I would like to thank contributors to our research funding:

William O. Rogers Endowment.
The Anderson Family to Support Visual And Ocular Research.
Peter LeHaye Fund for Ocular research

Current Interests:

Visual function in children with infantile nystagmus.

We are relating anatomical findings of the retina (light sensitive layer in the eye that provides vision) with nystagmus in infancy (nystagmus is the abnormal and involuntary oscillation of the eyes). We use spectral-domain optical coherence tomography to examine the fine detail of the retina and compare these findings with visual acuity (i.e., how low can you go on the reading chart), eye movement recordings, Visual Evoked Potentials (VEP), full field electroretinography, and multi-focal electroretinography. We are using the VEP as an approach to understand rapid changes in the visual system during the eye movement.

Relevant References

Avery H. Weiss, James O. Phillips, John P. Kelly. Anatomy and function of the macula and outcome of surgical tenotomy and reattachment in achiasma. Ophthalmology, 2013, Ophthalmology. 2013 Jul;120(7):1469-75..

Weiss AH, Kelly JP, Phillips JO. Extraction of a Check Reversal VEP under Conditions of Simulated Nystagmus. Book Chapter in the Proceedings of the Second International Congenital Nystagmus Symposium, 2012. get the pdf here

Weiss AH, Kelly JP, Phillips JO. Relationship of slow-phase velocity to visual acuity in infantile nystagmus associated with albinism. J AAPOS. 2011 Feb;15(1):33-9.

Weiss AH, Doherty D, Parisi M, Shaw D, Glass I, Phillips JO. Eye movement abnormalities in Joubert syndrome. Invest Ophthalmol Vis Sci. 2009 Oct;50(10):4669-77.

Weiss AH, Kelly JP. Acuity development in infantile nystagmus. Invest Ophthalmol Vis Sci. 2007 Sep;48(9):4093-9.

Kelly JP, Weiss AH. Topographical retinal function in oculocutaneous albinism. Am J Ophthalmol. 2006;141:1156-8.

Weiss, AH, Phillips JO, Kelly JP. Infantile nystagmus syndrome: When is visual acuity extracted? Invest. Ophthalmol. Vis. Sci. 2012, 53: E-Abstract 511.

Kelly JP, Phillips JO, Weiss, AH. Infantile nystagmus syndrome: Where is that visual cortical signal? Invest. Ophthalmol. Vis. Sci. 2012, 53: E-Abstract 512.

Detection of visual loss and management in children with optic pathway gliomas and retinoblastoma.

Much still needs to be known about visual loss due to optic pathway tumors. These tumors (usually low-grade astrocytomas) can lead to severe visual loss in a subset of affected patients. We hope to continue searching for better detection and management protocols.

Relevant References

Kelly JP, Leary S, Khanna P, Weiss AH. Longitudinal measures of visual function, tumor volume, and prediction of visual outcomes after treatment of optic pathway gliomas. Ophthalmology. 2012 Jun;119(6):1231-7. Epub 2012 Feb 25.

Kelly JP, Weiss AH. Comparison of Pattern Visual-Evoked Potentials to Perimetry in the Detection of Visual Loss In Children With Optic Pathway Gliomas. J AAPOS. 2006;10:298-306.

Kelly JP, Leary S., Weiss, AH. Changes In Visual Function Before And After Chemotherapy For Optic Pathway Gliomas. Invest. Ophthalmol. Vis. Sci. 2011, 52: E-Abstract 4546.

Kelly JP, Weiss, AH. The Time-Course of Changes in Visual Function Before and After Chemotherapy for Optic Pathway Gliomas. Invest. Ophthalmol. Vis. Sci. 2010, 51: E-Abstract 5274.

Weiss AH, Kelly JP, Kapur RP, Pendergrass T. Retinal function and corresponding pathology in advanced retinoblastoma. Arch Ophthalmol. 2008 Nov;126(11):1507-12.

Kelly JP, Kapur R., Sohn E., Weiss AH. Pathology, Retinal Function and Acuity in Stage V Retinoblastoma (RB). Invest. Ophthalmol. Vis. Sci. 2008 49: E-Abstract Session 103.

Sohn, E.H. Weiss A.H., Pendergrass T., Kelly JP. Retinal Function After Retinal Reattachment In Retinoblastoma. Invest. Ophthalmol. Vis. Sci. 2006 47: E-Abstract 2802.

VEP evaluation of cone function in children with cone dysfunction syndromes.

