As a cornea specialist, Meraf Wolle uses the latest medical and surgical treatments to keep patients’ corneas healthy and to heal them when they become diseased. She is also interested in complex cataract surgeries. One of Wolle’s specialties is a type of partial thickness cornea transplant called the Descemet membrane endothelial keratoplasty, which allows removal of diseased tissue and the exact replacement with healthy donor tissue without affecting the surrounding healthy host tissue.

Wolle’s other area of focus is leading research projects to help eliminate trachoma around the world, under the guidance of her mentor, Sheila West. Trachoma, the leading infectious cause of blindness, is a recurrent bacterial infection contracted by children. Eventually, the recurring infection causes scarring of the conjunctiva, which can progress to turning in of eyelashes, a condition known as trichiasis. As Wolle describes the process, the eyelashes turn in and repeatedly scratch the cornea, which results in the cornea breaking down and healing repeatedly until it scars over. By adulthood, the cornea becomes opacified, resulting in blindness.

A World Health Organization (WHO) mandate to reduce the incidence of trachoma around the world by 2020 has spurred great progress. The Kongwa region of Tanzania once had some of the highest rates of trachoma infection, with 70% to 80% of children under age 9 affected. But today, infection levels in Kongwa hover around 5%. Still, Wolle says there’s much work to be done globally: Approximately 1.9 million adults are irreversibly blind or otherwise visually impaired because of trachoma, and about 158 million are at risk of blindness, meaning they live in areas that are endemic with ongoing infection. The communities affected are among the poorest and most vulnerable in the world.

The WHO strategy to eliminate trachoma includes antibiotics to clear the infection, surgery to correct trichiasis, proper facial cleansing to reduce transmission, and improved access to water and sanitation to facilitate hygiene. Wolle and her team are embarking on a study to determine how to evaluate facial cleanliness accurately and to identify the best facial cleaning practices. “Once we figure that out,” says Wolle, “we can assess how to support communities and households so that they can implement the best practices. We can then use these findings to execute a public health campaign and see if, over time, children’s faces are cleaner, and if that reduces the active trachoma and infection rate in the long run.”

There is precedent for such a campaign: Wolle points out that trachoma was once endemic in the U.S., but when potable water became more accessible, public health campaigns about cleanliness were launched. By the early 1900s, trachoma was eliminated in the U.S.

Today, trachoma remains endemic in 44 countries, and efforts to eliminate it are underway. Wolle hopes that in the next five to 10 years, we’ll see the elimination of trachoma in Tanzania, but she says achieving that will be a challenge. “There are still unknowns, including how long countries will be encountering new cases of trichiasis that require treatment to prevent blindness, and whether the trachoma elimination efforts will halt trachomatous blinding disease,” she says.

These are questions Wolle and her team are researching — research that has the potential to significantly affect millions of people around the world.