How did you first become involved in ophthalmology research?

My introduction to ophthalmology research was rather serendipitous. As an MS2, I was appointed the student chief coordinator of my school’s literary committee. Little did I know that one of the committee faculty mentors was an ophthalmologist. Fast forward another year, and during my ophthalmology elective, I was working with that same faculty mentor: Parul Ichhpujani, MS.

At this point in my training, I had only just begun to take an interest in academia, and my experience was limited to a few case reports. During this rotation, I decided to approach Dr. Ichhpujani with research ideas. She knew about my interest in photography from our literary committee endeavors, and we ended up brainstorming ideas to incorporate my photography background into a telemedicine-based research project.

What ensued was a longstanding (and still active) collaboration and a series of manuscripts describing practical applications of smartphone-based photography in postoperative glaucoma patients. One of the first features describing this work was, in fact, published in the BMC publication Glaucoma Today.¹ Looking back, this formative experience was instrumental in shaping my interest in ophthalmology, telemedicine, and academia at large.

What is the focus of your current research?

My current research work involves advanced ophthalmic imaging applications with a focus on diabetic retinopathy and age-related macular degeneration. Some of these applications include quantitative imaging biomarker discovery, AI-based automated disease detection, disease modeling for prediction of progression, and quality improvement protocols for increasing efficiency and yield of clinical trials of novel therapeutic agents in vitreoretinal disease and uveitis.

I have also taken interest in some topics related to ophthalmic education, including an assessment of changes in residents’ pre- and post-match research productivity and the incidence of residual astigmatism in resident cataract surgery cases. Additionally, a big focus of my research has been improving access to quality care using automations and telemedicine applications.

Who is/are your research mentor/mentors?

I consider myself fortunate to have had the opportunity to work with many incredible mentors who have shaped my clinical and research career. In medical school, Dr. Ichhpujani (glaucoma) and Vipin Gupta, MD (neurosurgery), gave me my formative research experiences. During my away rotations in ophthalmology, I collaborated with Evan L. Waxman, MD (comprehensive ophthalmology); Roxana Fu, MD (oculoplastics); Jay Chhablani, MD (retina); Ken Nischal, MD (pediatric ophthalmology); Ian Conner, MD, PhD (glaucoma); and Grayson Armstrong, MD (ophthalmic telemedicine).

After graduating medical school, I completed a short-term project in uveitis and vitreoretinal disease with Vishali Gupta, MD (uveitis and retina); Rupesh Aggarwal, MD (uveitis and retina); and Anniruddha Aggarwal, MD (uveitis and retina). Subsequently, I completed a research fellowship in vitreoretinal disease with Justis P. Ehlers, MD, at the Cleveland Clinic. During my time at the Cleveland Clinic, I also collaborated with Sunil Srivastava, MD (uveitis and retina); Katherine Talcott, MD (retina); and Charles Wykoff, MD (retina) on various research projects.

I am extremely grateful for all these wonderful people in my life with whom I continue to collaborate and engage.

How do you typically find a research opportunity or identify a project you would like to pursue?

I strongly believe that collaboration precedes quality research. Looking for a research opportunity can be daunting, but only if you try to do it alone. Collaborating with mentors and colleagues can open doors that you might not have known existed. Many research opportunities that I was presented with spanned multiple continents and institutions—something that I would not have been able to comprehend 4 years ago.

For specific ideas or research projects that I want to initiate, I usually prepare a proposal for one of my mentors that includes an outline of the methods along with a brief review of literature showcasing the importance/impact of the proposed project. Based on personal interest and the viability of the idea, my mentor can then advise whether it is worth pursuing. With time, you will start to develop an understanding of where the current research space is and where it is heading. Then, it becomes easier to get projects off the ground.

What do you look for in a research partner, either on the physician or industry side?

Communication, integrity, and motivation are three priorities for me. It may sound cliché; however, these go a longer way than sheer talent or skill. You may be the best analyst or medical writer; however, if you aren’t effective at communicating and closing the loop, it falls short. Also, even if you are highly skilled and have brilliant ideas, if you are not self-motivated, you will have a hard time seeing projects through. Finally, if you aren’t true to your word and fail to keep professional integrity, your words will lose all value. These three soft skills are surely some of the key traits that I look for in a research partner.

What areas of research excite you most about the future of ophthalmology?

As we continue to generate and assess large amounts of data for various diseases, there are several exciting prospects in ophthalmology that have grasped my attention. Disease modeling and progression prediction is one of these prospects that I am excited about. This will likely guide clinical trial enrollment and significantly improve yields in the near future, in addition to allowing for a much more robust prognostication specific to each patient. Another exciting avenue is the continued innovation in therapeutics, including a motivated industry leadership that is continuously tackling diseases that we did not have treatments for in the past (eg, Apellis and IvericBio in the dry AMD space). Finally, I am excited for advances in presbyopia correction, MIGS, subretinal implants, suprachoroidal interventions, and gene therapy. These areas are very exciting for the future of this field.

What are your overall research goals?

With advanced quantitative biomarkers and big data, we are close to achieving the precision medicine that has been promised in recent years. Some of my current and ongoing research work focuses on predictive biomarkers and phenotype modeling algorithms that can help us achieve patient-specific treatment and prognostication guidelines. Additionally, by using the advantages of such automations, telemedicine applications could allow significant improvements in access to advanced care in rural areas.

What advice would you give to other aspiring or young ophthalmologists looking to conduct research?

For aspiring and young ophthalmologists who are new to research, below is a set of dos and don’ts that may help provide a solid start in these endeavors.

Dos

• Do maintain consistent communication with your team. If there are delays in the project, staying in touch can ease tension on either side. If progress is made, share updates on a regular basis to keep everyone on the same page.
• Do set timelines. For most projects, it is helpful to set up a timeline together with your mentor, including target dates for the first draft, revisions, submission for publication, etc.
• Do be proactive. If a topic interests you, ask to participate in or lead a project. If there is a meeting at which you would like to present, reach out to your mentor to discuss ideas for potential submissions. It is often helpful to know the submission deadlines for annual meetings for the entire year and plan proactively for the meetings to which you would like to submit. Typically, timing is key.
• Do preserve integrity. Keep your word. Always maintain a loop of transparent communication with your mentors.
• Do maintain relationships. If there is a mentor with whom you have not communicated in some time, put in the effort to maintain your relationship with them. If you do it right, these awesome people will end up becoming your work family and friends.

Don’ts

• Don’t be afraid to dabble in different areas of research. First projects can give you good hands-on research experience in general, and most principles you learn during this time can be applied to other areas of research. In other words, don’t worry if your initial projects focus on glaucoma versus retina, especially if you do not yet know what you like the most.
• Don’t spread yourself too thin. Know what you are capable of handling and only take on commitments that you can see through.
• Don’t shy away from introducing yourself to your heroes. Almost always, they will be receptive. Ophthalmology is an awesome field! I once sent a direct message on social media to the current director of the National Eye Institute, and he responded. It is always worth a shot.

1. Kalra G, Ichhpujani P. Smartphone-based ocular photography. Glaucoma Today. November/December 2019. https://glaucomatoday.com/articles/2019-nov-dec/smartphone-based-ocular-photography