We are currently using the Visual Evoked Potential (VEP), full field electroretinography, and multi-focal electroretinography for assessment of cone photoreceptor function in the central visual field of pediatric patients. We have found the VEP to be a very useful alternative to electroretinography and other standard clinical testing in children, who would not otherwise tolerate testing. The Full-field Electroretinogram (ERG) serves as a standard method of objective assessment of retinal rod and cone function.

We have found several advantages to the VEP over ERG testing:

The ERG is a costly and time-consuming procedure in the pediatric clinic. Often we must sedate the patient in order to tolerate contact lens electrodes. The VEP takes about ½ hour and does not need sedation/anesthesia.
Children tolerate the VEP much better than the ERG.
The ERG is prone to noise from nystagmus, whereas the VEP is still robust if horizontal grating stimuli are presented.
While the ERG is sensitive to gross rod dysfunction, the ERG may not detect dysfunction of cone receptors in the macula or fovea.
Assessment of individual cone types (L, M, S or red, green, blue) is easily performed with the VEP. Control children generate very robust VEPs to these stimuli. Therefore color vision screening is objectively assessed without requiring any cognitive skills (such as sorting with the FM-100, isochromatic plates, etc.).

Relevant References

Weiss AH, Kelly JP, Bisset D, Deeb SS. Reduced L- and M- and increased S-cone functions in an infant with thyroid hormone resistance due to mutations in the THRβ2 gene. Ophthalmic Genet. 2012 May 2.

Kelly JP, Weiss AH, Rowell G, Seigel GM. Autofluorescence and infrared retinal imaging in patients and obligate carriers with neuronal ceroid lipofuscinosis. Ophthalmic Genet. 2009 Dec;30(4):190-8.

Weiss AH, Kelly JP, Kapur RP, Pendergrass T. Retinal function and corresponding pathology in advanced retinoblastoma. Arch Ophthalmol. 2008 Nov;126(11):1507-12.

Kallman JC, Phillips JO, Bramhall NF, Kelly JP, Street VA. In search of the DFNA11 myosin VIIA low- and mid-frequency auditory genetic modifier. Otol Neurotol. 2008 Sep;29(6):860-7.

Kelly JP, Crognale MA, Weiss AH. ERGs, cone-isolating VEPs and analytical techniques in children with cone dysfunction syndromes. Doc Ophthalmol. 2003;106(3):289-304.

J.P. Kelly, S. Chang, Development of chromatic and luminance detection contours using the sweep VEP, Vision Research 2000, 40; 14; 1887 - 1905.

M.A. Crognale, J.P. Kelly, A.H. Weiss, D.Y. Teller, Development of the spatio-chromatic visual evoked potential (VEP): a longitudinal study, Vision Research 38 (21) (1998) pp. 3283-3292.

Crognale, M.A., Kelly, J.P., Chang, S., Weiss, A.H., Teller, D.Y. Development of pattern-reversal and pattern-onset visual evoked potentials: Longitudinal measurements in human infants. Optometry and Vision Science, 1997, 74, 808-815.

J.P. Kelly, K. Borchert, D.Y. Teller, The Development of Chromatic and Achromatic Contrast Sensitivity in Infancy as Tested with the Sweep VEP, Vision Research 37 (15) (1997) pp. 2057-2072.

Peterzell D.H., Kelly J.P. Development of spatial frequency tuned "covariance" channels: Individual differences in the electrophysiological (VEP) contrast sensitivity function. Optometry and Vision Science, 1997, 74, 800-807.

Links:
RetNet -- a summary of genes that cause retinal diseases

Anatomical mechanisms of nasolacrimal duct obstruction

Relevant References

Weiss AH, Baran F, Kelly J. Congenital Nasolacrimal Duct Obstruction: Delineation of Anatomic Abnormalities With 3-Dimensional Reconstruction. Arch Ophthalmol. 2012.

Moscato EE, Kelly JP, Weiss A. Developmental Anatomy of the Nasolacrimal Duct: Implications for Congenital Obstruction. Ophthalmology. 2010 Dec;117(12):2430-4.

(Also be sure to look for the links at the 3D reconstructions on my home page!)

Objective assessment of vision in children with visual loss on a cortical basis or cortical visual impairment.

