Introduction

For nearly 25 years, the National Eye Institute (NEI) and the National Advisory Eye Council (NAEC) have maintained a unique partnership in addressing the most pressing visual health needs through the development and publication of a series of strategic plans at roughly 3- to 5-year intervals. While the NAEC's Vision Research Program Planning Subcommittee (VRPPS) has been charged with the overall responsibility for its development on behalf of the NAEC, this partnership presumes the full participation of other NAEC members, NEI staff, and members of the vision research community and its supporters in numerous scientific, voluntary, and philanthropic organizations throughout the country. Without their cooperation, hard work, and foresight, neither this publication nor its predecessors would have been possible.

Both the NEI and the NAEC took seriously the requirement in the NEI's establishing legislation—to plan for the training of research scientists and the research of disabling eye diseases, with emphasis on the causes of blindness and the loss of visual function. They established a formal planning process that resulted in the publication of the first plan, Vision Research Program Planning, in 1975. That first plan set the stage for the process that would guide the development of subsequent plans for more than 20 years by recommending that the planning process be governed by four guiding principles:

1. Research planning procedures must not disrupt extremely successful ongoing programs.

2. Planning procedures must sustain reliance on the investigator-initiated research grant as the primary mechanism for supporting research in the basic biological sciences and ensure that the highest priority is given to the highest quality research.

3. Planning procedures must rely on peer review for assessment of scientific quality and the programmatic considerations of the NAEC.

4. Research program planning must be a prospective, continuing process.

In addition, the need for involving the research community in the development of the recommendations during the planning process was stressed.

The vision research plans have always resulted from a dynamic process. Changes in approach, structure, and format have been made with each plan in an attempt to improve the process and be responsive to the changing needs of the field and existing public health challenges. Although no specific government-wide format has been specified for strategic plans, several common elements have been identified: a comprehensive mission statement covering the organization's major functions and operations; general goals and objectives of the organization (including outcome-related goals and objectives to allow the assessment of success in achieving those goals and objectives); a description of how the goals and objectives are to be achieved, including the operational processes, skills, technology, and resources required; identification of any external factors that could significantly affect the achievement of the goals and objectives; and a description of program evaluations used to establish or revise the goals and objectives.

In this current effort, panels of experts were assembled to represent each of the five formal program areas—Retinal Diseases; Corneal Diseases; Lens and Cataract; Glaucoma; and Strabismus, Amblyopia, and Visual Processing—along with specialized groups representing Visual Impairment and Its Rehabilitation and Health Services Research. Each panel was asked to assess the progress that has been made in vision research during the preceding 5 years; set realistic goals and objectives; determine research needs and opportunities; and, finally, to develop research strategies for achieving those goals and objectives.

To provide input to the panels, and to solicit views of those who will be affected by or are interested in the plan, two questions were posted on the NEI homepage on the World Wide Web (http://www.nei.nih.gov/): 1. Looking back at the past 5 years, what have been the most significant accomplishments or advances that have moved the field of vision research forward? 2. Looking ahead to the next 5 years, what are the most important vision research questions that should be addressed?The availability of this request for information was announced via letter to grantees and organizations conducting and supporting vision research. Additionally, a request for input was made at a major annual meeting of vision researchers sponsored by the Association for Research in Vision and Ophthalmology in May 1997.

Pertinent information submitted through this solicitation was provided to each of the panels for their consideration. The panels were then asked to prepare a report that had the following elements:

Program Overview and Goals—a brief general overview or description of the research supported within the program, followed by overarching long-range goals.

Assessment of Progress—the most important scientific advances that have taken place within the program, particularly as they relate to the previous plan's goals and objectives, so that scientific progress could be evaluated.

Program Objectives—shorter range and less general than goals, these constitute the areas of primary research focus and are based on the most pressing needs and opportunities in the program for the period covered by the plan.

Research needs and opportunities—identification of the specific needs within the areas of research covered by the each objective and/or the specific opportunities that exist for making significant progress.

Strategic research questions—the strategies or research approaches to be used in addressing the needs and opportunities, stated as the research questions to be asked, with some elaboration on their significance.
Previous plans were much more exhaustive in the detail provided, often at the individual project level. For this round of planning, the VRPPS felt it was necessary to prepare a shorter, more focused document that addressed the plan's most important objectives to be achieved during the period covered by the plan, rather than concentrating on individual projects that should be undertaken to achieve the objective. It should also be emphasized that a great deal of valuable research occurs within each program that may not be covered by a specific objective. This research is the foundation upon which future progress and accomplishment will be built. The objectives in this plan represent those areas in which there is compelling need or unique scientific opportunity to make significant progress over the next 5 years.

It is also important to consider external factors that could significantly affect the achievement of the goals and objectives. In past plans and in this current plan this area has been identified as the Cross-Cutting and Policy Issues. Those areas of research activity that cut across program lines are reiterated in this section, as well as policy issues of importance to the support and conduct of research activities. These include the external influences, such as funding policies, and operational processes, skills (including training), technology, and resources required to achieve the goals and objectives specified in the plan.

The draft panel reports were reviewed by the NAEC at a special subcommittee meeting following the September NAEC meeting. The drafts that contained the comments and suggestions of NAEC members were then returned to the panels for their consideration. Final drafts were then sent to organizations that conduct and support vision research, as well as to the full Council, to solicit their views on the plan's final recommendations. Reviewers were asked specifically to consider whether any important areas of research or specific issues of importance to vision research had been overlooked.

The result of this process is this strategic plan for vision research for Fiscal Years 1999 to 2003. To be sure, it is not a perfect process, for the planning of scientific research is a daunting undertaking. It presumes a vision of where the field should move, based on the needs and opportunities, a knowledge of what has been accomplished, and insight on what might be accomplished in the near future. But it is a sincere effort, undertaken by members of the vision research community on behalf of the entire vision research community and the Nation, to convey the most pressing needs and opportunities in this field and to determine the goals and objectives for the next 5 years.

It has been our pleasure to be associated with and oversee this effort on behalf of the VRPPS of the NAEC. Although our gratitude to those who have so freely given of themselves, their intellect, and their time is scarcely sufficient, it is most humbly offered. We hope the result of this effort will be the improvement in the visual health of our fellow citizens in the years to come.

Eve Higginbotham, M.D.
David Beebe, Ph.D.
Cochairs, Vision Research Program Planning Subcommittee
National Advisory Eye Council