Professor Irene Gottlob

Professor Irene GottlobEmeritus Professor of Ophthalmology
Department of Neuroscience, Psychology & Behaviour, University of Leicester

Contact details

For general enquiries, please email the secretary Mrs Sam Kerr or phone 0116 252 3152.


Address: University of Leicester, Robert Kilpatrick Clinical Sciences Building, Level 5, Leicester Royal Infirmary, Leicester, LE2 7LX

Personal details

I am involved with the Leicester Ophthalmology group and my main areas of research are the regulation of eye movements and their disorders, in particular nystagmus. Current areas of active research include understanding the genetics of neuro-ophthalmic diseases, improving diagnosis and treatment of nystagmus, amblyopia and other neuro-ophthalmic diseases.

I am the author of more than 150 peer reviewed research papers and book chapters.  I am section editor of the British Journal of Ophthalmology and on the editorial board of other scientific journals. I'm an enthusiastic teacher of clinical and research students and trainees. I greatly enjoy teaching and have been named academic role model for students and trainees by the BMA.



Anwar S, Nath M, Patel A, Lee H, Brown S, Gottlob I, Proudlock FA. Retina. 2019 Jul 24. doi: 10.1097/IAE.0000000000002622. [Epub ahead of print]

Pilat AV, Shah S, Sheth V, Purohit R, Proudlock FA, Abbott J, Gottlob I. BMJ Open Ophthalmol. 2019 Jun 24;4(1):e000194. doi: 10.1136/bmjophth-2018-000194. eCollection 2019.

Thomas MG, Maconachie GDE, Constantinescu CS, Chan WM, Barry B, Hisaund M, Sheth V, Kuht HJ, Dineen RA, Harieaswar S, Engle EC, Gottlob I. Br J Ophthalmol. 2019 Jul 13. pii: bjophthalmol-2019-314293. doi: 10.1136/bjophthalmol-2019-314293. [Epub ahead of print]

Anwar S, Nath M, Patel A, Lee H, Brown S, Gottlob I, Proudlock FA. Retina. 2019 Jul 24. doi: 10.1097/IAE.0000000000002622. [Epub ahead of print]

Pilat AV, Shah S, Sheth V, Purohit R, Proudlock FA, Abbott J, Gottlob I. BMJ Open Ophthalmol. 2019 Jun 24;4(1):e000194. doi: 10.1136/bmjophth-2018-000194. eCollection 2019.

Thomas MG, Maconachie GDE, Constantinescu CS, Chan WM, Barry B, Hisaund M, Sheth V, Kuht HJ, Dineen RA, Harieaswar S, Engle EC, Gottlob I. Br J Ophthalmol. 2019 Jul 13. pii: bjophthalmol-2019-314293. doi: 10.1136/bjophthalmol-2019-314293. [Epub ahead of print]

Reading Individual Words Within Sentences in Infantile Nystagmus. Prakash E, McLean RJ, White SJ, Paterson KB, Gottlob I, Proudlock FA. Invest Ophthalmol Vis Sci. 2019 May 1;60(6):2226-2236.

Homozygous stop mutation in AHR causes autosomal recessive foveal hypoplasia and infantile nystagmus. Mayer AK, Mahajnah M, Thomas MG, Cohen Y, Habib A, Schulze M, Maconachie GDE, AlMoallem B, De Baere E, Lorenz B, Traboulsi EI, Kohl S, Azem A, Bauer P, Gottlob I, Sharkia R, Wissinger B. Brain. 2019 Jun 1;142(6):1528-1534.

The potential and value of objective eye tracking in the ophthalmology clinic. Clark R, Blundell J, Dunn MJ, Erichsen JT, Giardini ME, Gottlob I, Harris C, Lee H, Mcilreavy L, Olson A, Self JE, Vinuela-Navarro V, Waddington J, Woodhouse JM, Gilchrist ID, Williams C. Eye (Lond). 2019 Apr 8.

