Spring 2014
THE TUFTS EYE ALUMNI ASSOCIATION
newsletter
p. 5 ~ welcoming the
volume 5 number 1
2014 New England Eye Center Graduation, June 13
This year’s NEEC resident and fellow commencement is Friday, June 13,
2014. Resident and fellow research presentations will begin at 12:30 pm.
more beginning on page 2
Inaugural Moshe Lahav, MD, Lecture
class of ’13 to TEAA
The family of the late, beloved Tufts University ophthalmic pathologist and
retinal surgeon Moshe Lahav has generously funded a new lectureship for
the annual graduation program. Eli Peli, OD, has been chosen to speak.
continued on page 2
Resident class of 2013
below, l to r
W. Morton Grant Lecture
Michelle Liang, MD
Kavita Bhavsar, MD
Laurel Vuong, MD
Steven Williams, MD
The 2014 W. Morton Grant Lecturer is Gullapalli N. Rao, MD. Dr. Rao
is the Distinguished Chair of Eye Health, L V Prasad Eye Institute, India.
continued on page 3
Alumni are cordially invited to
attend the New England Eye
Center graduation June 13, 2014
(right)
Michael Cooper,
MD, PhD, (center)
recipient of the
2013 Residents’
Award for Teaching
Excellence
1
2014 Resident and Fellow Graduation: June 13
Dr. Peli to deliver the first Lahav Lecture continued from p 1
“Dr. Lahav was a committed physician and scientist who was also blessed with a human touch; his
patients and colleagues loved him and he helped many people during the course of his life. The Lahav
family hopes the lecture fund will contribute to the advancement of knowledge in the field of
ophthalmology with a focus on the role of pathology, while recognizing the human
impact of medicine.”
The Lahav lecturer will be someone who embodies the personal attributes that Dr.
Lahav projected as a physician, teacher and researcher here at Tufts. We are delighted
to announce that the first lecturer will be Dr. Eli Peli, MSc, OD.
Dr. Peli has been caring for visually impaired patients as the Director of the Vision
Rehabilitation Service at Tufts Medical Center since 1983. He earned a BSc in
Electrical Engineering and a MSc in Biomedical Engineering from the Technion Israel
Institute of Technology. He then came to Boston where he received his OD degree
from the New England College of Optometry. He is Adjunct Professor of
Ophthalmology at Tufts University School of Medicine. Dr. Peli is also the Moakley Scholar in Aging Eye
Research at Schepens Eye Research Institute, and Professor of Ophthalmology at Harvard Medical School.
Dr. Peli will lecture on “Driving with Low Vision.”
In memory of Moshe Lahav, MD
Moshe Lahav, MD, died in 1998, having long
battled pulmonary disease which never diminished
his productivity or love of life. A specialist in
vitreoretinal diseases and an ophthalmic pathologist,
Dr. Lahav directed the diagnostic and experimental
pathology laboratory at New England Eye Center
for 17 years.
Moshe Lahav was born in Tel Aviv, Israel, on
November 10, 1939. In 1966, upon graduating
medical school at Hebrew University, he received
the Tabori Prize for Ophthalmology. This inspired
him to pursue his studies in ophthalmology,
ultimately traveling to the United States for
residency and fellowship at Yale University. He
became Chief Resident at Yale in 1972. He was a
fellow in ophthalmic pathology at the Armed Forces
Institute of Pathology, and he joined the Yale faculty
in 1974. That same year he returned to Israel where
he worked as a Senior Physician and the director of
the Diagnostic and Experimental Eye Pathology
Laboratory at the Hadassah Medical Center in
Jerusalem.
He returned to the United States in 1979, invited
to establish the eye pathology laboratory at the
Massachusetts Eye and Ear Infirmary. In 1981, he
joined the department of
ophthalmology at the Tufts
University School of
Medicine and became chief
of ophthalmology at the
Boston Veterans
Administration Medical Center. He was appointed
Professor of Ophthalmology at Tufts University
School of Medicine in 1988. Thereafter he served
as an ophthalmologist and director of the retina
service at New England Medical Center and chief of
ophthalmology at the Boston Veterans
Administration Medical Center.
A prolific contributor to the ophthalmic
literature, Dr. Lahav’s early research concerned eye
pathology. Case reports and series of important
diseases provided significant insights relating clinical
findings with pathology. One interesting project
involved the use of methoxyflurane, an anesthetic.
