Imagine learning that your newborn child is visually impaired or blind. After the shock of hearing this devastating news, a million questions would surface. Is there anything that can be done to help my child? How much can she or he see? What rehabilitation should be offered to my child? How will this affect my child's overall well-being? At Smith-Kettlewell Eye Research Institute's infant vision lab, we are working to determine the answers to these and other important questions.

To be sure, blindness in children is uncommon, occurring in 2 or 3 newborn children per 1000. Yet the incidence of blindness is increasing, ironically due to important advances that have occurred in other medical fields. For example, many premature infants who would have succumbed to a variety of diseases in years past now survive their newborn period, but are afflicted with multiple chronic illnesses. In some cases, the visual system will be damaged too. The emotional, social, developmental, and economic cost of vision impairment in young children is enormous, making efforts to prevent and treat these various conditions very rewarding.

To measure the residual vision in these visually impaired children, we use the sweep visual evoked potential system created at Smith-Kettlewell. By placing sensitive sensors on the back of the child's head, we can record responses to a variety of visual targets. We want to learn practical visual situations that could help the child optimize his or her remaining vision. Does the child see best under dim or brightly lit conditions? Is color more easily identified than black or white? The answers to these and other questions can help to direct a rehabilitation program for the poorly sighted child.

Prevention of blindness in children is the most desirable goal. The National Eye Institute is funding a research program with Smith-Kettlewell as the Headquarters, directed at preventing blindness in children from a condition called retinopathy of prematurity. Retinopathy of prematurity is the second leading cause of blindness in children in the United States. Over the next several years, we will learn whether particular treatment efforts prevent this disease.

One day we hope to be able to predict which child could become visually impaired, and to offer a specific intervention that would prevent blindness. The prediction of potential blindness might come from visual evoked potential tests, or from other biological markers of the disease in question. The intervention could come in the form of genetic therapy, rehabilitation, medical, or surgical treatment. In the meantime, investigation of visually impaired children offers insight into the functioning of the child's visual system that further enhance our ability to help these children. The answers to parents' important questions about visually impaired children will come from research like that being conducted at Smith-Kettlewell.

For more information, visit Bill Good's lab web pages.

Collaborators: Chuan Hou, Francesca Pei, Monica Hubbard, Lisa Young, Michelle Quintos, Anthony Norcia, Arthur Jampolsky, Ann Skoczenski, Alan Scott, Ashima Madan, Bob Hardy, Betty Tung, Susan Day, Patricia Kjaer.