About

Dr. Michael Earley is a Clinical Professor of Practice at The Ohio State University College of Optometry. He graduated from Northwestern University in 1983 with a BA in Biology, emphasizing Anatomy and Physiology. He entered The Ohio State University College of Optometry in 1984 through a dual degree program, earning his OD and MS in Physiological Optics in 1988, graduating Summa cum Laude and receiving the Beta Sigma Kappa silver medal. Continuing his research in the laboratory of Dr. P.E. King-Smith, he obtained his PhD in Physiological Optics in 1992, with a dissertation focused on acquired visual losses associated with amblyopia. Dr. Earley has been recognized for his teaching excellence, receiving the Alumni Award for Distinguished Teaching in 1998 and being inducted into the Academy of Teaching. He currently teaches courses in anatomy, histology, and ocular anatomy. His clinical leadership includes serving as chief of the Binocular Vision and Pediatric Services and chairing the Admissions committee. His research activities involve active participation in multiple multicentered studies related to binocular vision, amblyopia, and visual deficits in children, including the Convergence Insufficiency Treatment Trial (CITT), Amblyopia Treatment Study (ATS), and Vision in Preschooler (VIP). His work also encompasses interdisciplinary research on sensory processing in reading evaluation, contributing to the understanding of visual deficits and their impact on reading and learning.

Research topics

• Biology
• Microbiology
• Medicine
• Geography
• Genetics

Selected publications

• Poor outcomes in both infection and colonization with carbapenem-resistant Enterobacterales

  Carolina Digital Repository (University of North Carolina at Chapel Hill) · 2024

  • Microbiology
  • Medicine
  • Biology

  Objectives: To describe the epidemiology of patients with nonintestinal carbapenem-resistant Enterobacterales (CRE) colonization and to compare clinical outcomes of these patients to those with CRE infection. Design: A secondary analysis of Consortium on Resistance Against Carbapenems in Klebsiella and other Enterobacteriaceae 2 (CRACKLE-2), a prospective observational cohort. Setting: A total of 49 US short-term acute-care hospitals. Patients: Patients hospitalized with CRE isolated from clinical cultures, April, 30, 2016, through August 31, 2017. Methods: We described characteristics of patients in CRACKLE-2 with nonintestinal CRE colonization and assessed the impact of site of colonization on clinical outcomes. We then compared outcomes of patients defined as having nonintestinal CRE colonization to all those defined as having infection. The primary outcome was a desirability of outcome ranking (DOOR) at 30 days. Secondary outcomes were 30-day mortality and 90-day readmission. Results: Of 547 patients with nonintestinal CRE colonization, 275 (50%) were from the urinary tract, 201 (37%) were from the respiratory tract, and 71 (13%) were from a wound. Patients with urinary tract colonization were more likely to have a more desirable clinical outcome at 30 days than those with respiratory tract colonization, with a DOOR probability of better outcome of 61% (95% confidence interval [CI], 53%-71%). When compared to 255 patients with CRE infection, patients with CRE colonization had a similar overall clinical outcome, as well as 30-day mortality and 90-day readmission rates when analyzed in aggregate or by culture site. Sensitivity analyses demonstrated similar results using different definitions of infection. Conclusions: Patients with nonintestinal CRE colonization had outcomes similar to those with CRE infection. Clinical outcomes may be influenced more by culture site than classification as "colonized"or "infected."

  PublisherDOI

• Colistin Versus Ceftazidime-Avibactam in the Treatment of Infections Due to Carbapenem-Resistant Enterobacteriaceae

  UNC Libraries · 2024-01-09

  articleOpen access

  Background The efficacy of ceftazidime-Avibactam-a cephalosporin-β-lactamase inhibitor combination with in vitro activity against Klebsiella pneumoniae carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CRE)-compared with colistin remains unknown. Methods Patients initially treated with either ceftazidime-Avibactam or colistin for CRE infections were selected from the Consortium on Resistance Against Carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE), a prospective, multicenter, observational study. Efficacy, safety, and benefit-risk analyses were performed using intent-To-Treat analyses with partial credit and the desirability of outcome ranking approaches. The ordinal efficacy outcome was based on disposition at day 30 after starting treatment (home vs not home but not observed to die in the hospital vs hospital death). All analyses were adjusted for confounding using inverse probability of treatment weighting (IPTW). Results Thirty-eight patients were treated first with ceftazidime-Avibactam and 99 with colistin. Most patients received additional anti-CRE agents as part of their treatment. Bloodstream (n = 63; 46%) and respiratory (n = 30; 22%) infections were most common. In patients treated with ceftazidime-Avibactam versus colistin, IPTW-Adjusted all-cause hospital mortality 30 days after starting treatment was 9% versus 32%, respectively (difference, 23%; 95% bootstrap confidence interval, 9%-35%; P =.001). In an analysis of disposition at 30 days, patients treated with ceftazidime-Avibactam, compared with those treated within colistin, had an IPTW-Adjusted probability of a better outcome of 64% (95% confidence interval, 57%-71%). Partial credit analyses indicated uniform superiority of ceftazidime-Avibactam to colistin. Conclusions Ceftazidime-Avibactam may be a reasonable alternative to colistin in the treatment of K. pneumoniae carbapenemase-producing CRE infections. These findings require confirmation in a randomized controlled trial.