Clinicians noticed white dots in the eyes of patients
who had undergone surgery. Dr. Lahav’s research
established that these white dots were oxylate
crystals formed by the breakdown of the anesthetic.
As a result of this work, use of this anesthetic was
discontinued.
2
Dr. Lahav was a distinguished surgeon. In a
number of later articles he reported techniques
developed for improving retinal surgery, as well as a
model of retinal degeneration in vitro. He
anticipated by a decade the local delivery of steroids
to the eye for neovascular disease of the retina and
choroid. Among his numerous research
publications in the 1980s and 1990s in well regarded
ophthalmology journals, a case record published in
the prestigious New England Journal of Medicine
stands out as a particular achievement.
Moshe loved travel, music, dance, and hosting
parties. His annual Halloween events are legendary.
In addition, he was a talented artist who loved to
paint and draw.
Dr. Lahav is remembered as a creative
researcher, a gifted pathologist, an excellent clinician
whose patients hold in the highest regard to this day,
and the compassionate and enthusiastic teacher of
scores of ophthalmology residents at Yale and Tufts.
His kindness and generosity, sense of humor and
courage touched patients, staff and colleagues.
W. Morton Grant Lecturer will be Gullapalli N. Rao, MD
Continued from page 1
Dr. Rao is Chairman, Hyderabad Eye Institute,
India, and Founder of the L.V. Prasad Eye
Institute. Dr. Rao received his basic
medical education in Guntur, Andhra
Pradesh, and completed his
postgraduate training in
ophthalmology at the All India
Institute for Medical Sciences, New
Delhi. He came to the United States
in 1974, where he was trained first at
Tufts University School of Medicine
in Boston, and later at the University of Rochester
School of Medicine, where he served on the faculty
until 1986. He then returned to India to establish
the well-known L V Prasad Eye Institute. The
Institute is considered to be among the top eye
institutes in the world and is renowned for its
innovative models of eye care delivery. His areas of
specialization include diseases of the cornea, eye
banking and corneal transplantation, community eye
health, eye care policy and planning. He
has published over 250 papers in national
and international journals, and has
contributed several book chapters. From
2004-2008, he served as President and
CEO of the International Agency for the
Prevention of Blindness, in which role he
led VISION 2020: The Right to Sight,
the global initiative to eliminate avoidable
blindness by the year 2020. He is currently Chair of
the International Centre for Eye Care Education
(ICEE) and continues to be actively involved in
global and national advocacy for eye care
development. Dr. Rao will lecture on “Global
Blindness: Eye Care in the Neglected
Communities.”
Dr. Seddon publishes important new findings in Nature Genetics
Director of the Tufts MC Ophthalmic Epidemiology and Genetics Service Johanna M.
Seddon, MD, ScM, fel ’77, res ’80 and her research team recently published “Rare
variants in CFI, C3 and C9 are associated with high risk of advanced age-related
macular degeneration” in Nature Genetics, November 2013 volume 45 number 11.
The authors sequenced the exons of 681 genes within all reported AMD loci and
related pathways in 2,493 cases and controls to define the role of rare variants in
advanced age-related macular degeneration (AMD) risk. Testing each gene for
increased or decreased burden of rare variants in cases compared to controls revealed
that 7.8% of AMD cases compared to 2.3% of controls are carriers of rare missense
CFI variants (odds ratio (OR) = 3.6; P = 2 × 10−8) with a predominance of dysfunctional variants in cases
3
compared to controls. Individual variants tested for association with disease demonstrated significant
association with rare missense alleles in genes other than CFI. Genotyping in 5,115 independent samples
confirmed associations with AMD of an allele in C3 encoding p.Lys155Gln (replication P = 3.5 × 10−5, OR
= 2.8; joint P = 5.2 × 10−9, OR = 3.8) and an allele in C9 encoding p.Pro167Ser (replication P = 2.4 × 10−5,
OR = 2.2; joint P = 6.5 × 10−7, OR = 2.2). Finally, the authors show that the allele of C3 encoding Gln155
results in resistance to proteolytic inactivation by CFH and CFI. These results implicate loss of C3 protein
regulation and excessive alternative complement activation in AMD pathogenesis, informing both the
direction of effect and mechanistic underpinnings of AMD.
