The major goals of this proposal are the prevention of blindness and of morbidity associated with inflammatory eye diseases, particularly trachoma and herpes simplex virus (HSV) infections. In the studies of trachoma, we will (1) develop improved techniques for treating it, (2) elucidate the role of Chlamydia trachomatis as an agent of systemic illness, particularly childhood pneumonia, in trachoma endemic areas, (3) evaluate new techniques for the rapid, inexpensive diagnosis of chlamydial infections, (4) attempt to further define the immunological response to C. trachomatis infections in trachoma through the use of specific chlamydial antigens. The hypothesis underlying these studies is that blindness and morbidity associated with endemic trachoma can be prevented, but that will involve new technologies for detection and treatment. While these studies on ocular chlamydial infection will be directed at practical, applied goals, we also will examine at a basic level the pathogenesis of chronic trachoma. By defining the antibody response to specific chlamydial antigens and the patterns of cellular response in the eye, we plan to develop a means to identify cases who are at risk of the blinding complications or who will not respond well to chemotherapy. This knowledge will be needed as a basis for the evaluation of possible subunit trachoma vaccines. The studies on ocular herpes simplex virus infections will focus on improving the management of this condition by the development of a computer based, artificial intelligence model of HSV eye infections that can be used as an expert consultant for management of herpetic eye disease. Continued development of this model will elucidate specific problems in the complex management of the disease. The model will be further extended to include the diagnosis and treatment of bacterial corneal ulcers and other forms of keratitis and uveitis.
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