About

Sonal S Tuli is a faculty member in the Department of Ophthalmology at the University of Florida College of Medicine. She is involved in providing comprehensive medical and surgical glaucoma care, leading a service dedicated to the diagnosis and management of complex glaucoma conditions, including primary open-angle glaucoma, angle-closure glaucoma, secondary glaucoma, and pediatric glaucoma. Her role includes contributing to resident education within the university and participating in clinical research and the development of new glaucoma therapies. She is part of a collaborative academic environment that emphasizes clinical excellence, surgical innovation, education, and translational research, supporting advanced glaucoma procedures such as trabeculectomy, glaucoma drainage device implantation, minimally invasive glaucoma surgery (MIGS), selective laser trabeculoplasty (SLT), and transscleral cyclophotocoagulation.

Research topics

• Medicine
• Optometry
• Medical physics
• Intensive care medicine
• Microbiology
• Pathology
• Internal medicine
• Virology
• Ophthalmology
• Dermatology

Selected publications

• Association of Low Vitamin D with Infectious and Non-Infectious Inflammatory Ocular Disease

  Ocular Immunology and Inflammation · 2026-03-17

  article

  PURPOSE: To validate the previously established association between vitamin D levels and non-infectious ocular inflammatory diseases and to assess for a potential relationship between vitamin D levels and subtypes of infectious ocular inflammation. METHODS: This retrospective case-control study identified 1468 cases and 490 controls with a measured serum 25-hydroxy vitamin level. Cases included patients diagnosed with infectious or noninfectious ocular inflammation while controls had a normal eye exam. The primary outcome was the odds of ocular inflammatory disease in participants with normal versus low serum vitamin D levels. Separate sub-analyses for vitamin D levels in individual types of infectious inflammation (endophthalmitis, orbital cellulitis, herpetic keratitis, other infectious keratitis, other infectious causes) and noninfectious ocular inflammation were performed. RESULTS: ≤ 0.001). CONCLUSIONS: Low vitamin D is associated with increased risk of infectious and non-infectious ocular inflammation in a retrospective study.

  PublisherDOI

• Distinguishing Factors for Microbial Keratitis Groups: A Cross-Sectional Survey of US Cornea Specialists

  Cornea · 2026-04-17

  article

  PURPOSE: To survey United States (US) cornea specialists on clinical factors that distinguish between microbial keratitis (MK) organism groups. METHODS: This cross-sectional survey of US cornea specialists assessed whether 61 clinical factors, including history factors, ocular symptoms, and exam findings, distinguished a specific organism group in the typical patient with MK. MK organism groups included gram-positive bacterial keratitis (GPBK), gram-negative bacterial keratitis (GNBK), mold fungal keratitis (MFK), yeast fungal keratitis (YFK), parasitic keratitis (PK), and viral keratitis (VK). The survey was distributed via the Cornea Society's email listserv from March 11, 2024 to May 7, 2024. Descriptive statistical analysis was performed to identify the percentage of specialists identifying a clinical factor as distinguishing a specific MK organism group. RESULTS: A total of 67 specialists completed the survey. There were 20 factors (32.8% of 61) that >75% of specialists identified as distinguishing a specific MK group, including 9 factors for BK (eg copious ocular discharge, loose ocular sutures), 3 factors for FK (eg feathery infiltrate, ocular trauma with organic matter), 5 factors for PK (eg pain out of proportion, perineuritis), and 3 factors for VK (eg reduced/absent corneal sensation, prodromal symptoms). The remaining 41 factors had ≤75% of specialists identify them as distinguishing. CONCLUSIONS: Specialists agreed that 32.5% of clinical factors distinguished different MK organism groups, aligned with prior work demonstrating difficulty with interorganism differentiation. These 20 factors may aid clinicians in their initial MK diagnosis; however, more work is needed to validate their salience in diagnosis.

  PublisherDOI

• Dissection of Retinal Detachment from Boston Keratoprosthesis Optic: A Novel Surgical Technique

  American Journal of Ophthalmology · 2025-10-31

  article
  PublisherDOI

• Bacterial and Fungal Keratitis

  Current practices in ophthalmology · 2025-01-01

  book-chapter1st authorCorresponding
  PublisherDOI

• Corneal Amiodarone Deposition and Its Implications for Autologous Serum Eye Drop Therapy: A Case Report

  Cureus · 2025-11-12 · 1 citations

  articleOpen accessSenior author

  Corneal toxicity and deposits can develop from a variety of systemic and topical medications used in ophthalmic and non-ophthalmic care. We report a case of a 69-year-old man with dry eye syndrome on long-term amiodarone therapy who developed bilateral corneal verticillata shortly after initiating autologous serum eye drops (ASEDs). Despite improvement in epithelial healing, the new deposits raised concern for exacerbation of amiodarone-related corneal toxicity, possibly influenced by ASEDs. This case underscores the potential interaction between systemic therapy and ASEDs, highlighting the importance of careful monitoring in patients with ocular surface disease receiving medications known to cause ocular complications.