To date, Seddon’s team has found half of the known genes related to this common visually threatening
disorder and their pioneering discoveries of modifiable risk factors have changed the management of this
disease worldwide.
Cynthia Mattox, MD, FACS, was elected Vice President/President-elect to the
American Glaucoma Society (AGS), for the 2015-2016 term. AGS has more than 1,000
glaucoma specialists globally from 17 different countries and is dedicated to sharing
clinical and scientific information for the benefit of patients, colleagues, fellows and
residents. Dr. Mattox, previously AGS’s Patient Care Committee Chair, will be the first
female Vice President/President-elect since the society’s inception in 1985.
New attendings will join NEEC on or around September 1, 2014. Alan
Lowinger, MD f ’14 (photo p. 8) is currently a glaucoma fellow in the combined
NEEC/OCB fellowship program. Dr. Lowinger will initially be working in both the glaucoma and
comprehensive ophthalmology services in Boston, as well as in our satellite offices. He completed his
ophthalmology residency at California Pacific Medical Center. Laurel Vuong, MD r’13 (group photo p. 1)
completed her residency at New England Eye Center and fellowship at Emory University. She will join Drs.
Hedges and Athappilly in the neuro-ophthalmology service. Kamden Kopani, MD f’14 (photo p. 8) is
completing a cornea fellowship at New England Eye Center and will join the faculty of the cornea service
here. Sylvia Yoo, MD, completed her eye residency at Jules Stein Eye Institute and a pediatric
ophthalmology fellowship at Johns Hopkins. She will join the NEEC pediatric eye service.
Felipe Tolentino, MD, Has Retired from Ophthalmic Practice
Fel Tolentino is an icon in the retina community. He has practiced retina in the Boston area for nearly 50
years, first with the Schepens Retina Associates and, for the past 11 years, at the New England Eye Center.
Dr. Tolentino’s academic reputation was built on his superlative surgical skills and his ability to take on
some of the most difficult cases. He wrote landmark papers on diabetic vitrectomy and new techniques of
scleral buckling. Beyond his surgical skills, his bedside manner and aplomb under the most difficult
circumstances allowed him to build an international practice. Patients who could fly anywhere for their
retina care flew to Boston to see Fel.
Over the past 20 years, Fel and his wife Flora spent a great deal of their time and money to build a free
standing eye center in the native country of the Philippines. This eye hospital has become one of the most
reputable deliverer of eye care in South Asia. In addition, Fel helped to start a local organization to combat
blindness called Restoring Sight International.
Dr. Tolentino’s dedication to his patients, practice, profession and the international community stands as
an inspiration to us all.
4
THE TUFTS EYE ALUMNI ASSOCIATION
2013 New England Eye Center Graduation
The New England Eye Center Graduation 2013 took place on Friday, June 28, 2013.
Richard L. Abbott, MD, delivered The W. Morton Grant Lecture. Dr. Abbott is the
Thomas W. Boyden Endowed Chair in Ophthalmology at the University of California
San Francisco, Health Sciences Professor, Cornea and External Diseases Service. An
expert in the political economy of ophthalmology, Dr. Abbot presented a timely,
informative contribution to the audience’s understanding of risk management.
Dr. Abbott was graduated from Tufts University with a Bachelor of Science degree
before commencing his medical education and ophthalmology career.
Tufts Alumni Speakers were Stefanie L. Davidson, MD res ’03
and Howard S. Weiss, MD, MPH TUSM ’85, res ’89. Dr.
Davidson, a member of the Division of Pediatric Ophthalmology
at the Children’s Hospital of Philadelphia and Assistant Clinical
Professor of Ophthalmology with the University of Pennsylvania
and Scheie Eye Institute spoke on “The Impact of Pediatric
Vision Problems in Adulthood.” Dr. Weiss, active in clinical
practice and academics at Walter Reed, Georgetown University
and Washington Hospital Center, and in cataract and glaucoma
research, spoke on “How to Learn New Surgical Procedures
During Practice.”
(Left) The electrophysiology laboratory at New England Eye
Center is to be dedicated to the late Samuel Sokol, PhD. The
plaque honoring Dr. Sokol, to be installed in the
electrophysiology lab in pediatric ophthalmology in the Floating
Hospital, is presented by Tom Hedges to Sam’s wife Heather.