Assessment of the anterior segment of patients with primary congenital glaucoma using handheld optical coherence tomography. Pilat AV, Proudlock FA, Shah S, Sheth V, Purohit R, Abbot J, Gottlob I. Eye (Lond). 2019 Mar 18. [Epub ahead of print]

Where are the missing gene defects in inherited retinal disorders? Intronic and synonymous variants contribute at least to 4% of CACNA1F-mediated inherited retinal disorders. Zeitz C, Michiels C, Neuillé M, Friedburg C, Condroyer C, Boyard F, Antonio A, Bouzidi N, Milicevic D, Veaux R, Tourville A, Zoumba A, Seneina I, Foussard M, Andrieu C, N Preising M, Blanchard S, Saraiva JP, Mesrob L, Le Floch E, Jubin C, Meyer V, Blanché H, Boland A, Deleuze JF, Sharon D, Drumare I, Defoort-Dhellemmes S, De Baere E, Leroy BP, Zanlonghi X, Casteels I, de Ravel TJ, Balikova I, K Koenekoop R, Laffargue F, McLean R, Gottlob I, Bonneau D, Schorderet DF, L Munier F, McKibbin M, Prescott K, Pelletier V, Dollfus H, Perdomo-Trujillo Y, Faure C, Reiff C, Wissinger B, Meunier I, Kohl S, Banin E, Zrenner E, Jurklies B, Lorenz B, Sahel JA, Audo I. Hum Mutat. 2019 Jun;40(6):765-787. doi: 10.1002/humu.23735. Epub 2019 Mar 28.

The treatment of amblyopia: current practice and emerging trends. Papageorgiou E, Asproudis I, Maconachie G, Tsironi EE, Gottlob I. Graefes Arch Clin Exp Ophthalmol. 2019 Jan 31. doi: 10.1007/s00417-019-04254-w. [Epub ahead of print] Review.

Aberrant visual pathway development in albinism: From retina to cortex. Ather S, Proudlock FA, Welton T, Morgan PS, Sheth V, Gottlob I, Dineen RA. Hum Brain Mapp. 2019 Feb 15;40(3):777-788. doi: 10.1002/hbm.24411. Epub 2018 Dec 4.

FRMD7-Related Infantile Nystagmus. 2009 Feb 12 [updated 2018 Aug 16].   Thomas MG, Maconachie G, Hisaund M, Gottlob I.  In: Adam MP, Ardinger HH, Pagon RA,Wallace SE, Bean LJH, Stephens K, Amemiya A, editors. GeneReviews®  Seattle (WA): University of Washington, Seattle; 1993-2018.

Genome-Wide Association Study Identifies a Susceptibility Locus for Comitant Esotropia and Suggests a Parentof-Origin Effect. Shaaban S, MacKinnon S, Andrews C, Staffieri SE, Maconachie GDE, Chan WM, Whitman MC, Morton SU, Yazar S, MacGregor S, Elder JE, Traboulsi EI, Gottlob I, Hewitt AW; Strabismus Genetics Research Consortium, Hunter DG, Mackey DA, Engle EC. Invest Ophthalmol Vis Sci. 2018 Aug 1;59(10):4054-4064.

Retinal and optic nerve changes in microcephaly: An optical coherence tomography study. Papageorgiou E, Pilat A, Proudlock F, Lee H, Purohit R, Sheth V, Vasudevan P, Gottlob I.  Neurology. 2018 Aug 7;91(6):e571-e585.

Retinal Layer Abnormalities as Biomarkers of Schizophrenia.  Samani NN, Proudlock FA, Siram V, Suraweera C, Hutchinson C, Nelson CP, Al-Uzri M, Gottlob I. Schizophr Bull. 2018 Jun 6;44(4):876-885.

The Effects of Feedback on Adherence to Treatment: A Systematic Review and Meta-analysis of RCTs. Seewoodharry MD, Maconachie GDE, Gillies CL, Gottlob I, McLean RJ. Am J Prev Med. 2017 Aug;53(2):232-240.

Development and clinical utility of a novel diagnostic nystagmus gene panel using targeted next-generation sequencing. Thomas MG, Maconachie G, Sheth V, McLean RJ, Gottlob I. Eur J Hum Genet. 2017 Jun;25(6):725734.