  PublisherOA PDFDOI

• Evaluation of the Activity of Vogt–Koyanagi–Harada Disease; A Comparison of Indocyanine Green Angiography Scoring, Enhanced Depth Imaging Optical Coherence Tomography, and Choroidal Vascularity Index

  Journal of Current Ophthalmology · 2024-01-01 · 2 citations

  articleOpen access

  Abstract Purpose: To investigate the correlation between choroidal biomarkers using enhanced depth imaging optical coherence tomography (EDI-OCT) and indocyanine green angiography (ICGA) scoring for monitoring the activity of Vogt–Koyanagi–Harada (VKH). Methods: Patients who were not in the acute phase of VKH were recruited. Simultaneous EDI-OCT and ICGA were captured in seven patients only at baseline, in six patients at the 3-month follow-up, and in two patients at both the 6- and 9-month follow-ups. Subfoveal choroidal thickness (SFCT), subfoveal choroidal area (SFCA), and choroidal vascular index (CVI) were measured on EDI-OCT using FIJI software and a denoising system. ICGA scoring was performed. Results: Fifteen subjects with the median of 4-month follow-up were recruited. Forty-eight pairs of EDI-OCT and ICGA were investigated. In univariate analysis, ICGA scores were positively associated with SFCT, and SFCA, but negatively with CVI. The strength of correlation between ICGA scores and SFCT was strong (correlation coefficient: 0.91). In multivariate analysis, only SFCT remained significant (B: 2.4, 95% confidence interval: 1.9–3.0; P < 0.001). Conclusions: SFCT can be an acceptable representative of the subclinical inflammatory activity of VKH. As an alternative to ICGA, SFCT functions better than SFCA and CVI.

  PublisherDOI

• Evaluation of Cyanoacrylate Tissue Adhesive Glue Application Outcomes in Corneal Thinning and Perforation

  Eye & Contact Lens Science & Clinical Practice · 2024-11-07 · 1 citations

  article

  OBJECTIVES: Corneal thinning and perforation are ocular emergencies necessitating urgent intervention to prevent visual impairment or enucleation. Cyanoacrylate tissue adhesive is frequently used to maintain globe integrity in these cases. However, gaps remain in understanding the outcomes of corneal gluing and the factors influencing its efficacy. This case series evaluates the clinical characteristics and outcomes of glue application in corneal thinning and perforation. METHODS: A retrospective chart review was conducted on patients treated for corneal thinning and perforation at the University of Florida between January 2012 and May 2023. Demographic data, clinical history, glue application details, and posttreatment outcomes were collected and analyzed. RESULTS: The study included 128 eyes from 125 subjects. Corneal perforation was found in 71 eyes (55.5%), mostly centrally (49.2%). The leading cause of perforation/thinning was microbial infection (45.3%). The average number of glue applications per eye was 1.66. Within 1 month, 23 patients (18.0%) required only glue reapplication, 37 (28.9%) required surgical intervention (regardless of glue reapplication), and 68 (53.1%) required no further treatment. Factors significantly linked to gluing failure (requiring surgery within 1 month) in univariate analysis included large perforation size, microbial infection, ocular surface disorder, single glue application, and indirect application via sterile drape. Multivariate analysis showed that only large perforation size was significantly associated with gluing failure. CONCLUSION: Corneal glue application is an effective temporizing measure for corneal thinning and perforation, with multiple applications potentially providing added stability to the globe. However, the need for surgical intervention is high.

