Matthew leads a group of more sixty research clinicians, epidemiologists, laboratory scientists and research assistants, working closely with academic partners in five countries. His main research focus is blinding eye infection (trachoma and corneal infection); in addition, he works on ocular surface squamous neoplasia, glaucoma, eye disease surveys and technology development. Clinical trials form a central component of the groups work.

Trachoma remains the commonest infectious cause of blindness in the world.  Our trachoma research has involved several clinical trials to improve the treatment of trachomatous trichiasis, quality of life, studies investigating the immunopathogenic basis of this disease, and developing more effective control strategies. This has led to changes in policy and practice in trachoma endemic countries. For example, a recent trichiasis surgery trial (Lancet Global Health 2016a) found substantially better outcomes from one particular operation.

New research in Ethiopia, supported through a Wellcome Collaborative Award called Stronger-SAFE, is seeking to understand the routes and determinants of ocular Chlamydia trachomatis transmission, develop interventions to suppress these, and to test these alongside enhanced antibiotic treatment schedules in a cluster randomised trial.

Corneal infection or microbial keratitis is a relatively common and devastating problem in tropical regions, where fungal pathogens account for >50%. Our research in Uganda, Tanzania, Nepal and India is investigating the epidemiology, microbiology, susceptibility patterns and pathophysiology of severe corneal infections, particularly those caused by fungi. We are developing and evaluating diagnostic tools and conducting a series of clinical intervention trials.

Ocular surface squamous neoplasia is a common and aggressive eye cancer in East Africa and elsewhere. We are investigating the epidemiology, pathophysiology and diagnostic tools. In Kenya, we recently completed a placebo-controlled trial of post-operative 5-fluorouracil eye drops and found a substantial reduction in recurrent disease (Lancet Global Health 2016b).

Glaucoma is a major cause of blindness, particularly in Sub-Saharan Africa. Our studies are focusing on developing and evaluating low cost tools for detection and we are currently conducting a clinical trial of a laser procedure (Selective Laser Trabeculoplasty), which may reduce the need for life-long use of daily eye drops.

Peek: Technology for Eye Care. We are developing and testing a package of mobile phone-based applications for eye care: Peek - Portable Eye Examination Kit. This will allow the user to conduct comprehensive examinations and to record data in remote locations, with a major impact on access to eye care and accuracy of diagnosis. Initial device applications are currently being field tested in Kenya, Tanzania, Botswana and India. The first application, a visual acuity app, has been released and shows excellent agreement with conventional devices (JAMA Ophthalmology 2015). We have used this system in a cluster randomised trial for visual impairment screening in school children, and found it to substantially improve the uptake of services (Lancet Global Health 2018a).