Research

• Neural mechanisms of ocular surface pain

  Our research aims to identify distinct phenotypes of chronic ocular pain by using a combination of clinical examinations, sensory testing, confocal microscopy, and fMRI brain imaging. We are comparing the activation patterns within the trigeminal system and throughout the brain in individuals with neuropathic ocular pain, Sjögren's-related Dry Eye, and healthy controls. The goal is to enable timely and appropriate interventions to prevent the transition from acute to chronic pain and improve treatments in individuals with a neuropathic component to pain.

• Ocular Graft-Versus-Host Disease

  Ocular graft-versus-host disease (GVHD) is a common cause of morbidity and mortality in individuals who undergo allogeneic hematopoietic stem cell transplantation. While this disease process is generally understood to cause inflammation followed by fibrosis in various organs, there is not currently a consensus regarding the pathophysiology of ocular GVHD (oGVHD). This lack of understanding results in inadequate preventative and treatment options for individuals with ocular GVHD who are chronically suffering from symptoms and signs including ocular surface pain, visual disturbances, decreased tear production, meibomian gland dysfunction, and epithelial disruption. In collaboration with Dr. Trent Wang, our research objectives are to identify prognostic and diagnostic ocular surface biomarkers in oGVHD and compare them with clinical presentation. Discovering such markers will allow us to better understand underlying pathological mechanisms in oGVHD and create targets for future therapies.

• Biomarkers of ocular symptoms after refractive surgery

  Laser-Assisted In Situ Keratomileusis (LASIK) and Photorefractive Keratectomy (PRK) are two common elective procedures performed to eliminate refractive error. Although favorable patient outcomes and high satisfaction levels are typically reported, there exists a potential for side effects, such as experiencing unpleasant eye sensations following surgery. Our team aims to provide insights into the risks and outcomes associated with these procedures, with the goal of optimizing outcomes after surgery and informing realistic expectations.

  In order to enhance understanding in this area, our research study entails a prospective investigation that aims to identify biomarkers associated with persistent ocular symptoms following refractive surgeries such as LASIK and PRK. This is a dual center study conducted at the University of Miami’s Bascom Palmer Eye Institute and Oregon Health & Science University’s Casey Eye Institute, where individuals are enrolled pre-operatively (day of surgery) and are subsequently followed post-operatively at day 1, months 3 and 6, and 1 year. Data from questionnaires capture eye symptoms, co-morbidities, satisfaction, and an examination provides information on ocular surface health. Tear samples are then collected and analyzed for proteins that predict or align with eye symptoms.

• Ocular Surface Microbiome

  Our research focuses on the integration of next-generation sequencing and culturomics to broadly characterize microbes that are found on the ocular surface in a healthy population. Employing a longitudinal, multi-center study framework, our objective is to identify the stability, diversity, and regional disparities of the ocular surface microbiome. Additionally, within healthy subjects, using flow cytometry, we aim to discern the constancy and composition of conjunctival immune cells. We anticipate that our findings will serve as a foundational resource for future studies, expanding our understanding of the ocular surface microbiome and providing insights for research exploring its potential role in disease prevention or contribution.

• Neural mechanisms of light sensitivity in individuals with traumatic brain injury

  Our research focuses on understanding photophobia (that is, light sensitivity) in individuals with traumatic brain injury (TBI) and evaluating whether botulinum toxin type A (BoNT-A) injections can enhance clinical outcomes. Using a multidisciplinary approach, our study incorporates various assessments including validated questionnaires, ocular examination, quantitative sensory testing, and functional Magnetic Resonance Imaging (fMRI) to delve into the complexity of TBI associated photophobia.