factors influence the development of refractive error (myopia, astigmatism, presbyopia, and long-sightedness)?
    2. What is the cause of both congenital and acquired nystagmus?
    3. How can the development of binocular vision in young children with squint and amblyopia be promoted, and would the same approach work in older individuals without inducing intractable diplopia?
    4. Would correction of refractive error have a positive impact on early life learning and development?
    5. Does early diagnosis of refractive error improve long-term prognosis and promote faster, more effective treatment?
    6. What is the effect of congenital nystagmus on visual and emotional development?
    7. What is the most effective treatment for exotropia and when should it be delivered?
    8. How can the functional effects of surgical treatment for squint be best assessed?
    9. Could the accurate testing of refractive error be made less dependent on a subjective response, i.e. the person's own response?
    10. How can myopia be prevented?

  • Retinal Vascular Disease

    At a workshop held on 28 May 2013 attended by patients and eye health professionals the following top 10 priorities for retinal vascular disease research were identified:

    Priorities

    1. What are the best methods to prevent retinopathy of prematurity?
    2. How can sight loss from diabetic retinal changes be prevented and reduced?
    3. What are the predictive factors for the progression to sight threatening diabetic eye disease?
    4. Is there a way to improve screening of premature babies for retinopathy of prematurity?
    5. Can an effective long lasting treatment for diabetic macular oedema, both ischaemic and non-ischaemic, be developed?
    6. Can a retinal vein occlusion be predicted and prevented?
    7. Can new non-invasive treatments be developed to slow down the progression of diabetic retinopathy?
    8. What are the barriers that prevent diabetic patients having regular eye checks?
    9. What rehabilitation programmes are best for the management of distorted vision from retinal diseases?
    10. What is the efficacy and safety of anti-VEGF agents in the treatment of retinopathy of prematurity?

  • Vitreoretinal/Ocular Trauma

    At a workshop held on 15 May 2013 attended by patients and eye health professionals the following top 10 priorities for Vitreoretinal/Ocular Trauma research were identified:

    Priorities

    1. How can surgical techniques be improved to save sight for eyes damaged by injury?
    2. How can the risk of losing sight for people with retinal detachment be reduced?
    3. How can better interventions be developed that are effective in treating vitreous opacities/eye floaters?
    4. What causes retinal detachment and can it be prevented?
    5. Can more effective diagnostic tools be developed for assessing the vitreous and eye floaters?
    6. Can a functioning prosthetic eye be developed to replace an eye damaged by injury?
    7. How can epiretinal membrane/fibrosis be prevented or treated?
    8. Can stem cells be used to regrow an eye or part of an eye?
    9. What causes posterior vitreous detachment/vitreous syneresis?
    10. Are there methods to prevent and improve the treatment of macular holes?