The microbiome and ophthalmic disease

Progress in microbiome research has accelerated in recent years. Through the use of 16S rRNA assays and other genomic sequencing techniques, researchers have provided new insights about the communities of microorganisms that inhabit human and animal hosts. There is mounting evidence about the importance of these ‘microbiotas’ in a wide variety of disease states, suggesting potential targets for preventative and therapeutic interventions. Until recently, however, the microbiome received relatively little attention in ophthalmology. This review explores emerging research on the roles that ocular and extraocular microbiotas may play in the pathogenesis and treatment of ophthalmic diseases. These include diseases of the ocular surface as well as autoimmune uveitis, age-related macular degeneration, and primary open angle glaucoma. Many questions remain about the potential impacts of microbiome research on the diagnosis, treatment, and prevention of ophthalmic disease. In light of current findings, we suggest directions for future study as this exciting area of research continues to expand. Impact statement This review describes a growing body of research on relationships between the microbiome and eye disease. Several groups have investigated the microbiota of the ocular surface; dysregulation of this delicate ecosystem has been associated with a variety of pro-inflammatory states. Other research has explored the effects of the gastrointestinal microbiota on ophthalmic diseases. Characterizing the ways these microbiotas influence ophthalmic homeostasis and pathogenesis may lead to research on new techniques for managing ophthalmic disease.