Sam’s career is described in the Newsletter 4:1, p. 4, “Samuel
Sokol, PhD: 40 years at Tufts.”
http://www.neec.com/Pages/Alumni/newsletter/v4n2_TEAA_W
inter_2012.pdf. His obituary appears in the Newsletter 4:2, p.5.
https://www.neec.com/Pages/Alumni/newsletter/v4n1_TEAA_S
pring_2012.pdf
Drs. Duker and Krishnan present the
Preefer Award to Steven Williams, MD
Millie Commodore, Kate Peterson, graduating cornea fellow
Elvia Canseco, MD, Michael Raizman, MD, graduating
cornea fellow Jonathan Kahn, MD, Jen Shields
5
and Minerva Bien-Aime
Graduate residents: where they are now
Steven Williams, MD
West Coast Retina
San Francisco, CA
Kavita Bhavsar, MD
Vitreous Retina Macula Consultants of
New York, NY
Laurel Vuong, MD
Atlanta, GA
Drs. Hung, Krishnan, graduating glaucoma fellows David Diaz, MD,
and Mehul Nagarsheth, MD, Drs. Mattox, Hsu and Liang
Michelle Liang, MD
New England Eye Center, Boston, MA
Graduate fellows : where they are now
Hyung Cho, MD Retina
Georgia Retina, Sandy Springs, GA
Darin Goldman, MD Retina
Retina Group of Florida
Fort Lauderdale, FL
Jonathan Kahn, MD Cornea
Madison Ophthalmology. New York, NY
Elvia Canseco, MD Cornea
Drs. Witkin, Duker, graduating retina fellows Hyung Cho, MD,
and Darin Goldman, MD, Drs. Rogers, Baumal, and Waheed
Houston, TX
Mehul Nagarsheth, MD Glaucoma
Eye Consultants of PA, Wyomissing PA
David Diaz, MD Glaucoma
University of Vermont, Shelburne, VT
Catherine Cox, MD Oculoplastics
Oakland Medical Center, Oakland, CA
Jordana Fein, MD Medical Retina
New England Eye Center, Boston, MA
Graduating oculopalastics
fellow Catherine Cox, MD,
with Dr. Kapadia
Photo right top, Kendrew Caporal and
Jean McGeary, RN; lower, Lisa Samborski,
Sue Grant and Kara Waldron
6
THE TUFTS EYE ALUMNI ASSOCIATION
NEW ENGLAND EYE CENTER RESIDENTS
1st year
Bradley Hansen, MD
Kendra Klein, MD
Residents in Ophthalmology at the New England Eye Center 2013-14
Kirsten Dunbar, MD
Kirstin Tawse, MD
Nora Muakkasa, MD
Gregory Lee, MD
Joseph Ho, MD
7
3rd year
Residents in Ophthalmology at the New England Eye Center 2013-14
Lauren Branchini, MD
2nd year
Claudia Bartolini, MD
Jen Renz, MD
Kevin Sitko, MD
Avneet Sodhi, MD
THE TUFTS EYE ALUMNI ASSOCIATION
Alan Lowinger, MD
Kamden Kopani, MD
Lauren Taney, MD
Madina Falcone, MD
David Lally, MD
glaucoma
cornea
medical retina
oculoplastics
retina
Fellows in Ophthalmology at the New England Eye Center 2013-14
Michelle Liang, MD
Brendon Sumich, MD Shlomit Sandler, MD Michael Tibbetts, MD MarissaWeber, MD Roger Goldberg, MD
retina
cornea
glaucoma
medical retina
retina
retina
,
A volunteer attending’s experience
Sharewood Eye Clinic Grows,
Doubles Its Clinic Schedule
by Yvonne Tsai, M.D.
Sharewood has been a delightful experience for
me — the medical students are enthusiastic, eager
to learn, inquisitive about the clinical aspects of
what they have learned in the classroom. Since
leaving my fellowship training at Manhattan Eye
and Ear in 1987, I have been in solo practice. I
realize how much I miss a teaching hospital
experience. Sharewood gives me the chance to
pay it forward — give the medical students and
residents some practical knowledge in
ophthalmology as well as to offer medical care to
the local citizens of Malden. I feel that the
students and residents are getting a valuable
exposure to their future careers by volunteering
at Sharewood and that physicians already in
practice benefit as well by seeing that they really
do enjoy what they do! I wish that this type of
program had been available back when I was in
medical school or residency training.