  PublisherDOI

• Characteristics of community-Acquired carbapenem-resistant Enterobacterales

  Carolina Digital Repository (University of North Carolina at Chapel Hill) · 2024

  • Geography
  • Biology
  • Microbiology

  Background: Community-Acquired carbapenem-resistant Enterobacterales (CA-CRE) are an important threat. Methods: In CRACKLE-2, we defined patients with CA-CRE as admitted from home, without pre-existing conditions, and a positive culture within 48 h of admission. Healthcare-Associated CRE (HA-CRE) were those with the lowest likelihood of community acquisition, not admitted from home and cultured >48 h after admission. Specific genetic markers in carbapenemase-producing Klebsiella pneumoniae were evaluated through random forest modelling. Results: CA-CRE and HA-CRE were detected in 83 (10%) and 208 (26%) of 807 patients. No significant differences were observed in bacterial species or strain type distribution. K. pneumoniae (204/291, 70%) was the most common CRE species, of these 184/204 (90%) were carbapenemase producers (CPKP). The top three genetic markers in random forest models were kpi_SA15, fimE, and kpfC. Of these, kpi_SA15 (which encodes a chaperone/usher system) was positively associated (OR 3.14, 95% CI 1.13-8.87, P = 0.026), and kpfC negatively associated (OR 0.21, 95% CI 0.05-0.72, P = 0.015) with CA-CPKP. Conclusions: Ten percent of CDC-defined CRE were CA. The true proportion of CA-CRE in hospitalized patients is likely lower as patients may have had unrecorded prior healthcare exposure. The kpi_SA15 operon was associated with the CA phenotype.

  PublisherDOI

• Accessory Genomes Drive Independent Spread of Carbapenem- Resistant Klebsiella pneumoniae Clonal Groups 258 and 307 in Houston, TX

  Carolina Digital Repository (University of North Carolina at Chapel Hill) · 2024

  • Microbiology
  • Biology
  • Genetics

  Carbapenem-resistant Klebsiella pneumoniae (CRKp) is an urgent public health threat. Worldwide dissemination of CRKp has been largely attributed to clonal group (CG) 258. However, recent evidence indicates the global emergence of a CRKp CG307 lineage. Houston, TX, is the first large city in the United States with detected cocirculation of both CRKp CG307 and CG258. We sought to characterize the genomic and clinical factors contributing to the parallel endemic spread of CG258 and CG307. CRKp isolates were collected as part of the prospective, Consortium on Resistance against Carbapenems in Klebsiella and other Enterobacterales 2 (CRACKLE-2) study. Hybrid short-read and long-read genome assemblies were generated from 119 CRKp isolates (95 originated from Houston hospitals). A comprehensive characterization of phylogenies, gene transfer, and plasmid content with pan-genome analysis was performed on all CRKp isolates. Plasmid mating experiments were performed with CG307 and CG258 isolates of interest. Dissection of the accessory genomes suggested independent evolution and limited horizontal gene transfer between CG307 and CG258 lineages. CG307 contained a diverse repertoire of mobile genetic elements, which were shared with other non-CG258 K. pneumoniae isolates. Three unique clades of Houston CG307 isolates clustered distinctly from other global CG307 isolates, indicating potential selective adaptation of particular CG307 lineages to their respective geographical niches. CG307 strains were often isolated from the urine of hospitalized patients, likely serving as important reservoirs for genes encoding carbapenemases and extendedspectrum b-lactamases. Our findings suggest parallel cocirculation of high-risk lineages with potentially divergent evolution.

