EPIDEMIOLOGY AND MANAGEMENT OF BACTERIAL KERATITIS

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This application provides a five-year plan of postgraduate education and inquiry that will permit the applicant, an ophthalmologist involved in the clinical practice of ocular infectious and inflammatory diseases and in the laboratory research of ocular microbiology, to obtain formal instruction in epidemiology and biostatistics. The planned training program for the applicant comprises coursework in the disciplines of public health leading to an M.P.H. degree at the University of Texas School of Public Health, an institution of operational excellence where there will be interaction with a scientific mentor who has experience in coordinating multicenter clinical trials in eye disease. The training period will involve a research thesis that will form the basis for developing a clinical research study on bacterial keratitis, a common ocular infection that affects approximately 1 in 8,500 Americans annually. The optimal management of bacterial keratitis has not been established. The graduate thesis of this training and research program will provide information necessary to calculate sample size and to select appropriate measurements for a clinical trial studying the role of laboratory testing, initial antibiotic selection, and adjunctive corticosteroids in bacterial keratitis. Specific aims of the research plan are to conduct a survey of ophthalmologists specializing in ocular infection to determine practice patterns of treating bacterial keratitis; to develop a data-collection instrument for recording clinical parameters and laboratory results on patients with bacterial keratitis; and to evaluate whether digital image-analysis methods of slit-lamp photographs could be used as an ancillary endpoint of bacterial keratitis outcome. This proposal is an outgrowth of the applicant's previous work and is an extension of a career development program focused on patient-oriented research.