The Sharewood Project, under the auspices of the
Tufts University School of Medicine, provides a
range of free and unscheduled health services to the
uninsured and underserved in the city of Malden.
Sharewood is operated by medical students under
the supervision of volunteer physicians, with
assistance from other affiliated health care
professionals and translators. The program is
located at The First Church in Malden Center, and
is funded solely through donations and fundraising.
The Vision Center of the Sharewood Project
offers diagnoses for visual abnormalities. A monthly
clinic session has been conducted by students who
are interested in ophthalmology, under the
administrative supervision of Thomas R. Hedges,
MD. Trial frames and loose lenses have
filled eye glass prescriptions. Medical students and
other interested volunteers learn to use the indirect
ophthalmoscope and slit lamp for dilated retinal
examination, as well as other ophthalmic
instruments including the lensometer, applanation
tonometer, and direct ophthalmoscope. The
diagnosis of visual disorders is performed under the
supervision of a volunteer ophthalmologist and
resident. The Sharewood Project’s Vision Center is
8
a unique opportunity for students of any level —
undergraduate to clinical fellowship — to gain
exposure and to hone skills.
Alex Legocki, now a second year medical
student at Tufts University, was elected to
coordinate the eye clinic of Sharewood in AY 201213. The eye clinic was then in its fourth year, with
an established infrastructure and ongoing challenges,
and the opportunity to lay a deeper foundation to
sustain the project. The challenges included
acquiring equipment and ensuring an adequate staff
of volunteer ophthalmologists to supervise.
Alex applied for a Tufts School of Medicine
Student Council Award aimed to fund an indirect
ophthalmoscope. Combined with a contribution
from the Tufts Ophthalmology Interest Group, the
Student Council Award granted Sharewood this
critical piece of equipment.
Toward the recruitment of volunteers, Alex
wrote a memorandum of outreach that the executive
committee of the New England Ophthalmological
Society NEOS generously communicated to its
membership, resulting in enlisting no fewer than
seven ophthalmologists from Massachusetts and
New Hampshire. Of these to date, Dr. Yvonne
Tsai, Dr. Matthew Lazzara, Dr. Michael Raizman,
and Dr. Macie Himmel have served as attendings
for the grateful students of Sharewood’s eye service.
On his experience as Sharewood’s Eye Clinic
coordinator, Alex reflects, “I gained valuable clinical
and technical skills and developed connections
throughout the ophthalmology field.”
Coordinators of Sharewood serve one year,
during their first year as Tufts medical students.
Following Alex Legocki’s term, Pamela Sherwood
(her name a coincidence) and Steven Young took
the reins as Sharewood coordinator and
ophthalmology clinic coordinator respectively in
January 2014. They are enthusiastic about
continuing the growth enabled by the strengthening
of the infrastructure under their predecessors. Both
Pam and Steve had previous experience working in
ophthalmology clinics prior to starting medical
school, and are looking to further develop their
skills.
They have implemented a more efficient clinic
intake and have started involving more graduate and
medical students in the clinic. Starting in April of
2014, Sharewood will begin holding ophthalmology
clinics twice a month. Additionally, they are working
with the Sharewood IT team to incorporate
ophthalmology into its electronic medical record
system.
Recruiting ophthalmologists and eye residents to
volunteer service in the clinic remains a priority.
Pamela has taken on the effort to contact and build
strong relationships between Sharewood and
community ophthalmologists. Recently John Liu, a
third year medical student at Tufts who previously
coordinated the Sharewood ophthalmology clinic,
arranged contact between the new coordinators and
the Massachusetts Society of Eye Physicians and
Surgeons, to reinforce the successful effort via
NEOS to encourage volunteering.
For his part, each month Steven reaches out to
the residents at Tufts Medical Center. Many of
them have taken time in their crowded schedules to
spend an evening at Sharewood. Among them are
former TUSM students who had volunteered at
Sharewood, to whom returning as residents to teach
holds special meaning.
“We have been lucky to have had such amazing
volunteers come and share their passionate
knowledge about the field with us. Our clinical skills
in ophthalmology have benefited tremendously
from their presence here at Sharewood.”
