summer 2018 scheie vision Department of Opthalmology

Like Watching a Miracle: From Landmark Gene Therapy to the Stage of America’s Got Talent IN THIS ISSUE A MESSAGE FROM THE CHAIR

Dear Friends, VISION Penn Medicine’s Department of Ophthalmology, Scheie Eye Institute, is dedicated to cutting edge research, 02 Like Watching a Miracle providing the highest quality of care in Philadelphia and around the world, and training the next generation 04 Landmark FDA Approval of ophthalmologists. Our faculty and staff strive to cultivate an environment of continued learning and 08 Studying Individual Photoreceptors mentoring, where young minds with great potential grow and thrive. Our alumni go on to lead impactful 10 Intraocular Bleeding from careers, maintaining relationships with peers and mentors and returning to the Annual Alumni Meeting Blood Clot Meds? each spring. This event is always a reminder of the outstanding accomplishments of Scheie’s alumni, 11 New Options for Dry Eye students, staff, and faculty, and their daily commitment to improving the lives of patients and colleagues. This issue of Scheie Vision covers the people behind SCHEIE COMMUNITY Scheie’s advances and mission of excellence. We 13 Beautiful Inside and Out feature Lang Lourng Ung, an ophthalmic technician who brings inspirational resilience and passion to working with patients; Sonul Mehta, MD, who travels 15 Faces of Scheie around the world to provide ophthalmic care in underserved communities; Jessica Morgan, PhD, whose 19 Eye Care Across the World research on photoreceptor function has tremendous implications for the diagnosis and treatment of retinal 20 Remembering Walker Kirby disease; and Jean Bennett, MD, PhD, and Al Maguire, MD, who have demonstrated unwavering commitment for over 25 years to making it possible for blind 21 144th Anniversary Weekend children to see. This issue also honors the memory of two more ALUMNI remarkable individuals who are no longer with us: Laura Ball, a beloved administrative assistant in the 18 Alumni Spotlight glaucoma service and close friend to many of Scheie’s staff and faculty, and Walker Kirby, a generous donor and friend to the Scheie Eye Institute for many years. 22 Alumni President Laura and Walker touched many lives, including my own, and I will always cherish their memories and countless contributions to this Department. CONTRIBUTORS I would like to express my gratitude for the Managing Editors and Writers: Rebecca Salowe, extraordinary individuals who make Scheie exceptional Ava Kikut, Emma Wells Editor: Benjamin Kim, MD in all its missions. It is our colleagues, students, and Art Director: Sai Merriam patients who bring true joy and fulfillment to this Designer: Caren Goldstein work, and who make possible the common vision of Photographer: Brian Holmes excellence we all share. I hope you enjoy flipping Cover design: Sai Merriam through these pages and reading their stories. If you would like to add/remove your name from this mailing list, or have any questions or comments, please Wishing you all a happy and healthy summer! email [email protected] or call 215.662.8415.

Joan O’Brien, MD 2

Christian Guardino performs on America’s Got Talent in 2017, four years after participating in the Phase III clinical trial for gene therapy. Photo credit: Trae Patton/NBC/NBCU Photo Bank/Getty Images.

Like Watching a

By Ava Kikut

MiracleBy Ava Kikut It was a summer evening in 2013. “What’re you doing buddy?” The explained the delay to the audience. The audience was waiting to hear host had found Christian backstage. “There wasn’t a dry eye in the Christian Guardino sing. The host “I’m looking at the moon,” house,” remembered Christian’s called his name a first time, and Christian replied. mother, Beth Guardino. then a second time. But Christian “You’ve never seen the moon didn’t go onstage. He stood still, before?” Christian was diagnosed with mesmerized by something he had “Nope.” Leber’s Congenital Amaurosis never seen before—a white ball in (LCA), a rare retinal degeneration, the night sky. When the host returned to the as an infant. “They didn’t really stage with Christian behind him, he know what genes were causing 3

LCA at that point,” explained Beth. she learned about an upcoming seen the moon for the first time. “We were told that he had the type conference in Philadelphia. It When he returned to school that of LCA that would either slightly was at this conference that the fall, Christian could recognize improve with age or remain stable.” Guardinos confirmed they had been people as they waved at him in misinformed when Christian was the hallway. His experience in the Christian’s limited vision posed first diagnosed. Christian’s vision classroom also improved. “I’ve been a number of challenges as he was not only declining; it was likely able actually to see the whiteboard entered school. He struggled to to deteriorate completely. Without much better,” he said. Christian, recognize faces of friends waving intervention, he would be blind who graduated from high school in at him in the hallway, and he often between the ages of 15 and 30. the spring of 2018, is now taking worried others would think he was time to focus on his singing career antisocial. “I don’t think the sighted But there was hope. The Guardinos before going to college for music world really understands the met Dr. Jean Bennett and learned or film. communication issues that happen of a clinical trial for a treatment when you’re not fully sighted,” targeting a specific genetic While Christian’s limited vision said Beth. mutation—RPE65. If Christian’s never deterred him from singing, LCA was caused by an RPE65 the improvements to his sight since In the classroom, despite always mutation, he would be eligible for the gene therapy have given him sitting in the front row, Christian the clinical trial, and his vision more freedom onstage. Beth noted, could not read the writing on the could potentially be saved by gene “Before he would have to be led board. “It was really tough for me to therapy. During the conference, onstage to perform because it was see and properly learn,” he recalled. Christian underwent genetic testing. too difficult for him to see. Now he Christian was especially sensitive just walks right out there and does to noise, and found it difficult to In March 2013, just before his thing. It’s made a huge change concentrate on the teacher’s voice Christian’s 13th birthday, the in his confidence.” when there were other sounds in conclusive report came from the the room. Teachers did not always lab. Christian did indeed have the In 2014, Christian became the understand why he was distracted. RPE65 mutation, qualifying him Grand Prize Champion at the “I feel like they would seem to for the gene therapy trial. The Apollo Theater’s “Amateur Night get both annoyed and confused,” treatment was scheduled during at the Apollo Stars of Tomorrow” he said. summer break three months later. category. In 2016, he sang the national anthem at the NY Islanders Beth made efforts to explain Christian was eager to take part playoff game. That same year he Christian’s visual behaviors to in the trial. “I wanted to stop that performed a duet with Jordin teachers at the beginning of each inevitable blindness. That was my Sparks for Michelle Obama’s “Fit school year, but misunderstandings main goal,” he said. But when he 2 Celebrate” Gala. And in 2017, continued to arise. “I think that was woke up from the surgery in June Christian stunned the audience more of a struggle than his peers,” 2013, he realized the procedure did and judges of America’s Got Talent, she said. “We would continually much more for his vision than he earning the Golden Buzzer from hear how distracted he was. had expected. “It was crazy because Howie Mandel. Christian was Christian was such a great student I already saw results as soon as I named Youth National Champion and very respectful, so that was woke up from the gene therapy. I by the Children’s Miracle Network hard for us.” remember waking up in a really Hospitals and a Vision Hero by the dark room and I looked over to Vision of Children Foundation. When Christian was eleven, Beth my left and there was this little He is currently working on a noticed he was having more lamp light. And one of the tech project with Grammy nominated difficulty than usual recognizing coordinators there, her name was songwriter Sacha Skarbek. people and objects. Despite having Dominque, and I said, Dominique been assured that Christian’s is that you? And it was her. And I “It’s been a dream come true,” vision would remain stable, Beth would never have been able to see Christian said. Beth added, “To go was certain it was declining. She in a room that dark.” from thinking your child would decided to do more research. never see your face to where we Just a couple weeks later, Christian are now…it’s literally like watching Through a Facebook search, found himself performing on a miracle. That’s exactly what it is.” Beth found a support group for an outdoor stage in front of an LCA patients and families, and emotional audience, having just Photo credit: Peggy Peterson The Team Making Blind Kids See SCHEIE PHYSICIANS RECEIVE FDA APPROVAL FOR LUXTURNA, THE FIRST GENE THERAPY FOR AN INHERITED DISEASE

