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School of Optometry

Faculty

Assistant Professor

skhanal@uab.edu

HPB 526

Office: (205) 934-4558

Lab: (205) 934-3093

Fax: (205) 996-6720

Teaching/research interests: Refractive errors, emmetropization, ocular and refractive development, retinal and choroidal physiology, myopia onset, progression, and treatment; visual electrophysiology, biostatistics

Office hours: By appointment

Education

  • BOptom, Tribhuvan University, Optometry
  • OD, Southwestern University, Optometry
  • MPH, University of Alabama at Birmingham, Public Health (Epidemiology)
  • PhD, The University of Auckland, Optometry
  • Postdoc, The University of Auckland, Myopia
  • Postdoc, University of Alabama at Birmingham, Myopia and Dry Eyes

Safal Khanal, OD, MPH, PhD, FAAO, is an assistant professor in the Department of Optometry and Vision Science at the University of Alabama at Birmingham. He also holds secondary appointments as an Associate Scientist in the Center for Clinical and Translational Sciences, the Comprehensive Neuroscience Center, the Comprehensive Healthy Living Research Center, the Center for Outcomes and Effectiveness Research and Education, and the Civitan International Research Center. At UAB School of Optometry, Dr. Khanal leads an independent myopia research program, runs the Visual Electrodiagnostic Clinic, and teaches optometry and vision science courses in the professional and graduate programs. Dr. Khanal has published 50+ peer-reviewed original research articles, 15+ editor-reviewed articles, and 45+ conference abstracts. His publications include highly influential papers such as the National Academies of Sciences, Engineering, and Medicine-commissioned papers on myopia treatment, the British Contact Lens Association CLEAR presbyopia report, and the International Myopia Institute myopia white paper. Dr. Khanal’s research has been recognized by a Fellowship, Career Development Award, and Irvin M. and Beatrice Award from the American Academy of Optometry, Emerging Vision Scientist Award from the National Alliance for Eye and Vision Research, and Eberhard Dodt Memorial Award from the International Society for Clinical Electrophysiology of Vision.

Research interests

Dr. Khanal’s research program focuses on mechanisms of eye growth regulation and refractive development, with a particular emphasis on myopia onset, progression, and control. Myopia is a global epidemic and a major public health problem. Myopia occurs in young children due to a failure of the emmetropization mechanism that normally regulates eye growth to achieve and maintain sharp vision. In myopia, the eyeball becomes excessively elongated, posing substantial risks of permanent vision loss from several sight-threatening pathologies. Simple optical methods can correct blurry vision but do nothing to reduce the risk of developing these pathologies. Developing effective interventions requires a complete understanding of the emmetropization mechanism and the reasons for its failure leading to myopia. The overarching goal of Dr. Khanal’s research program is to learn how the emmetropization mechanism 1) integrates visual information to generate growth signals, 2) processes these signals to modulate eye growth, and 3) fails or loses efficiency, leading to the development of refractive errors like myopia. To answer these questions, Dr. Khanal’s lab conducts basic, clinical, and translational research in tree shrews (dichromatic primate-like mammals) and humans, including children. The current focus is on understanding the key operating characteristics of the emmetropization mechanism and developing effective, clinically translatable strategies to control myopia in children.

Professional appointments and memberships

  • Editorial Board Member, Investigative Ophthalmology and Visual Science
  • Associate Editor, Ophthalmic and Physiological Optics
  • Editorial Board Member, Scientific Reports
  • Editorial Board Member, Frontiers in Neuroscience
  • Vice Chair, American Academy of Optometry Scientific Program Committee
  • Member, Association of School and Colleges of Optometry Research Committee
  • Fellow, American Academy of Optometry
  • Member, International Myopia Institute
  • Member, Association for Research in Vision and Ophthalmology
  • Member, International Society for Clinical Electrophysiology of Vision

