From Biblical references to Shakespeare, the eyes have long been compared to a window, revealing what’s within. Today, they also are known as the window of multiple sclerosis (MS), according to doctors at the University of Houston’s eye clinic for MS patients.
Celebrating 10 years, the Multiple Sclerosis Eye Center for Analysis, Research and Education (MS Eye CARE) has seen about 1,000 patients annually throughout its decade of existence. A partnership between the University Eye Institute at UH’s College of Optometry and the National Multiple Sclerosis Society, MS Eye CARE has led the way to making eye care an integral part of the MS diagnosis and treatment process.
“When we first opened, research on new drugs and tests for how to predict eye issues in MS were just coming out,” said Dr. Rosa Tang, a neuro-ophthalmologist and co-director of the clinic. “These discoveries brought to light that the eye is the window to MS. We were at the forefront of that development because we had the equipment that many other centers didn’t have.”
In MS, a person’s immune system attacks the central nervous system, which is made up of the brain, spinal cord and optic nerves. The eyes are often one of the first places MS manifests, putting eye care professionals on the frontlines of defense against this disabling disease. Vision problems present in 50 to 75 percent of patients with MS.
According to the National Multiple Sclerosis Society (NMSS), it’s estimated that more than 400,000 people in the U.S. have MS, with approximately 200 new cases being diagnosed each week. The prevalence of MS in Texas is estimated to be close to 100 cases per 100,000 population, considering the number of patients registered with the NMSS in the state.
“MS is a criterion of how many parts of your nervous system are involved, so oftentimes neurologists need us to make that final diagnosis,” Tang said. “The eyes are the window of MS because the optic nerve is a target, and we can look at it with a variety of eye tests we have. While neurologists have tools to diagnose MS, the disease can be identified more quickly if the eye is also incorporated into the diagnostic process.”
As a result, the eyes are now more likely to be viewed in the diagnostic process than in the past. With neuro-ophthalmologists helping neurologists diagnosis and treat the disease early, physicians have a chance to intervene before significant damage is done, thereby improving patients’ quality of life. Before the advent of earlier diagnoses made possible through collaborations between eye care professionals and neurologists, the prognosis of MS patients was much poorer.
Another important role the clinicians at MS Eye CARE play is in monitoring the disease. By looking at the optic nerve with their instruments, the doctors at the eye clinic can see how patients are responding to their medications. In some instances, eye changes have tipped them off that the MS is still progressing despite treatment, resulting in a need to change a patient’s medication. And in some cases, their eye findings have even ruled out initial misdiagnoses of MS.
One of Tang’s primary goals with the clinic is to provide patients with access to care regardless of their ability to pay. In addition to never turning away patients, she says most are seen the week they call to make an appointment, and if they are acute, they are worked in sooner. Without access to this clinic, she says, patients would have to wait months or perhaps not be seen at all.
The center also helps patients from a humanitarian perspective. Last year, quality of life questionnaires were incorporated into the treatment plan, asking such things as how MS impacts patients’ abilities to do activities at home and how the drugs affect their lifestyles. One more hallmark of the clinic is its dedication to community service. Beyond the eye exams, patients are followed to see how they progress, and the staff works with their caregivers and social workers, helping with referrals to a variety of services.
Another crucial goal of the clinic, Tang says, is the ability to do research with patients, as well as try new drugs. This is made possible through a combination of having access to the newest technologies and equipment, as well as being able to approach MS from both a clinical and basic research perspective. In its 10 years, the clinic has done a tremendous number of studies on its patients who volunteered to be followed clinically, resulting in many published articles and Ph.D. theses. Through this, the clinicians, researchers and graduating optometrists have become very sensitive to how to approach MS patients, as well as learn about the issues associated with the disease, what the major concerns are and where to you look for manifestations in the eye. Because of this, they are better able to get the MS patients to the right doctors more quickly.
In addition to Tang, Dr. Jade S. Schiffman, co-director of the center, and Dr. Victor M. Rivera, distinguished emeritus professor of neurology at Baylor College of Medicine and adjunct professor at UH, have joined in the research efforts. Laura J. Frishman, John and Rebecca Moores Professor of Optometry, directs the research efforts and is a well-known, respected researcher in this field.
“The next 10 years are even more exciting, because now there are new drugs and new ways we’re moving toward a cure for MS,” Tang said. “The exciting part is that most of these new drugs coming down the pike to treat MS and stop it in its tracks from continuing are basing their clinical research on the eyes. As a result of what we have accomplished here, the eye is now more likely to be viewed in the diagnostic process.”
About the University of Houston
The University of Houston is a Carnegie-designated Tier One public research university recognized by The Princeton Review as one of the nation’s best colleges for undergraduate education. UH serves the globally competitive Houston and Gulf Coast Region by providing world-class faculty, experiential learning and strategic industry partnerships. Located in the nation’s fourth-largest city, UH serves more than 40,900 students in the most ethnically and culturally diverse region in the country. For more information about UH, visit the university’s newsroom.
About the UH College of Optometry
Since 1952, the University of Houston College of Optometry (UHCO) has educated and trained optometrists to provide the highest quality vision care. One of only 22 optometry schools in the country, UHCO offers a variety of degree programs, including Doctor of Optometry (O.D.), a combined Doctor of Optometry/Doctor of Philosophy (O.D./Ph.D.), Master of Science (M.S.) and Doctor of Philosophy (Ph.D.). UHCO serves an average of 50,000 patients a year through The University Eye Institute and its external clinics located in the Houston and Dallas-Fort Worth regions.