By Rebecca Salowe and Emma Wells Children born with Leber’s Maguire have dedicated their careers husband, Dr. Maguire, working Congenital Amaurosis (LCA) are to the belief that a single genetic over a cadaver in anatomy lab. A not defined by blindness, but will mutation should not determine a partnership that extended beyond face obstacles unimaginable to most child’s fate. On December 19th, marriage and into the world of sighted individuals. With low vision 2017, the world saw the beginning research was formed. from an early age, these children of a new era as this vision was may be sidelined from regular realized. The FDA had officially Dr. Bennett carefully followed the activities such as sports, bike riding, approved their gene therapy regimen progress of gene therapy during and trick-or-treating. They may be for a form of LCA caused by the medical school and subsequent unable to see the chalkboard in the RPE65 mutation. Luxturna, the fellowships. Meanwhile, Dr. Maguire classroom and be highly sensitive to brand name for this treatment, had completed his training to become a distracting noises, making it difficult just become the first gene therapy for retinal surgeon. to learn. They will need to memorize an inherited disease ever approved in fire escape routes, be escorted across the United States. Then, in 1990, Dr. William French the street, explain their condition Anderson conducted the first gene countless times to teachers and IT ALL BEGAN IN ANATOMY LAB therapy on a human: a four-year- peers, and rely on others to describe old girl named Ashanti DeSilva, surroundings. Children with LCA Just two decades earlier, gene who had adenosine deaminase tend to overcome these challenges therapy was a field with few (ADA) deficiency, a genetic disease with outstanding resilience. Their promising results. The idea that leaving her defenseless against visual impairment makes them no normal genes could be used to infections. The therapy involved less intelligent, creative, or talented. correct mutations causing genetic treatment of Ashanti’s cells in a dish What distinguishes a child with LCA disorders was an exciting one, but and then return of these treated cells from his/her peers is a rare genetic difficult to implement—and often into Ashanti’s bloodstream. This mutation, a microscopic error in the dangerous. “ex vivo” treatment was successful, biological blueprint. and led to a partial improvement in These setbacks did not deter Dr. Ashanti’s condition. Over the past 25 years, a team of Bennett. After completing her PhD in scientists has worked to prove that zoology and post-doc in molecular The breakthrough ignited an idea in DNA is not as fixed as previously biology, she attended Harvard Dr. Maguire. He asked his wife, “Do believed—that defects caused by Medical School to gain expertise you think we could ever develop a a mutated gene can be overcome in diseases that could potentially gene therapy to cure inherited forms by delivery of a normal copy of be treated in the future with gene of blindness?” She immediately the gene. Drs. Jean Bennett and Al therapy. There, she met her now- answered: “Yes, of course.” 5 EARLY FAILURES IN GENE THERAPY Therapeutics at Children’s Hospital Dr. Bennett with a proposal. “She of Philadelphia (CHOP), in the PBS walked into my office, and I looked Ever the optimist, Dr. Bennett did documentary Genes as Medicine. up and she said, ‘Jean, how would not initially mention to Dr. Maguire “All the companies that had been you like to run a clinical trial?’ And the long list of ingredients that would involved in gene therapy were either I was just totally floored,” said Dr. be required to design successful gene turning away from it or they were Bennett in Genes as Medicine. Dr. therapy for retinal degeneration. failing.” Bennett agreed without hesitation. For example, the genes involved “That was the beginning of a whole in inherited blindness had not yet Again, despite the seemingly infusion of energy and enthusiasm been identified. Extrapolation insurmountable barriers in this field, and support.” of the approach used in Ashanti’s Drs. Bennett and Maguire persevered. case to treatment of the retina was “With the belief that our approaches Over the next several years, Dr. unlikely to be effective. Viruses for treating retinal disease would Bennett and her team worked were being considered for gene be safe and effective, we continued relentlessly to prepare for the clinical delivery to retinal cells, but none had to move forward cautiously with trial. They created a clinical viral been shown to do so safely. There our bench research despite the vector, generated a full set of safety were no genetically characterized unpopularity of gene therapy,” and efficacy data, bred animals, animal models of retinal disease. said Dr. Bennett. By 2000, they designed protocols, defined outcome The surgical techniques to deliver were ready to test a gene therapy measures, and purchased equipment. genes to the retina had not yet been procedure in dogs that were blind After less than two and a half years developed. Finally, even if these from LCA. The treatment delivered a of preparation, they enrolled the hurdles were overcome, there were healthy copy of the RPE65 gene into first subject. no metrics to evaluate the effect of the retina of dogs using an adeno- gene therapy on vision. However, associated virus. The safety bar for human gene these obstacles did not discourage therapy protocols had been Drs. Bennett and Maguire. Soon after treatment, the dogs were heightened following the death of placed in an obstacle course, which Jesse Gelsinger—and this matter was By the 1990s, Drs. Bennett and they had previously blundered further complicated by the inclusion Maguire were married and had been through blindly. Now, the dogs of children in the trial, which recruited to the Scheie Eye Institute ran through the course safely and necessitated a special review by the at the University of Pennsylvania quickly. They turned in circles, US Recombinant DNA Advisory (UPenn). Their initial gene therapy looking around at the world with Committee. However, when the experiments yielded frustrating the treated eye for the first time. time came for the first injection, results, though they eventually Electroretinograms, carried out by Drs. Bennett and Maguire were fully demonstrated a proof-of-concept of their colleagues at Scheie, confirmed confident in the safety of gene therapy in a mouse model of that the photoreceptor response of the treatment. retinitis pigmentosa. Meanwhile, the dogs was restored. faith in gene therapy was crumbling “It was a bold step embarking on the around them. In 1999, an 18-year- The story of blind dogs regaining first injection,” Dr. Bennett recalled. old boy named Jesse Gelsinger died sight was featured in numerous “Although Albert’s and my criteria in a gene therapy trial (in which they media outlets, including Good for moving forward were far more were not involved) at UPenn. All Morning America, and was presented stringent than any of the institutional gene therapy trials across the nation at the U.S. Congress. “The obvious or federal criteria. That was, if were immediately halted. next thought was, wouldn’t it be great our child was affected with this to use this approach so that blind condition, would we allow him/her “There had been a general sense that children could see?” said Dr. Bennett. to participate? Our definitive answer this was a therapy that was not ready was yes.” for primetime, that there were too SEEING THE SUN FOR many things we didn’t understand,” THE FIRST TIME The Phase I clinical trial at CHOP, said Katherine High, MD, the then- which was conducted simultaneously director of the Center for Molecular In 2005, Dr. Katherine High, a with two other trials at University gene therapy expert, approached College London and University of

a timeline of gene therapy 1999 1990 Jesse 2007 First gene Gelsinger 2001 Phase I therapy dies in Successful clinical trial 1968 performed gene RPE65 gene for RPE65 First virus- in humans therapy therapy gene therapy mediated gene (for ADA) trial at in dogs transfer Penn

