A window to the mind: Developing adaptive optics to understand changes in visual behaviour with eye disorders
Lead Research Organisation:
Newcastle University
Department Name: Institute of Neuroscience
Abstract
Seeing involves a complex set of processes that allow us to extract information from the physical world. As you read this, an image of the text is formed by the optical elements of your eye and this image is sensed by the light-sensitive cells that tile your retina. Neurons in your retina and brain process this sensory input, ultimately allowing you to extract meaning from the text. This happens in a fraction of second between jump-like movements of your eyes that shift your gaze across the text. Even during the periods when we think our eyes are still, they continually make microscopic movements that are fundamental to seeing anything at all.
Disruption to the sensory input, such as by retinal degeneration or refractive errors, places a fundamental limit on the information available to the visual system. Visual disorders significantly impact on an individual's health, wellbeing and quality of life. Visual impairments in childhood can affect school performance, and in the elderly they can severely restrict everyday activities and affect independence. Visual disorders have their effect at many levels, from changes in the eye, to deficits in visual and cognitive processing, and alterations to the efficient movement of the eyes. Visual disorders are best tackled with a cross-disciplinary approach, working across these levels.
Adaptive optics is a powerful technique originally developed for astronomy that has revolutionised the study of the eye, allowing human vision to be characterised with extraordinary precision. By correcting for optical distortions, which are present in every eye, adaptive optics allows imaging of individual cells in the living human eye and provides exciting new capabilities for tracking the tiniest of eye movements with unprecedented accuracy. By manipulating the optical distortions of the eye, adaptive optics also allows investigation of the impact of refractive errors on sight. I will take an interdisciplinary approach, developing adaptive optics techniques in combination with precise experiments in human vision to understand how the visual system processes information and how this is disrupted by visual impairments. I will address these fundamental questions through targeted investigation of two leading causes of visual impairment:
1. Age-related macular degeneration affects around 600,000 people in the UK, severely affecting sight by causing loss of central vision - imagine the difficulty of having a blind spot follow wherever you look. Being incurable, treatments aim to preserve remaining sight and so early detection is crucial. I will investigate the relationship between degeneration in the retina, eye movements and visual function. This will inform interventions, such as visual aids and eye movement training, to make the best use of patients' remaining sight. The high precision of adaptive optics will allow me to make very sensitive measures of alterations to eye movements. I will look for characteristic changes that could be screened for, leading to very early detection of disease.
2. Refractive errors (e.g. myopia and astigmatism) affect around 1 in 7 children in the UK. Even in the healthy eye, there are more complex high-order optical distortions that are not correctable with spectacles. Optical distortions impair visual acuity - such as the ability to identify letters on a chart - but can cause further problems in more cognitively demanding tasks, such as reading. Our society makes heavy use of text to convey important information. My research will use adaptive optics to investigate how optical distortions impact on reading, for example by impairing recognition or disrupting eye movements. This will enable better accessibility to information, through improved visual aids or eye guidance training, or through designing fonts for educational materials that are more robust to refractive errors.
Disruption to the sensory input, such as by retinal degeneration or refractive errors, places a fundamental limit on the information available to the visual system. Visual disorders significantly impact on an individual's health, wellbeing and quality of life. Visual impairments in childhood can affect school performance, and in the elderly they can severely restrict everyday activities and affect independence. Visual disorders have their effect at many levels, from changes in the eye, to deficits in visual and cognitive processing, and alterations to the efficient movement of the eyes. Visual disorders are best tackled with a cross-disciplinary approach, working across these levels.
