Prominent discoveries in laboratory science, imaging, surgical interventions, and treatments
Duke researchers and clinician-scientists have been on the forefront of innovations in ophthalmology since the department was formally established in 1965. The commitment is stronger than ever to advance the field through continuous research and innovation. The department's interdisciplinary approach, leveraging collaborations across Duke University, and generous gifts like the one to establish the Ocular Innovation Hub ensure that Duke remains at the cutting edge of ophthalmic research and patient care.
The Ocular Innovation Hub will serve as a dynamic repository, showcasing both historical discoveries and the latest advancements. This resource will be updated regularly, so please check back often to explore the many ways Duke Ophthalmology continues to shape and influence the field of ophthalmology.
The innovations at Duke Ophthalmology directly translate into improved patient care. Here are some ways these advancements benefit patients:
- Enhanced Diagnosis and Treatment: Advanced imaging and diagnostic techniques enable earlier and more accurate detection of eye diseases, leading to more effective treatments and better patient outcomes.
- Personalized Medicine: Gene therapy and other personalized treatment approaches are tailored to the specific eye conditions, offering more targeted and effective care.
- Improved Surgical Outcomes: New surgical techniques reduce the risk of complications and shorten recovery times, enhancing the overall patient experience.
- Novel discoveries: Scientists aim to understand the molecular composition of ocular structures and have identified treatment targets that result in innovative new drugs.
Innovations from Duke Ophthalmology
Duke Ophthalmology has generated numerous prestigious innovations. Check back often as we expand this list of meaningful contributions to the field of ophthalmology.
The Father of Vitreoretinal Surgery
Some of most memorable innovations from Duke Ophthalmology are the discoveries of Robert Machemer, MD, the third chair of Duke Department of Ophthalmology. His surgical inventions changed the world of retinal surgery, especially with his introduction the new surgical technique, pars plana vitrectomy. Under Dr. Machemer's leadership, the department advanced from a clinical center into a first-class clinical and research department. His legacy of innovation and discovery continues today.
"Progress comes from doing the unconventional." - Robert Machemer, MD
Dr. Machemer developed pars plana vitrectomy, a surgical procedure which revolutionized the treatment of posterior segment eye diseases. Patients who were previously hopelessly blind had a chance for vision recovery.
Vitreous surgery is now well established worldwide. It is hard to estimate the vast number of patients who have been treated with this surgical technique, including those with diabetic retinopathy, complicated retinal detachments including with proliferative vitreoretinopathy, and severe ocular injuries.
Machemer received numerous accolades recognizing his achievements as an innovator
- Albrecht von Graefe Prize of the German Ophthalmological Society
- Ernst Jung Prize 1993
- Helen Keller Prize for Vision Research 1997
- Gonin Medal of the International Council of Ophthalmology 1998
- American Academy of Ophthalmology Laureate Award 2003
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Pioneering Imaging Techniques
Cynthia Toth, MD is well known as a pioneer in optical coherence tomography (OCT). Over the last 30 years Toth, along with Duke Ophthalmology and Duke Biomedical Engineering colleagues, have revolutionized OCT. They have translated OCT to human imaging and refined and discovered innovative applications including the first handheld OCT imaging system.
Research in this and other areas has led to better ways to diagnose and predict the course of blinding eye diseases, such as macular degeneration and retinopathy of prematurity, one of the most common causes of childhood vision loss. Duke researchers have developed cutting-edge imaging techniques that allow for better diagnosis and monitoring of eye diseases. These advancements include high-resolution imaging of the retina and optic nerve, which are crucial for early detection and treatment.
3D Viewing Systems: Innovations in 3D viewing systems have improved the accuracy and safety of vitreoretinal surgeries. These systems provide surgeons with enhanced depth perception and visualization, leading to better surgical outcomes.
Robotic Imaging: Duke Ophthalmology researchers developed a robotically aligning OCT system that captures a three-dimensional image of the entire eye. This robotically aligning OCT system builds off of a predecessor prototype system developed by Pratt School of Engineering collaborators.
Detecting Neurodegenerative Diseases
Eye Multimodal Imaging in Neurodegenerative Disease (iMIND)
A research team led by Sharon Fekrat, MD, FACS, FASRS is a multidisciplinary group focused on imaging retinal tissue using multimodal retinal images. Combined with machine learning techniques, they are discovering promising approaches to detect various neurodegenerative conditions before symptoms begin, as well as confirm an accurate diagnosis earlier in the disease continuum.
Transforming Glaucoma Care
Laboratory Research from Duke Ophthalmology led to the development of a new glaucoma drug.
In December 2017, the FDA approved Rhopressa® (netarsudil ophthalmic solution 0.02%) for the reduction of elevated eye pressure in patients with glaucoma. Rhopressa was the first new glaucoma drug class to be FDA-approved in 20 years, and the first to target and inhibit Rho kinase as a way to lower intraocular pressure.
The journey from discovery to drug development is a prime example of the bench-to-bedside translational research and teamwork taking place daily at Duke Ophthalmology.
Identifying New Retinal Structures
Duke researchers made an important – and surprising – discovery in human eye anatomy. Using enhanced imaging technology, they identified a previously unknown part of photoreceptor cells in the retina. Their finding challenges long-standing assumptions about the retina and opens new avenues for understanding vision and genetic eye diseases.
Inside the retina are photoreceptor cells, commonly known as rods and cones. Photoreceptor cells convert light signals into electrical messages that the brain decodes and processes into visual images. The team found that each rod photoreceptor cell contains a large, mechanically reinforced protrusion, which they’ve termed the accessory inner segment (aIS).