Main interests:

• Aetiology
• Outcomes/Impact
• Treatment and support

Vision in children with neurodevelopmental impairments

Cathy Williams has an NIHR career development fellowship to investigate detection, diagnosis and management of children with vision problems in the context of other developmental conditions. In addition she heads a programme of work on visual development within the ALSPAC cohort. Current and recently completed projects include:

• Systematic review of interventions for children with vision and other problems
• Grading study of optic nerve pictures from ALSPAC participants, to examine predictors and associations of optic nerve morphology
• School-based normative data study on children’s cognitive visual functions
• Refractive error development (with Jean Golding)
• Nutritional predictors of visual function in ALSPAC
• Accidents in visually-impaired and/or hearing impaired children
• Eye movements in children with developmental impairments
• Genetic factors that affect vision and other parts of the CNS “eye –brain”
  disorders
• Vision problems in children with DCD, reading impairment
• Visual outcomes in premature children who had a bleed in their brains as babies (DRIFT school-age study)
• Development of an App for neurorehabiliation
• Pilot study of effectiveness of a game for children with visual field loss
• Study of rehabilitative strategies for children with cerebral palsy in Bangladesh.

The main focus of our work is to understand the risk factors, impacts and the best methods of support/treatment, for children with visual impariment. Cathy Williams a began 5-year NIHR Senior Fellowship on 1/11/2015 and this funded a programme of work on cerebral visual impariment, "The CVI Project", which is managed by Dr Anna Pease. Other projects are ongoing with both internal and external collaborators.

The CVI Project

A 5 year programme of work relating to cerebral visual impairment in children including sub-studies investigating:

Prevalence
Impact
Data Linkage of children
Feasibility cluster-RCT of complex intervention to help children with CVI.

This programme involves collaborations with DECIPHer (the feasibility RCT has been "adopted", key contact Dr Ruth Kipping), with the PenCRU Peninsula Cerebral Research Unit Exeter (collaborators Dr Chris Morris and Ms Sharon Blake) and with the PEARL project (UoB data linkage hub) and BRTC (Bristol Randomised Trial Collaboration).

DRIFT10

An NIHR HTA study (PI Dr Karen Luyt) investigating the outcome at age 10 years of new intervention (Drainage, Irrigation & Fibrinolytic Treatment) for premature babies who suffered intervention (Drainage, Irrigation and Fibrinolytic Treatment) for premature babies who suffered intraventricular haemorrhage (IVH). The behavioural outcomes studies are Cognitive, Motor, Visual and Behavioural and MRI data is available. Cathy Williams and research orthoptist Penny Warnes leads the vision strand.

App Development

An intervention to help children with visual impairment is being developed in collaboration with Professor Iain Gilchrist, Mr Kieren Pitts (research IT) and Ms Alex Luca (artist) and has been developed and adapted in collaboration with Emerson's Green School and Belgrave School.

Motion Detection

In primary school children - a test protocol to measure motion detection in school-aged children has been developed by Dr Chris Benton (UoB Exp Psychology) and planning for a normative data study are ongoing (collaborators Dr Chris Benton, Mrs Penny Warnes).

Optical Coherence Tomography (OCT)

Of the retina and optic nerve in children. Funds we awarded by the FoHS to purchase new cutting-edge imaging equipment suitable for use with babies, young children and children with special needs. Studies collectiing data in healthy and patient populations are being developed (collaborators Dr Denize Atan, Dr Karen Luyt, Alexandra Creavin and Penny Warnes)

Cerebral Visual Impairment in children with Cerebral Palsy in Bangladesh

Data collected by Mr Richard Bowman (Consultant Paediatric Opthamologist at Great Ormond Street Hospital and London School of Hygiene & Tropical Medicine) on a quality of life in children with CVI has been collected. Cathy Williams and Kate Northstone are leading the analysis of how CVI impacts on QoL and how this can be improved.

Epidemiology of Refractive Errors

In this research programme - co-led with Professor Jez Guggenheim (Cardiff University), we have analysed data from ALSPAC and from UK Biobank, to explore the environmental and genetic predictors of refractive error. One project on genetic influences on myopia in Bio bank is about to start and another (NERC-funded PhD project) on gene-gene and gene-environment interactions affecting myopia in UK Biobank and in ALSPAC. Other analyses are ongoing.

PhD Students Supervised

Jocelyn Cherry: Accidents in children with sensory (vision and hearing) impairment (lead supervisor Cathy Williams, co-supervisors Dr Julie Mytton and Dr Amanda Hall)

Ed Mountjoy: Genetic determinants of visual and cognitive development

Alexandra Creavin: Optic Nerves in Children- normal and abnormal development