Dr. Freedman is a clinician and surgeon caring for infants and children with a variety of disorders including childhood glaucoma, cataracts, retinopathy of prematurity, and amblyopia; and for adults and children with strabismus. She studies new diagnostic and therapeutic techniques in childhood glaucoma and retinopathy of prematurity, and collaborates with Drs. Toth, El-Dairi, and Vajzovic on new methods of retinal and optic nerve imaging in infants and children (especially optical coherence tomography, OCT), with emphasis on the links between optic nerve and brain development in health and in disease. Dr. Freedman obtained her medical degree from Harvard Medical School, completed Ophthalmology residency at Massachusetts Eye and Ear Infirmary, and fellowships in both Pediatric Ophthalmology and Strabismus (at Boston Children’s Hospital) and Glaucoma (at Duke Eye Center). Before joining the Duke faculty in 1995, Dr. Freedman was on the faculty at UNC-Chapel Hill. As division chief, Dr. Freedman takes delight in mentoring many clinical and clinical research fellows, as well as residents, medical students, and visiting ophthalmologist from around the US and internationally.
Along with Dr. Cynthia Toth, Dr. Mays El Dairi and Dr. Lejla Vajzovic, Dr. Freedman formed the Duke Pediatric Retina and Optic Nerve Center. The development of the neural tissue of the retina and optic nerve has received limited attention in large part because of the multitude of technical challenges in studying eye development and the connection to brain development in the small eyes of newborn infants.
Dr. Freedman has enjoyed collaborating with Dr. Cynthia Toth since her arrival, and more recently, with Drs. El-Dairi and Vajzovic, both of whom trained at Duke. Dr. Toth’s pioneering work in developing novel methods for portable bedside OCT imaging of the eyes of awake infants, has led to many advances, including the first demonstration of the in vitro process of retinal maturation, both in normal and in abnormal neonates (especially those with extreme prematurity), as well as the link between delayed retinal development in the Neonatal Intensive Care Unit and neurodevelopmental delay demonstrated at 2 years of age. The team is multidisciplinary and includes neonatologists, neuroradiologists, child development specialists and pediatric ophthalmologists to investigate the developing eye-brain connection in premature infants. Through our collaborative work led by Dr. Cynthia Toth, our eye-brain discoveries in infants have pioneered the early use of bedside imaging of the eye (retina and optic nerve) to aid in early identification of the infant at risk for neurodevelopmental and vision problems and in monitoring response to future therapeutic interventions.
1. Maldonado RS, O'Connell RV, Sarin N, Freedman SF, Wallace DK, Cotten CM, Winter KP, Stinnett S, Chiu SJ, Izatt JA, Farsiu S, Toth CA. Dynamics of Human Foveal Development after Premature Birth. Ophthalmology. 2011 Dec; 118(12):2315-25. Epub 2011 Sep 21. PMCID: 3496560
2. Maldonado RS, O'Connell RV, Ascher SB, Sarin N, Freedman SF, Wallace DK, Chiu SJ, Farsiu S, Cotten M, Toth CA. Spectral-Domain Optical Coherence Tomographic Assessment of Severity of Cystoid Macular Edema in Retinopathy of Prematurity. Arch Ophthalmol. 2012 May;130:569-78.
3. Rothman AL, Sevilla MB, Freedman SF, Tong AY, Tai V, Tran-Viet D, Farsiu S, Toth CA, El-Dairi MA. (2015) Assessment of Retinal Nerve Fiber Layer Thickness in Healthy, Full-Term Neonates. Am J Ophthalmol. 2015 Jan 26. pii: S0002-9394(15)00046-X. doi: 10.1016/j.ajo.2015.01.017. [Epub ahead of print] PMID: 25634528
4. Rothman AL, Tran-Viet D, Gustafson KE, Goldstein RF, Maguire MG, Tai V, Sarin N, Tong AY, Huang J, Kupper L, Cotten CM, Freedman SF, Toth CA. Poorer Neurodevelopmental Outcomes Associated with Cystoid Macular Edema Identified in Preterm Infants in the Intensive Care Nursery. Ophthalmology. 2015 Mar;122:610-9.
5. Vajzovic L, Rothman AL, Tran-Viet D, Cabrera MT, Freedman SF, Toth CA. Delay in retinal photoreceptor development in very preterm compared to term infants. Invest Ophthalmol Vis Sci. 2015 Jan 13;56:908-13.