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FALL 2017/WINTER 2018

Cataract surgery is one of the oldestsurgical procedures known to humans.Wall paintings found in Egyptian tombs dating backto 1200 B.C. depict a procedureknown as “couching,” whichinvolved using a sharp instrumentto push the cloudy lens into theback of the eye, leaving the patientwith limited—but unfocused—vision. The first modern cataractsurgery involving true extractionof cataracts from the eye wasperformed by Frenchophthalmologist Jacques Davielin 1747.

For many people today, themention of cataract surgeryinvokes memories of the thick“Coke-bottle” glasses that theirparents or grandparents had towear after having the clouded lensremoved entirely, or of days andweeks they spent in the hospitalrecovering from extensive surgicalprocedures. But today’s cataractsurgery, involving state-of- the-artmachines and lasers, can take aslittle as 15-20 minutes withminimal recovery time and restorepatients to vision that in some cases is better than evenbefore they developed the cataract.

“Our patients no longer go from virtually blind to seeingreasonably well, but to seeing better than they ever didbefore, with less spectacle dependence,” says Leejee Suh,

MD, Miranda Wong Tang Associate Professor ofOphthalmology and Director of the Laser VisionCorrection Center as well as the Cornea and Anterior

Segment Service.“I hear itfrom my patients all thetime: ‘I’ve never been ableto see like this.’ It has ahuge impact on theirquality of life.”

Columbia University isat the forefront ofmodern cataract surgery,offering two differentmethods of cataractsurgery. In the standardmethod, also known asphacoemulsification, thesurgeon makes an incisioninto the cornea with ablade, breaks the cataractinto pieces withphacoemulsificationenergy, and then implantsa new artificial lens intothe eye. A more recentdevelopment in cataractsurgery is Femtosecond(FS) laser-assisted cataractsurgery (FLACS) in which

the laser makes incisions in the cornea and lens, followedby the surgeon removing the cataract and inserting theartificial lens implant manually like in the standardsurgery.“Femtosecond laser-assisted cataract surgery canvery precisely center the new intraocular lens in the eye,with the option of reducing

Moving up appropriatelycharacterizes the newly renovatedHarkness Eye Clinic. The new Eye Clinic,part of the NewYork-Presbyterian AmbulatoryCare Network, moved from the Harknessbasement to the first floor of the Eye Institute andopened its doors to patients in September. With16 exam rooms, and multiple diagnostic andtreatment spaces offering advanced imaging andlaser technology, the new facility provides anattractive, modern, and highly functionalenvironment for patients, staff, and physicians –residents and attendings – who work in the clinic.Patients appreciate the natural light from the

ample windows and enjoyviews of the Hudson River.

The move from thebasement of the Eye Institutewas highly symbolic, saysJason Horowitz, MD, A.Gerard DeVoe – B. DobliSrinivasan Director of theHarkness Eye Clinic andAssistant Professor ofOphthalmology.“We now

share the first floor withthe main faculty practicefacility. This sends apowerful message to ourpatients and the residentphysicians fromNewYork-Presbyterian.While the quality ofmedical care has alwaysbeen stellar, the newsurroundings clearlydemonstrate that we strivefor and are committed toproviding a level ofcommunity care that

INSIDE

Jason Horowitz, MD,Clinic Director

continued on page 6

Leejee Suh, MD

continued on page 2

Everybody Rise: Renovated HarknessEye Clinic Opens

View from the Chair 2Clinical Spotlight 3

Visionaries &Luminaries 4-5

Faculty Spotlight6-7

The Last Word 8

Transforming Cataractand Corneal Surgery

The Eyes of a Child:New PediatricCornea Clinic Opens

Drs. Silvermanand ZhangAwarded Tenure

ColumbiaOphthalmologyChampions NationalResearch Initiativefor All of Us ResearchProgram

New AdministrativeDirector to SupportJonas Children’sVision Care

A Laser Focus onVision Correction at880 Third Avenue

One Million Hits!

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matches the very high standards set in Columbia’sOphthalmology private practice locations.That has always been true, but the new facilitycrystallizes the message for patients, support staff,attending and resident physicians.”

G.A. (Jack) Cioffi, MD, Jean and Richard DeemsProfessor, Edward S. Harkness Professor andChairman of the Department of Ophthalmology,envisioned the new clinic space when he assumedthe chair’s position five years ago, but because thenew location had been occupied by other prac-tices, an intricate choreography of relocation hadto be scheduled over years.

