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Dr. Wong's Eye Movement & Vision Neuroscience Laboratory

Brief Biography

Dr. Wong graduated from Boston University in 1990. She obtained her MD degree from McGill University in 1994 and completed her residency in Ophthalmology at the University of Toronto in 1999. Residency was followed by a PhD in Neuroscience and clinical fellowship in Neuro-Ophthalmology at the University of Toronto. This was followed by a combined research and clinical fellowship in pediatric ophthalmology and strabismus at Washington University in St. Louis.

Dr. Wong is currently an Associate Professor of Ophthalmology & Vision Sciences, Neurology, and Otolaryngology – Head & Neck Surgery at the University of Toronto. She is also a scientist, as well as an active staff physician, at both The Hospital for Sick Children and the Toronto Western Hospital. She divides her time between the clinical practice of neuro-ophthalmology and strabismus, and research in eye movement disorders. Her research focuses on abnormal eye movements in adults and children who have strabismus (crossed eye) and the underlying neural mechanisms.

Dr. Wong currently holds six peer-reviewed research grants, including two from the Canadian Institutes for Health Research (CIHR). Since 1994, she has published over 35 research papers. Her research work has been recognized by many professional organizations, as well as several provincial and federal granting agencies. She is also a much sought-after speaker who has delivered over 20 named lectureships / visiting professorships, as well as over 100 research presentations at various scientific meetings.

Despite her busy research activities, Dr. Wong also dedicates herself to the training and mentoring of future generations of physicians and scientists. She has received numerous prestigious awards in recognition of her high quality of clinical teaching and research supervision.

Clinical Care Activities

Dr. Wong maintains an active clinical practice, specializing in Neuro-Ophthalmology and Strabismus. Neuro-ophthalmology deals with neurologic disorders of the visual system. Since approximately 45 per cent of the brain is related to the visual system, many brain abnormalities cause visual disturbances. These visual disturbances, if left undetected or untreated, often deteriorate and cause severe disability or become life-threatening. Dr. Wong applies her specialized training to help these patients. In addition, Dr. Wong specializes in strabismus, and offers medical as well as surgical therapy for these patients. She also conducts active research in understanding and finding a cure for childhood strabismus.

Areas of Specialty 

• Neuroophthalmology
• Strabismus

Research Interests

• Brain mechanism of abnormal eye movements
• Brain mechanism and treatment of infantile strabismus (crossed eyes)

Research Activities 

My research focuses on the interaction between the eyes and the brain in normal and diseased states. I use sophisticated techniques to measure visual functions, eye movements, brain activities, and brain connectivity with the eyes to investigate how the normal brain functions, and how these brain functions change in the diseased states. Presently, I have two main research areas:

• In Children: Crossed eyes in infancy is a common health condition that affects 8 per cent of children under age 18. It is a major cause of lazy eye, which is the number one cause of blindness in one eye in people between 20 and 70 years of age. Contrary to the popular belief that crossed eyes is a purely cosmetic condition, children born with crossed eyes suffer from a number of visual and eye movement impairments. My goal is to understand the brain mechanisms that cause crossed eyes and to find a cure for it.

Specifically, my research aims to answer three major questions: (1) How do the brain circuits that control vision and eye movements differ between cross-eyed and visually-normal infants? (2) How can we alter the development of these brain circuits to prevent or cure crossed eyes in infancy? (3) Can early surgery prevent maldevelopment of these brain circuits?

• In Adults: Crossed eyes and double vision are common and disabling features of many diseases, including strokes, tumours, diabetes, and multiple sclerosis. A better understanding of crossed eyes would not only improve therapy, but would also provide clues as to how the brain normally controls the eyes.

My research, using a state-of-the-art technique that is available only in a handful of laboratories world-wide, aims to answer three major questions: (1) How are the three-dimensional characteristics of eye movements altered by diseases of the brain? (2) What are the mechanisms underlying these changes, and how do they adapt over time? (3) What are the effects of different kinds of surgery on vision and on brain recovery / adaptation?

External Funding

• Canadian Foundation of Innovation (Principal Investigator)
• Canadian Institutes of Health Research (Principal Investigator)
• Ontario Ministry of Research and Innovation (Principal Investigator)
• E.A. Baker Foundation for Prevention of Blindness, Canadian National Institute for the Blind (Principal Investigator)
• National Institutes of Health, USA (Major Collaborator and Consultant)

Achievements

Research Awards:

• Early Researcher Award – from the Ontario Ministry of Research and Innovation (2006)
• Young Investigator Award – from the North American Neuro-Ophthalmology Society (2003)
• Young Investigator Award (Inaugural) – from the American Association of Pediatric Ophthalmology and Strabismus (2003)
• New Investigator Award – from the Canadian Institutes of Health Research (2002)

Clinical Teaching Awards (from University of Toronto):