Adaptive optics is a powerful technique originally developed for astronomy that has revolutionised the study of the eye, allowing human vision to be characterised with extraordinary precision. By correcting for optical distortions, which are present in every eye, adaptive optics allows imaging of individual cells in the living human eye and provides exciting new capabilities for tracking the tiniest of eye movements with unprecedented accuracy. By manipulating the optical distortions of the eye, adaptive optics also allows investigation of the impact of refractive errors on sight. I will take an interdisciplinary approach, developing adaptive optics techniques in combination with precise experiments in human vision to understand how the visual system processes information and how this is disrupted by visual impairments. I will address these fundamental questions through targeted investigation of two leading causes of visual impairment:
1. Age-related macular degeneration affects around 600,000 people in the UK, severely affecting sight by causing loss of central vision - imagine the difficulty of having a blind spot follow wherever you look. Being incurable, treatments aim to preserve remaining sight and so early detection is crucial. I will investigate the relationship between degeneration in the retina, eye movements and visual function. This will inform interventions, such as visual aids and eye movement training, to make the best use of patients' remaining sight. The high precision of adaptive optics will allow me to make very sensitive measures of alterations to eye movements. I will look for characteristic changes that could be screened for, leading to very early detection of disease.
2. Refractive errors (e.g. myopia and astigmatism) affect around 1 in 7 children in the UK. Even in the healthy eye, there are more complex high-order optical distortions that are not correctable with spectacles. Optical distortions impair visual acuity - such as the ability to identify letters on a chart - but can cause further problems in more cognitively demanding tasks, such as reading. Our society makes heavy use of text to convey important information. My research will use adaptive optics to investigate how optical distortions impact on reading, for example by impairing recognition or disrupting eye movements. This will enable better accessibility to information, through improved visual aids or eye guidance training, or through designing fonts for educational materials that are more robust to refractive errors.
Planned Impact
The elderly
Visual impairments have a profound impact on the elderly, making everyday tasks difficult. Age-related macular degeneration is the leading cause of visual impairment in the developed world and affects around 600,000 people in the UK. It causes a loss of the centre of the field of vision, severely limiting mobility and activities such as reading and recognising faces. Being incurable, early detection is crucial for preserving sight. Current detection relies on self-reporting of changes in vision, which may not be noticeable in early onset and has been shown to miss a large proportion of degenerative changes. My research will look for sensitive, objective measures of the onset of AMD through changes in eye movements. In the long term this will allow earlier detection and therefore earlier treatment. In the short to medium term, my research will inform interventions for making the most patients' remaining sight, allowing them to maintain independence and quality of life.
Children
Reading skills are important for children's educational attainment and long-term job prospects. Refractive errors affect around 1 in 7 children in the UK and evidence suggests the affect children's literacy (Bruce et al, 2019. BMJ Open, 6, e010434). Refractive errors are difficult to detect in children and while the NHS recommends testing children's eyesight in their first year of school, there is nothing to ensure that the results are acted upon. My research will link refractive errors to impairment in cognitive tasks such as reading. This will highlight the importance of visual screening early in childhood and the adherence to visual correction. During and beyond the fellowship, I will engage with children, parents and educators through outreach and public engagement activities to maximise the impact of my research. I will engage with the UK Vision Strategy and connect with policy makers such as Public Health England so that, in the medium and long term, visual screening recommendations can be informed by my research. Models of how refractive errors affect processes in reading can inform the development of educational and literacy materials, such that the typeface and layout are robust to visual impairment, making them more accessible.
Industry and Clinic
Adaptive optics is a powerful tool for eye and vision research, yet there are few systems worldwide and most are custom-made instruments in dedicated research laboratories. Adaptive optics allows retinal changes to be detected much earlier and over much shorter timescales. With new developments, such as optogenetics and gene therapy, the need for cell-specific biomarkers for eye disease will be increasingly important. In the short term, collaboration between adaptive optics labs will lead to accelerated development of these techniques. In the medium term, the development of commercially available research instruments will open this technology to those at the forefront of research into sight loss and its treatment. In the longer term this will lead to a clinical tool for early disease detection, closer treatment monitoring and potentially accelerate clinical trials so that treatments are approved faster and at lower cost. The worldwide market for ophthalmology products is £33 billion, including diagnostic instrumentation (£2 billion) and eye care (£10 billion). My research and collaborative network will position the UK to develop this technology for commercial deployment.