“Orchestrating this move in a 90-year-old buildingwith many infrastructure idiosyncracies presenteda daunting challenge. The minimal disruption topatient care during the clinic move is a credit tothe entire team,” says Dr. Horowitz.“It was abuilding-wide endeavor, from the basement to theroof, but at no time did the move interfere with

clinical practice or surgical procedures. HarknessEye Clinic patients continued to get superb careand now have the physical space that appropriatelysymbolizes that quality.”

For residents, the contrast between the new facilityand the old clinic is almost literally night and day,says residency program director Royce Chen, MD,the Helen and Martin Kimmel Assistant Professorof Ophthalmology.“There’s actually exposure tosunlight! We have better access to internet and cellphone connectivity, and I’ve heard residents jokingthat the space is so much nicer that they don’tmind staying late anymore. I was here as aresident several years ago, and while the clinichas always been one of the gems of theophthalmology program, the location in thebasement did affect perception.”

Patients and staff alike have been delighted withthe new space as well, says clinic nurse LibradaSosa, RN.“The patients love the setting, and the

space is very well organized, which facilitates ourwork in teams.” The clinic’s close proximity to thefaculty practice also allows for an even greaterdegree of interaction between residents andattending staff as well as convenient access to theimaging suite.

“The complete renovation of the Harkness EyeClinic stresses the importance that we place oncaring for our Washington Heightsneighborhood,” says Dr. Chen.“To our patients,it says that no matter what your socioeconomicstatus, we want you to get the best possible care inthe world. And to our residents, it says that we careabout the environment in which you work, andwe want you to have a state-of- the-art space thatmatches the caliber of the residents we can get.Our program is really hitting its stride and cancompete with the top programs in the country,and we now have a resident clinic to match.”

Everybody Rise: Renovated Harkness Eye Clinic Opens continued from page 1

from the Chair

Dear Friends,

The cornea is virtually unique among the tissues of the body, in thatit contains no blood vessels to nourish and protect it. This clear,dome-shaped outermost surface of the eye is essential to healthy visionand particularly vulnerable toinjury. In this edition ofViewpoint, we focus on thework of our highly skilledclinicians and researchers whooffer advanced treatments forcorneal disease and trauma,including the cornea servicedirector, Leejee Suh, MD;surgeon-scientist David Paik,MD; noted laser visioncorrection pioneer StephenTrokel, MD; and Danielle Trief,MD, MSc, who heads the newpediatric corneal clinic.

Dr. Suh also directs ourRefractive Surgery Center,which has recently moved to newly renovated space in our convenientlylocated 880 Third Avenue location in midtown Manhattan. There, ourpatients not only have access to the latest laser vision correctiontechnology, but also a wide array of general and specialized optometricservices, including medically necessary contact lens fitting.

Our emphasis on Precision Ophthalmology™ positions theDepartment as an ideal partner for All of Us, a historic nationalinitiative spearheaded by the National Institutes of Health aimed ataccelerating research by gathering data on more than one milliondiverse individuals. Columbia is leading the New York CityConsortium of health care providers working to engage patients inAll of Us, and the Department of Ophthalmology has gladly takenthe lead in recruiting patients to participate in this importantresearch effort.

I am delighted to announce that the Department of Ophthalmology nowhas nine tenured professors, as Ronald Silverman, PhD, and Xin Zhang,PhD, were both awarded tenure over the summer. In this issue of Viewpoint,we discuss the meaning of tenure and describe their important work.

Last spring, we featured the opening of the Jonas Children’s VisionCare Center, our state-of-the-art pediatric ophthalmology center.This fall, we welcome the administrative director of the center, LisaHark, PhD, RD, who will help to build its national reputation as atop referral program.

If you were in the United States on August 21—and even if youweren’t—you probably gave at least some thought to whether andhow to view the “Great American Eclipse.” With “eclipse fever”gripping the nation, we created an educational video andaccompanying materials featuring retina service director TongalpTezel, MD. The multi-media offerings drew nearly one millionvisitors to the medical center’s newsroom.

When I assumed the position of chair five years ago, one of my firstpriorities was to relocate the Harkness Eye Clinic from its longtimeplace in the basement of the Eye Institute, to renovated, modern spaceon the first floor that reflects our commitment to offer clinic patientsthe highest quality vision care, and to give the residents and attendingsthe best possible experience in providing that care. My thanks toeveryone who helped us finally make that vision a reality when weopened the renovated Eye Clinic this fall.

Thank you, as well, for taking the time to learn about our workthrough the Viewpoint and for your dedication to our mission ofimproving and restoring vision, advancing scientific understandingof ocular function, and nurturing the next generation ofophthalmologists and ophthalmic scientists.

