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Assistant Professor, Department of Ophthalmology
Wilmer Eye Institute, Room 116
Phone: 410 614 2874
BA University of Pennsylvania, Economics and Environmental Studies
PhD Johns Hopkins School of Hygiene and Public Health, Epidemiology
Trachoma is the leading infectious cause of blindness worldwide, with the majority of the affected population living in rural areas of developing countries. Blindness results from corneal opacification that occurs after continual corneal abrasion by inturned lashes. Surgery is available to correct inturned lashes, but research has shown high rates of recurrence. My current research focuses on finding ways to reduce recurrence and improves outcomes following surgery, including modifications to the current surgical procedure and development and testing of new instrumentation.
Endophthalmitis is one of the most unfavorable adverse events following cataract surgery. Although it occurs rarely, frequency of the procedure makes it an important public health problem worldwide. We recently reported a potential increase in the rate of post-cataract surgery endophthalmitis among Medicare beneficiaries. Our current research project is a large, NIH-funded case-control study to evaluate risk factors for endophthalmitis following cataract surgery. We hope to ultimately conduct clinical trials to evaluate specific interventions that might reduce the incidence of endophthalmitis following surgery.
Clinical Trials for Treatment of Retinal Diseases
We are conducting several small (~20 persons each) randomized controlled clinical trials to evaluate the role of treatment therapies on improving retinal health:
Two trials evaluate the effects of treatment with pegaptanib sodium for treatment or prevention of macular edema among patients undergoing ocular surgery. In the first trial, we are investigating the role of pre- and post-surgical treatment on reducing the risk of post-surgical macular edema among diabetics. In the second, we are evaluating the role of post-surgical treatment on reducing macular edema among patients who have failed treatment with steroids.
Two additional trials examine the effects of treatment with ranibizumab on improving outcomes in patients with hemorrhagic CNV and idiopathic parafoveal telengiectasia
1. Gower EW, Solomon AW, Burton MJ, Aguirre A, Munoz BE, Bailey RW, Holland M, Makalo P, Massae P, Mkocha H, Mabey DC, West SK. Chlamydial Positivity of Nasal Discharge at Baseline is Associated with Ocular Chlamydial Positivity Two Months Following Azithromycin Treatment. Invest Ophthalmol Vis Sci. In press.
2. Abraham, AG, Congdon N, Gower EW. The new epidemiology of cataract. Ophthalmol Clin N. Amer. In press.
3. West SK, West ES, Alemayehu W, Melese M, Munoz B, Imeru A, Worku A, Gaydos C, Meinert CL, Quinn T. Randomized Trial of Azithromycin to Prevent Trichiasis Recurrence Following Surgery. Archives of Ophthalmology. 2006 Mar; 124(3):309-14.
4. West ES, Munoz B, Imeru A, Alemayehu W, Melese M, West SK. The Association Between Epilation and Corneal Opacity Among Eyes with Trachomatous Trichiasis. Br J Ophthalmol. 2006 Feb, 90(2) 171-4.
5. Melese M, West ES, Alemayehu W, Munoz B, Worku A, Gaydos C, West SK. Characteristics of Trichiasis Patients Presenting for Surgery in Rural Ethiopia. Br J Ophthalmol. 2005 Sep;89(9):1084-8.
6. West ES, Alemayehu W, Munoz B, Melese M, Imeru A, West SK. Surgery for Trichiasis, Antibiotics to Prevent Recurrence: STAR Clinical Trial Methodology. Ophthal Epidemiol. 2005 Aug;12(4):279-86.
7. West ES, Behrens A, McDonnell PJ, Tielsch JM, Schein OD. The Incidence of Endophthalmitis Following Cataract Surgery Among the US Medicare Population Increased Between 1994-2001. Ophthalmology. Aug;112(8):1388-94.
8. Merbs SL, West SK, West ES. Pattern of Recurrence of Trachomatous Trichiasis Following Surgery:
Surgical Technique as an Explanation. Ophthalmology. 2005; 112(4):705-9.
9. West S, Bedri A, Kim T, West ES, Alemayehu W, Mariotti SP. Final Assessment of Trichiasis Surgeons. Geneva: WHO Programme for the Prevention of Blindness. 2005.
10. West ES, Mkocha H, Munoz B, Mabey D, Foster A, Bailey R, West SK. Risk Factors for Trichiasis Recurrence in a Trachoma-Endemic Area. Invest Ophthalmol Vis Sci. 46(2)447-53.
11. West ES and Schein OD. Sunlight and Age-Related Macular Degeneration. Int. Ophthalmol Clin. 2005; 45(1): 41-47.
12. West ES, Munoz B, Mkocha H, Holland MJ, Aguirre A, Solomon AW, Bailey R, Foster A, Mabey D, West SK. Mass Treatment and the Effect on the Load of C. trachomatis Infection in a Trachoma Hyper-endemic Community. Invest Ophthalmol Vis Sci. 2005; 46(1):83-87.
13. Cummings KJ, Lee SM, West ES, Cid J, Fein SF, Aoki Y, Sulkowski MS and Goodman SN. Interferon and Ribavirin vs. Interferon Alone in the Re-treatment of Chronic Hepatitis C Previously Nonresponsive to Interferon: A Meta-analysis of Randomized Trials. JAMA. 2001; 285(2):193-199.
14. Dunford RW, Johnson FR and West ES. Whose Losses Count in Natural Resource Damages? Contemporary Economic Policy. 1997; 15(3):77-87.