2010 2000 2003 1953 1997 Christian Phase I/II Watson and RPE65 gene First approval clinical trial for Guardino of human Crick discover mutation born RPE65 gene double helix 1983/4 for LCA gene therapy therapy of DNA First gene discovered worldwide transfer into (China) mice Florida, enrolled 12 subjects with damage to the initially injected eye continued follow-up studies on RPE65-related LCA. The subjects through immune sequelae.” LCA patients, as well as exploring received an injection of the viral gene therapy options for other vector containing the RPE65 gene The team returned to the lab, degenerative eye diseases. In into their worse-performing eye, performing readministration in 2013, a new gene therapy startup while the other eye acted as a six dogs with RPE65-related LCA company, Spark Therapeutics, was control. who had previously received the founded specifically to serve the treatment in one eye, as well as in RPE65 project. Dr. High became When the bandages over their eyes four normal-sighted monkeys. The the president of the company. Dr. were removed, patients reported bilateral injection was found safe and Bennett and her team worked seeing the brightness of the sun for effective, producing no inflammatory with Spark to further test the the first time. They commented on response. intervention. the colors of the world. They passed the obstacle course test with ease–a The team cautiously continued The treatment was soon tested radical change from their difficulty with readministration studies in the in a Phase III clinical trial. This navigating just days earlier. Further human clinical trial subjects. The trial enrolled 31 individuals testing showed that all subjects trial was a resounding success: no whose RPE65-mediated retinal had safe and stable improvement adverse effects resulted from the degenerations would otherwise in retinal and visual function in the vector, and repeat administration progress to total blindness. (Among treated eye. Most subjects showed led to durable improvements in these patients was Christian improvement in light sensitivity, retinal and visual function. This Guardino, whose story is featured navigational ability, activation in trial represented the first successful on the previous pages.) Patients in the visual cortex, and structure and readministration of gene therapy in the intervention group underwent function of the visual pathways. humans. injection of the viral vector in both As predicted, younger participants eyes. Additional patients were gained visual abilities closest to Interestingly, the results also shed designated as controls and did not normal-sighted individuals. light on the tremendous plasticity receive the reagent for the first year, of the human visual system. It was but were treated in both eyes in the Drs. Bennett and Maguire were previously thought that the brain second year. Again, the treatment was a success, leading to stable and overjoyed. They deeply care for their lost its malleability after about durable improvements in retinal patients, often referring to them as three years of age. However, Dr. and visual function. There were no family. Before and after treatment, Manzar Ashtari, Director of CNS serious adverse events or immune Dr. Bennett often visited the patients’ Imaging at Penn Ophthalmology, responses related to the product. homes or watched the kids give proved in these trials that patients music recitals. She and Dr. Maguire can experience brain restructuring Meanwhile, the idea for a center waived all financial gain if the after the critical period of vision at UPenn where scientists could therapy proved successful, in order development. Before gene therapy, continue researching and treating to ensure their ethical standards patients’ visual pathways were blinding conditions was born. The remained high. impaired structurally, potentially Center for Advanced Retinal and due to atrophy after long-term Ocular Therapeutics (CAROT) WILL IT LAST? visual deprivation. However, after was established in 2014, with Drs. gene therapy, the visual pathways Bennett and Maguire as Co-Directors The next step was readministration in the treated retina were similar to and immunologist Junwei Sun, of the therapy to the contralateral those of control subjects, suggesting MS, MBA, as Chief Administrator. eye. “The concern was that the initial that visual experience can lead to Dr. Tomas Aleman was recruited injection of the virus would serve structural changes in the brain. as an expert in retinal degenerative as a vaccination,” explained Dr. conditions and to run clinical trials. Bennett. “Then, when the second SCALING UP THE THERAPY The mission of CAROT is to develop eye was treated, an immune response novel therapies for retinal and ocular might not only prevent benefit in In the following years, Dr. Bennett, disorders and to restore sight in the second eye, but might also cause Dr. Maguire, and colleagues visually impaired or blind individuals.

2012 2017 MAR OCT 2012 2012 2017 Lab results First approval 2017 FDA Advisory Phase III confirm Christian AUG Committee DEC clinical trial for of human gene FDA-approval of has RPE65 therapy in EU First FDA- endorses RPE65 gene mutation approval of Luxturna in Luxturna for retinal therapy gene therapy unanimous (16-0) diseases caused by in US RPE65 mutation.

2011 2017 Christian’s 2012 2013 OCT mother JUN Spark Christian notices Christian Therapeutics testifies on his vision participates in launched behalf of the declining Phase III clinical therapy. trial

7 THE FINAL HURDLE On December 19, 2017, Drs. identified to cause inherited retinal Bennett and Maguire got the call degeneration—a sharp contrast to Following the success of the Phase that Luxturna had been approved. the zero genes identified when Dr. III trial, the final step to making Bennett began her research. Today, the therapy available to the public A BRIGHTER FUTURE there are close to three dozen ocular was approval from the US Food gene therapy trials in progress or and Drug Administration (FDA). Luxturna marks many firsts. It follow-up, with even more targets In October 2017, physicians, is the first FDA-approved gene being considered by various groups. researchers, patients, and their therapy for an inherited disease, the A dozen additional ocular gene parents converged in Silver Spring, first pharmacological treatment for therapy targets are in the pipeline Maryland, to testify before an FDA an inherited retinal degeneration, for clinical trials at Scheie and advisory panel during a daylong and the first gene therapy to use CAROT. hearing. The panel would then an adeno-associated virus vector. make a recommendation to the But, the most important first for “I believe that the success of the FDA for or against approval. this therapy is undoubtedly the Luxturna clinical development opportunity it presents individuals program will pave the way for The day saw emotional testimonies with RPE65-related LCA. For the development of other gene from patients and their families the very first time, the one to two therapies, that may help the whose lives were transformed by thousand people with this disease millions of patients with genetic the treatment. have a promising treatment option diseases who currently have limited that will likely greatly improve their or no treatment options,” said Dr. “I just want you to know that this sight. Bennett, in a Spark press release. was significant to me, significant in the way that I can plan and live As of now, the therapy is available The FDA agrees. “I believe gene my life,” said Caitlin Corey, who at only designated treatment therapy will become a mainstay received the treatment a few days facilities throughout the country, in in treating, and maybe curing, before her 21st birthday in 2013. order to ensure safe administration. many of our most devastating and “I can finally live my life the way I On March 20, 2018, groups at intractable diseases,” said FDA want to.” three different institutions (Bascom commissioner Dr. Scott Gottlieb. Palmer, Children’s Hospital Los “This milestone reinforces the “What I saw in the clinic was Angeles, and Massachusetts Eye and potential of this breakthrough remarkable,” said Dr. Maguire to the Ear) simultaneously performed the approach in treating a wide range of panel. “Most patients became sure first injections of Luxturna since the challenging diseases.” of themselves and pushed aside approval. their guides. Rarely did I see a cane “It now sets a path for others to after treatment.” Not only will this technique help follow going forward, where there to restore sight in patients blind was none before,” said Dr. Bennett, The vote for approval came in at a from LCA, but it will also guide the in an interview with Penn Medicine unanimous 16-0. Then all there was development of similar products Magazine. “This is looking way to do was wait for the final decision for other blinding diseases. down the road, but maybe not as from the FDA. To date, 265 genes have been far as you think.”