In Vivo Morphology of the Optic Nerve and Retina in Patients with Parkinson's Disease. Pilat A, McLean RJ, Proudlock FA, Maconachie GD, Sheth V, Rajabally YA, Gottlob I.  Invest Ophthalmol Vis Sci. 2016 Aug 1;57(10):4420-4427.

Association between Adherence to Glasses Wearing During Amblyopia Treatment and Improvement in Visual Acuity.  Maconachie GD, Farooq S, Bush G, Kempton J, Proudlock FA, Gottlob I. JAMA Ophthalmol. 2016 Oct 13.

Altered whole-brain connectivity in albinism.  Welton T, Ather S, Proudlock FA, Gottlob I, Dineen RA.  Hum Brain Mapp. 2017 Feb;38(2):740-752.

Optic Nerve Head Development in Healthy Infants and Children Using Handheld Spectral-Domain Optical Coherence Tomography.  Patel A, Purohit R, Lee H, Sheth V, Maconachie G, Papageorgiou E, McLean RJ, Gottlob I, Proudlock FA.  Ophthalmology. 2016 Oct;123(10):2147-57.

Pediatric Optical Coherence Tomography in Clinical Practice-Recent Progress. Lee H, Proudlock FA, Gottlob I.  Invest Ophthalmol Vis Sci. 2016 Jul 1;57(9):OCT69-79.

The Development of a Nystagmus-Specific Quality-of-Life Questionnaire.  McLean RJ, Maconachie GD, Gottlob I, Maltby J.  Ophthalmology. 2016 Sep;123(9):2023-7.

Loss of MAFB Function in Humans and Mice Causes Duane Syndrome, Aberrant Extraocular Muscle Innervation, and Inner-Ear Defects.  Park JG, Tischfield MA, Nugent AA, Cheng L, Di Gioia SA, Chan WM, Maconachie G, Bosley TM, Summers CG, Hunter DG, Robson CD, Gottlob I, Engle EC.  Am J Hum Genet. 2016 Jun 2;98(6):12207.

Hand-held optical coherence tomography imaging in children with anterior segment dysgenesis.  Pilat AV, Sheth V, Purohit R, Proudlock FA, Anwar S, Gottlob I.  Acta Ophthalmol. 2016 Apr 30.

Abnormally Small Neuromuscular Junctions in the Extraocular Muscles From Subjects With Idiopathic Nystagmus and Nystagmus Associated With Albinism. McLoon LK, Willoughby CL, Anderson JS, Bothun ED, Stager D Jr, Felius J, Lee H, Gottlob I.  Invest Ophthalmol Vis Sci. 2016 Apr 1;57(4):1912-20.

The challenges of amblyopia treatment.  Maconachie GD, Gottlob I.  Biomed J. 2015 Dec;38(6):510-6. 36. Reply.  Pilat A, Proudlock FA, Gottlob I.  Ophthalmology. 2016 Mar;123(3):e20

Pseudo-Monocular Nystagmus Associated with Duane's Syndrome: Report of Two Cases. Constantinescu SE, McLean RJ, Innes J, Gottlob I.  Strabismus. 2015;23(3):132-4.

New variational image decomposition model for simultaneously denoising and segmenting optical coherence tomography images.  Duan J, Tench C, Gottlob I, Proudlock F, Bai L.  Phys Med Biol. 2015 Nov 21;60(22):8901-22.

Retinal development in albinism: a prospective study using optical coherence tomography in infants and young children.  Lee H, Purohit R, Sheth V, Papageorgiou E, Maconachie G, McLean RJ, Patel A, Pilat A, Anwar S, Sarvananthan N, Proudlock FA, Gottlob I.  Lancet. 2015 Feb 26;385 Suppl 1:S14.

Characterization of Abnormal Optic Nerve Head Morphology in Albinism Using Optical Coherence Tomography.  Mohammad S, Gottlob I, Sheth V, Pilat A, Lee H, Pollheimer E, Proudlock FA.  Invest Ophthalmol Vis Sci. 2015 Jul;56(8):4611-8.

In Vivo Foveal Development Using Optical Coherence Tomography.  Lee H, Purohit R, Patel A, Papageorgiou E, Sheth V, Maconachie G, Pilat A, McLean RJ, Proudlock FA, Gottlob I.  Invest Ophthalmol Vis Sci. 2015 Jul;56(8):4537-45.

