Safal Khanal Laboratory – School of Optometry

Khanal Laboratory

The Mechanistic Basis of Eye Growth Regulation and Myopia

Myopia (nearsightedness) is a global epidemic that affects over 2 billion people worldwide and up to 90% of the population in East Asia. In the United States, the prevalence of myopia has increased from 25% in the 1970s to 42% in the 2000s. It is estimated that, by 2050, myopia will affect half of the global population and account for 27% to 43% of uncorrectable visual impairment in the United States.

Myopia develops when the eye grows excessively long for its optics. This stretches tissues at the back of the eye and predisposes it to sight-threatening pathologies such as myopic maculopathy, retinal detachment, glaucoma, and cataracts. Contrary to common belief, myopia has no safe threshold. Individuals with high myopia are at exceptionally high risk of vision loss from these myopia-related complications, but even those with low to moderate myopia carry significant risks.

The rapidly increasing prevalence and the growing threat to eye health have made myopia the biggest public health problem of the twenty-first century. Developing safe and effective interventions to control myopia is an urgent need, and this requires a comprehensive understanding of how the eye regulates its growth and why it is increasingly failing to do so, leading to excessive axial elongation and myopia development and progression.

The Khanal laboratory is interested in the mechanistic basis of emmetropization, eye growth regulation, and refractive development. The specific focus of the lab is on understanding how the eye detects the sign of defocus and regulates its growth and what causes this regulatory mechanism to malfunction, leading to the genesis of refractive errors like myopia in children. Our research includes basic, clinical, and translational studies using cellular and molecular, clinical, imaging, and electrophysiology techniques.

The primary models are tree shrews (small dichromatic mammals closely related to primates) and humans, including children. The lab conducts a broad range of experiments (in vitro, ex vivo, and in vivo) using a multimodal approach that includes advanced imaging, electrophysiology, and proteomic strategies. The aim is to study structural, neural, and functional signals and to map the retina-choroid-scleral pathway of eye growth and myopiagenesis. The overall goal is to use this knowledge to develop novel and effective strategies for controlling the onset and progression of childhood myopia.