On May 2, 2018, the Penn Medicine Board of Trustees celebrated the FDA approval of Luxturna. Dr. Joan O’Brien and Dean Larry Jameson presented Drs. Maguire and Bennett with a plaque commemorating the first dogs to receive gene therapy (including Mercury, posing with Dr. Maguire), who were later adopted by Drs. Maguire and Bennett. the next step in precision medicine By Rebecca Salowe

Researchers at the Center for Advanced Retinal and information to assess if a treatment is safe and providing a Ocular Therapeutics (CAROT) are seeking to expand benefit to patients?” the range of treatment options available to patients with hereditary blindness. Since receiving the Food and Drug Dr. Morgan believes that the answer will soon be yes, with a Administration’s approval of a gene therapy for Leber’s bit more work. Currently, adaptive optics imaging provides Congenital Amaurosis, CAROT is focused on developing information solely on structural changes in photoreceptors; therapeutic approaches for other retinal degenerations. this information has not previously been correlated with Dr. Jessica I. W. Morgan, an Assistant Professor of functional changes in vision. Thus, Dr. Morgan’s current Ophthalmology, has a unique and vital role in this process. research focuses on understanding how the structural changes observed through adaptive optics imaging affect In many retinal diseases, vision loss is caused by damage the function of those same photoreceptors. to rod and cone photoreceptors. Thus, researchers must be able to closely evaluate the structure and function of In 2015, Dr. Morgan began collaborating with Dr. David photoreceptors in order to gauge if a treatment is effective. Brainard, who had recently received a Stein Innovation Did the therapy help to protect and preserve these cells? Is Award from Research to Prevent Blindness. Together, a disease worsening – or has its progression been halted? they have incorporated two distinct methods of assessing photoreceptor function into the adaptive optics imaging Dr. Morgan uses a technology called adaptive optics to system, with the goal of correlating this functional answer these questions. Adaptive optics imaging provides information with structural images. high-resolution photos of individual photoreceptors, allowing her to evaluate how single cells are affected by The first method, cellular-scale microperimetry, measures treatments. cone function by testing a patient’s response to a visual stimulus. The stimulus is focused on an individual cone, “Many advances are being made in regenerative medicine, taking advantage of the high resolution provided by the gene therapy, stem cell therapy, and optogenetics – and adaptive optics system. “We flash a light that is received all of those treatment approaches aim to restore function by one cone only and ask a patient, ‘Did you see it? Did to individual cells,” she explained. “And we now have you not?’” explained Dr. Morgan. Over multiple trials, Dr. the capability to noninvasively observe individual Morgan can then determine the ‘threshold of seeing’ at the photoreceptors. The question is: can we use that individual cone level. 9

from normal controls,” said Dr. Morgan.

As clinical trials These functional tests allow disease progression to be closely monitored in a way that was not previously for gene therapy feasible. Physicians will thus be able to provide a more and other cellular precise diagnosis and prognosis to patients with retinal therapies grow diseases. more common, Dr. “Ultimately, we want to use these methods to assess which photoreceptors in the retina take up a therapy Morgan’s research on and which ones do not,” said Dr. Morgan. “The cells how these therapies could regain normal function, regain partial function, stay steady, decline, or decline faster.” This data alter photoreceptor provides valuable information on how many “treated structure and cells” are needed to maintain good vision or improve vision. Or, in the event that a therapy fails, researchers function will become can determine if a therapy should be amped-up to more and more target more cells. valuable. The first disease to be targeted is choroideremia, a rare retinal degeneration that causes gradual loss of vision in males. Phase I/II gene therapy clinical trials are currently in progress at CAROT. Dr. Morgan recently received a National Institutes of Health RO1 grant to The second method measures how the intrinsic conduct add-on studies to these trials. reflectance of individual photoreceptors changes in response to light stimulation. Again, the stimulus is “We already know that cone photoreceptors remain delivered through the adaptive optics system; cone structurally present in near normal numbers in patients response is then observed using infrared imaging light. with choroideremia,” explained Dr. Morgan. “However, Dr. Morgan tested this method on healthy controls, our preliminary findings show that the functional showing that intrinsic reflectance is an accurate response of these cells is reduced. Now we want to reflector of actual cone function. These results were know whether gene therapy restores their function.” published in Biomedical Optics Express. As clinical trials for gene therapy and other cellular Now that these techniques have been successfully therapies grow more common, Dr. Morgan’s research applied to healthy controls, the next step is turning to on how these therapies alter photoreceptor structure patients with retinal disease. and function will become more and more valuable. Her foresight in developing precise ways to evaluate “We are now undertaking cross-sectional and disease outcomes may soon affect the diagnosis and longitudinal studies to compare functional responses treatment of many retinal diseases. from photoreceptors affected by retinal disease to those

Dr. Jessica Morgan poses with adaptive optics equipment, which provides high-resolution photos of individual photoreceptors. By Emma Wells

Assessing the While newer antithrombotics have Risk of Intraocular been increasing in popularity, their ocular Bleeding from Blood safety profile had not been extensively Clot Medications researched.

A new analysis led by Brian VanderBeek, MD, MPH, aspirin or clopidogrel. MSCE, explored the ocular safety profile of novel antithrombotics. While newer antithrombotics have been increasing in popularity, their ocular safety profile had not been Oral antithrombotic medications are a mainstay for extensively researched. “On top of that, there was a preventing blood clots, but they have associated ocular steady stream of case reports suggesting that the new risks. Because of the anti-clotting nature of these ones were not as safe,” explained Dr. Brian VanderBeek, medications, certain antithrombotics have been shown an Assistant Professor of Ophthalmology and retina to increase risk for intraocular hemorrhages (bleeding specialist at the Scheie Eye Institute. “And there was no in the eye). real data to back this idea up other than case reports.”

Antithrombotics designed to reduce the blood’s clotting Recognizing this gap in the medical literature, Dr. ability fall into two main categories: anticoagulants VanderBeek set out to design a study assessing the and antiplatelet drugs. Traditional anticoagulant risk of intraocular bleeding in patients taking novel therapies employ warfarin, which antithrombotics. Dr. VanderBeek collaborated with requires careful monitoring Retinal Degeneration and Medical Retina Fellow due to risk of excess Katherine Uyhazi, MD, PhD and UPenn clinical bleeding. In recent pharmacist and epidemiologist, Todd Miano, PharmD, years, several new MSCE. Together, they conducted a retrospective antithrombotic cohort study mining a large national insurance claims medications database. This analysis compared risk of intraocular that do not hemorrhage from novel antithrombotics versus older require routine medications over five years. monitoring have become “We did two different comparisons, one for antiplatelets increasingly and one for anticoagulants,” said Dr. VanderBeek. popular. The antiplatelet analysis compared the incidence of There are intraocular bleeding in patients taking clopidogrel also several (older drug) to patients taking prasugrel (novel drug). novel antiplatelet A similar analysis for anticoagulants compared warfarin medications to the novel anticoagulants dabigatran and rivaroxaban. available, which are frequently prescribed The study, published in JAMA Ophthalmology in instead of traditional February 2018, found that newer antiplatelet antiplatelet therapies medications were no more likely to lead to intraocular utilizing hemorrhage than traditional ones. Additionally, newer anticoagulants actually had an improved ocular risk profile, reducing the risk of having an intraocular bleed by about 25%.