Goals now include building new partnerships
with charitable organizations or start-ups to develop
the scope of service and innovative technology at
Sharewood. For example, Warby Parker sells
prescription frames at low cost, through which it
funds Vision Spring to provide eyeglasses to people
who cannot afford prescription spectacles. Another
lead, from Dr. Yvonne Tsai, involves a start-up out
of MIT that is working on a vision technology
mobile app that may be useful to pilot at the clinic.
The excellent contribution and progress of
Sharewood rely on continuing volunteer efforts, and
your opportunity to serve awaits. Please do not
hesitate to sign up for one evening of participation.
You may well decide that the Sharewood experience
is one to which you will wish to make the time to
return.
Please contact Pamela.sherwood@tufts.edu or
Steven_K.Young@tufts.edu to volunteer, discuss a
donation of equipment, or for further information.
9
COS opens at
Continued from p. 11
New England Eye Center
Upon the opening of COS, New England Eye
Center administrative director Linnea Olsson
observed, “The Comprehensive Ophthalmology
Service will allow us to better serve patient needs for
both urgent and routine comprehensive
ophthalmology care. It will be much easier to
accommodate new patients who wish to come to
New England Eye Center, with faster appointment
times. We believe that the structure of COS will
greatly enhance our residency training
program. The optometry department has been
relocated to Biewend 11, and our optometrists and
technicians as well as physicians are very excited
about the beautiful new space and equipment!
“Many people have worked hard on the planning
and set-up of the new area. Drs. Jordana Fein and
Dru Krishnan have spent countless hours
conceptualizing and organizing how COS will run,
and I would like to particularly acknowledge the
contributions of Dr. Cynthia D’Auria, Chris
Kiernan, Bianca Cardona, Nathan Knowles,
Meredith Dunbar, Jean McGeary, Amanda Bruce,
and our unsung hero of logistics, David Schultz!”
The establishment of the COS will enable the
NEEC and the Tufts Department of
Ophthalmology to grow, and represents the strength
and foresight that will serve us through many years
of change and challenges in the future of eye care.
situation ensues and we grow our volume enough,
we may have to address staffing and facilities
expansion to keep up the pace, but that would not
be a bad situation to be in.” Dr. Fein also observes
that billing for emergency visits is now more
consistent, with far fewer chances that billing for
services might be overlooked.
Tom Bigelow, manager of New England
Eyewear, the optical dispensary of NEEC, adds his
witness that patients are happier and better served.
“Patients have reported to me that they are now
getting appointments in a far more timely way.
They’re very satisfied.”
In addition to the full-time participation of Dr.
Fein, COS is attended by Brooke Miller, MD, and
Sergey Urman, MD as well as Dr. Lauren Taney
and Dr. Michael Tibbets, our current medical retina
fellows.
Senior optometrist Cynthia D’Auria, OD,
comments, “The Optometry Service is thrilled to be
on the 11th floor working alongside the COS. It is
refreshing to be in a new space with new
equipment. The patient flow works well with the
New England Eyewear optical shop just steps away
to service our patients for their glasses and contact
lens needs.”
Pride in Tufts Medical History
Thomas R. Hedges, MD, has been elected President of the
Tufts Medical Alumni Association. Tom graduated from TUSM in
1975 and has been on the faculty of Tufts since 1981. He hopes to
use his position to remind the Tufts medical alumni of the great
history of this institution.
For the eye alumni Tom would like to make us aware of Josef
Igersheimer who was a professor at Tufts from 1939 to 1968. After
escaping Nazi Germany he went to Turkey where he helped
modernize ophthalmology there. In 1930 he came to the United
States where he was welcomed by The Boston Dispensary and
Tufts Medical School. Dr. Igersheimer, a student of Gonin, was
one of the first to treat retinal detachments by closing breaks in the
retina. He also performed one of the first corneal transplants, in
Boston.
10
Josef Igersheimer, M.D.
COS opens at New England Eye Center
Continued from the back page
The new service is organized and staffed in such
a way as to facilitate the care and follow-up of
patients presenting through emergency services and
urgent consults, and, additionally, provide a
dedicated area where patients with general
ophthalmological needs may obtain convenient
appointments and be seen in a timely way.
Director of COS Dr. Fein describes the
organization and operational system of COS as well
as its advantages.