Sincerely,

G. A. (Jack) Cioffi, M.D.Jean and Richard Deems ProfessorEdward S. Harkness ProfessorChairman, Department of Ophthalmology

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There are many different corneal diseases that canaffect children, including congenital as well as acquired conditions,but relatively few experts around the country specialize in treating cornealdisease in children. One of those experts, Danielle Trief, MD, MSc, AssistantProfessor of Ophthalmology, has now launched a specialized PediatricCornea Clinic at Columbia.

“I had kids with corneal disease scattered throughout my practice, but nowwe’ve consolidated the cases into a clinic held on every second Friday of themonth,” says Dr. Trief. “The clinic is rapidly growing and we expect toexpand it to a full-day clinic soon. If we fill up that day, then we’ll add

another.” The clinic, which caresfor patients from all backgroundsregardless of insurance status, issupported in part with fundingfrom the Jonas Family Fund andan anonymous donor.

Some of the most commonconditions Dr. Trief cares forinclude the complications ofsevere, chronic allergies, includingblepharitis and inflammation ofthe conjunctiva. “During allergyseason, we see many children withvernal conjunctivitis, which cancause an ulcer that thins out thecornea over time,” she says. Often,this condition can be treated withstandard allergy medications, butsometimes it also requires steroid

treatment. Usually the thinningis reversible with this treatment,but if the cornea becomes verythin, on rare occasions aprocedure is required to implantan amniotic membrane, whichhas anti-inflammatory propertiesthat can heal ocular surfacedisease. If there is severe scarring,occasionally corneal surgeryis necessary.

Rarer conditions found in children include congenital corneal opacities.“Sometimes children are born with opacification [clouding] of thecornea, because it did not develop properly and is missing a layer. If theopacification is not treated properly, the child can have poor vision forthe rest of his or her life,” Dr. Trief says. “And children with congenitalglaucoma, because of the number of surgeries they have been through,can sometimes develop swelling of the cornea.”

In these cases, Dr. Trief will perform a partial corneal transplant to restorethe lost cells of the cornea. “It’s a nice procedure for children because lesstissue is involved, which means that there is lower risk of rejection and fewerstitches than with a full transplant, and they have a much faster recovery.”

Some children, however, require a full corneal transplant—one of theseconditions is a congenital clouding of the cornea called Peters anomaly,which can be caused by many different genetic and non-genetic factors.“The cornea doesn’t develop properly. This is because the natural lensor iris adheres to the cornea and it becomes opacified,” says Dr. Trief.“In that situation, we have to replace the whole cornea. A traumaticinjury will also sometimes require full corneal replacement, as canprogressive keratoconus.”

Treating corneal conditions in children poses a number of uniquechallenges. “For example, the tissue of a child’s eye is different than theocular tissue of an adult. It’s flimsier and there is high posterior pressurein the eye, so you have to be very delicate when suturing,” Dr. Trief says.Children also heal faster than adults, which has the down side of requiringthat they must be brought back to the operating room to have stitchesremoved surgically.

There is also a very short window for surgical intervention in youngchildren. “The connections between the eye and the brain develop over

a critical window inchildhood, up untiladolescence,” Dr. Triefexplains. “If a child is bornwith clouding of the corneaand doesn’t receive a cornealtransplant until the age of16, vision will be very pooreven if the cornea itselflooks fine, because theconnections between theeye and the brain neverreally formed.”

Dr. Trief’s commitment topediatric vision care datesback to her youth. Whilegrowing up in Tenafly,New Jersey, she frequentlyvolunteered with visuallyimpaired children at whatwas then the Jewish Guildfor the Blind (whichmerged in 2013 withLighthouse International

to become the Lighthouse Guild), where her mother served as principalof the preschool. “Although I didn’t enter medical school intending to doanything related to vision, it was always a part of who I was because of thatexperience,” she says.

During her end-of-year clinical rotations as a third-year medical student atColumbia University College of Physicians and Surgeons, Dr. Trief assistedwith a cataract surgery performed by Professor of Ophthalmology JamesAuran, MD—and discovered her passion. “I just thought it was so beautifuland such a tangible thing, to take someone who can’t see well and give thatperson vision and improve his life.”

The Eyes of a Child:New Pediatric Cornea Clinic Opens

B O A R D O F A D V I S O R SDepartment of Ophthalmology

Sir Howard Stringer, ChairmanWilliam AcquavellaRand V. AraskogDebra BlackShirlee and Bernard BrownRobert L. Burch IIIHoward L. Clark, Jr.Joseph C. ConnorsAlan K. DocterPolly EspyLouis V. Gerstner, Jr.Arthur HershaftLeslie HintonJoel S. HoffmanFlorence IrvingMichael M. KellenHelen KimmelDr. Henry KissingerJean Sheng LarkinAmbassador John L. Loeb, Jr.John ManiceCecilia MullenBjorg and Stephen OllendorffJohn RobinsonStephen RossJames ShinnMiranda Wong TangDavid TobeyRichard WoolworthStanley ZabarGregory Zaic

I N M E M O R I A M

Gloria Milstein FlanzerLouis FlanzerT. C. HsuHerbert IrvingMartin S. KimmelSeymour MilsteinJ. Dukes Wooters, Jr.