Dr. VanderBeek stressed that the study should not be taken as medical advice. “Talk to your primary care provider to decide what’s best for you,” he said. 11

service has a full team of highly trained optometrists and technicians who specialize in scleral lens fittings. Expanded With grant support from the Board of Women Visitors, Scheie was equipped with a new slit lamp and special camera for fitting scleral lenses and Options for recording the degree of dryness on the surface of the eye. The grant has also helped assist patients whose insurance Treating does not cover the cost of the lenses. “Scleral lenses may be better for a subset of patients who have nerve Dry Eye pain and are exquisitely sensitive to evaporation of the tear film. They can By Ava Kikut also help correct the vision if there are corneal irregularities,” explained Dry Eye Disease (DED) is a common chronic condition that Dr. Massaro. For patients with these disproportionately affects women. DED occurs when an individual does symptoms, the availability of scleral not produce enough quality tears to protect and lubricate the eye. A lack lenses and fittings at Scheie has made of protective moisture causes severe irritation and sensitivity to light, a world of difference. and it can lead to scarring in the cornea and visual impairment. DED has many causes, including aging, hormonal changes, dry environments, In 2012, Deborah Pley was diagnosed contact lenses, certain medications, and autoimmune diseases. with Sjogren’s syndrome, an Treatments vary depending on the cause and severity of the condition. autoimmune disease that attacks The Penn Dry Eye and Ocular Surface center at the Scheie Eye Institute is the body’s moisture glands, causing dedicated to meeting the specific needs of each patient. particularly severe symptoms of DED. “It feels like sand is in your eye— Led by Drs. Giacomina (Mina) Massaro-Giordano and Vatinee Bunya, itchy, scratchy, blurred vision,” she the Dry Eye and Ocular Surface Center expanded in 2016, becoming described. After being diagnosed with one of a dozen centers nationwide approved to offer customized scleral Sjogren’s, Deborah sought specialized lenses. Scleral lenses are designed to treat symptoms of severe DED by DED treatment from Dr. Massaro. holding soothing saline solution against the eye. Scheie’s contact lens Dr. Massaro started Deborah on immunosuppressive When the virus subsided, Dr. Massaro prescribed drops, which helped reduce inflammation and customized scleral lenses, which were fitted in the increase tear production for a few years. new scleral lens center. For Deborah, scleral lenses have been even more effective and convenient than In December 2015, Deborah had an exacerbation of the treatment she used before the virus. She can a viral infection in her left eye, which precluded her now see better than she has in years. “Scleral lenses from continuing her immunosuppressive drops. Until made life 100% better,” Deborah said. “I’m not the virus healed, Deborah had to rely on antiviral uncomfortable at work anymore,” she added. “I can drops and over-the-counter drops to lubricate the work a ten hour shift and it doesn’t bother me…I like outer surface of the eye. While artificial tears are a going outside when it’s nice out—doing anything, common remedy for DED, they are less effective and washing the car, yardwork.” Deborah expressed require very frequent application for patients like gratitude for the individualized care she received at Deborah with severe symptoms. Scheie. “Dr. Massaro and her team are very supportive and helpful and try to do whatever they can to get As a pharmacist, Deborah works in front of a people to a better place.” computer screen for a significant portion of the day, which exacerbates her DED symptoms. During the Deborah’s testimony illustrates that each experience few months she was using artificial tears, Deborah with DED is unique and changes over time. In had to pause from work every 15 minutes to reapply addition to scleral lenses, there are a number of the drops. Additionally, the dryness caused sensitivity treatments for DED, including anti-inflammatory to light, limiting her ability to drive and participate steroid drops, inserts (lacriserts), punctal plugs, in outdoor activities. “I really didn’t go outside that specialized contacts with amniotic membranes, much. I have wraparound sunglasses, and I would autologous serum, nasal stimulating devices (True have to make sure I had them on. The brightness of Tear), and oral neuromodulating drugs. While the the sun was just irritating.” The sensitivity to light same treatment may not work for everyone, the Dry and dependence on artificial tears was isolating. “I Eye and Ocular Surface Center at Scheie is committed didn’t do as much socially because you just don’t feel to finding and providing the most effective approach good. You can’t see, you don’t feel like going out. You for each patient. don’t want to go someplace and be putting drops in your eyes every 10-15 minutes,” Deborah explained. During this period, the virus caused scarring in her cornea, damaging her vision.

Dr. Massaro, Deborah, and contact lens specialist, Kathy McNelis, COA, NCLC 13

beautifulBy Emma Wells inside and out The faculty and staff mourn the loss of Laura Ball, beloved Ad- ministrative Assistant at the Scheie Eye Institute. Laura passed away on February 1, 2018, after a lengthy battle with brain and breast cancer. She was 64.

Laura worked for Penn Medicine in various roles for 37 years, most recently as an Administrative Assistant for the Glaucoma Service at Scheie. She retired from Scheie in November 2017. Laura cherished the many friendships she made at Scheie, and she was loved and respected by her colleagues and patients alike.

Faculty and staff shared their memories of Laura and the myriad of ways she touched their lives.

I met Laura 30 years ago when I began working at Scheie. Laura has always been a beautiful person inside and out. She “would give everyone the most pleasant smile even when she I started here at Scheie in 1983. Over was rushed. She never said anything negative about anyone, the years I have been at the HUP and when you spoke with Laura you knew you would get an location and now at Radnor. For the encouraging word. She was definitely one of the most positive “ people I knew. I’m glad I had the privilege of knowing such a most part, my conversations with loving soul.” Laura were over the phone but always — Debra Dana received with the kindness she would show if in person. Her goodness and authenticity never wavered. Laura was one of those rare people that if you’re fortunate, you appreciate all along the way.” Laura was a sweet, gentle soul. She was such a delight to — Cathy Lawn see and greet every day. She was patient with everyone she interacted with, patients, faculty, and staff. It was because of “her and several others that the African American Celebration was brought back. Thanks for bringing the community together, Laura.” — Lila Lapides

I will always remember her loving and caring spirit, with a smile to top it off. “She made your feelings hers, which made you feel loved and inspired in return.” — Nekisha Ammons Laura had such a positive impact on my days at Scheie. She greeted everyone with a warm and heartfelt smile that “matched her sincere and kind essence. She truly was a beautiful person, both inside and out!”

— Sheri Grand Drossner The last time I saw Laura was When Laura told me she was interested in joining the shortly after her father passed Glaucoma Service as our Administrative Assistant I thought away. Our paths frequently crossed I’d gone to heaven. Laura’s effervescent personality and “in the hallway, and she always had “positive attitude uplifted me on even the worst days. The a friendly, smiling face and took patients absolutely loved her. Her spirituality nourished us. I the time to ask how I was doing. think of Laura every day, of talking and laughing with her. She I thought this was an incredibly was a bright star who blessed us all. Thank you, Laura, for thoughtful act, especially during being part of the Glaucoma family. I miss you.” the time of her father’s unexpected and untimely passing. Laura had — Eydie Miller-Ellis a smile as warm and as bright as anyone I have ever known. During years of African American History Month Celebrations, I had the wonderful opportunity to work with Laura and to enjoy her creativity, problem solving, warmth, and kindness toward every person she Laura greeted me with the most welcoming smile on my encountered. Laura will always live very first day here at Scheie. I was assigned to train with on in my memory.” Laura, and I was so amazed by her patience and all the “compassion she showed every patient. She seemed to know — Joan O’Brien most of them and loved them like family. I could see the great respect the staff showed her. Laura knew how to lift your spirits and pray with you, especially during sorrowful times. I’ll always remember the enjoyable visits to her office, whether planning for our annual African American Celebration or just sharing our family life events. Laura’s laughter was contagious! We’ll remember Laura here at Scheie always with love and great respect.” Her lovely spirit and deep faith in God — Cheryl A. Nathaniel were always inspirational to me.” “ — Cheryl Devine