Celebrating 10 years, the Multiple Sclerosis Eye Center for Analysis, Research and Education (MS Eye CARE) has seen about 1,000 patients annually throughout its decade of existence. A partnership between the University Eye Institute at UH’s College of Optometry and the National Multiple Sclerosis Society, MS Eye CARE has led the way to making eye care an integral part of the MS diagnosis and treatment process.
“When we first opened, research on new drugs and tests for how to predict eye issues in MS were just coming out,” said Dr. Rosa Tang, a neuro-ophthalmologist and co-director of the clinic. “These discoveries brought to light that the eye is the window to MS. We were at the forefront of that development because we had the equipment that many other centers didn’t have.”
In MS, a person’s immune system attacks the central nervous system, which is made up of the brain, spinal cord and optic nerves. The eyes are often one of the first places MS manifests, putting eye care professionals on the frontlines of defense against this disabling disease. Vision problems present in 50 to 75 percent of patients with MS.
According to the National Multiple Sclerosis Society (NMSS), it’s estimated that more than 400,000 people in the U.S. have MS, with approximately 200 new cases being diagnosed each week. The prevalence of MS in Texas is estimated to be close to 100 cases per 100,000 population, considering the number of patients registered with the NMSS in the state.
“MS is a criterion of how many parts of your nervous system are involved, so oftentimes neurologists need us to make that final diagnosis,” Tang said. “The eyes are the window of MS because the optic nerve is a target, and we can look at it with a variety of eye tests we have. While neurologists have tools to diagnose MS, the disease can be identified more quickly if the eye is also incorporated into the diagnostic process.”
As a result, the eyes are now more likely to be viewed in the diagnostic process than in the past. With neuro-ophthalmologists helping neurologists diagnosis and treat the disease early, physicians have a chance to intervene before significant damage is done, thereby improving patients’ quality of life. Before the advent of earlier diagnoses made possible through collaborations between eye care professionals and neurologists, the prognosis of MS patients was much poorer.
Another important role the clinicians at MS Eye CARE play is in monitoring the disease. By looking at the optic nerve with their instruments, the doctors at the eye clinic can see how patients are responding to their medications. In some instances, eye changes have tipped them off that the MS is still progressing despite treatment, resulting in a need to change a patient’s medication. And in some cases, their eye findings have even ruled out initial misdiagnoses of MS.
One of Tang’s primary goals with the clinic is to provide patients with access to care regardless of their ability to pay. In addition to never turning away patients, she says most are seen the week they call to make an appointment, and if they are acute, they are worked in sooner. Without access to this clinic, she says, patients would have to wait months or perhaps not be seen at all.
The center also helps patients from a humanitarian perspective. Last year, quality of life questionnaires were incorporated into the treatment plan, asking such things as how MS impacts patients’ abilities to do activities at home and how the drugs affect their lifestyles. One more hallmark of the clinic is its dedication to community service. Beyond the eye exams, patients are followed to see how they progress, and the staff works with their caregivers and social workers, helping with referrals to a variety of services.
Another crucial goal of the clinic, Tang says, is the ability to do research with patients, as well as try new drugs. This is made possible through a combination of having access to the newest technologies and equipment, as well as being able to approach MS from both a clinical and basic research perspective. In its 10 years, the clinic has done a tremendous number of studies on its patients who volunteered to be followed clinically, resulting in many published articles and Ph.D. theses. Through this, the clinicians, researchers and graduating optometrists have become very sensitive to how to approach MS patients, as well as learn about the issues associated with the disease, what the major concerns are and where to you look for manifestations in the eye. Because of this, they are better able to get the MS patients to the right doctors more quickly.
In addition to Tang, Dr. Jade S. Schiffman, co-director of the center, and Dr. Victor M. Rivera, distinguished emeritus professor of neurology at Baylor College of Medicine and adjunct professor at UH, have joined in the research efforts. Laura J. Frishman, John and Rebecca Moores Professor of Optometry, directs the research efforts and is a well-known, respected researcher in this field.
“The next 10 years are even more exciting, because now there are new drugs and new ways we’re moving toward a cure for MS,” Tang said. “The exciting part is that most of these new drugs coming down the pike to treat MS and stop it in its tracks from continuing are basing their clinical research on the eyes. As a result of what we have accomplished here, the eye is now more likely to be viewed in the diagnostic process.”
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About the University of Houston
The University of Houston is a Carnegie-designated Tier One public research university recognized by The Princeton Review as one of the nation’s best colleges for undergraduate education. UH serves the globally competitive Houston and Gulf Coast Region by providing world-class faculty, experiential learning and strategic industry partnerships. Located in the nation’s fourth-largest city, UH serves more than 40,900 students in the most ethnically and culturally diverse region in the country. For more information about UH, visit the university’s newsroom.
About the UH College of Optometry
Since 1952, the University of Houston College of Optometry (UHCO) has educated and trained optometrists to provide the highest quality vision care. One of only 22 optometry schools in the country, UHCO offers a variety of degree programs, including Doctor of Optometry (O.D.), a combined Doctor of Optometry/Doctor of Philosophy (O.D./Ph.D.), Master of Science (M.S.) and Doctor of Philosophy (Ph.D.). UHCO serves an average of 50,000 patients a year through The University Eye Institute and its external clinics located in the Houston and Dallas-Fort Worth regions.