M E D I C A L A D V I S O R S

Lama Al-Aswad, MD, MPHRando Allikmets, PhDJames D. Auran, MDRobert Braunstein, MDSteven E. Brooks, MDStanley Chang, MDGeorge A. Cioffi, MDMax Forbes, MDJeffrey Liebmann, MDJanet Sparrow, PhDLeejee H. Suh, MDTongalp H. Tezel, MDStephen Trokel, MDBryan Winn, MD

V I E W P O I N T

Editor-in-ChiefJane E. Heffner

WritingGina Shaw

Graphic DesignDavid Sakla

PhotographyDavid McMahon/Lanyi Zhao

Danielle Trief, MD, MSc with patient.

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&VisionariesLuminaries

Columbia’s Department of Ophthalmology now boastsnine tenured professors, as Ronald Silverman, PhD, Professor ofOphthalmic Science (in Ophthalmology) and Xin Zhang, PhD, Jules andDoris Stein Research to Prevent Blindness Professor and Associate Professorof Ophthalmic Sciences (in Ophthalmology and Pathology & Cell Biology),were awarded tenure in June.

“To be tenured at ColumbiaUniversity is not only a hugehonor, but it’s a recognition of afaculty member’s place in theacademic world and his or herachievements to date,” says G.A.(Jack) Cioffi, MD, Jean andRichard Deems Professor, EdwardS. Harkness Professor andChairman of the Departmentof Ophthalmology. “These twoscientific investigators have mademajor contributions in theirrespective fields. Receiving tenureis an acknowledgement that theyhave contributed throughlaboratory research, publicationsin top tier journals, educationalprograms for students, residents,fellows, and clinician-scientists,and as leaders in national andinternational societies. Itrecognizes that they are thewhole package.”

An expert in ophthalmicapplications of ultrasound,Dr. Silverman came to bothophthalmology and ultrasoundresearch later in his career, havingworked as a biochemistrytechnician while earning hismaster’s degree in bioengineeringand a doctorate in computer science, specializing in non-linear signal-and image-processing. For nearly three decades, he worked in theophthalmology department at Weill Cornell Medical College withDepartment Chair D. Jackson Coleman, MD on diagnostic andtherapeutic ultrasound research. In 2010, he moved to Columbia,where he was joined two years later by his mentor, Dr. Coleman, whois today a Professor of Ophthalmology at CUMC.

Dr. Silverman is funded by the National Eye Institute for his work indeveloping ultra-fast plane wave imaging, a tool for structural imagingof the eye that offers 10,000 images per second, compared with the tenimages per second available with standard ultrasound.“This technologyallows us to see structures within the hidden layers of the eye and isparticularly useful in imaging and measuring blood flow, giving it anumber of possible applications,” he says. “We are using this tool tostudy blood flow in both normal and glaucomatous eyes. Anotherclinician in the department is interested in using ultra-fast plane waveimaging to assess blood flow in front of the eye following muscle surgery,while yet another wants to use it in studying ocular tumors andvascular malformations.”

After studying molecular biology in graduate school, Dr. Zhang foundhimself particularly fascinated with the development of the eye.“For

humans, vision is probably our most important sense.Eye disease is so common, particularly among the agingpopulation, and I was drawn to the field because thereis so much that we can offer to help our patients,” hesays. A developmental geneticist whose research focus ison ocular development in health and disease, Dr. Zhanghas concurrent Research Project Grants (R01s) from theNational Institutes of Health.

Among his current projects is the so-called “eye in a dish,” whichmanipulates pluripotent embryonic stem cells to generate ocular structuresin vitro. “We are especially interested in a peripheral retinal structure calledthe ciliary body and are starting to see ways in which we can generate thosestructures,” Dr. Zhang says. “The ciliary body can be lost due to injury, such

as trauma in accidents or in combat, and there is currentlyno treatment for that kind of injury. We are very hopefulthat our basic research can guide us to a way to generatethose necessary tissues and develop a treatment.”

