Cornea
Summer 2025
by Julie Schallhorn, MD
Cornea Editor
This issue’s articles focus on medical treatment of common conditions—dry eye, neurotrophic keratitis, and zoster. Two of the articles highlight the amazing new treatments that our innovative industry continues to develop. The pipelines for dry eye and neurotrophic keratitis are strong, and soon our patients will be seeing the benefits of our robust drug industry. One of these articles is not like the other, however. The Zoster Eye Disease Study (ZEDS) focuses on valacyclovir, a therapeutic that is neither new nor particularly innovative. Rather, it examines a well-described drug in a novel circumstance—to prevent recurrence of zoster keratitis and neuropathic eye pain. This is not the only difference among this month’s articles. The other, unacknowledged difference is the source of funding for these studies. New drugs and devices benefit from the funding in our markets to drive innovations from concept into profitable products. This has manifest benefits that one only needs to glance at our pipeline to realize. Older drugs and therapeutics, as well as studies on interventions that don’t include either, do not have the benefit of market-driven funding. Instead, these rely upon funding from our institutional and philanthropic sources. In the U.S., this is driven primarily by the National Eye Institute at the National Institutes of Health.
As ophthalmologists and physicians, we need to ensure that the institutional funding mechanism continues to exist in its ability to provide life-changing research for our patients.
The current climate for institutional funding is fraught. Plans are in the works for elimination of the National Eye Institute, with lumping of vision research into a new entity combined with brain and neurology research.1 This would come with a dramatic cut overall to the National Institutes of Health budget. This is independent of the proposed cuts to indirect costs, which have received so much publicity in the news. The Department of Defense, traditionally a strong funding source for vision research, had its Vision Research Program entirely eliminated.1
Anyone who has had a patient who lost vision due to zoster keratitis or with post-herpetic neuralgia in the V1 distribution knows the pain and the agony that these patients experience. The Zoster Eye Disease Study demonstrated that an inexpensive, well-tolerated, and nearly universally available treatment is effective and safe in helping to prevent these sequelae. The innovations that our field produces come in all areas—from wonderful new drugs and devices to shifts in how we deliver care using existing resources. Both are critical for our patients, but only one of these is funded by market-driven mechanism. As ophthalmologists and physicians, we need to ensure that the institutional funding mechanism continues to exist in its ability to provide life-changing research for our patients.