Recent courses taught

Course Director

  • OPT 122: Ocular Microbiology
  • VIS 700: Vision Science Literature Review
  • Invited Lectures
  • VS 131: Neurobiology of the Visual System
  • VS 111: Ocular Anatomy and Physiology
  • VS 610: Ocular Anatomy and Biology (Guest Lecture)
  • OPT 228: Public Health Optometry (Guest Lecture)
  • VIS 611: Biology and Pathology of Ocular Disease (Guest Lecture)
  • VS 121: Visual Optics (Guest Lecture)

Clinical specialties and/or areas of expertise

Visual electrophysiology, myopia control

If you are a clinician, in what UAB Eye Care clinic do you provide care?

Visual Electrodiagnostic Clinic

Selected publications

Peer-reviewed journal articles

  • Gawne TJ, She Z, Talajia K, Khanal S. Evaluating the Effect on Emmetropization of the Timing and Spectrum of Breaks From a Myopiagenic Environment. Invest. Ophthalmol. Vis. Sci. 2026;67(6):56.
  • Khanal S, Dhakal R. S-cone retinal pathway dysfunction in myopia. Invest. Ophthalmol. Vis. Sci. 2026;67(4):59.
  • Dhakal R, Sanchez NC, Gawne TJ, Khanal S. Measuring electroretinograms in tree shrews with a portable electrophysiology device. Doc Ophthalmol. 2026 Mar 30.
  • Weise KK, Khanal S. Atropine vs cyclopentolate for cycloplegic refraction in children. JAMA Ophthalmol. 2025;143(11):914–915.Khanal S, Tomiyama ES, Harrington SC. Childhood Myopia Part I: Contemporary Treatment Options. Invest Ophthalmol Vis Sci. 2025 Jun 5;66(7):6.
  • Khanal S, Tomiyama ES, Harrington SC. Childhood Myopia Part II: Treatment Mechanisms, Emerging Options, and Considerations. Invest Ophthalmol Vis Sci. 2025;66(7):7.
  • Gawne TJ, She Z, Khanal S. Human Trichomacy and refractive development. Vision Research. Vision Res. 2025 Sep;234:108632.
  • Sanchez NC, Roig-Lopez JL, Mobley J, Khanal S. Proteomic signatures of retinal pigment epithelium-derived exosomes in myopic and non-myopic tree shrew eyes. Frontiers in Medicine. 2025;12:1523211.
  • Horn D, Salzano AD, Jenewein EC, Weise KK, Schaeffel F, Mathis U, Khanal S. Topical review: Potential mechanisms of atropine for myopia control. Optom Vis Sci. 2025;102(5):260-270.
  • Yam JC, Khanal S, Phillips JR. Does 0.01% atropine have a place as a myopia control therapy?. Ophthalmic and Physiological Optics. 2025 Apr 9.
  • Gawne TJ, Khanal S, Norton TT. An Alternative Mechanism for the Anti-Myopia Effectiveness of Diffusion Optics Technology (DOT) Lenses. Trans. Vis. Sci. Tech. 2025;14(1):15.
  • Khanal S, Turnbull PR, Kim L, Phillips JR. Response of the human choroid to short-term changes in eyelid and periocular temperature. Clinical and Experimental Optometry. 2024 Jul 18:1-7.
  • Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, Kollbaum P, Marcotte-Collard R, Montanii G, Plainis S, Richdale K, Simard P, Wolffsohn JS. BCLA CLEAR Presbyopia – Mechanism and Optics. Cont Lens Anterior Eye. 2024 May 24:102185.
  • Khanal S, Phillips JR. Is Recommending 0.01% Atropine for Myopia Control Clinically Meaningful? JAMA Ophthalmol. Published online February 15, 2024.
  • Salzano AD, Khanal S, Cheung NL, Weise KK, Jenewein EC, Horn DM, Mutti DO, Gawne TJ. Repeated Low-level Red-light Therapy: The Next Wave in Myopia Management? Optom Vis Sci. 2023 Dec 1;100(12):812-822.
  • Dahal M, Dahal HN, Gautam P, Shrestha JB, Khanal S. Pattern visual evoked potential and foveal sensitivity in amblyopia. Doc Ophthalmol. 2023 Oct;147(2):109-119.
  • Khanal S. Is myopia a disease or just a dis-ease? Ophthalmic Physiol Opt. 2023 Jul;43(4):595-597.
  • Khanal S, Norton TT, Gawne TJ. Limited bandwidth short-wavelength light produces slowly-developing myopia in tree shrews similar to human juvenile-onset myopia. Vision Research. 2023; 204: 108161
  • Logan NS, Radhakrishnan H, Cruickshank F, Allen PM, Bandella PK, Davies LN, Hasebe S, Khanal S, Schmid KL, Vera-Diaz FA, Wolffsohn JS. IMI: Accommodation and Binocular Vision in Myopia Development and Progression. Invest. Ophthalmol. Vis. Sci. 2021;62(5):4.
  • Khanal S, Norton TT, Gawne TJ. Amber light treatment produces hyperopia in tree shrews. Ophthalmic Physiol Opt. 2021 Aug 11.
  • Norton TT, Khanal S, Gawne TJ. Tree shrews do not maintain emmetropia in initially-focused narrow-band cyan light. Exp. Eye Res. 2021 Mar 10:108525.
  • Turnbull P, Khanal S, Dakin S. The effect of cellphone position on driving and gaze behavior. Scientific Reports. 2021 Apr 8;11(1):1-0.
  • Khanal S, Rathod SN, Phillips JR. The acute effect of atropine eye drops on the human full-field electroretinogram. Doc Ophthalmol. 2021 Jun;142(3):315-328.
  • Kharal A, Khanal S, Shrestha JB, Shrestha GS, Paudel N. Flash VEP in clinically stable pre-term and full-term infants. 2020;141(3):259-267.
  • Khanal S, Phillips JR. Which low-dose atropine for myopia control? Clinical and Experimental Optometry. 2019; 103: 230-232.
  • Khanal S, Turnbull PRK, Lee N, Phillips JR. Effect of atropine on global flash mfERG responses to retinal defocus. Invest Ophthalmol Vis Sci. 2019;1(60):218-225.
  • Khanal S, Turnbull PRK, Vaghefi E, Phillips JR. Repeatability of arterial spin labeling MRI in measuring blood perfusion in the human eye. JMRI. 2019 Apr;49(4):966-74.