Retinal Development in Infants and Young Children with Achromatopsia.  Lee H, Purohit R, Sheth V, McLean RJ, Kohl S, Leroy BP, Sundaram V, Michaelides M, Proudlock FA, Gottlob I. Ophthalmology. 2015 Oct;122(10):21457.

High-Resolution Imaging of the Optic Nerve and Retina in Optic Nerve Hypoplasia. Pilat A, Sibley D, McLean RJ, Proudlock FA, Gottlob I.  Ophthalmology. 2015 Jul;122(7):1330-9.

Nystagmus in childhood.  Papageorgiou E, McLean RJ, Gottlob I.  Pediatr Neonatol. 2014 Oct;55(5):341-51.  45. A randomized controlled trial comparing soft contact lens and rigid gas-permeable lens wearing in infantile nystagmus.  Jayaramachandran P, Proudlock FA, Odedra N, Gottlob I, McLean RJ.  Ophthalmology. 2014 Sep;121(9):1827-36.

Re: Sundaram et al.: retinal structure and function in achromatopsia: implications for gene therapy (Ophthalmology 2014;121:234-45).  Thomas MG, Gottlob I.  Ophthalmology. 2014 Sep;121(9):e46-7.

Morphology of retinal vessels in patients with optic nerve head drusen and optic disc edema. Pilat AV, Proudlock FA, McLean RJ, Lawden MC, Gottlob I.  Invest Ophthalmol Vis Sci. 2014 May 1;55(6):3484-90.

Impact of chiasma opticum malformations on the organization of the human ventral visual cortex.  Kaule FR, Wolynski B, Gottlob I, Stadler J, Speck O, Kanowski M, Meltendorf S, Behrens-Baumann W, Hoffmann MB. Hum Brain Mapp. 2014 Oct;35(10):5093-105.

Abnormal retinal development associated with FRMD7 mutations.  Thomas MG, Crosier M, Lindsay S, Kumar A, Araki M, Leroy BP, McLean RJ, Sheth V, Maconachie G, Thomas S, Moore AT, Gottlob I.  Hum Mol Genet. 2014 Aug 1;23(15):4086-93.

An educational intervention to improve adherence to high-dosage patching regimen for amblyopia: a randomised controlled trial.  Pradeep A, Proudlock FA, Awan M, Bush G, Collier J, Gottlob I.  Br J Ophthalmol. 2014 Jul;98(7):865-70. Erratum in: Br J Ophthalmol. 2014 Nov;98(11):1604.

Normal macular structure measured with optical coherence tomography across ethnicity.  Pilat AV, Proudlock FA, Mohammad S, Gottlob I.  Br J Ophthalmol. 2014 Jul;98(7):941-5.

Vision and multiple sclerosis.  Hickman SJ, Raoof N, McLean RJ, Gottlob I.  Mult Scler Relat Disord. 2014 Jan;3(1):3-16.

The effect of font size on reading performance in strabismic amblyopia: an eye movement investigation.  Kanonidou E, Gottlob I, Proudlock FA.  Invest Ophthalmol Vis Sci. 2014 Jan 23;55(1):451-9.

Aetiology of infantile nystagmus.  Gottlob I, Proudlock FA.  Curr Opin Neurol. 2014 Feb;27(1):83-91. Review.

The effect of colored overlays on reading performance in infantile nystagmus.  Barot N, McLean RJ, Gottlob I, Proudlock FA.  Ophthalmology. 2014 Mar;121(3):804-5.e2.

Macular morphology in patients with optic nerve head drusen and optic disc edema.  Pilat AV, Proudlock FA, Kumar P, Lee H, Papageorgiou E, Gottlob I.  Ophthalmology. 2014 Feb;121(2):552-7.

Autosomal-dominant nystagmus, foveal hypoplasia and presenile cataract associated with a novel PAX6 mutation.  Thomas S, Thomas MG, Andrews C, Chan WM, Proudlock FA, McLean RJ, Pradeep A, Engle EC, Gottlob I.  Eur J Hum Genet. 2014 Mar;22(3):344-9.