  PublisherDOI

• Extensively Drug-Resistant <i>Pseudomonas</i> and Eye Drops—Stay Vigilant

  JAMA Ophthalmology · 2024-03-21

  articleSenior author

  Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Ophthalmology HomeNew OnlineCurrent IssueFor Authors Podcast Journals JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Ophthalmology journal

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• Clinical and microbiological characteristics of fungal keratitis in the United States, 20012007: A multicenter study

  UNC Libraries · 2023-07-13

  articleOpen access

  Objective: To study the epidemiology, clinical observations, and microbiologic characteristics of fungal keratitis at tertiary eye care centers in the United States. Design: Retrospective multicenter case series. Participants: Fungal keratitis cases presenting to participating tertiary eye care centers. Methods: Charts were reviewed for all fungal keratitis cases confirmed by culture, histology, or confocal microscopy between January 1, 2001, and December 31, 2007, at 11 tertiary clinical sites in the United States. Main Outcome Measures: Frequency of potential predisposing factors and associations between these factors and fungal species. Results: A total of 733 cases of fungal keratitis were identified. Most cases were confirmed by culture from corneal scraping (n = 693) or biopsies (n = 19); 16 cases were diagnosed by microscopic examination of corneal scraping alone; and 5 cases were diagnosed by confocal microscopy alone. Some 268 of 733 cases (37%) were associated with refractive contact lens wear, 180 of 733 cases (25%) were associated with ocular trauma, and 209 of 733 cases (29%) were associated with ocular surface disease. No predisposing factor was identified in 76 cases (10%). Filamentous fungi were identified in 141 of 180 ocular trauma cases (78%) and in 231 of 268 refractive contact lens-associated cases (86%). Yeast was the causative organism in 111 of 209 cases (53%) associated with ocular surface disease. Yeast accounted for few cases of fungal keratitis associated with refractive contact-lens wear (20 cases), therapeutic contact-lens wear (11 cases), or ocular trauma (21 cases). Surgical intervention was undertaken in 26% of cases and was most frequently performed for fungal keratitis associated with ocular surface disease (44%). Surgical intervention was more likely in cases associated with filamentous fungi (P = 0.03). Among contact lens wearers, delay in diagnosis of 2 or more weeks increased the likelihood of surgery (age-adjusted odds ratio = 2.2; 95% confidence interval, 1.24.2). Conclusions: Trauma, contact lens wear, and ocular surface disease predispose patients to developing fungal keratitis. Filamentous fungi are most frequently the causative organism for fungal keratitis associated with trauma or contact lens wear, whereas yeast is most frequently the causative organism in patients with ocular surface disease. Delay in diagnosis increases the likelihood of surgical intervention for contact lens-associated fungal keratitis. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

  PublisherDOI

• Comparison of the fluorescein angiography-guided and indocyanine green angiography-guided photodynamic therapy in the treatment of non-resolving central serous chorioretinopathy

  Scientific Reports · 2023-01-30 · 9 citations

  articleOpen access

  To compare the functional and anatomical outcome of fluorescein angiography (FA) versus indocyanine green angiography (ICGA) guided photodynamic therapy (PDT) in the treatment of non-resolving central serous chorioretinopathy (CSCR). In this prospective interventional case series, all patients with non-resolving CSCR, defined as persistent SRF involving subfoveal area for at least three months, were nonrandomly assigned to receive either FA or ICGA-guided half dose PDT. Baseline and 4 months post-treatment data including best corrected visual acuity (BCVA), the status of foveal subretinal fluid, subfoveal choroidal thickness, choroidal vascularity index, pigment epithelial detachment area, treatment and PDT spot numbers were collected. Thirty-six eyes were included; 24 received ICGA-guided and 12 received FA-guided PDT. Overall, improvement in BCVA and choroidal parameters were observed in all patients. There was no significant difference in baseline parameters as well as follow-up measurements between groups. However, the mean total energy dose and spot number in the IGCA-guided PDT were significantly higher than the FA-guided PDT group (P = 0.001). Both FA-guided and ICGA-guided half-dose PDT were effective in the treatment of non-resolving CSCR, with favorable functional and anatomical outcome. In FA group, PDT with smaller spot sizes and fewer numbers of spots were applied.

  PublisherOA PDFDOI

Frequent coauthors

• William T. Driebe

  Fundación Juan March

  42 shared

• Robert M. Knape

  University of Miami

  41 shared

• Gregory S. Schultz

  University of Southern California

  36 shared

• Mark B. Sherwood

  27 shared

• Tiffany N. Szymarek

  University of Michigan–Ann Arbor

  25 shared

• Alfred S. Lewin

  University of Florida

  25 shared

• Mary Fran Smith

  25 shared

• Sanjeev Y. Tuli

  21 shared

Education

• M.D.

  Indiana University

  2000

• Other, Cornea and External Diseases

  Bascom Palmer Eye Institute

• M.A., Education

  University of Florida

  2012

Awards & honors

• invited and served as an oral examiner for the American Boar…