Visual impairments have a profound impact on the elderly, making everyday tasks difficult. Age-related macular degeneration is the leading cause of visual impairment in the developed world and affects around 600,000 people in the UK. It causes a loss of the centre of the field of vision, severely limiting mobility and activities such as reading and recognising faces. Being incurable, early detection is crucial for preserving sight. Current detection relies on self-reporting of changes in vision, which may not be noticeable in early onset and has been shown to miss a large proportion of degenerative changes. My research will look for sensitive, objective measures of the onset of AMD through changes in eye movements. In the long term this will allow earlier detection and therefore earlier treatment. In the short to medium term, my research will inform interventions for making the most patients' remaining sight, allowing them to maintain independence and quality of life.
Children
Reading skills are important for children's educational attainment and long-term job prospects. Refractive errors affect around 1 in 7 children in the UK and evidence suggests the affect children's literacy (Bruce et al, 2019. BMJ Open, 6, e010434). Refractive errors are difficult to detect in children and while the NHS recommends testing children's eyesight in their first year of school, there is nothing to ensure that the results are acted upon. My research will link refractive errors to impairment in cognitive tasks such as reading. This will highlight the importance of visual screening early in childhood and the adherence to visual correction. During and beyond the fellowship, I will engage with children, parents and educators through outreach and public engagement activities to maximise the impact of my research. I will engage with the UK Vision Strategy and connect with policy makers such as Public Health England so that, in the medium and long term, visual screening recommendations can be informed by my research. Models of how refractive errors affect processes in reading can inform the development of educational and literacy materials, such that the typeface and layout are robust to visual impairment, making them more accessible.
Industry and Clinic
Adaptive optics is a powerful tool for eye and vision research, yet there are few systems worldwide and most are custom-made instruments in dedicated research laboratories. Adaptive optics allows retinal changes to be detected much earlier and over much shorter timescales. With new developments, such as optogenetics and gene therapy, the need for cell-specific biomarkers for eye disease will be increasingly important. In the short term, collaboration between adaptive optics labs will lead to accelerated development of these techniques. In the medium term, the development of commercially available research instruments will open this technology to those at the forefront of research into sight loss and its treatment. In the longer term this will lead to a clinical tool for early disease detection, closer treatment monitoring and potentially accelerate clinical trials so that treatments are approved faster and at lower cost. The worldwide market for ophthalmology products is £33 billion, including diagnostic instrumentation (£2 billion) and eye care (£10 billion). My research and collaborative network will position the UK to develop this technology for commercial deployment.
Organisations
- Newcastle University (Fellow, Lead Research Organisation)
- UNIVERSITY OF OXFORD (Collaboration)
- DURHAM UNIVERSITY (Collaboration)
- University College London (Collaboration)
- L'Institut d'Optique Graduate School (Collaboration)
- University of Murcia, Spain (Collaboration)
- National Office for Aerospace Studies and Research (Collaboration)
- Laboratoire d'Astrophysique de Marseile (Collaboration)
- Newcastle upon Tyne Hospitals NHS Foundation Trust (Project Partner)
People |
ORCID iD |
Laura Young (Principal Investigator / Fellow) |
Publications
Christou JC
(2021)
Feature issue introduction: applications of adaptive optics.
in Optics express
Hexley A
(2022)
Measuring and modelling fixational eye movements
in Journal of Vision
Kordek D
(2022)
Effect of Dioptric Blur on Pattern-Reversal and Motion-Onset VEPs as Used in Clinical Research.
in Translational vision science & technology
Strong S
(2022)
British Congress of Optometry and Vision Science 2021.