  PublisherDOI

• Observer‐perceived light aversion behaviour in photophobic subjects with traumatic brain injury

  Clinical and Experimental Optometry · 2019-05-01 · 6 citations

  article

  BACKGROUND: Photophobia is a common sequela of traumatic brain injury (TBI). Diagnostic tools for this debilitating condition are lacking. This investigation sought to determine whether masked observers can distinguish subjects with TBI-associated photophobia from matched controls based on video recordings of their ocular responses to light stimulation. METHODS: ), flashing (0.10 Hz) red (625 nm) and blue (470 nm) light stimuli to subjects, and consensual pupil light responses were recorded. Using a five-point scale, masked observers later graded light aversion behaviour in the pupil video recordings obtained from the student cohort based on observed blinking, tearing and squinting. A grading scale was developed and used by masked observers to grade light aversion behaviour in videos obtained from subjects with post-TBI photophobia and the matched controls. These subjects also scored their perceived discomfort during each light pulse using a five-point scale. RESULTS: The subjects in the TBI cohort scored both the blue and red flashing stimuli as evoking more discomfort, relative to control subjects, consistent with their reported photophobia. There was strong agreement among the masked observers for their grades of light aversion behaviour in the videos of ocular light stimulation (interclass correlation co-efficient = 0.78; 29 per cent perfect concordance). However, the median grades for the videos obtained from the TBI subject cohort were not significantly different from those for the control group. CONCLUSIONS: Clinicians cannot diagnose TBI-related photophobia based solely on video recordings of ocular responses to light. The need remains for an objective test to diagnose and manage this prevalent post-TBI symptom.

  PublisherDOI

• The Woman Who Cooked her Husband

  2016-04-15

  article1st authorCorresponding
  PublisherDOI

• Altered Adaptation of the Pupillary Light Reflex and Sleep Irregularity in Photophobic Individuals with TBI

  2016-09-26 · 1 citations

  article

• Blue and Red Light‐Evoked Pupil Responses in Photophobic Subjects with TBI

  Optometry and Vision Science · 2016-07-27 · 22 citations

  article

  PURPOSE: Photophobia is a common symptom in individuals suffering from traumatic brain injury (TBI). Recent evidence has implicated blue light-sensitive intrinsically photosensitive retinal ganglion cells (ipRGCs) in contributing to the neural circuitry mediating photophobia in migraine sufferers. The goal of this work is to test the hypothesis that ipRGC function is altered in TBI patients with photophobia by assessing pupillary responses to blue and red light. METHODS: Twenty-four case participants (mean age 43.3; 58% female), with mild TBI and self-reported photophobia, and 12 control participants (mean age 42.6; 58% female) were in this study. After 10 minutes of dark adaptation, blue (470 nm, 1 × 10 phots/s/cm) and red (625 nm, 7 × 10 phots/s/cm) flashing (0.1 Hz) light stimuli were delivered for 30 seconds to the dilated left eye while the right pupil was recorded. The amplitude of normalized pupil fluctuation (constriction and dilation) was quantified using Fourier fast transforms. RESULTS: In both case and control participants, the amplitude of pupil fluctuation was significantly less for the blue light stimuli as compared to the red light stimuli, consistent with a contribution of ipRGCs to these pupil responses. There was no significant difference in the mean pupil fluctuation amplitudes between the two participant groups, but case participants displayed greater variability in their pupil responses to the blue stimulus. CONCLUSIONS: Case and control participants showed robust ipRGC-mediated components in their pupil responses to blue light. The results did not support the hypothesis that ipRGCs are "hypersensitive" to light in TBI participants with photophobia. However, greater pupil response variability in the case subjects suggests that ipRGC function may be more heterogeneous in this group.

  PublisherDOI

• Blue and red light-evoked pupil responses in photophobic individuals with traumatic brain injury

  2015-06-11

  articleSenior author

• The Hand in Art: Mountmellick Embroidery Work of the Areas Reached by the First Dorsal Metacarpal Artery Flap

  The Journal Of Hand Surgery · 2014-02-21

  articleSenior author
  PublisherDOI

Frequent coauthors

• S. Jamil-Copley

  St Bartholomew's Hospital

  75 shared

• Ralph Schilling

  Charité - Universitätsmedizin Berlin

  51 shared

• I. G. Diab

  Tishreen University

  51 shared

• S. Sporton

  50 shared

• Nick Linton

  Imperial College London

  50 shared

• M. Dhinoja

  King's College London

  50 shared

• Vijay Sawhney

  Government Medical College

  50 shared

• Zachary I. Whinnett

  Hammersmith Hospital

  45 shared

Labs

• Research | College of OptometryPI

Awards & honors

• Beta Sigma Kappa silver medal
• Ezell Fellowship from the American Optometric Foundation
• Auxiliary Fellowship from the American Optometric Associatio…
• Alumni Award for Distinguished Teaching by The Ohio State Un…
• Induction into the Academy of Teaching (1998)