Thomas MG, Crosier M, Lindsay S, Kumar A, Thomas S, Araki M, Talbot CJ, McLean RJ, Surendran M, Taylor K, Leroy BP, Moore AT, Hunter DG, Hertle RW, Tarpey P, Langmann A, Lindner S, Brandner M, Gottlob I. The clinical and molecular genetic features of idiopathic infantile periodic alternating nystagmus. Brain. 2011 Mar;134(Pt 3):892-902

Betts-Henderson J, Bartesaghi S, Crosier M, Lindsay S, Chen HL, Salomoni P, Gottlob I, Nicotera P. The nystagmus-associated FRMD7 gene regulates neuronal outgrowth and development. Hum Mol Genet. 2010 Jan 15;19(2):342-51.

Knapp CM, Gottlob I, McLean RJ, Rajabally YA, Abbott RJ, Rafelt S, Proudlock FA.  Vertical optokinetic nystagmus in Parkinson's diseaseMov. Disord. 2009;24:1533-8.

Sarvananthan N, Surendran M, Roberts EO, Jain S, Shah N, Proudlock FA, Thompson JR, McLean RJ, Degg C, Woodruff G, Gottlob I.  The prevalence of nystagmus:  The Leicestershire nystagmus survey. Invest. Ophthalmol. Vis. Sci. 2009.

Thomas S, Proudlock FA, Sarvananthan N, Roberts EO, Awan M, McLean RJ, Surendran M, Kumar AS, Farooq SJ, Degg C, Gale RP, Reinecke RD, Woodruff G, Langmann A, Lindner S, Jain S, Tarpey P, Raymond FL, Gottlob I.  Phenotypical characteristics of idiopathic infantile nystagmus with and without mutations in FRMD7. Brain. 2008;131:1259-67.

Farooq SJ, Gottlob I, Benskin S, Proudlock FA.  The effect of aging on torsional optokinetic nystagmus. Invest. Ophthalmol. Vis. Sci. 2008; 49:589-93.

Knapp CM, Gottlob I, McLean RJ, Proudlock FA.  Horizontal and vertical look and stare optokinetic nystagmus symmetry in healthy adult volunteers. Invest. Ophthalmol. Vis. Sci. 2008; Feb;49(2):581-8;(3.3766).

Pieh C, Simonsz-Toth B, Gottlob I.  Nystagmus characteristics in congenital stationary night blindness (CSNB). Br. J. Ophthalmol. 2008;Feb:92(2):236-40.

McLean RJ, Proudlock FA, Thomas S, Degg C, Gottlob I.  'Congenital nystagmus: randomized, controlled, double-masked trial of memantine/gabapentin.' Ann. Neurol. 2007 Feb;61(2):130-8.

Tarpey P, Thomas S, Sarvananthan N, Mallya U, Lisgo S, Talbot CJ, Roberts EO, Awan M, Surendran M, McLean RJ, Reinecke RD, Langmann A, Lindner S, Koch M, Jain S, Woodruff G, Gale RP, Degg C, Droutsas K, Asproudis I, Zubcov AA, Pieh C, Veal CD, Machado RD, Backhouse OC, Baumber L, Constantinescu CS, Brodsky MC, Hunter DG, Hertle RW, Read RJM, Edkins S, O'Meara S, Parker A, Stevens C, Teague J, Wooster R, Futreal PA, Trembath RC, Stratton MR, Raymond FL, Gottlob I. 'Mutations in FRMD7, a newly identified member of the FERM family, cause X-linked idiopathic congenital nystagmus'Nat. Genet. 2006 Nov;38(11):1242-4.

Proudlock FA, Khanna A, Gottlob I. Filling-in along horizontal and vertical meridianInvest. Ophthalmol. Vis. Sci.  2006; 47:453-60.

Sabri K, Knapp CM, Thompson JR, Gottlob I. The VF-14 and psychological impact of amblyopia and strabismus. Invest Ophtalmol Vis Sci 2006; 47; 4386-92.