in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)
Young L
(2021)
Emulated retinal image capture (ERICA) to test, train and validate processing of retinal images
in Scientific Reports
Description | European Adaptive Optics Summer School |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Influenced training of practitioners or researchers |
Impact | Participants self-reported improved and broader knowledge of adaptive optics. Participants and academic and industry contributors had the opportunity to network. |
Description | Training material added to graduate course |
Geographic Reach | Local/Municipal/Regional |
Policy Influence Type | Influenced training of practitioners or researchers |
Description | Early detection of cerebrovascular deficits via adaptive optics retinal imaging: Enhancing translation proof-of-concept in PREDICTOR |
Amount | £47,243 (GBP) |
Funding ID | 0011558 |
Organisation | Medical and Life Sciences Translational Fund |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 02/2022 |
End | 07/2022 |
Description | PREDICTOR - PRE-symptomatic DIagnosis through adaptive optiCal Tomographic sensing Of the Retina |
Amount | £302,931 (GBP) |
Funding ID | EP/W004534/1 |
Organisation | Engineering and Physical Sciences Research Council (EPSRC) |
Sector | Public |
Country | United Kingdom |
Start | 09/2021 |
End | 12/2022 |
Description | PhD Studentship in Vision Science - Understanding whether eye 'jitter' can improve vision using advanced retinal imaging |
Amount | £432,042 (GBP) |
Organisation | Reece Foundation |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 04/2022 |
End | 03/2026 |
Description | Studying retinal structure and function with detailed adaptive optics imaging and multifocal electroretinography |
Amount | £27,778 (GBP) |
Organisation | Newcastle upon Tyne Hospitals NHS Foundation Trust |
Sector | Academic/University |
Country | United Kingdom |
Start | 09/2022 |
End | 06/2023 |
Title | ERICA: Emulated Retinal Image CApture |
Description | ERICA is an end-to-end simulation of data capture through an adaptive optics scanning laser ophthalmoscope (AOSLO). This tool allows generation of large quantities of realistic images that can be used to test, train and validate image analysis algorithms and machine learning approaches for high resolution retinal images. The parameters of the imaging process (e.g. wavelength, pupil size, noise, residual aberrations, retinal composition, eye movements, scan configuration and speed) can be specified to test their impact on analysis algorithms and define performance limits. |
Type Of Material | Computer model/algorithm |
Year Produced | 2021 |
Provided To Others? | Yes |
Impact | This has enabled a number of projects within my group and by my collaborators to better understand the sources of error when analysing AO retinal images and to develop and improve algorithms for detecting and rejecting poor quality data, estimating and accurately characterising eye movements, and automation of the labelling of images. |
Description | European Adaptive Optics Summer School |
Organisation | Durham University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I led the organisation of the summer school. |
Collaborator Contribution | Contributions included planning and development of the school, lectures, workshops and demonstrations. |
Impact | This summer school was designed to (1) train new researchers who are developing or using adaptive optics (AO) techniques, (2) bridge the range of domains where AO is used, including vision/ophthalmology, astronomy, microscopy, optical communications and other related areas and (3) expand European AO research networks. The summer school ran virtually and attendees and contributors came from 23 countries, spread across 6 of the 7 continents. There were 120 attendees including postgraduate students, postdoctoral researchers, independent and permanent researcher staff, technical staff, clinical staff and researchers from industry. Contributions included: lectures on the fundamentals of AO and its application; live on-bench an in-simulation workshops; lab tours from 13 research groups spread across Europe and across astronomy, ophthalmology and microscopy; demonstrations from three companies; a keynote talk; a live demo from the VLT in Chile; lectures in engagement, equality and career development; and networking opportunities. Feedback from attendees was very positive both on content and delivery. There was discussion and questions both live during the lectures and demonstrations and through Gather Town and Slack. Around two-thirds of attendees reported meeting new people and around one third reported making new academic or collaborative relationships. The school will run again in 2022 and we anticipate this continuing annually. |
Start Year | 2021 |
Description | European Adaptive Optics Summer School |
Organisation | L'Institut d'Optique Graduate School |
Country | France |
Sector | Academic/University |
PI Contribution | I led the organisation of the summer school. |
Collaborator Contribution | Contributions included planning and development of the school, lectures, workshops and demonstrations. |
