Cornea, Ocular Surface and Refractive Disorders

Dr. Puro uses a novel research strategy to address the common clinical problem of dry eye, whose current remedies are far from optimal. To facilitate discovery of new potential targets for therapeutic intervention, he uses laboratory techniques not previously applied to the study of this uncomfortable and sight-threatening disorder. With generous support of a Stein Innovation Award from Research to Prevent Blindness, Dr. Puro explores the role of transcellular ion channels in the response of tear-film-stabilizing goblet cells to the electrolyte imbalance (hyperosmolarity) that characterizes tears on the ocular surface of dry eye patients. This new avenue of research indicates that altered ion channel activity early in the course of dry eye impairs the ability of conjunctival goblet cells to effectively respond to this osmotic stress.  Elucidation of this previously unsuspected pathophysiological mechanism may lead to new strategies to treat dry eye.

Grant Support

• Research to Prevent Blindness
• Stein Innovation Award: A Novel Experimental Approach to Dry Eye: Role of Ion Channels in the Physiology and Pathobiology of Conjunctival Goblet Cells

Corneal Neovascularization

Corneal neovascularization (CN) is a risk factor for corneal graft failure and rejection. Neovascularization compromises the immune-privileged status of the cornea by introducing immune cells and inflammatory mediators to the cornea.  Dr. Shtein is studying specific patterns of CN to determine which characteristics worsen the prognosis for graft survival.

Conventional techniques to study neovascularization do not permit accurate measurements or images that could be correlated with rejection. Confocal biomicroscopy is a new technique that can accurately determine the presence and patterns of CN and, thus, help identify patients who are at risk for tissue rejection and may be helped by therapeutic intervention.  

Dry Eye and Ocular Surface Disease

Dr. Shtein is Principal Investigator of a clinical trial that examines the pathogenesis of idiopathic dry eyes. This trial evaluates patients with dry eye symptoms that do not have any apparent cause.  She is hoping to learn about the relationship between dry eye symptoms and fibromyalgia in order to better understand and treat these conditions.

Molecular Basis of Graft Rejection

Dr. Shtein performs histopathologic studies of corneal tissue in the laboratory to understand the molecular basis of graft rejection and possible targets for therapies to protect the transplanted cornea.

Corneal Transplantation Delivery

Clinicians created eye banks in the mid-twentieth century with strong clinical intuition, but limited research into best practices. Dr. Woodard's research addresses eye bank best practices, focusing on improvements in eye banking tissue processes, highlighted threats to tissue supply, and establishment of the clinical correlation of tissue characteristics and patient outcomes.