Current Students

  • PhD: Samira Anwar, Ravi Purohit, Helena Lee and Gail Maconachie; co-supervision of Tu Zhanhan, Sarim Mohammad, Viral Sheth and Rebecca McLean
  • MD: Anil Kumar
  • Intercalated BSc: Mansha Seewoodharry


  • PhD: Anastasia Pilat, Mervyn Thomas, Shegufta Farooq, Mazz Awan MD: Archana Pradeep, Nagini Sarvananthan, Evgenia Kanonidou, Christopher Knapp
  • Intercalated BSc: Vijay Patel, Rebecca Annis, Niraj Barot, Pavitra Jayaramachandran, Sarim Mohammad, Mervyn Thomas, Astrid Jorgensen, Thomas Sanctuary, Aman Khanna, Himanshu Shekhar, Mark Jesky.



Infantile nystagmus (IN) is a to and fro oscillation of the eyes which is estimated to have a prevalence of 2.4 per 1000. It has a direct impact upon visual function through constant motion of images on the retina as well as often being associated with retinal deficits.

IN also has a profound effect on psychosocial aspects of life such as self-esteem and confidence. More than a decade of collaborative research has resulted in the Leicester group being at the forefront of nystagmus research pioneering investigations from many different aspects the disease.

Genetic causes

In 2006 we discovered the first gene causing idiopathic IN (the FRMD7 gene) in collaboration with the University of Cambridge and the Sanger Institute (Tarpey et al., 2006). The causes of IN are currently unknown. The discovery of the gene has opened up avenues for identifying the mechanisms behind IN.

Since then we have shown that FRMD7 expression is spatially and temporally regulated in the retina and gaze stabilization centres and that FRMD7 expression promotes neurite outgrowth during development of the ocular motor neural network (Betts-Henderson et al., 2010). Recent work in collaboration with the genetics department in the University of Leicester has shown that the FRMD7 protein interacts with Calcium Calmodulin Dependant Kinase (CASK) a protein which links the plasma membrane to the actin cytoskeleton in developing neurons (Watkins et al., 2013). As a result of this work the Leicester group has developed a genetic test for FRMD7 mutations which is now used clinically by the NHS. This can help patients in excluding other diseases earlier reducing the amount of diagnostic tests needed to diagnose the type of IN.

Improved diagnosis

We have used high-resolution optical coherence tomography (OCT), a technique which provides near microscopic resolution of retinal tissue in vivo, and eye movement recordings to improve the diagnosis of IN. Over recent years we have been at the forefront of using these technologies in IN where we have been able to use then to fully characterise the retinal and ocular motor abnormalities in diseases such as:

• FRMD7 associated IN (Thomas et al., 2008; Kumar et al., 2011)
• Achromaptosia (Thomas et al., 2012, 2013)
• Albinism (Mohammad et al., 2011)
• PAX6 mutations (Thomas et al., 2014)

Further work is ongoing on the characterisation of visual pathway abnormalities in these disease and other conditions associated with IN. These developments have changed the specificity and ease with which we can diagnose IN. We have also developed a grading scheme to quantify foveal hypoplasia clinically based on our findings (Thomas et al., 2011).

In 2011, the Leicester group was the first UK centre to acquire hand-held OCT, for research and clinical use in infants and young children. The group has since been used hand-held OCT to develop improved strategies of diagnosing in this age group (Lee et al., 2013).

This work is important for providing early diagnosis as well as improving the prognosis of the degree of visual deficit later in life to parents. We are also using hand-held OCT to investigate normal retinal development and disrupted development of the retina caused by premature birth


Infantile nystagmus has long been considered an untreatable condition with limited options for pharmacological or surgical intervention. Treatment options are now emerging with the Leicester group pioneering many of these new treatments.

The success of two medications, memantine and gabapentin, for treating acquired nystagmus led the Leicester group to complete the first randomised controlled trial into pharmacological treatment for IN (McLean et al., 2007). This work has continued in the form of a large crossover trial for the same two medications, which is nearing completion.

We have also collaborated with MERZ Pharma to test a new medication, Neramexane. Other forms of treatment that have been evaluated by the group include comparing contact lens wear in IN, evaluating of the effects of the surgical procedure of “tenotomising” eye muscles for IN, and investigating the effect of biofeedback for improving nystagmus. These studies have informed clinicians about the value of different options and provide possibilities of treatment for patients with nystagmus that were not previously possible.