In addition to Dr. Silverman and Dr. Zhang, the othertenured professors in the Department of Ophthalmologyinclude:

Rando Allikmets, PhD, William and Donna AcquavellaProfessor of Ophthalmic Sciences (in Ophthalmology andPathology & Cell Biology) and Research Director, Edward S.Harkness Eye Institute

Past Chair Stanley Chang, MD, K.K. Tse and Ku Teh YingProfessor of Ophthalmology

G.A. (Jack) Cioffi, MD, Jean and Richard Deems Professor,Edward S. Harkness Professor and Chairman of theDepartment of Ophthalmology

Peter Gouras, MD, Professor of Ophthalmology

Department Vice Chair Jeffrey Liebmann, MD, Shirlee andBernard Brown Professor of Ophthalmology and GlaucomaService Director

Janet Sparrow, PhD, Anthony Donn Professor of OphthalmicSciences (in Ophthalmology), and Professor of Pathology &Cell Biology

Stephen H. Tsang, MD, PhD, Laszlo T. Bito AssociateProfessor of Ophthalmology and Associate Professor ofPathology & Cell Biology

Drs. Silverman andZhang Awarded Tenure

Ronald Silverman, PhD

Xin Zhang, PhD

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The Department of Ophthalmology isrecruiting participants for a groundbreaking nationwidestudy that aims to enroll one million or more people in order toaccelerate medical research and improve health. Sponsored by

the National Institutes of Health, All of Us Research Program isnot focused on any single specific disease or community;instead, it will serve as a national research resource to informthousands of studies, covering a wide range of healthconditions. By taking into account individual differences inlifestyle, environment, and biology, researchers will identifypaths toward making precision medicine an everyday reality.

The unprecedented scale and scope of All of Us willfacilitate research for both common and rare diseases as well asimproving understanding of disease prevention. It will also havethe statistical power to identify connections between healthoutcomes and various environmental or biological factors.

Patient enrollment for All of Us is being driven by tenuniversity-based consortia across the country, with ColumbiaUniversity Medical Center leading the New York CityConsortium. Over the next five years, Columbia and its NYCpartners aim to enroll as many as 150,000 patients in theproject, according to David Goldstein, PhD, Director of theInstitute for Genomic Medicine, John E. Borne Professor ofGenetics and Development, and Principal Investigator of theConsortium. To jump-start efforts toward reaching thataudacious goal, several departments at Columbia have beenidentified as key champions and clinical partners, and theDepartment of Ophthalmology was one of the first to sign on.

“All of Us fits exactly with the paradigm that our departmenthas established with Precision Ophthalmology™,” says G. A.(Jack) Cioffi, MD, Jean and Richard Deems Professor,Edward S. Harkness Professor and Chairman of theDepartment of Ophthalmology. “A number of steps are neededfor us to have meaningful and actionable clinical data regardinggenomic information. It is essential to develop such a hugedatabase so that we know what the ‘normal’ population lookslike and use the opportunity to compare when we see variationsfrom that normal.”

In order to ensure that the benefits of precision medicine—improved diagnosis, treatment, and disease prevention—areavailable to everyone, All of Us has prioritized the recruitmentof a diverse population of participants from all races, cultures

and socioeconomic backgrounds. The Departmentof Ophthalmology is ideally positioned to helpachieve that goal, says Dr. Cioffi. “We see patientsfrom all walks of life and of all ages, and we havelong-term relationships with most of them.”

Participants in All of Us will be asked to contributeinformation about their medical history andlifestyle; they may be asked to have their physicalmeasurements taken (such as blood pressure,height and weight), and to donate a blood andurine sample. The program is committed togiving people back their own data, so anyone whoparticipates in All of Us will have access to theirown study results as well as summarized datafrom across the program.

“The NIH wants this data to be as available aspossible, not just to university researchers. Theagency is trying to engage citizen scientists andfacilitate participant involvement and feedback inthe research questions that are proposed,” saysLouise Bier, Director of Genetic Counseling andClinical Engagement at the Institute for GenomicMedicine. “Community outreach and partnerships

are a key component of the program. Some information isobviously very sensitive, so there are standards and protectionsin place to make sure that privacy is appropriately respected.”

The program is open to people, healthy and sick, from allcommunities, and Dr. Cioffi has already taken the lead inenrolling a number of his own patients to participate. “OnSeptember 7th , the first morning we started recruiting in theclinic, we had five patients interested within the first hour,” hesays. “I wanted to start with my own patients, to set an examplefor the department and work out any kinks in the processbefore we asked the rest of the faculty to participate.”

That approach is exactly what the program needs, saysDr. Goldstein. “All of Us depends on very strong clinicalengagement; we couldn’t possibly recruit this many patientswithout that. We really need clinical champions who believethat valuable data will be generated by this program and whoshare that enthusiasm with their patients. When that supportcomes from a department chair, it’s very powerful.”