Editor-reviewed articles

  • Khanal S. Repeated low-level “laser” red light therapy for childhood myopia Too Soon? Mastering Myopia, Contact Lens Spectrum. February 7, 2024.
  • Khanal S. Combination treatment strategy for myopia control. Mastering Myopia, Contact Lens Spectrum. May 18, 2022.
  • Khanal S. Not all myopias are the same. Mastering Myopia, Contact Lens Spectrum. April 20, 2022.
  • Khanal S. Myopia—Not Just "Nearsightedness" But a Disease. Mastering Myopia, Contact Lens Spectrum. September 15, 2021.
  • Khanal S. Myopia Management: A Specialty or Primary Care? Mastering Myopia, Contact Lens Spectrum. July 21, 2021.
  • Khanal S. Ocular Growth Charts: A New Decision-Making Tool For Myopia Management. Mastering Myopia, Contact Lens Spectrum. June 23, 2021.
  • Khanal S. Evidence-based Myopia Management: Clinical Considerations. MiVision. December 2020. (Continuing Professional Development Article)
  • Khanal S. 0.01% Atropine’s puzzling disconnect. MiVision. February 2020.
  • Khanal S. Which low-dose atropine for myopia control? NZOptics. March 2020.
  • Khanal S, Turnbull PRK. Atropine: Efficacy and possible mechanisms for myopia control. MiVision. November 2017.