We also use the Visual Evoked Potential (VEP) in addition to Magnetic Resonance Imaging and CT scans for assessment of pediatric patients, who appear to be blind but have a normal eye exam. We have applied the T2circ analysis of the transient VEP in these children to determine whether a statistically significant visual response is present (for information on the T2circ, see Victor JD, Mast J. A new statistic for steady-state evoked potentials. Electroencepholography and Clinical Neurophysiology, 1991;78:378-388.). Often we find that this statistical analysis is the only way to determine if a child can see. In some cases, the visual disorder may be attributed to "delayed visual maturation" while other cases may result from "cortical visual impairment."

Relevant References

Kelly JP, Ishak GE, Phillips JO, Nguyen H, Weiss AH. Visual sensory and ocular motor function in children with polymicrogyria: relationship to magnetic resonance imaging. J AAPOS. 2016 Feb;20(1):37-43

Weiss AH, Kelly JP, Phillips JO. The infant who is visually unresponsive on a cortical basis. Ophthalmology. 2001,108(11):2076-2087.

Links:
The Center for Children with Special Needs <http://www.cshcn.org/>

Prediction of visual development in children with bilateral optic nerve hypoplasia.

This disorder can severely affect vision in newborn children. The disorder causes abnormally low numbers of retinal ganglion cells resulting in reduced vision, variable brain malformations, and possibly abnormal endocrine system function. There is no cure for the disease so the child will experience reduced vision for the rest of his or her life. There is wide variation in how much vision the child will have from the disease. Our research has shown that the expected outcome in visual acuity depends upon the size of the optic nerve and the initial visual acuity assessment after six months age. The analysis of visual evoked potentials can also lead to the distinction between children who will have better than 20/200 vision.

Relevant References

Kelly JP, Phillips JO, Weiss AH. VEP analysis methods in children with optic nerve hypoplasia: relationship to visual acuity and optic disc diameter. Doc Ophthalmol. 2016
get pdf here

Weiss AH, Kelly JP. Acuity, ophthalmoscopy, and visually evoked potentials in the prediction of visual outcome in infants with bilateral optic nerve hypoplasia. J AAPOS. 2003;7(2):108-15.

Probing brain mechanisms with Visual Evoked Potentials in children with anisometropic amblyopia.

Using the transient VEP we have isolated unique components that respond to successful patching.

Relevant References

Weiss AH, Kelly JP. Spatial-frequency-dependent changes in cortical activation before and after patching in amblyopic children. Invest Ophthalmol Vis Sci. 2004;45(10):3531-7.

AH Weiss, JP Kelly. VEP Correlations With Anisometropic and Strabismic Amblyopia in Children Before and After Patching Investigative Ophthalmology & Visual Science (Suppl), 2002.

Optimization studies for applications of a scanned light display.

Work was performed at the Human Interface Technology Laboratory at the University of Washington. The lab uses a high speed mechanical resonant scanner to generate a raster-based display on the retina with lasers. The display is called the Virtual Retinal Display or VRD. This work investigates how the VRD display characteristics can be optimized as a display device, and the effects of laser light on visual function. We have collected information on the temporal characteristics of scanning a laser light across the retina and its potential effect of zero image persistence, hyper-acuity, and contrast sensitivity. Currently we are examining how observer’s accommodation can vary with a monochromatic monocular display that uses a very small exit pupil. Under these conditions, the observer has few cues that provide feedback about the accuracy of accommodation. In the past, I collaborated with Conor Kleweno and Eric Seibel on applications of the VRD to observers with low vision.

Relevant References

Kelly JP, Weiss AH, Zhou Q, Schmode S, Dreher AW. Imaging a child's fundus without dilation using a handheld confocal scanning laser ophthalmoscope. Arch Ophthalmol. 2003 ;121(3):391-6.

McQuaide S.C., Seibel E.J., Kelly J.P., Schowengerdt B.T., Furness III T.A. A retinal scanning display system that produces multiple focal planes with a deformable membrane mirror. Displays. 2003; 24 (2): 65-72.

Schowengerdt, B.T., Seibel, E.J., Kelly, J.P., Silverman, N.L. and Furness, T.A. (2003). Binocular retinal scanning laser display with integrated focus cues for ocular accommodation. Proceedings of the SPIE, Vol. 5006: Stereoscopic Displays and Virtual Reality Systems X, 5006, 1-9.

Kelly JP, Turner S, Pryor H.L. et al. Vision with a scanning laser display: comparison of flicker sensitivity to a CRT. 2001, Displays, 22, 169-175.

Kleweno, C.P., Seibel, E.J., Viirre, E.S., Kelly, J.P. and Furness, T.A.III. The virtual retinal display as a low-vision computer interface: A pilot study. Journal of Rehabilitation Research and Development, 2001, 38; 431-44