Impact | This summer school was designed to (1) train new researchers who are developing or using adaptive optics (AO) techniques, (2) bridge the range of domains where AO is used, including vision/ophthalmology, astronomy, microscopy, optical communications and other related areas and (3) expand European AO research networks. The summer school ran virtually and attendees and contributors came from 23 countries, spread across 6 of the 7 continents. There were 120 attendees including postgraduate students, postdoctoral researchers, independent and permanent researcher staff, technical staff, clinical staff and researchers from industry. Contributions included: lectures on the fundamentals of AO and its application; live on-bench an in-simulation workshops; lab tours from 13 research groups spread across Europe and across astronomy, ophthalmology and microscopy; demonstrations from three companies; a keynote talk; a live demo from the VLT in Chile; lectures in engagement, equality and career development; and networking opportunities. Feedback from attendees was very positive both on content and delivery. There was discussion and questions both live during the lectures and demonstrations and through Gather Town and Slack. Around two-thirds of attendees reported meeting new people and around one third reported making new academic or collaborative relationships. The school will run again in 2022 and we anticipate this continuing annually. |
Start Year | 2021 |
Description | European Adaptive Optics Summer School |
Organisation | Laboratoire d'Astrophysique de Marseile |
Country | France |
Sector | Academic/University |
PI Contribution | I led the organisation of the summer school. |
Collaborator Contribution | Contributions included planning and development of the school, lectures, workshops and demonstrations. |
Impact | This summer school was designed to (1) train new researchers who are developing or using adaptive optics (AO) techniques, (2) bridge the range of domains where AO is used, including vision/ophthalmology, astronomy, microscopy, optical communications and other related areas and (3) expand European AO research networks. The summer school ran virtually and attendees and contributors came from 23 countries, spread across 6 of the 7 continents. There were 120 attendees including postgraduate students, postdoctoral researchers, independent and permanent researcher staff, technical staff, clinical staff and researchers from industry. Contributions included: lectures on the fundamentals of AO and its application; live on-bench an in-simulation workshops; lab tours from 13 research groups spread across Europe and across astronomy, ophthalmology and microscopy; demonstrations from three companies; a keynote talk; a live demo from the VLT in Chile; lectures in engagement, equality and career development; and networking opportunities. Feedback from attendees was very positive both on content and delivery. There was discussion and questions both live during the lectures and demonstrations and through Gather Town and Slack. Around two-thirds of attendees reported meeting new people and around one third reported making new academic or collaborative relationships. The school will run again in 2022 and we anticipate this continuing annually. |
Start Year | 2021 |
Description | European Adaptive Optics Summer School |
Organisation | National Office for Aerospace Studies and Research |
Country | France |
Sector | Public |
PI Contribution | I led the organisation of the summer school. |
Collaborator Contribution | Contributions included planning and development of the school, lectures, workshops and demonstrations. |
Impact | This summer school was designed to (1) train new researchers who are developing or using adaptive optics (AO) techniques, (2) bridge the range of domains where AO is used, including vision/ophthalmology, astronomy, microscopy, optical communications and other related areas and (3) expand European AO research networks. The summer school ran virtually and attendees and contributors came from 23 countries, spread across 6 of the 7 continents. There were 120 attendees including postgraduate students, postdoctoral researchers, independent and permanent researcher staff, technical staff, clinical staff and researchers from industry. Contributions included: lectures on the fundamentals of AO and its application; live on-bench an in-simulation workshops; lab tours from 13 research groups spread across Europe and across astronomy, ophthalmology and microscopy; demonstrations from three companies; a keynote talk; a live demo from the VLT in Chile; lectures in engagement, equality and career development; and networking opportunities. Feedback from attendees was very positive both on content and delivery. There was discussion and questions both live during the lectures and demonstrations and through Gather Town and Slack. Around two-thirds of attendees reported meeting new people and around one third reported making new academic or collaborative relationships. The school will run again in 2022 and we anticipate this continuing annually. |
Start Year | 2021 |
Description | European Adaptive Optics Summer School |
Organisation | University College London |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I led the organisation of the summer school. |
Collaborator Contribution | Contributions included planning and development of the school, lectures, workshops and demonstrations. |