Dr. Cioffi believes that the All of Us partnership will help toforge closer ties between the Department of Ophthalmologyand the other departments in the medical center, such as theInstitute of Genomic Medicine. “My observation has beenthat ophthalmology programs can become distant from themedical school and other departments, and I think that’s tothe detriment of the field,” he says. “Many systemic diseaseshave a bearing on eye health, and the eye has a bearing onmany systemic diseases. By championing an effort like All of Us,we will be a ‘good university citizen,’ and we will acceleratevision research and vision care with closer relationships to ourcolleagues in genetics, bioinformatics, and other departments.”

More information about All of Us is available on the NIHwebsite at allofus.nih.gov and Joinallofus.org/NYC

Research Spotlight:

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Image courtesy of the National Institutes of Health

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Lisa Hark, PhD, RD, an experiencedprogram director, has joined theDepartment of Ophthalmology as Professorof Ophthalmic Sciences. Dr. Hark will use herextensive experience and expertise to help buildand grow the many components encompassedwithin the newly launched Jonas Children’s VisionCare initiative at Columbia University MedicalCenter. Supported by generous funding from theBarbara and Donald Jonas Family Fund and theColumbia University Medical Center Departmentof Ophthalmology, this ambitious initiative bringstogether the collaborative efforts of physicians,scientists, educators, and advocates to address thekey issues that affect children’s vision. Its ultimategoal is to ensure that children are able to leadhealthy lives, with clear vision.

Dr. Hark’s new position at Columbia is ahomecoming of sorts, as she received her master’sdegree in human nutrition from the ColumbiaCollege of Physicians and Surgeons in 1988before earning a doctorate in education at theUniversity of Pennsylvania. Her professionalcareer has been marked by continuedproductivity, innovation, and accomplishment.Prior to transitioning into ophthalmic researchand program development, she directed thenutrition education program at the University ofPennsylvania School of Medicine for nearly 15years. She then joined the Wills Eye Hospital in2009, where she directed their Department ofResearch, the Glaucoma Research Center, and theWills Vision Research Training and MentoringProgram for medical students.

In 2011, Wills Eye Hospital was funded by aprivate foundation to develop a program aimed atimproving vision screening and access to eye carefor underserved children in Philadelphia. Theultimate goal of the program was to improveliteracy levels and academic achievement (60% ofchildren in the Philadelphia School District couldnot read by 4th grade). Working with Alex Levin,MD, Chief of Wills Eye Pediatric Ophthalmologyand Ocular Genetics Service, Dr. Hark createdand directed this program, which screened morethan 35,000 children in the city over four years.

Here at Columbia, Dr. Hark will join Stephen H.Tsang, MD, PhD (Research Director for JonasChildren’s Vision Care) and Steven E. Brooks, MD(Medical Director for Jonas Children’s VisionCare) to launch the many programs that theinitiative supports.“We are focused on bringingnational and international recognition to thiscomprehensive referral center for children. Wehave the capability and expertise to manage alltypes of ocular conditions affecting children,across all ophthalmic specialties, including rarehereditary disorders that affect the eyes,” shesays.“I will be responsible for helping tosupport and build the many different facetsof the initiative, and to establishing Columbiaas the preeminent place for pediatric eye careand research.”

Dr. Hark also wears a second hat in theDepartment of Ophthalmology as co-director ofthe Clinical Trials Unit, along with C. Gustavo De

Moraes, MD, MPH, Associate Professor ofOphthalmology. During her tenure at Wills, Dr.Hark developed a broad range of experience withboth industry-funded and investigator-initiated

clinical trials, including study design, grantwriting, data analysis, managing clinical researchcoordinators, and serving as a co-investigator.

“Clinicians who have a heavyclinical case load and surgicalschedule may not have the time todesign studies or write protocolsand grant applications,” she says.“I’ll be able to alleviate some of thatburden by helping to obtain grants,submit manuscripts, and integratefellows, residents, and medicalstudents into projects.”

The move back to New York is awin-win for her family, says Dr.Hark, who has two children, one ofwhom just graduated from GeorgeWashington University while theother is a freshman at theUniversity of Massachusetts inAmherst. For the past ten years,she’s maintained a home inPhiladelphia and commuted backand forth to New York, as herhusband is a medical professor atthe City University of New YorkSchool of Medicine. She’s delightedto be back in her apartment inWashington Heights, where sheregularly bikes and hikes aroundFort Tryon Park and Central Park.

“It’s wonderful to be back in New York and workclosely with such a wonderful faculty,” she says.

