Freedman Laboratory

2351 Erwin Road, DUMC 3802 Durham, NC 27710

Sharon Freedman, MD, Principal Investigator

Professor of Ophthalmology and Pediatrics
Chief, Pediatrics and Strabismus Service
 
Duke Eye Center
2351 Erwin Road, DUMC 3802
Durham, NC  27710

Education
  • Duke Eye Center Glaucoma Clinical and Research Fellowship 1990-1992
  • Boston Children's Hospital, Pediatric Ophthalmology and Strabismus Fellowship 1989-1990
  • Massachusetts Eye and Ear Infirmary, Ophthalmology Residency 1989
  • Harvard University, MD, 1985
  • Duke University, 1981
 
 
Phone: (919) 684.3957
sharon.freedman@duke.edu 

Childhood Glaucoma – diagnostic and therapeutic strategies

Glaucoma occurs rarely in infants and children, and can be primary or secondary to other ocular conditions, such as removal of childhood cataracts. Glaucoma in very young children is usually readily recognized (from the visible ocular changes to the young eye under very high intraocular pressures), while the disease is sometimes harder to confirm in older children with more subtle findings.  Existing strategies for evaluating and treating this potentially blinding disease group are currently suboptimal.  Our group is interested in evaluating the genetic determinants of primary infantile glaucoma (the most common type of primary glaucoma in children).  We have also been active in evaluating the noninvasive imaging technique of optical coherence tomography as a way to more accurately evaluate the optic nerve in children with known or suspected glaucoma.  We have also been active in evaluating rebound tonometry as a tool for home pressure monitoring in children with known and suspected glaucoma.  Other work aims to evaluate newer medical and surgical interventions in pediatric glaucoma, identifying successes as well as limitations to their use.

Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is one of the leading causes of childhood blindness. Severe ROP is treated with laser or anti-Vascular Endothelial Growth Factor intravitreal injection, which is generally indicated when the posterior retinal blood vessels become engorged and tortuous, a clinical sign known as plus disease.  Unfortunately, the judgment of plus disease is extremely subjective and error-prone. Our group is interested in developing methods to more objectively quantify plus disease. We have developed a computer program, called "ROPtool," that traces retinal blood vessels in high-quality photographs and then calculates vessel dilation and tortuosity. We have conducted many studies to validate ROPtool and to expand its application to different types of retinal images.   We are active in a randomized, prospective, multicenter trial for help find the optimal dose of bevacizumab for severe ROP, ROP1 (PI is a Duke faculty member, Dr. David Wallace), sponsored by the Pediatric Eye Disease Investigator Group.  In recent years, we have also worked with colleague Grace Prakalapakorn, whose interest in Global health has inspired study of a portable handheld digital camera as a tool for ROP telemedicine, with the goal to help ameliorate an international shortage of physicians available to screen prematurely born infants for severe and potentially blinding ROP worldwide.

Pediatric Retina and Optic Nerve Center at Duke

Our group has worked together with Dr. Cynthia Toth and her DARSI laboratory group for years.  We have studied the use of handheld Optical Coherence Tomography in neonates and young children, studying the normal and the abnormal development of the retina and optic nerve in health and in disease.  We have shown a strong relationship between the retinal nerve fiber layer and the development of the central nervous system in premature infants, and will be furthering our study through the recently awarded RO1 grant with Dr. Toth as PI, and our colleagues in neonatology, pediatric neurology, and radiology.