Meet a Specialist: Joseph F. Rizzo III, M.D.

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World-renowned for leading research that has challenged the limits of vision impairment, Dr. Joseph F. Rizzo III, the Director of Mass. Eye and Ear’s Neuro-Ophthalmology Service, candidly admits that he likes a good challenge—and the more complex, the better. That is what drew him to the field of neuro-ophthalmology, which studies the complicated neural interplay between eye, brain, and inner ear to diagnose the causes of vision loss.

“Our field is rooted in a strong tradition of diagnostic expertise” Dr. Rizzo said. “We assess a broad range of vision problems—including the purely neurological, the purely ophthalmological, and those that result from inner ear dysfunction. We also evaluate patients whose vision loss might be caused by disease within the body, like multiple sclerosis. So our focus is very broad, but also involves disorders that are very rare.”

The physicians of Mass. Eye and Ear’s Neuro-Ophthalmology Service address optic nerve disease, brain tumors that affect vision, strokes that cause visual loss or double vision, migraine with visual symptoms, muscular disease that affects the eye, and unexplained vision loss. Dr. Rizzo’s clinical expertise includes treatment of inflammatory and ischemic optic neuropathies, giant cell arteritis, pseudotumor cerebri, and vision-related trauma, among others.

Board-certified in Neurology and Ophthalmology, Dr. Rizzo completed his medical degree at Louisiana State University, his Neurology residency at Tufts New England Medical Center, and his Ophthalmology residency at Boston University under Dr. Simmons Lessell. When Dr. Lessell became Director of the Neuro-Ophthalmology Service at Mass. Eye and Ear, Dr. Rizzo followed his mentor, becoming Dr. Lessell’s first neuro-ophthalmology fellow at Mass. Eye and Ear—and eventually, his colleague. Today, Dr. Rizzo evaluates patients and conducts research, teaches and trains residents and neuro-ophthalmology fellows, and directs the Neuro-Ophthalmology section of the annual Lancaster Course in Ophthalmology, founded in 1946, which draws participants from around the world.

Throughout his career, no challenge has fascinated Dr. Rizzo more than the question of how to restore lost vision. His quest led to the formation in the late 1980s of the Boston Retinal Implant Project (BRIP), a multi-disciplinary team of collaborators from Mass. Eye and Ear, Massachusetts Institute of Technology, and several other institutions. Collaboratively, they are developing a “bionic eye” – a retinal prosthesis that can deliver visual input to the brain, restoring some vision to those with certain acquired forms of blindness. Limited human testing has demonstrated that the implant enables some legally blind patients to see basic shapes and lines. BRIP’s research has yielded another device—“Smart” Glasses—that is being designed to transform the lives of many who are blind or visually impaired by enabling them to navigate independently.

The retinal prosthesis depends on the healthy optic nerve cells that usually survive despite blindness caused by the loss of rods and cones. BRIP’s bionic eye relies on a micro-camera on the patient’s “Smart” Glasses. The camera collects visual input, then transmits that digitized signal to the implant’s electrode chip that has been surgically attached to the patient’s retina, stimulating still-healthy optic nerve cells, recruiting them to function as the rods and cones once did to transmit those signals to the brain, and thereby simulating the vision process. Dr. Rizzo hopes BRIP to undertake Phase I clinical trials in two years.

Difficult questions of biological and engineering feasibility have arisen at every step. But the greatest challenge, Dr. Rizzo asserted, “has been whether we can emulate the sophisticated signaling that accounts for vision.”

Fortunately, he said, the Boston Retinal Implant has been built on advanced neuroscience. And its 256 electrodes are individually controllable, so the patient’s vision can be adjusted. Dr. Rizzo believes this advantage will grow over time as he and his colleagues conduct research on the neural code underlying eye-brain communication. Dr. Rizzo’s other research efforts have included development of an intraocular lens implant that doses medication less invasively and more precisely than traditional eye drops following cataract surgery. With Drs. Dean Cestari and Demetrios Vavvas, he is also studying neural protection in the search for alternatives to steroids, currently the only treatment for disorders that cause acute retinal or optic nerve damage resulting in vision loss.

Dr. Rizzo’s 25-year research efforts have been fueled by his clinical experience. “Over the years, I’ve seen how blindness affects people’s lives, and that continues to drive my research,” he said. “There have been significant hurdles to overcome along the way, but my patients keep me going.”

Contact Dr. Rizzo’s office at 617-573-3412.

View Dr. Rizzo’s online bio for more information.

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