The Leicester group is currently developing ways to evaluate the impact of interventions on patient centred outcome measures such as quality of life and measures of functional vision such as reading performance.

The Leicester Ophthalmology Group has now become the foremost centre for the diagnosis and treatment of nystagmus in the UK and sees over 600 patients with nystagmus per year. The majority of patients are referred from outside the service area, including patients being referred to internationally from Europe and even further afield.


Amblyopia (or lazy eye) is the most common visual disease in childhood affecting an estimated 2 to 5 per cent of the population. Amblyopia is caused by unequal inputs from the two eyes during visual development in childhood, usually either because of an eye turn (strabismus), a difference in refractive properties of the two eyes (anisometropia), or a combination of both.
The visual deficits in amblyopia are really due to disrupted development of the visual brain areas. It can be treated by patching the stronger and with glasses to improve refractive problems. Treatment of amblyopia accounts for approximately 90 per cent of visits to children’s’ eye clinics.

Exploring reasons for poor outcomes for amblyopia treatment

We have developed electronic monitors in collaboration with the Medical Physics department in Leicester to measure adherence to patching treatment in amblyopia. We found that adherence is variable and often poor (Awan et al., 2005) which explains the prolonged treatment times and poor outcomes we have observed (Awan et al., 2010).

More recently we have developed electronic monitors to measure glasses wearing for the first time. We find that adherence is variable and outcomes of treatment are suboptimal.

Improving adherence and optimising treatment

We used feedback from parents and children to develop an educational/motivational intervention pack to improve amblyopia treatment (Pradeep et al., 2014). The pack contains a story book for children with illustrations of treatment of an amblyopic boy where the eyes are represented as two characters “Ra Ra” and “La La” speaking to each other. The pack also contains information booklets for parents, children, teachers, family and friends about amblyopia, its treatment and common misconceptions as well as other motivational elements such as an “amblyopia passport” and reward stickers for the children.

We are also looking at the effect of using electronic monitors to feedback to the parents and children how well they are doing. We are currently running a large clinical trial into the role of glasses wearing in amblyopia (funded by Action Medical Research). It is a multicentre study involving centres in Austria, Germany, Switzerland as well as around the UK.

Effect on reading

We have investigated the effect of amblyopia on reading using eye movement recordings and find that there are often subclinical deficits present for example when reading with both eyes open or the non-amblyopic eye open (Kanonidou et al., 2010, 2014).


University of Leicester

Medical Physics - Christopher Degg, Glen Bush, Julie Wooldridge; Genetics – Sue Shackleton, Chris Talbot; Psychology - Phil Duke, Claire Hutchinson; Psychology - Mohammed Al-Uzri, Mike Reveley; Health Sciences - Mary Dixon-Woods, Kate Windridge; Neurology - Yusuf Rajabally; Cardiology - David Adlam, Shiju Joseph; Ophthalmology - Theo Empeslidis, Neonatology - Joe Fawke.

Other Collaborators

Paul Morgan, Robert Dineen, Chris Tench and Cris Constantinescu (University of Nottingham); Elizabeth Engle (Harvard Medical School); Lucy Raymond (University of Cambridge); Robert Reinecke (Will’s Eye Hospital, Philadelphia); Hans Hilmar Goebel (Universität Mainz); Thomas M. Bosley (King Khaled Eye Specialist Hospital, Saudi Arabia); Michael Greaf (Universität Giessen); Michael Hoffmann (Universität Magdeburg); Susanne Kohl (Universität Tübingen); Michael Michaelides, Annegret Dahlman-noor (Moorfields Eye Hospital, London); Christina Pieh (Universität Freiburg); Jacqueline Collier (University of East Anglia); Christophe Valmaggia (St Gallen); MERZ pharmaceutical.

Research funding

Ulverscroft Foundation, Action Medical Research, Medical Research Council, Nystagmus Network, College of Optometrists, Medisearch, National Eye Research Centre, Fight for Sight, The Children’s Research Fund, University of Leicester (UHL) NHS Trust, Ormsby Charitable Trust.

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