The National Eye Institute (NEI) is part of the U.S. National Institutes of Health (NIH), an agency of the U.S. Department of Health and Human Services. The mission of NEI is "to eliminate vision loss and improve quality of life through vision research." NEI consists of two major branches for research: an extramural branch that funds studies outside NIH and an intramural branch that funds research on the NIH campus in Bethesda, Maryland. Most of the NEI budget funds extramural research. NEI was established in 1968 as the nation's leading supporter of eye health and vision research projects. These projects include basic science research into the fundamental biology of the eye and the visual system. NEI also funds translational and clinical research aimed at developing and testing therapies for eye diseases and disorders. This research is focused on developing therapies for leading causes of vision loss including glaucoma, diabetic retinopathy, age-related macular degeneration (AMD), cataract, myopia and amblyopia. NEI also funds research on many other causes of vision loss including retinitis pigmentosa, uveitis, retinal detachment, and rare eye diseases and disorders. Since its founding, NEI has supported the work of several Nobel Prize recipients, including Roger Y. Tsien (2008); Peter Agre (2003); David H. Hubel (1981); and Torsten Wiesel (1981).

History

National Institute of Neurological Disease and Blindness, 1950 to 1968

Before 1968, vision research at NIH was funded and overseen by the National Institute of Neurological Disease and Blindness (now known as the National Institute of Neurological Disorders and Stroke), which was established in 1950, after President Harry S. Truman signed the Omnibus Medical Research Act. This bill marked the beginning of vision research at the federal level. Organizing, structuring, and separating vision and neurological research was a challenge at National Institute of Neurological Disease and Blindness. In its early years, securing funding was difficult. The institute established an Ophthalmology Branch, which served primarily as an ophthalmic consultation service for NIH. Ophthalmic research grew slowly throughout the 1950s and early 1960s, producing results despite small budgets. One notable example was the study that identified the cause of retrolental fibroplasia (now known as retinopathy of prematurity, the leading cause of blindness among children at the time. Despite this progress, some prominent members of the vision research community asserted that too many important proposals for ophthalmic research were not granted funding. They also emphasized that ophthalmology could stand on its own as a discrete academic discipline beyond surgery and neurology. This prompted some leading academic ophthalmologists and vision community supporters to campaign for a separate institute focused solely on vision research. These advocates included Bernard Becker, M.D.; A. Edward Maumenee, M.D.; David Glendenning Cogan, M.D.; Frank Newell, M.D.; Michael J. Hogan, M.D.; Frank C. Winter, M.D.; John M. McLean, M.D.; and Jules Stein, M.D. The lobbying campaign for a separate ophthalmology-focused institute began in earnest in the mid-1960s and culminated in President Lyndon B. Johnson signing legislation creating NEI as part of NIH. NEI was established on August 16, 1968, as the United States' first civilian governmental body focused on eye diseases, eye disorders, and vision research.

NEI, 1968 to present

NEI officially began operating on December 26, 1968, and the first meeting of the National Advisory Eye Council occurred on April 3, 1969. The first director of NEI, Carl Kupfer, was appointed on January 11, 1970. From 1970 to Kupfer's retirement in 2000, NEI's budget grew from $24 million to over $500 million.[3] Kupfer expanded NEI's vision research program to focus not only on the eyes but on the entire visual system, including visual processing in the brain. In June 2001, Paul A. Sieving, joined NEI as its second director and served until July 2019. Under Sieving's directorship, NEI established the Audacious Goals Initiative for Regenerative Medicine. The initiative is a strategic research effort to replace cells of the retina that have been damaged by disease or injury and to restore their connections to the visual centers of the brain. Success will mean new approaches to prevent and even reverse vision loss caused by diseases such as AMD and glaucoma.

Past directors

Directors dating to 1970

Organizational structure

Director

In November 2020, Michael F. Chiang, began serving as the third director of NEI. Chiang, a pediatric ophthalmologist, conducts research on the interface of biomedical informatics and clinical ophthalmology in areas such as retinopathy of prematurity, telehealth, artificial intelligence, electronic health records, data science, and genotype–phenotype correlation.

Extramural Research Program

NEI supports extramural vision research through about 2,100 research grants and training awards to scientists at more than 150 medical centers, universities, and other institutions across the United States and worldwide. The NEI extramural research program is organized by anatomy and disease around core areas: retina; cornea; lens and cataract; glaucoma and optic neuropathy; strabismus, amblyopia, and visual processing; and vision rehabilitation. These core areas reflect clinical divisions of most ophthalmology and optometry departments. In addition to these core program areas, the NEI Strategic Plan Vision for the Future 2021-2025 outlines seven cross-cutting areas of emphasis: genetics, neuroscience, immunology, regenerative medicine, data science, quality of life, and public health and health disparities. These areas emphasize the methodological expertise required to address challenges across the entire visual system and facilitate translation of promising findings into clinical care and population health.