When my father died, Laura gave me a simple porcelain angel as a gift of remembrance. The words, ‘You will always be in I had the pleasure of meeting Laura 12 my heart’ are written subtly on the doll. It was an elegant and years ago. Laura’s inner and outer beauty “kind memento. When I look at it now, I realize it is the same “was visible. Her positive spirit was gift she gave to each of us. She was relentlessly elegant and displayed in her walk, talk, and poised unwaveringly kind. That was her unique gift and her perpetual look. I would visit her in her office, and legacy.” we would have the best conversations. If you were having a bad day, her presence — Thomasine Gorry alone would lift your spirits. Her kind and caring words would make you feel like everything will be fine. I thank God for bringing her into my life! Laura, you will be truly missed!” — Donna Kirkland

Laura and I met 30 years ago at Scheie and who would have ever thought that God would bless me with such a “remarkable friend, sister and lunch partner. When you saw one the other wasn’t far behind. When Laura and I met, we instantly clicked. As the years progressed, I can truly say that she became“ a member of my own family. She was Laura was one of a kind. Warm, present at every family celebration, coming early to ensure caring, and giving. She was very that decorations were pristine and staying late because she “special and I will miss her a lot.” loved to talk. I can say that Scheie will not be the same without her beautiful soul.”

— Prithvi Sankar — Phyllis Robinson 15 faces of

By Ava Kikut OphthalmicSCHEIE: Technicians, with a spotlight on Lang Lourng Ung

You are just finishing reading an article inScheie Vision when your name is When the Vietnamese invaded called. You look up to see a petite woman in royal blue scrubs standing in in 1979, bringing an end to the the doorway between the lobby and the clinic. The woman leads you into an Khmer Rouge Regime, Lang and empty exam room and introduces herself. “My name is Lang. L-A-N-G.” her family fled the work camp and returned to their home village. An ophthalmic technician, Lang first asks your name and date of birth. She Shortly after, her parents decided types notes as you answer questions about your symptoms, pain level, and to leave Cambodia to find a health history. She hands you what looks like a masquerade mask with one eye better life. They paid in gold to hole and asks you to read letters from a screen across the room. She performs be escorted to a point close to the a peripheral vision test, asking you to say how many fingers she is holding up Thai border, walked several miles on either side of your face. She turns off the overhead light and shines a bright through the jungle, and made it to beam in each of your eyes. a refugee camp in Thailand, only to be turned around. Lang performs each test with energy. You are one of dozens of patients she has seen today, but it doesn’t show. Like the other technicians at the Scheie Eye “The Thai officers forced us at Institute, Lang loves working with people. She is thoroughly trained, detail- gunpoint to get on a bus,” said oriented, agile, and compassionate. She seamlessly gathers information for the Lang. As they rode through physician while making you feel comfortable. Thailand, villagers tried handing Lang and her family plastic bags Technically, Lang is one of Scheie’s newest technicians. But she has known this filled with water and rice through eye institute longer than most of the staff and faculty. Lang trained in the Scheie the bus windows. Confused by Medical Technologies Program during the mid-1980s, only a few years after her the gesture, they didn’t take the family immigrated to Philadelphia from Cambodia. bags. “We could not speak their Lang was eight when the Khmer Rouge (communist party) seized power in language, but we could see the Cambodia in 1975. Her family was evacuated from their village and placed in sadness on their faces, like they an agricultural labor camp for the next four years. wanted to tell us something but Top left: Lang outside Scheie in 1986, while attending the Ophthalmic Medical Technologist Training program. Top right: Lang outside Scheie in 2017. Bottom left: COMT Graduation in June 1989 [Left to Right: Linda Griffith, Michele, Lang, Michele Piccone, MD (Resident Class ‘92)]. Bottom right: Michele and Lang outside Scheie in 2017.

know where my family was if they had left me behind.”

The second time around, Lang, her siblings, and her parents were accepted into the Thai refugee camp. A year later, they moved to a camp in the Philippines, where her youngest brother was born. The family remained in the Philippines for a year, before coming to the United States, through San Francisco, to Philadelphia.

Lang’s family joined a refugee community in West Philadelphia. They moved into an apartment on 40th and Market, just above a Chinese restaurant. Lang and her siblings matriculated at University City High School across the Lang was eight when the street from the Scheie Eye Institute. Khmer Rouge (communist By that time, Lang was fourteen. She party) seized power in had not attended school for six years. She had been forbidden from speaking Cambodia in 1975. Her any language other than Cambodian family was evacuated from under the Khmer Rouge, and would need to relearn other languages she their village and placed in an knew prior to the war. Every afternoon, she and her siblings went to the agricultural labor camp for the University of Pennsylvania for English next four years. and math tutoring with study abroad undergraduate students from China. Afterward, they attended evening typing classes at West Philadelphia High School. On Saturdays they took they couldn’t.” The buses drove through Bangkok and across the border, Mandarin lessons at South Philadelphia leaving the refugees back on the Cambodian side of the Himalayan High School. At home, they relearned Mountains. Cantonese by watching Chinese movies. During the summers, Lang and the other Lang and her family used ropes to hoist themselves down the slopes and refugee children attended school four through minefields. Over the next several months, they moved from days a week and picked blueberries for sunrise to sunset from one village to the next, where Vietnamese soldiers $3.25 a case the other three days. guarded them from Khmer Rouge soldiers that had retreated into the jungle. With no food, clean water, or medical help, many of the travelers Just as everyone pitched in with berry didn’t survive. picking, all the siblings were expected to help support the family as soon “Along the way we lost a few more family members,” said Lang. “I lost as possible. After high school, Lang an uncle who was thirty years old. He stepped on a piece of bamboo and enrolled in an associates program at could have been cured with antibiotics, but we didn’t have any.” Harcum Junior College in Bryn Mawr, PA. While she was attending Harcum, When Lang’s family returned to their village, their property had been taken the school’s program director found an by neighbors. “We had lost everything,” she said. Her dad decided to take advertisement in the Philadelphia Inquirer the family back to Thailand a second time. “I was twelve years old. I was for an ophthalmic medical technologist too scared. I came along unwillingly. Now I’m glad I came here. I wouldn’t 17

When Lang returned to the Scheie technician team in October 2017, she immediately felt at home. “This is where I belong,” she said.