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Faculty Spotlight:

New Administrative Director toSupport Jonas Children’s Vision Care

Lisa Hark, PhD, RD

low levels of astigmatism with custom incisionson the cornea,” says Dr. Suh.“The FS laser canpre-soften the cataract as well, meaning that lessphacoemulsification energy is used to take thecataract out, making recovery potentially easier.”

Our patients have access to the latest artificiallens implants, also known as intraocular lenses,including toric lenses to correct cornealastigmatism that can remain after removal of thecataract, as well as multifocal lenses which offergood distance and near vision and can make aperson less reliant on glasses. Not all patients arecandidates for multifocal lenses, Dr. Suh cautions;for example, individuals with other conditions,such as glaucoma, retinal conditions, or severedry eye, would have suboptimal vision qualitywith a multifocal implant. Finally, insurance alsotypically does not cover toric or multifocal lenses.

Transforming Corneal SurgeryThe cornea is the transparent, front lining of theeye and must be clear to allow for optimal vision.The health of the inner lining of the cornea, calledthe endothelium, is vital to maintaining corneal

clarity. When only the corneal endothelium isaffected by a disease process, patients have cornealswelling or edema, the leading cause for cornealtransplantation. Now, surgeons may opt for aprocedure called an endothelial keratoplasty,which involves selectively transplanting only theaffected area.“We just treat the inner lining of thecornea. This approach offers faster recovery andbetter visual acuity than the traditional full-thickness transplant,” Dr. Suh explains.“Patientswho receive this type of transplant will probablystart seeing within two weeks, as compared to theapproximately six months required to stabilizewith a traditional transplant.” The Cornea Serviceat Columbia now provides two different methodsof endothelial keratoplasty, Descemet’s StrippingAutomated Endothelial Keratoplasty (DSAEK)and Descemet’s Membrane EndothelialKeratoplasty (DMEK).

Columbia is also a leader in other types of cornealsurgery. In 2008, the department became one ofthe first centers in North America to performcorneal collagen crosslinking to treat keratoconus,a condition in which the normally round corneathins out and develops a bulge that resembles a

Transforming Cataract and Corneal Surgery continued from page 1

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Access to the latest vision correction technology, along with general andspecialized optometric care is now available at a convenient midtown location in Columbia’s newRefractive Surgery Suite in the Gloria and Louis Flanzer Vision Care Center at 880 Third Avenue,which officially opened in the spring. These services were previously located at the Eye Institute’smain building on the Columbia University Medical Center campus.

“Our space on the third floor is dedicated to the cornea and refractive surgery and optometryservices, as well as to oculoplastics, and has been optimized for our specialties with the latestdiagnostic and treatment modalities,” says Leejee Suh, MD, Miranda Wong Tang Associate Professorof Ophthalmology and Director of the Laser Vision Correction Center as well as the Cornea andAnterior Segment Service.

The laser vision center offers state-of- the-art vision correction lasers for LASIK and PRK, includingthe Intralase Femtosecond laser and the VISX S4 Excimer laser, which incorporates Wavefront-guidedtreatments that allow for more accurate and precise results and also 3D ActiveTrak™ technology toautomatically follow the tiniest eye movements and reposition the laser to ensure accuracy.

Appointments for all services in the Laser Vision Center can be made by calling (212) 305-9535 orvia email at columbialasik@columbia.edu.

In the same location, optometrist Suzanne Sherman, OD, FAAO, Instructor in Optometric Science,offers medically necessary and complex contact lens fitting. “Patients who qualify for these difficultcontact lens fits are those with ocular surface disease, cornea scarring, severe dry eye, cornealdystrophies, and those who’ve had corneal transplants,” Dr. Suh explains. “These situations requirethe expertise of Dr. Sherman.”

Dr. Sherman is the only optometrist in New York City, and one of only a handful in the tri-state area,certified as an EyePrint Practitioner, meaning that she can prescribe the latest in specialty contacts,the EyePrintPRO™. This prosthetic scleral cover shell improves vision by creating a new, smooth,refractive surface for the eye. Unlike standard contact lenses, the EyePrintPRO™ can match the exactcontour of any eye, even in highly difficult conditions when other options have failed.

Dry eye disease is one of the mostcommon conditions affecting theeye, with about one out of every fourpatients who seek ophthalmologic carereporting dry eye symptoms. (SOURCE:ncbi.nlm.nih.gov/pmc/articles/PMC2720680/)

Chronic dry eye occurs when the tear filmthat keeps the eye moist and lubricatedbecomes unstable and loses its naturalprotective qualities. One of the primary causesof dry eye is dysfunction of the meibomianglands, which produce the lipid layer of thetear film, which is seen in the condition ofblepharitis, or inflammation of the eyelidmargin.“If the lipid layer is unstable, thetear film breaks down and evaporates morequickly,” says Dr. Sherman.