Impact | This summer school was designed to (1) train new researchers who are developing or using adaptive optics (AO) techniques, (2) bridge the range of domains where AO is used, including vision/ophthalmology, astronomy, microscopy, optical communications and other related areas and (3) expand European AO research networks. The summer school ran virtually and attendees and contributors came from 23 countries, spread across 6 of the 7 continents. There were 120 attendees including postgraduate students, postdoctoral researchers, independent and permanent researcher staff, technical staff, clinical staff and researchers from industry. Contributions included: lectures on the fundamentals of AO and its application; live on-bench an in-simulation workshops; lab tours from 13 research groups spread across Europe and across astronomy, ophthalmology and microscopy; demonstrations from three companies; a keynote talk; a live demo from the VLT in Chile; lectures in engagement, equality and career development; and networking opportunities. Feedback from attendees was very positive both on content and delivery. There was discussion and questions both live during the lectures and demonstrations and through Gather Town and Slack. Around two-thirds of attendees reported meeting new people and around one third reported making new academic or collaborative relationships. The school will run again in 2022 and we anticipate this continuing annually. |
Start Year | 2021 |
Description | European Adaptive Optics Summer School |
Organisation | University of Murcia, Spain |
Country | Spain |
Sector | Academic/University |
PI Contribution | I led the organisation of the summer school. |
Collaborator Contribution | Contributions included planning and development of the school, lectures, workshops and demonstrations. |
Impact | This summer school was designed to (1) train new researchers who are developing or using adaptive optics (AO) techniques, (2) bridge the range of domains where AO is used, including vision/ophthalmology, astronomy, microscopy, optical communications and other related areas and (3) expand European AO research networks. The summer school ran virtually and attendees and contributors came from 23 countries, spread across 6 of the 7 continents. There were 120 attendees including postgraduate students, postdoctoral researchers, independent and permanent researcher staff, technical staff, clinical staff and researchers from industry. Contributions included: lectures on the fundamentals of AO and its application; live on-bench an in-simulation workshops; lab tours from 13 research groups spread across Europe and across astronomy, ophthalmology and microscopy; demonstrations from three companies; a keynote talk; a live demo from the VLT in Chile; lectures in engagement, equality and career development; and networking opportunities. Feedback from attendees was very positive both on content and delivery. There was discussion and questions both live during the lectures and demonstrations and through Gather Town and Slack. Around two-thirds of attendees reported meeting new people and around one third reported making new academic or collaborative relationships. The school will run again in 2022 and we anticipate this continuing annually. |
Start Year | 2021 |
Description | European Adaptive Optics Summer School |
Organisation | University of Oxford |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | I led the organisation of the summer school. |
Collaborator Contribution | Contributions included planning and development of the school, lectures, workshops and demonstrations. |
Impact | This summer school was designed to (1) train new researchers who are developing or using adaptive optics (AO) techniques, (2) bridge the range of domains where AO is used, including vision/ophthalmology, astronomy, microscopy, optical communications and other related areas and (3) expand European AO research networks. The summer school ran virtually and attendees and contributors came from 23 countries, spread across 6 of the 7 continents. There were 120 attendees including postgraduate students, postdoctoral researchers, independent and permanent researcher staff, technical staff, clinical staff and researchers from industry. Contributions included: lectures on the fundamentals of AO and its application; live on-bench an in-simulation workshops; lab tours from 13 research groups spread across Europe and across astronomy, ophthalmology and microscopy; demonstrations from three companies; a keynote talk; a live demo from the VLT in Chile; lectures in engagement, equality and career development; and networking opportunities. Feedback from attendees was very positive both on content and delivery. There was discussion and questions both live during the lectures and demonstrations and through Gather Town and Slack. Around two-thirds of attendees reported meeting new people and around one third reported making new academic or collaborative relationships. The school will run again in 2022 and we anticipate this continuing annually. |
Start Year | 2021 |
Description | Lifelong Learning lecture |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Public/other audiences |
Results and Impact | Members of Explore Lifelong Learning attended an hour long lecture on "Imaging neurons in the living eye". The talk described the basics of the eye and visual system and how researchers can study these in more detail using high resolution imaging technologies to better understand both the normal healthy retina and how it is altered in diseases that affect the retina, including ophthalmic and systemic diseases. The lecture prompted questions and discussions on a range of related topics and interest from members of the general public in the future of the technology. |
Year(s) Of Engagement Activity | 2023 |
Description | Women In Science Doing Outstanding Maths & Physics outreach profile |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | Regional |
Primary Audience | Schools |
Results and Impact | An online personal profile was given for an annual outreach event run by Women In Science Doing Outstanding Maths & Physics (WISDOM), which is aimed at encouraging year 9 and 10 girls in STEM. |
Year(s) Of Engagement Activity | 2021 |
URL | https://conferences.ncl.ac.uk/wisdom/ |