national eye institute national eye institute the national eye institute (nei) is part of the u.s. national institutes of health (nih), an agency of the u.s. department of health and human services. the mission of nei is “to eliminate vision loss and improve quality of life through vision research.” nei consists of two major branches for research: an extramural branch that funds studies outside nih and an intramural branch that funds research on the nih campus in bethesda, maryland. most of the nei budget funds extramural research. national eye instituteabbreviationneiformation1968typeu.s. government agencylegal statusactivepurpose"...eliminate vision loss and improve quality of life through vision research"headquartersbethesda, marylandregion served united statesofficial language englishdirectormichael f. chiangparent organizationnational institutes of healthaffiliationsunited states public health servicewebsitewww.nei.nih.gov established in 1968, nei is the nation’s leading supporter of eye health and vision research. these projects include basic science research into the fundamental biology of the eye and the visual system. nei also funds translational and clinical research aimed at developing and testing therapies for eye diseases and disorders. these projects work to develop therapies for leading causes of vision loss including glaucoma, diabetic retinopathy, age-related macular degeneration (amd), cataract, myopia and amblyopia. nei also funds research on many other causes of vision loss including retinitis pigmentosa, uveitis, retinal detachment, and rare eye diseases and disorders. since its founding, nei has supported the work of several nobel prize recipients, including roger y. tsien, ph.d. (2008); peter agre, m.d. (2003); david h. hubel, m.d. (1981); and torsten wiesel, m.d. (1981). history nei director michael f. chiang, m.d. national institute of neurological disease and blindness, 1950 to 1968 before 1968, vision research at nih was funded and overseen by the national institute of neurological disease and blindness (now known as the national institute of neurological disorders and stroke), which was established in 1950, after president harry s. truman signed the omnibus medical research act. this bill marked the beginning of vision research at the federal level. organizing, structuring, and separating vision and neurological research was a challenge at national institute of neurological disease and blindness. in its early years, securing funding was difficult. the institute established an ophthalmology branch, which served primarily as an ophthalmic consultation service for nih. ophthalmic research grew slowly throughout the 1950s and early 1960s, producing results despite small budgets. one notable example was the study that identified the cause of retrolental fibroplasia (now known as retinopathy of prematurity, the leading cause of blindness among children at the time. despite this progress, some prominent members of the vision research community asserted that too many important proposals for ophthalmic research were not granted funding. they also emphasized that ophthalmology could stand on its own as a discrete academic discipline beyond surgery and neurology. this prompted some leading academic ophthalmologists and vision community supporters to campaign for a separate institute focused solely on vision research. these advocates included bernard becker, m.d.; a. edward maumenee, m.d.; david glendenning cogan, m.d.; frank newell, m.d.; michael j. hogan, m.d.; frank c. winter, m.d.; john m. mclean, m.d.; and jules stein, m.d. the lobbying campaign for a separate ophthalmology-focused institute began in earnest in the mid-1960s and culminated in president lyndon b. johnson signing legislation creating nei as part of nih.nei was established on august 16, 1968, as the united states' first civilian governmental body focused on eye diseases, eye disorders, and vision research. nei, 1968 to present nei officially began operating on december 26, 1968, and the first meeting of the national advisory eye council occurred on april 3, 1969. the first director of nei, carl kupfer, m.d., was appointed on january 11, 1970. from 1970 to kupfer's retirement in 2000, nei's budget grew from $24 million to over $500 million. kupfer expanded nei’s vision research program to focus not only on the eyes but on the entire visual system, including visual processing in the brain. in june 2001, paul a. sieving, m.d., ph.d., joined nei as its second director and served until july 2019. under sieving's directorship, nei established the audacious goals initiative for regenerative medicine. the initiative is a strategic research effort to replace cells of the retina that have been damaged by disease or injury and to restore their connections to the visual centers of the brain. success will mean new approaches to prevent and even reverse vision loss caused by diseases such as amd and glaucoma. past directors directors dating to 1970 portrait director took office left office carl kupfer january 11, 1970 july 15, 2000 jack a. mclaughlin (acting) july 16, 2000 june 16, 2001 paul a. sieving june 17, 2001 july 19, 2019 santa j. tumminia (acting) july 20, 2019 november 15, 2020 organizational structure director in november 2020, michael f. chiang, m.d., began serving as the third director of nei. chiang, a pediatric ophthalmologist, conducts research on the interface of biomedical informatics and clinical ophthalmology in areas such as retinopathy of prematurity, telehealth, artificial intelligence, electronic health records, data science, and genotype–phenotype correlation. extramural research program nei supports extramural vision research through about 2,100 research grants and training awards to scientists at more than 150 medical centers, universities, and other institutions across the united states and worldwide. the nei extramural research program is organized by anatomy and disease around core areas: retina; cornea; lens and cataract; glaucoma and optic neuropathy; strabismus, amblyopia, and visual processing; and vision rehabilitation. these core areas reflect clinical divisions of most ophthalmology and optometry departments. in addition to these core program areas, the nei strategic plan vision for the future 2021-2025 outlines seven cross-cutting areas of emphasis: genetics, neuroscience, immunology, regenerative medicine, data science, quality of life, and public health and health disparities. these areas emphasize the methodological expertise required to address challenges across the entire visual system and facilitate translation of promising findings into clinical care and population health. intramural research program nei's intramural research program is part of the nih intramural research program, which conducts eye and vision research on the nih campus in bethesda, maryland. research initiatives and offices in support of its extramural and intramural activities, the nei has established several offices and research initiatives to facilitate oversight and collaboration in