“Many of our patients who have dry eye alsohave blepharitis,” Dr. Suh adds. Blepharitis isparticularly common in patients who use eyedrops for glaucoma and those with skinconditions like rosacea.

The LipiFlow Thermal Pulsation system,an effective treatment for meibomian glanddysfunction, has recently become availableat Columbia Ophthalmology’s 880 ThirdAvenue location. This treatment takes lessthan 15 minutes and is virtually painless,applying heat and gentle pressure to theinner eyelids in order to release the lipidsneeded to produce natural tear film. In aclinical study, 79% of patients reportedimproved overall dry eye symptoms withinfour weeks of treatment.

“The system uses a vectored thermal pulsetechnology to deliver the maximum amountof heat and a little bit of pressure to the inner

eyelids, in order to‘express’ the glandsand break up whatis clogging them,”Dr. Shermanexplains. She notesthat most patientsreport decreased dryeye symptoms forabout six months toa year following asingle treatment.

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Above: Dr. Suh performs a LASIK procedure.Right: Dr. Sherman uses the LipiFlow machine.

Entrance to the new third-floor facility.

A Laser Focus onVision Correction at880 Third Avenue

Relief forDry Eyes

cone. With one of the largest sets of outcomesdata on the procedure, our investigators areexploring shorter protocols for the treatment thatappear to provide more comfort for the patient,with equal effectiveness.

As we reported in the Fall 2016/Winter 2017 issueof Viewpoint, David Paik, MD, Assistant Professorof Ophthalmic Science (in Ophthalmology), isstudying crosslinking treatments using topicaldrugs based on an array of some 60 compoundscommonly used as cosmetic preservatives.“These

compounds are known to have anti-microbial andanti-fungal properties, and since they are widelyused at low concentrations in cosmetics, they areknown to be safe and non-toxic,” Dr. Paik says. Heand Dr. Suh are now in the process of designing aclinical trial to assess the long-term effectiveness ofthese agents in stabilizing keratoconus.

The compounds have also shown promise instabilizing corneal infections.“Effective treatmentsfor corneal infections are becoming an importantarea of focus due to the emergence of

antibiotic-resistant forms of Staphylococcusaureus, Enterococcus, and Pseudomonas,” saysDr. Paik.“It appears that the compounds can notonly directly kill bacteria and fungus, but they canalso prevent the further spread of infection bymodifying proteins in the tissue.”

With such revolutionary medical and surgicaltreatments for corneal diseases now available, ourpatients have more options than ever before tomaintain and improve their vision.

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As eclipse fever gripped thecountry in August, with a totalsolar eclipse crossing the entire countrycoast-to-coast for the first time since 1918,the Department of Ophthalmologyanticipated an enormous demand foronline information about how viewingthe eclipse could affect vision.

On Monday, August 21, the day before theeclipse, a public service announcementdeveloped by Jeffrey Liebmann, MD,Professor of Ophthalmology andGlaucoma Service Director, and G.A.

(Jack) Cioffi, MD, Jean and RichardDeems Professor, Edward S.Harkness Professor and Chairmanof the Department ofOphthalmology, brought recordtraffic to Columbia’s website.Nearly one million visitors cameto the CUMC Newsroom to readinformation about how to safelyview a solar eclipse, and to watcha two-minute educational videofeaturing Tongalp Tezel, MD,

Chang Family Professor of Ophthalmologyand Director of the Vitreoretinal Division.

“Many people will think it’s safe to take aselfie with the eclipse in the background

because they aren’t looking directly at thesun,” warned Dr. Tezel in the online article.“What they may not realize is that thescreen of your phone reflects the ultravioletrays emitted during an eclipse directlytoward your eye, which can result in asolar burn.”

The video itself was viewed nearly100,000 times, and both the online articleand video were linked and mentionedrepeatedly by major online and broadcastmedia. The CUMC newsroom article wasalso shared on Facebook more than140,000 times.

On August 22, the day after the eclipse, Dr.Cioffi and past Chair Stanley Chang, MD,K.K. Tse and Ku Teh Ying Professor ofOphthalmology, provided expert advice forpeople worried about their eyes after theeclipse in a New York Times feature article.Glancing at the eclipse for less than a fewseconds and then looking away probablydid not do any significant damage, butlooking repeatedly could have causedproblems because the effects of damage tolight-sensing nerves are cumulative, Dr.Cioffi said. He advised anyone withconcerns to visit an ophthalmologist foran assessment of any possible damage.

One Million Hits!

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THE EDWARD S. HARKNESS EYE INSTITUTE AND

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