ZEISS Young Investigator Award in Myopia Research and Josh Wallman Memorial Lecture. Understanding Myopia Development.

Barbara Swiatczak was awarded the ZEISS Young Investigator Award for Myopia Research in 2024. The corresponding publication appeared in Ophthalmic and Physiological Optics, Volume 45, Issue 4, pp 951-957, in 2025. In this interview, she talks about the findings of her research, the significance of the ZEISS Young Investigator Award, and her advice to young researchers.

My primary research interest focuses on one of the most pressing, unanswered questions in the field: What is the initial signal or cellular trigger that sets the eye on a pathological path? While we are familiar with known myopia risk factors, such as time spent outdoors or prolonged near-work, a central puzzle remains: why can two children with seemingly similar lifestyles and environments have completely different visual outcomes? This suggests that there is some specific unidentified 'trigger' that still awaits discovery. I am investigating the specific cellular initiator that launches the pathological cascade, leading to the excessive axial elongation that defines myopia. Essentially, I am searching for the “first domino”: the key biological event that, once tipped, initiates the entire myopia progression. Identifying this primary cause is the most direct path to developing truly targeted and effective cures for myopia, allowing us to move beyond just managing symptoms.

The paper published in Ophthalmic and Physiological Optics in April 2025 summarizes our findings so far by addressing those three topics. We started by searching for a predictor of myopia onset and discovered an early biomarker of myopia development in the animal model. We found a significant thinning of the inner retina and myelin sheath around neuronal axons, which occurred before any measurable changes in eye length. Furthermore, during human studies, we found that myopic eyes show a much weaker response to key visual cues like defocus and chromatic aberration than the eye without refractive error, which implies a breakdown in the retinal "stop" signals that should control eye growth.

This insight could shift our understanding of myopia from being a simple "structural" problem to being a "neuro-functional" problem first. The most common hypothesis assumes that a “myopiagenic” environment causes the eye to grow too long, and this subsequently impacts the retina. However, the other hypothesis, supported by our research, suggests the opposite: the retina may "malfunction" first, and this change in neuronal signaling then triggers the excessive eye growth. This is a crucial distinction. In fact, some human studies have already shown that pre-myopic children have decreased retinal activity before their eyes start to elongate. The big question has always been "Why?". In our model, we showed that the decrease in axon diameter and the loss of myelin from retinal axons—which is essential for fast signal transmission—is one of the very first things to happen during early stages of myopia development. This degradation would directly impair retinal signaling, which aligns with the retinal functional deficits reported in pre-myopic children. This could change how we think about myopia onset. It suggests that myopia isn't just a simple focus error, but could be a more complex neuronal malfunctioning process. Therefore, for predictive biomarkers, instead of only measuring the physical length of the eye, I believe that in the future we should also be screening for retinal functional biomarkers to identify at-risk children long before their vision even begins to change.

We found that reading bright-on-dark text can significantly increase choroidal thickness. This is a crucial finding because a thicker choroid may slow the eye's elongation in myopia. I envision this as a simple "digital intervention" that could be easily implemented by parents. It could work as a support tool for children already in treatment (like atropine drops or special lenses), which could help enhance the standard of care. The other option would be to use it as a preventive habit, becoming a healthy recommendation for all children and adolescents. Setting school tablets and home computers to "dark mode" with a larger font is a simple, no-cost habit that could potentially help protect children's vision.

The award has been a significant catalyst. The most immediate impact was bringing greater recognition to our studies, which is incredibly validating. This increased visibility has already opened many doors, making it easier to initiate collaborations with leading scientists in the field and expanding opportunities within the wider community of experts shaping the future of myopia research.

First of all, believe in yourself and your unique ideas. Don't be afraid to move against the 'common' trends, because that's often where the real breakthroughs are found. Stay focused on your goals and the milestones needed to test your hypothesis. Be a sponge for knowledge, learning from your own mistakes and the experiences of your colleagues. Discuss your achievements, but also be vulnerable by sharing your challenges. Be proactive in building your career, especially for women in science. Seek visibility by accepting speaking invitations, step into leadership that aligns with your goals, and always ask for clear authorship and credit. As a final piece of advice, try discussing new hypotheses not only with colleagues in your field but with people completely outside of it. This may bring a fresh perspective, leading to unexpected ideas that could change the thinking of the entire field.

Publication: Swiatczak B. ZEISS Young Investigator Award in myopia research and Josh Wallman Memorial Lecture. Understanding Myopia Development. Ophthalmic Physiol Opt. 2025 Jun;45(4):951-957. doi: 10.1111/opo.13506. Epub 2025 Apr 22. PMID: 40261601. https://pubmed.ncbi.nlm.nih.gov/40261601/