Intramural Research Program

NEI's Intramural Research Program is part of the NIH Intramural Research Program, which conducts eye and vision research on the NIH campus in Bethesda, Maryland.

Research Initiatives and Offices

In support of its extramural and intramural activities, the NEI has established several offices and research initiatives to facilitate oversight and collaboration in specific areas of emphasis.

Research achievements

NEI-supported research has contributed important knowledge about the cause, progression, and treatment of many eye diseases. Some notable examples are described below.

Age-related macular degeneration

AMD typically happens when aging damages the macula. It is a leading cause of vision loss for older adults. It can blur the sharp central vision needed to read, see faces, and do close-up work. NEI has supported several studies investigating treatments for AMD, including: Although AREDS2 found no overall additional benefits, it did show that two groups of participants had improved results: participants who took the AREDS formulation with no beta-carotene and participants with very low initial levels of lutein and zeaxanthin in their diets.

Diabetic retinopathy

Diabetic retinopathy is an eye condition that can cause vision loss and blindness in people with diabetes. NEI has supported several studies on the treatment of diabetic retinopathy, including:

Glaucoma

Glaucoma refers to a group of eye diseases that damage the optic nerve and cause vision loss and blindness. Open-angle glaucoma is the most common form of glaucoma in the United States. Most clinical trials focus on managing open-angle glaucoma by reducing intraocular pressure (IOP), the only known modifiable risk factor for glaucoma. NEI has supported several studies, including:

Amblyopia (lazy eye)

Amblyopia is a type of visual impairment that occurs when the brain does not recognize visual signals from one eye and favors the other eye. NEI has supported research into effective treatment for amblyopia, including:

Corneal stromal keratitis

Corneal stromal keratitis or herpetic simplex keratitis is inflammation of the cornea caused by herpes infection of the eye. NEI-funded research led to a breakthrough in treatment for this condition:

Optic nerve diseases

Optic nerve diseases, like optic neuropathy and optic neuritis, can damage the connection between the eye and the visual processing centers of the brain and cause vision loss. NEI has supported studies on the treatment of optic nerve disease, including:

Retinopathy of prematurity

Retinopathy of prematurity happens when abnormal blood vessels grow in the retina and cause vision loss and blindness in babies who are premature or who weigh less than 3 pounds at birth. NEI has supported studies investigating the treatment and progression of retinopathy of prematurity, including:

Retinitis pigmentosa

Retinitis pigmentosa refers to a group of genetic eye diseases that cause cells in the retina to degenerate, leading to impaired night vision and loss of peripheral vision. NEI has supported research into therapies that slow disease progression, including:

Uveitis

Uveitis is inflammation of the uvea, the middle layer of the eye between the sclera and the retina. NEI has supported several studies to examine the causes of uveitis, including:

Leber congenital amaurosis

Leber congenital amaurosis is a rare inherited eye disease that impairs vision starting in infancy. NEI supported work leading to a gene therapy for one type of this disease: In December 2017, Luxturna became the first directly administered gene therapy approved in the United States that targets a disease caused by mutations in a specific gene. It was approved for the treatment of patients with confirmed biallelic RPE65 mutation-associated retinal dystrophy that leads to vision loss and may cause complete blindness in certain patients.

Technology development

NEI has invested in the development of technologies to support diagnosis and management. A few examples of this investment include:

Education and outreach activities

Part of NEI's mission is to educate health care providers, scientists, policymakers, and the public about advances in vision research and their impact on health and quality of life. This effort is led by NEI's National Eye Health Education Program.

National Eye Health Education Program

NEI created the National Eye Health Education Program to educate professionals and the public about the importance of eye health. The program partners with more than 60 national organizations representing health professionals, educators, and patients in accomplishing this mission. It also oversees public and professional education programs on diabetic eye disease, glaucoma, vision rehabilitation, special population outreach, and vision and aging—with a focus on individuals and populations at higher risk of eye health disorders, including older people, those with diabetes, Black/African American people, and Hispanic/Latino people. The program also draws on research supported by NIH and NEI to identify other populations at risk (e.g., Asian American people, residents of rural communities) and to produce educational materials for professional and public audiences. It emphasizes the importance of early detection and timely treatment of eye disease and the benefits of vision rehabilitation. The program also aims to increase awareness among health professionals and the public of science-based health information that can be applied to preserving sight and preventing blindness.

Eye on the Future Teen Video Contest

In 2022, the NEI created the Eye on the Future Teen Video Contest to foster the next generation of American scientists. The NEI awards American youth who create educational videos in three categories: "Science in your world," "Science in the field or lab," and "Science in your future." One winner is selected in each category, each receiving a prize of $2,000 USD.