J. Crawford Downs, Ph.D., professor in the Department of Ophthalmology and Visual Sciences at the University of Alabama at Birmingham, has been awarded a four-year, $2.35 million R01 grant from the National Eye Institute (NEI) to further his study of glaucoma risk and progression—research that spans over two decades and continues to shape how experts understand the disease.
Commonly referred to as the “silent thief of sight,” glaucoma progresses slowly over several years before significant changes in vision are noticed, generally after significant peripheral blindness has manifest. Affecting nearly 95 million people worldwide, glaucoma is regarded as the leading cause of irreversible blindness and has no known cure—yet.
Downs’ project, which analyzes data from his other NEI grant in new, innovative ways, will evaluate how fluctuating pressures inside and surrounding the eye influence the optic nerve head (ONH), a critical structure involved in transmitting visual signals from the retina to the brain. While elevated intraocular pressure (IOP) is recognized as glaucoma’s principal risk factor, the role it plays in how the disease develops and progresses over time remains unclear.
Trained as an engineer, Downs is accustomed to developing innovative approaches to eye research. To investigate the relationship between IOP and glaucoma, he approaches the eye as a mechanical pressure vessel, using engineering-based methods and multiscale computational models to predict how fluctuations in IOP influence the ONH.
This grant will support Downs and his collaborators in further analyzing data he has gathered over several years. He will analyze the information using tools pioneered by his lab, including viscoelastic, computer-based models of the ONH microstructure and three-dimensional morphology of the lamina cribrosa, the mesh-like tissue that supports retinal neurons as they leave the eye. The team will then use artificial intelligence to analyze the ONH images, model outputs, and morphological measurements to identify correlations with the risk of glaucoma onset and faster progression.
Downs refuses to let the complexity of glaucoma deter him: “I’m constantly asking myself, ‘What if it doesn’t work?’,” Downs said. “Tenacity plays a large role—you must have confidence that you’re on the right track. Stare down adversity every day. Solve unsolvable problems. Soldier on.”
Downs and the Department of Ophthalmology and Visual Sciences will lead this four-year R01 in collaboration with co-principal investigators Michael J.A. Girard, Ph.D., associate professor at Emory University; and Ali Karimi, Ph.D., assistant professor at Oregon Health and Science University.