Matthew BurtonReader in International Eye Health at the London School of Hygiene & Tropical Medicine and Honorary Consultant Ophthalmologist at Moorfields Eye Hospital, LondonSenior Research Fellowships in Clinical Science
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Getting Wellcome Trust funding
What attracted you to Wellcome and to this scheme?
The Trust has funded me through most of my research career. Its long-standing commitment to tropical medicine makes it a natural choice for people interested in international health. I’m interested in addressing complex biological questions but also want to improve people’s health. I think this aligns with the Trust’s own goals. And the Trust’s attention to the long-term career development pathway of clinically qualified researchers was also important to me.
What aspects of the Senior Research Fellowship funding are most useful to you?
The fellowship gives me the stability, level and duration of funding to develop a major research programme that can make a real difference in international health. It also allows me to combine research with some limited clinical practice.
The salary provision can be critical if you’re still developing your academic career. Many institutions struggle to support clinical academics below professor level. My intermediate-level fellowship enabled me to establish research groups in Tanzania and Ethiopia, which remain the base of much of our current research. The fellowship was flexible enough to enable me to complete my specialist training in ophthalmology and tailor my training to my research interests. This was incredibly helpful. It also provided support for me to study on the Diploma in Tropical Medicine & Hygiene course, which gave me a broader perspective on key issues in international health.
I’ve also had the freedom to play a lead role in the Commonwealth Eye Health Consortium. This is a major initiative funded by the Queen Elizabeth Diamond Jubilee Trust to develop people, knowledge and tools for eye health in low-income and middle-income countries.
We’re helping to:
- train ophthalmologists in different sub-specialties
- develop an eye health research network with multiple PhD and postdoctoral fellows
- support new screening and treatment programmes for diabetic retinopathy in sub-Saharan Africa.
We’re also developing smartphone-based approaches to test visual function and examine eyes.
What do you think of the application process?
I found it clear and well-structured, albeit rather lengthy. I hear it now has a much stronger focus on communicating your research vision, in a relatively short application form. The interview was very important and tough.
How challenging have you found it to secure funding?
I’ve been fortunate that all my major grant applications have been successful. But it’s a tough environment and you have to be prepared to put in a lot of effort into prepare.
What advice would you give to other applicants?
Plan ahead: you need to be thinking about your next grant application early in the life cycle of your current one. Published outputs make a big difference to the likely success of your application. If you can, map out a series of possible published outputs and try to develop some these early in your funding cycle. It means you’ll have things to include in your application even if you haven't completed all your studies and analysed all your data.
For the application itself, make sure you get plenty of input into your proposal – not just from close colleagues but also people from other fields. You need to check that the vision and importance of your proposed work comes across clearly, even to people unfamiliar with your particular area.
And it’s probably impossible to do too much interview practice.
- 2013–present Wellcome Trust Senior Research Fellowship in Clinical Science, London School of Hygiene and Tropical Medicine
- 2008–13 Wellcome Trust Research Career Development Fellowship in Clinical Tropical Medicine, London School of Hygiene and Tropical Medicine
- 2004–08 Registrar, higher specialist training in ophthalmology, Moorfields Eye Hospital
- 2001–04 Clinical Research Fellowship, leading to PhD, funded through programme grant from Wellcome Trust/Burroughs–Wellcome Fund, London School of Hygiene and Tropical Medicine
- 1998–2000 Basic specialist training in ophthalmology, Oxford Eye Hospital
- 1996–98 Basic specialist training in adult medicine, Oxford
What have been the defining moments in your career so far?
When I was a medical student, I helped out on a cataract survey project in northern Pakistan during a long vacation. It was a fantastic opportunity and set me on the course I have followed ever since.
The continuity of funding I’ve had from Wellcome has enabled me to combine my clinical training with developing an extensive research programme in the UK and Africa. We’ve been able to establish programmes in Africa that are making a real contribution to research capacity building and are having a positive impact on people’s health.
My wife’s a paediatrician and has been incredibly gracious in following me around the world. She carried out voluntary work in Africa and was able to do her own research leading to an MD. She’s now a consultant in Cambridge, so has also been able to develop her own career. Our children lived in Tanzania for a while, which I’m sure benefited them. It’s been a very positive experience at a personal and family level.
Research and public engagement
What’s the key question you’re addressing?
Trachoma, infection with Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. But we don't understand how. One aim is to try to understand this disease process, so we can develop better interventions. A second aim is to test innovations in treatment. Current methods are OK, but there’s room for improvement.
How are you going about answering this question?
In Ethiopia, we’ve been running a series of clinical trials to test new treatment approaches1,2,3. These have generated much useful information. For example, we showed that absorbable sutures worked fine, and were are more convenient as patients don’t need to be traced later to have stitches removed2. They’re now routinely used in many countries.
Our most recent study, funded by Wellcome, has identified which operation has the best outcome for treating trichiasis, and is anticipated to lead to a shift in practice in trachoma endemic countries.
In Tanzania, we’re following a cohort of children, looking at their infections and immune responses, to see how these relate to disease progression.
- Rajak SN et al. Surgery versus epilation for the treatment of minor trichiasis in Ethiopia: a randomised controlled non-inferiority trial. PLoS Med 2011; 8(12): e1001136
- Rajak SN et al. Absorbable versus silk sutures for surgical treatment of trachomatous trichiasis in Ethiopia: A randomised controlled trial. PLoS Med 2011; 8(12): e1001137
- Habtamu E et al. Posterior lamellar versus bilamellar tarsal rotation surgery for trachomatous trichiasis in Ethiopia: a randomized controlled trial. Lancet Global Health 2016
- Burton MJ et al. Pathogenesis of Progressive Scarring Trachoma in Ethiopia and Tanzania and its Implications for Disease Control: Two Cohort Studies. PLOS Negl Trop Dis 2015; 13;9(5):e0003763
- Burton MJ et al. Re-emergence of Chlamydia trachomatis infection after mass antibiotic treatment of a trachoma endemic Gambian community. Lancet 2005; 365: 1321-28
Find out more about Matthew's work on the London School of Hygiene and Tropical Medicine website.