Lang (second from left) and her family, after moving to Philadelphia in 1983.

training program at the Scheie Eye Institute. Lang worked as a technician for ten years, before taking time off to focus on her three kids—a “I didn’t even know what ophthalmology was,” Lang daughter, now a junior at Rutgers University, and two said. Nevertheless, she needed work and it sounded sons, currently attending Cherry Hill High School like a good opportunity. Scheie was only a block from East. In the fall of 2017, she felt ready to return to where her family lived. Additionally, she learned, work as a technician and was excited to learn of an there were only eight accredited medical technologist opening at Scheie. training programs in the country at the time. “So I said to myself, I’d better go because that means there When Michele Sheehan, now the Director of will be a job.” With the support of sponsors from Ophthalmic Technicians at Scheie, saw Lang’s Swarthmore College, Drs. John and Gail Gustard, application she was ecstatic. “I knew I wanted to hire Lang entered Scheie’s ophthalmic technician training her right away,” Michele said. “I knew what a sweet, program in 1986. kind, wonderful technician she was.” When Lang came to Scheie for an interview in the fall of 2017, In ophthalmology clinics, technicians play a she was excited to reconnect with her old friend. significant role in optimizing the quality and “The last time I saw Michele was at my wedding in efficiency of care. Technicians at Scheie all become 1994.” certified by the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO) Lang also met Lina Sanchez, the Manager of as Ophthalmic Assistants (COAs), Ophthalmic Technicians and Scribes. During the interview, Lang Technicians (COTs), and/or Ophthalmic Medical recounted her family’s experiences leaving Cambodia Technologists (COMTs). Technicians prepare and coming to Philadelphia. Lina was so moved by patients for exams and procedures and relay Lang’s story she couldn’t let herself blink. “I didn’t necessary information to physicians, including health want her to see me cry,” she said. history, medications, allergies, vitals, visual acuity, refractometry, lensometry, intraocular pressure, and When Lang returned to the Scheie technician team several other measurements. Lang enthusiastically in October 2017, she immediately felt at home. learned to perform these specialized preliminary “This is where I belong,” she said. “Every day I am screenings and tests. A people person, she enjoyed excited about my job. This department is unique the opportunities to interact with patients as a because it is so well-organized. The team is also technician, especially in pediatrics. In 1988, after special in that it is filled with people who care about completing COT training, Lang became a full-time each other, including our wonderful managers. The ophthalmic technician at the Children’s Hospital of patients are so nice and friendly; they make each Philadelphia (CHOP). day a joy. Our job is very rewarding because we help people see better. I have deep gratitude to all In addition to working at CHOP, Lang also worked as of the Ophthalmology Department’s faculty, staff, a scribe technician every other weekend in the Scheie fellows, and residents, and especially for the other operating room (OR). At the time, there were only ophthalmic technicians. Thank you for welcoming two ophthalmic technicians assisting physicians in me a second time. Words cannot express how the OR: Lang and Michele Sheehan. Lang had been overjoyed I am every day at Scheie to be surrounded a year ahead of Michele in the medical technologist by such a great team.” training program and had helped to train her. The two enjoyed working together and became close friends. Jonathan Prenner, MD Alumni Spotlight By Rebecca Salowe

Dr. Jonathan Prenner may live in the heart of Princeton’s campus, but he is a Penn Quaker at heart.

Originally from New York, Dr. Prenner received his undergraduate degree at the University of Pennsylvania and his medical degree at the State University of New York at Stony Brook. After completing an internship at Long Island Jewish Medical Center in 1999, he moved back to Philadelphia for his residency at the Scheie Eye Institute.

Dr. Prenner distinctly remembers one of the reasons why he chose to pursue ophthalmology. “One of my fraternity brothers, Rick Kaiser, was a resident at Scheie when I was choosing a field,” he said. “He loved ophthalmology. I figured that if he liked it, then I would as well. Not a great method of decision making, but it luckily worked out.”

Dr. Prenner described his time as a Scheie resident as a “homecoming” for him. “It was a warm and nurturing environment that fostered intellectual curiosity and academic achievement in concert with clinical excellence,” he said. When looking back, he most remembers building strong relationships with friends and mentors at Scheie, and still cherishes these “rare relationships.”

In particular, the mentorship of several faculty members (Drs. Jeff Berger, Al Maguire, and Sandy Brucker) helped Dr. Prenner choose a career as a retina specialist. “The camaraderie and fulfillment that went along with caring for people with severe diseases was inspiring,” he explained. “It was an outstanding era, when retina was really the specialty of the house.”

After completing his vitreoretinal fellowship with the Associated Retinal Consultants at William Beaumont Hospital, Dr. Prenner joined NJ Retina, a 20-doctor private practice specializing in retina. Two other Scheie graduates, Drs. Paul Hahn and Leonard Feiner, now serve as his partners. Though a high-volume clinical practice, NJ Retina also focuses on independent research and clinical trials. Dr. Prenner particularly enjoys researching and publishing on novel surgical techniques regarding complex intraocular lens surgery.

In 2017, Dr. Prenner was named the Chairman of the Ophthalmology Department at Rutgers Robert Wood Johnson Medical School. In this role, he hopes to continue to strengthen the mentoring program for medical students interested in ophthalmology. He is thrilled that the vitreoretinal surgery fellowship program has become one of the highest volume surgical programs in the nation.

Today, Dr. Prenner lives in Princeton with his wife, Becky, and two children, Sofia (13) and Max (8). They love living in a college town and close to family in New York.

“Scheie really gives residents the foundation required to have a superb career,” Dr. Prenner concluded. “I am exceptionally grateful to have benefitted so extensively from both Scheie and the University.” 19 Bringing Eye Care Across the World By Emma Wells

“In many parts of the world, there is one ophthalmologist for a million patients. Many Dr. Sonul Mehta Dr. Mehta operating on an orbital lesion in Guatemala patients do not have access to an Dr. Sonul Mehta, an Assistant Professor of Ophthalmology and ophthalmologist an oculoplastic and reconstructive surgeon, is passionate about providing medical care to underserved populations. At least once or medical a year, she travels internationally to provide medical services to professional, while areas with limited access to eye care. others do not have She has taken multiple trips to the Philippines, China, India, and the means to be various parts of Southeast Asia, as well as Ecuador, Guatemala, Panama, and other parts of South America. evaluated and treated. Today, 180 During these service trips, Dr. Mehta is part of a team of surgeons, anesthesiologists, operating room nurses, and million people in the ophthalmic technicians. This group sets up a tent hospital, world suffer from performing anywhere between 50 and 100 surgeries a day. “We try to provide as much medical care as possible in the short blindness—but 80% period of a week,” said Dr. Mehta. “The goal is to see, evaluate, of world blindness and treat as many patients as we can.” is avoidable. It’s just For more complex procedures, the team joins forces with local a matter of getting physicians and hospitals. “This gives an opportunity for local physicians to learn to treat these more complex conditions and adequate care and to better understand how to treat them post-operatively, so they medical attention can then treat more of their population,” explained Dr. Mehta. to them.” –Sonul Mehta, MD One of the greatest challenges when volunteering abroad is a lack of resources. “We bring as many supplies as we can, everything from sutures to donated glasses to instruments,” said Dr. Mehta. But access to imaging modalities and medications, such as antibiotics to prevent post-operative infection, remains limited.

