The aims of my groups work are to: To provide innovative imaging tools (such as DARC) for the early diagnosis and identification of blinding conditions such as: Glaucoma Diabetic eye disease Retinal detachment and Macular degeneration To offer meaningful endpoints and investigate novel therapeutic approaches in neuroprotection and sight-saving strategies in the eye To promote the eye as a window for the rest of the brain with particular reference to Alzheimers disease These are to be achieved using novel non-invasive techniques to assess structural and functional changes in different models of disease and their treatment, with a view to offering quick and effective translation to the clinical arena, enabled through my post as an Honorary Consultant Ophthalmologist. DARC offers the opportunity to image changes occurring in retinal nerve cells apoptosing over hours, days and months, will potentially provide a powerful new clinical tool with which to diagnose and identify patients with early glaucoma before they lose vision, and opens the door to directly observing effects of therapeutic strategies in glaucoma using meaningful endpoints that are based on the direct assessment of RGC death. It may also serve as a surrogate biomarker of outcome in glaucoma clinical studies, dramatically reducing the duration of such trials that currently rely on the use of visual field status as a key endpoint. Nerve cell loss is implicated in chronic and devastating neurodegenerative disorders such as Alzheimer's Disease. There is increasing evidence that similar mechanisms in the eye and the brain cause the development of this nerve cell loss. This suggests that the processes of cell death occurring in the eye may be an indicator of, or window on, cell death occurring in other parts of the brain. We have already shown that it is possible to assess therapeutic and sight-saving strategies using our methods and this has great implications in the testing and validation of neuroprotective regimens in all aspects of neurodegeneration including Alzheimers Disease. We have also recently begun investigating the importance of retinal neurodegeneration in diabetic retinopathy. Current thinking suggests that an early event in retinopathy that precedes ischaemia and neovascularisation is nerve cell loss. Retinal neuronal apoptosis may therefore be an valuable screening and diagnostic marker. We shortly commence a proof-of-principle clinical trial not only in glaucoma patients. Our final aim is to establish an apoptotic index of cell degeneration with which individuals can be diagnosed and also monitored to assess treatment response or progression rates. This may help negate or avoid visual loss ever occurring in the first place, as the use of DARC in these patients will be as a screening investigation to help identify patients with early disease.