He has been active since 1984 in computer vision, and since 2002 in medical image analysis, publishing more than 250 refereed papers and 2 textbooks, and serving on the organizing or program committee of the major international and UK conferences, an international research initiative led by the Universities of Dundee and Edinburgh (co-director Dr Tom MacGillivray), member of the UK Biobank Eye and Vision Consortium. VAMPIRE develops software tools for efficient data and image analysis with a focus on multi-modal retinal images. VAMPIRE has been used in UK and international biomarker studies on cardiovascular risk, stroke, dementia, diabetes and complications, cognitive performance, neurodegenerative diseases, and genetics. Industrial collaborators include Canon Medical, OPTOS plc, NIDEK, and Epipole plc; institutional collaborations include the College of Optometrists, the Royal College of Ophthalmologists, and the Royal College of Veterinaries. Recent VAMPIRE projects led or co-led by Manuel includes a £7M NIHR grant Dundee-Chennai on precision medicine for diabetes (PI Prof C Palmer), a £1.1M EPSRC grant on multi-modal biomarkers for vascular dementia (PI E Trucco), the 3M-Euro ITN "REVAMMAD" (PI Prof A Hunter, Lincoln), and PhD studentships sponsored by OPTOS plc, NIDEK Technologies, SINAPSE and Toshiba.