Though challenges arise, Mehta views her international service as some of the most rewarding work she has done. “The patients continue to inspire me,” she said. “So many times, patients will wake up from surgery with the ability to see again after not seeing for 30-plus years, and the joy on their faces is so contagious. It’s truly a second chance at life.” Dr. Mehta plans to continue taking part in service throughout her career because of the joy and gratitude it summons. “Through each service trip, This young girl from the Philippines suffered Wait lines for I’ve learned that improving the lives of those who need it most from strabismus and lid ptosis. She is one of treatment in the eight siblings, and because of her impaired Philippines is like no other feeling you can imagine. You come back and you vision, her parents did not send her to school. feel so grateful for what you have.” She and her aunt travelled three hours to bring her to the clinic for surgery. She is now attending school. Walker will be remembered remembering for her limitless kindness and generosity.

walker kirbyBy Emma Wells

Walker and Fred had four children, Prithvi Sankar, MD, the Director ten grandchildren, and eight of Medical Student Education at great-grandchildren, all of whom the Department of Ophthalmology. they loved beyond measure. “It “Her kindness and generosity were was an honor and a pleasure so admirable and will continue to to care for Walker Kirby,” said live on with all her efforts.” Joshua L. Dunaief, MD, PhD. “She would always tell me about Also extraordinary was Walker’s the meaningful pursuits of her devotion to The Seeing Eye, children, grandchildren, and great- a philanthropic organization grandchildren. She loved them, and in Morristown, NJ, that trains felt deeply loved and cared for by guide dogs for people with visual them.” impairments, where Walker sat on the board for 30 years. Walker Walker will be remembered initiated a program at Seeing Eye for her limitless kindness and called Walkie’s Walkers, which generosity. She devoted her life organizes play and exercise breaks to philanthropic work, and her for puppies undergoing rigorous We are deeply saddened by the loss contributions to Ophthalmology at training. In 1991, The Seeing Eye of Walker Kirby, a patient, friend Penn were many. awarded her the Dorothy Harrison and generous donor of the Scheie Eustis Humanitarian Award. Eye Institute for many years. She Walker served as a board member passed away on November 11, of the F.M. Kirby Foundation Equally remarkable as her life- 2017, at the age of 93. for over 30 years, a family changing philanthropic work were foundation established in 1931 the small kindnesses that Walker “Through my seven years as by her grandfather-in-law. Penn’s extended to everyone she met. Chairman I came to know Walker F.M. Kirby Center for Molecular Dr. Dunaief keenly remembered well,” said Joan O’Brien, MD. Ophthalmology was founded in Walker’s thoughtful gestures. “Walker loved back porches, 1994 with a generous gift from the “During her visits, she would always the beautiful trees her husband F.M. Kirby Foundation, which has inquire about our latest research cherished, and the summers and continued to provide consistent on retinal disease. Without fail, she holidays spent with her loving support to the center for nearly would bring a gold bag of peanuts family. Over the years, I learned 25 years. This support has been from North Carolina—the best my very much about the family she instrumental in several high-impact colleagues and I have ever tasted!” cared for so deeply. I will miss her research advances. added Dr. Dunaief. “I will miss very much, as she had become a her, and the memory of this warm, dear friend.” In 2015, Scheie Eye Institute altruistic, dignified woman will established the Walker D. Kirby continue to serve as an inspiration.” Walker grew up in Greensboro, Ophthalmology Medical Student North Carolina. In 1949, she Award. This award is given every Dr. O’Brien concurred: “For many married Fred Morgan Kirby II, year, in perpetuity, to a medical years we shared lunch together, who was the former chairman and student graduating from the and she always brought me a CEO of Alleghany Corporation, as Perelman School of Medicine who thoughtful gift when she visited. well as the president of the F.M. plans to pursue ophthalmology and Walker will never be forgotten by Kirby Foundation. When Fred who embodies Walker’s core values me, the Scheie Eye Institute, and passed away in 2011, Walker told of respect, loyalty, perseverance, the medical students who carry her Dr. O’Brien she would never stop empathy, responsibility, and values forward to care for others as missing her late husband, but “that honesty. “She was so thoughtful Walker always did. I too will try my was the price she willingly paid for to meet with the student who very best to exemplify the values such a happy marriage.” received the award and best she taught me.” embodied Walker’s values,” said 21 144 YEARS OF THE DEPARTMENT OF OPHTHALMOLOGY

By Emma Wells

The Department of Ophthalmology celebrated its 144th Anniversary at the Scheie Alumni Meeting this past April. The weekend provided an opportunity for alumni to reconnect with old friends and discuss the most current advances in ophthalmology research.

Friday and Saturday were packed with lectures and presentations of research and clinical case studies from each subspecialty. Topics spanned retinal degeneration, neuro-ophthalmology, oculoplastics, pediatric ophthalmology, glaucoma, retina, and cornea.

The 2018 Honored Alumni Lecturer was Dr. Michael Kazim, who is a Clinical Professor of Ophthalmology and Surgery at Columbia University. Dr. Kazim delivered a captivating lecture titled “Evolution of the Precision Care of Optic Nerve Glioma.” Dr. Graham Quinn, a Professor of Ophthalmology at Penn and an Attending Surgeon at Children’s Hospital of Philadelphia (CHOP), gave an equally inspiring Annual David M. Kozart Memorial Lecture on “Retinopathy of Prematurity: Where are We Going and Why?”

The Department continued its tradition of hosting a celebratory dinner at the Rittenhouse Hotel on Friday evening. The evening was filled with delicious food, lively conversation, and dancing with old friends and colleagues. Heartfelt speeches were given in honor of Dr. Quinn’s 40 years of service at Scheie and CHOP.

Please save the dates of April 12 and 13 for the 2019 Scheie Alumni Weekend.

Many thanks to Course Director Dr. Stephen Orlin, Course Dr. Joan O’Brien (left) and Dr. Monte Mills Co-Directors Drs. Alexander Brucker and Vatinee Bunya, and (center) present Dr. Graham Quinn (right) with a Lea Bramnick and Karen Cope-Scarfo for organizing this meeting. Philadelphia Bowl. alumni president

dear friends

Family. There is nothing like it. Scheie Eye is a special place We share a common ancestry and with a great history and great linkage that cannot be broken. We people. This year’s spring grow up in the same home and Alumni meeting saw the return eventually develop wings strong of Oculoplastics Fellow Dr. Mike enough to take us away from Kazim and the recognition of the nest, yet our bonds always Dr. Graham Quinn, Pediatric remain. As time passes, it gives us ophthalmologist extraordinaire, perspective to reflect on the past for his long and distinguished and the lessons learned from our career at Penn and CHOP. siblings, parents, and grandparents. Many former residents and fellows returned to share their Life as a student, resident or knowledge and celebrate our fellow really isn’t much different. common bonds. It was a great We “grow up” together, learning weekend, as always, enjoyed along the journey from those with by all who came. We are always Scott M. Goldstein, MD Pediatrics & Adult more experience before we head happy to see our extended family Oculo-Facial Plastic Surgeon out into our own practices. Yet come home. So don’t be a stranger! Tri-County Eye & Wills Eye Institute the bonds formed last our entire Continue to keep in touch and career. Every time we cross paths join us throughout the years in after going our different ways, we the spring and fall, or whenever share stories of days long gone in Philly! You’ll be amazed at how while catching up on family and much we have grown! life. We reflect on our training and those who trained us. Find us online at www.pennmedicine. org/departments-and-centers/oph- Scott M. Goldstein, MD Res ‘00, Fel ‘02 thalmology or www.facebook.com/ President, Scheie Alumni Society ScheieEye Penn Medicine Scheie Eye Institute 51 N. Myrin Circle Philadelphia, PA 19104

find us on facebook at www.facebook.com/ScheieEye

SCHEIE summer 2018 EYE INSTITUTE

The Scheie Eye Institute is the Department of Ophthalmology at the University of Pennsylvania. Scheie has been a leader in the field of ophthalmic research, education, and patient care for 144 years. Many of our greatest advancements in vision saving therapy have been made possible by donations from individuals and organizations.

Will you join the Scheie Eye Institute? For more information contact us at 215.662.8415 Or by email: [email protected]

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