• Resident Teaching Award (2005 and 2006)
• Dr. Fred Feldman Teaching Award (Inaugural) (2005)
• PAIRO Excellence in Clinical Teaching Award (Nominee) (2005)
• J.D. Morin Award (2003)

Awards for Research Supervision:

• Best Student Paper, North American Neuro-Ophthalmology Society Meeting (2006)
• Best Research Paper, Annual Meeting of the Canadian Association of Pediatric Ophthalmologists (2006)
• Gold Award – Pfizer Film Festival for surgical technique and medical cases, Royal Australian and New Zealand College of Ophthalmologists Meeting (2005)
• Best Fellow Award (Inaugural), Frank B. Walsh Session of the 30th Annual North American Neuro-ophthalmology Society Meeting (2004)
• Best Research Paper, Canadian Neuro-Ophthalmology Society Meeting (2004)
• Alumni Award (for Best Fellow Paper), Annual Ophthalmology Research Day, University of Toronto (2003)

Publications

Fesharaki M, Karagiannis P, Tweed D, Sharpe JA, Wong AM. Adaptive neural mechanism for Listing’s law revealed in patients with skew deviation caused by brainstem or cerebellar lesion. Investigative Ophthalmology and Visual Science 2008;49:204-214.

Kessler P, Tomlinson D, Blakeman A, Rutka J, Ranalli P, Wong AM. The high-frequency/acceleration head-heave test in detecting otolith diseases. Otology & Neurotology 2007;28:896-904.

Wong AM. An update on opsoclonus. Current Opinion in Neurology 2007;20:25-31.

Wong AM, McReelis K, Sharpe JA. Saccade dynamics in peripheral versus central sixth nerve palsies. Neurology 2006;66:1390-1398.

Niechwiej-Szwedoa E, Gonzáleza E, Begae S, Verrier MC, Wong AM, Steinbach MJ. Proprioceptive role for palisade endings in extraocular muscles: Evidence from the Jendrassik Maneuver. Vision Research 2006;46:2268-2279

Eizenman M, Sapir-Pichhadze R, Westall CA, Wong AM, Lee H, Morad Y. Eye movement responses to disparity vergence stimuli with artificial monocular scotomas. Current Eye Research 2006; 31:471-480.

Wong AM, Sharpe JA. Cerebellar skew deviation and the torsional vestibulo-ocular reflex. Neurology 2005;65:412-419.

Tychsen L, Wong AM, Burkhalter A. Paucity of horizontal connections for binocular vision in V1 of naturally-strabismic macaques: Cytochrome-oxidase compartment specificity. Journal of Comparative Neurology. 2004;474:261-275.

Tychsen L, Wong AM, Foeller P, Bradley D. Early versus delayed repair of infantile strabismus in macaque monkeys: II. Effects on motion visually evoked potentials. Investigative Ophthalmology and Visual Science 2004;45:821-827.

Wong AM, Foeller P, Bradley D, Burkhalter A, Tychsen L. Early versus delayed correction of infantile strabismus in macaque monkeys: I. Ocular motor effects. Journal of the American Association for Pediatric Ophthalmology and Strabismus 2003; 7:200-209.

Wong AM, Tychsen L.. Effects of extraocular muscle tenotomy on congenital nystagmus in macaque monkeys. Journal of the American Association for Pediatric Ophthalmology and Strabismus 6:100-107, 2002.

Wong AM, Tweed D, Sharpe JA. Vertical misalignment in unilateral sixth nerve palsy. Ophthalmology 2002; 109:1315-1325.

Wong AM, Sharpe JA, Tweed D. Adaptive neural mechanism for Listing's law revealed in patients with fourth nerve palsy. Investigative Ophthalmology and Visual Science 2002; 43: 1796-1803.

Wong AM, Tweed D, Sharpe JA. Adaptive neural mechanism for Listing's law revealed in patients with sixth nerve palsy. Investigative Ophthalmology and Visual Science 2002; 43:112-119.

Wong AM, Tweed D, Sharpe JA. The vestibulo-ocular reflex in fourth nerve palsy: Deficits and adaptation. Vision Research 2002; 42:2205-2218.

Wong AM, Sharpe JA. Adaptations and deficits in the vestibulo-ocular reflex after third nerve palsy. Archives of Ophthalmology 2002; 120:360-368.

Wong AM, Tweed D, Sharpe JA. Adaptations and deficits in the vestibulo-ocular reflex after sixth nerve palsy. Investigative Ophthalmology and Visual Science 2002; 43:99-111.

Wong AM, Musallam S, Tomlinson RD, Shannon P, Sharpe JA. Opsoclonus in three dimensions: Oculographic, neuropathologic and modelling correlates. Journal of the Neurological Sciences 2001: 189:71-81.

Wong AM, Lueder GT, Burkhalter A, Tychsen L. Anomalous retinal correspondence: neuroanatomic mechanism in strabismic monkeys and clinical findings in strabismic children. Journal of the American Association for Pediatric Ophthalmology and Strabismus 2000; 4:168-174.