specific areas of emphasis. research achievements nei-supported research has contributed important knowledge about the cause, progression, and treatment of many eye diseases. some notable examples are described below. age-related macular degeneration amd typically happens when aging damages the macula. it is a leading cause of vision loss for older adults. it can blur the sharp central vision needed to read, see faces, and do close-up work. nei has supported several studies investigating treatments for amd, including: age-related eye disease study (areds): this randomized controlled trial showed that a dietary supplement formula with high doses of antioxidants, zinc, and copper reduced the risk of advanced amd and related vision loss. age-related eye disease study 2 (areds2): this study investigated the roles of zinc and beta-carotene in the original areds formulation. it also examined whether adding omega-3 fatty acids and the antioxidants lutein and zeaxanthin would improve the effectiveness of the areds formulation. although areds2 found no overall additional benefits, it did show that two groups of participants had improved results: participants who took the areds formulation with no beta-carotene and participants with very low initial levels of lutein and zeaxanthin in their diets. comparison of age-related macular degeneration treatments trial: lucentis-avastin trial: this two-year, multicenter clinical trial compared the effectiveness of two treatments used for amd: lucentis and avastin. it showed that both treatments are equally effective in treating amd and improving vision, whether used monthly or as needed. complications of age-related macular degeneration prevention trial: this study assessed the safety and effectiveness of laser treatment in preventing vision loss caused by amd in people with large drusen. it showed that laser treatment was not effective at preventing vision loss. submacular surgery trials: these trials investigated the risks and benefits of surgery to remove a type of lesion—known as choroidal neovascularization—that is associated with amd. the results showed that surgery to remove these lesions did not help preserve or improve vision in patients with amd. diabetic retinopathy diabetic retinopathy is an eye condition that can cause vision loss and blindness in people with diabetes. nei has supported several studies on the treatment of diabetic retinopathy, including: diabetic retinopathy study: this study evaluated whether treatment with either an argon laser or xenon arc lamp could prevent severe vision loss caused by diabetic retinopathy. it showed that this type of treatment effectively reduced the risk of severe vision loss, especially in patients at higher risk. diabetic retinopathy vitrectomy study: this study assessed whether patients with diabetic retinopathy would benefit from early vitrectomy (within one to six months). the results showed that patients receiving early vitrectomy had better visual acuity than those receiving delayed vitrectomy (after 12 months). early treatment diabetic retinopathy study: this multicenter, randomized clinical trial investigated using laser treatment and aspirin to treat and delay the progression of clinically significant macular edema. this study showed that focal argon laser photocoagulation reduced the risk of additional vision loss but that aspirin had no effect on the risk, onset, progression, or severity of retinopathy. anti-vegf therapy for diabetic retinopathy: this two-year, nei-supported study, by the drcr retina network found that the drug lucentis can be an effective treatment for people with advanced diabetic retinopathy or proliferative diabetic retinopathy. lucentis is a vascular endothelial growth factor (vegf) inhibitor that can block the growth of abnormal blood vessels—a feature of proliferative diabetic retinopathy. the results suggested that vegf inhibitors like lucentis may help prevent macular edema. glaucoma glaucoma refers to a group of eye diseases that damage the optic nerve and cause vision loss and blindness. open-angle glaucoma is the most common form of glaucoma in the united states. most clinical trials focus on managing open-angle glaucoma by reducing intraocular pressure (iop), the only known modifiable risk factor for glaucoma. nei has supported several studies, including: advanced glaucoma intervention study : this prospective, multicenter randomized trial aimed to assess the long-range outcomes of two intervention sequences to manage advanced glaucoma. after seven years, the study found different results for black/african american patients and white patients. as a result, a treatment program that begins with laser surgery is recommended for black/african american patients with advanced glaucoma, while a treatment program that begins with trabeculectomy is recommended for white patients with advanced glaucoma and no life-threatening health problems. collaborative initial glaucoma treatment study: this study compared the effects of medical treatment to early filtration surgery in newly diagnosed open-angle glaucoma. it found that increased eye pressure was significantly decreased in both the medically and surgically treated groups, with the surgery group having a larger decrease. however, in the surgery group, the need for subsequent cataract surgery was significantly higher, and patients were more likely to lose visual acuity and visual field within the first few years. after four years, patients in both groups were similar in visual acuity and visual field. few patients developed serious vision loss from glaucoma after either treatment. early manifest glaucoma trial: this study evaluated the effects of reducing eye pressure versus no treatment or late treatment for early open-angle glaucoma. it showed that reducing eye pressure can be valuable as early glaucoma treatment—but when to offer this treatment should be decided on a case-by-case basis. fluorouracil filtering surgery study: this study investigated the safety and effectiveness of 5-fluorouracil after trabeculectomy. it showed that using 5-fluorouracil after glaucoma surgery improved patients' results and reduced the need for additional surgeries and medications. glaucoma laser trial and glaucoma laser trial follow-up study: the initial study examined the safety and effectiveness of argon laser trabeculoplasty for treating primary open-angle glaucoma. the results showed that argon laser trabeculoplasty was as safe and effective as using timolol maleate eye drops (the standard treatment). the follow-up study confirmed the results and showed that the side effects of argon laser trabeculoplasty were temporary. ocular hypertension treatment study: this study measured the effectiveness of medicated eye drops to treat high eye pressure to see whether this treatment could help prevent primary open-angle glaucoma. it showed that treating high eye pressure with medicated eye drops can safely and effectively delay or prevent primary open-angle glaucoma. amblyopia (lazy eye) amblyopia is a type of visual impairment that