“COS provides a service in which residents,
under appropriate supervision, can participate in the
care and follow-up of their own patients and
develop the continuing
relationship that is
beneficial to both the
patient as well as the
educational need of the
resident. The service
provides a properly
designated facility as well as
a scheduled time, free
from other responsibilities,
during which the resident
may see his or her patient.
“The first year residents
will begin to realize early in
their training the advantages of independent, albeit
supervised, management of patient care that
previously had not been so available until the third
year of training. The resident will be the patient’s
doctor and both will benefit from the continuity of
care and its efficient management.”
Previously, emergency patients would be seen by
the resident on call. However, due to the resident’s
responsibility to the subspecialty service to which he
or she was assigned, and lacking a designated time
or place for a follow up visit, the patient would likely
not then be followed by the original resident and so
there would not be the long-term follow-up for the
resident.
“Now they have a dedicated time and place to
see such patients.
“At the same time in the past, patients who came
to our eye center for routine examination or for
undiagnosed problems would be given excellent
care, but within a subspecialty unit. There was a
degree of competition for the available facilities and
provider time. This system resulted in longer waits
for routine appointments, longer stays in the waiting
room, and impinged teaching time. The system
worked, but as an educational environment and
comfortable patient experience it needed
improvement.”
In the planning, Dr. Fein explained, director of
clinical services Nathan Knowles analyzed patient
flow data and derived the number of appointment
slots necessary to build into the system to
accommodate emergency
patients in COS. Currently
four slots are reserved daily
for emergency add-ons; the
remainder are available for
scheduling routine
appointments and followups.
COS also has the
advantage of being located in
the same area as our
optometry service. This
provides the advantage of the
excellent teaching our
experienced optometrists can provide, especially for
refraction.
The work distribution and teaching
conduciveness in a resident-centered academic
practice are arguably superior to other systems.
Supervision and teaching are more uniform and
dedicated. Patient care is standardized at the highest
level. Patients benefit from a team effort and have
the advantage of access to the very latest diagnostic
and treatment protocols.
“Such a system allows for the efficient delivery of
the highest quality of care, it is really the state-of theart academic care structure. COS will operate at the
same level of excellence as all of the subspecialty
and adjunct services of our highly respected, worldclass tertiary referral center.”
Thus far, patients are now getting appointments
within weeks rather than months. “If the best
Continued on p. 10
11
New England Eye Center Opens Comprehensive Ophthalmology Service
Under Directorship of Jordana Fein, MD res ’12, fel ’13
Top to bottom,
The culmination of years of planning
and groundwork, the long-anticipated
Comprehensive Ophthalmology Service
(COS) of the New England Eye Center
opened on Biewend 11 on January 13,
2014. The new service will contribute to
the delivery of general ophthalmic care
and the education of resident
physicians.
The service has been built from the
experience of residents and attending
physicians in treating patients at the New
England Eye Center. Its mission and
organization are thus informed by the
inseparable collaboration between
faculty and resident.
When Dr. Jordana Fein started her
residency at the NEEC in 2009, a
“general” ophthalmology service had
already been on the mind of Jay Duker,
MD, chairman of the department. Such
a service would provide for the needs of
the emergency patients as well as routine
eye exams. It would also be the service
where residents, even in their first year,
could have the substantial responsibility
for care management, and the
opportunity to follow patients from first
presentation through the course of their
care. The possibility was well discussed.
While requiring the knowledge and
supervision of the experienced attending
physician, the delivery of patient care in
all specialties is largely dependent on the
work of the resident. Dru Krishnan,
MD, director of residency training,
shared his understanding that the
founding of such a service as COS was
key in addressing challenges of both
resident education and expeditious
delivery of eye care. Trained as resident
at the NEEC, Dr. Krishnan understands
the dynamic at the New England Eye
Center, particularly the role of the house
officer as trainee and patient care
provider.
It was during her own residency and
fellowship, under the tutelage of Drs.
Duker and Krishnan, that Dr. Fein made
a commitment to the goal of establishing
the COS. Drs. Duker and Krishnan had
already begun the procedures for
obtaining institutional approval and
support, space acquisition and
development, budgeting and
organizational planning. Dr. Fein
became the administrative coordinator
who would see the plan to completion.
Continued on p. 11
Photographs: Kathleen Warren
12
and the New England Eye Center
Photography Department
Jordana Fein, MD
Brooke Miller. MD
Sergey Urman, MD
Cynthia D’Auria, OD