In addition to the warning issued by the FDA, the American Academy of Ophthalmology warns some Halloween revelers may be taking an unnecessary risk with their vision by wearing costume contact lenses improperly or without a prescription. 

To safely wear decorative contact lenses this Halloween or any time of year, the American Academy of Ophthalmology recommends following these guidelines:

• Only buy decorative contact lenses from an eye care professional such as an ophthalmologist or a retailer that requires a prescription and sells FDA-approved products.
• If you don't already have a contact lens prescription, obtain a valid prescription and eye exam from an ophthalmologist or optometrist, a health care professional who provides primary vision care ranging from sight testing and correction to the diagnosis, treatment and management of vision changes.
• Even for those with perfect vision, an eye exam and prescription are mandatory in order to fit the right size contacts. Do not fall victim to false advertising claims and lenses labeled as "one size fits all" or "no need to see an eye specialist."
• Follow the directions for cleaning, disinfecting and wearing the lenses. Contacts that are left in for too long or that are not properly cleaned and disinfected can significantly increase the risk of an eye infection.
• Never share contact lenses with another person or wear expired lenses.
• If you notice redness, swelling, excessive discharge, pain or discomfort from wearing contact lenses, remove the lenses and seek immediate medical attention from an ophthalmologist. Eye infections like keratitis can quickly become serious and cause blindness if left untreated.

For more on the dangers of decorative lenses and the warning issued by the FDA, please read this article from the Los Angeles TImes.

According to the American Academy of Ophthalmology:

Tens of thousands of sports and recreation-related eye injuries occur each year. The good news is that 90 percent of serious eye injuries are preventable through use of appropriate protective eyewear.  The risk of eye injury can vary depending on the activity. Make sure the level of eye protection you or others in your family use is appropriate for the type of activity. Regular eyeglasses do not offer proper eye protection.

Visit the UNC Optical Shop to get fitted for the appropriate protective eyewear for the sports in which you and your family participate during the Spring and Summer.

To schedule an appointment to be fitted for prescription protective eyewear for sports, please call 919-966-5509 between 9am and 5pm, Monday through Friday.

To read more from the AAO on protective eyewear, please click here.

The new surgical clinic’s phone number is 919-799-4050. The Chatham Hospital Medical Office Building is located at 475 Progress Blvd., Suite 100, in Siler City, NC.

Specific surgical procedures offered in Ophthalmology include:

• Retina - J. Niklas Ulrich, MD
• Glaucoma - Scott D. Lawrence, MD
• Cataract  - W. Craig Fowler, MD

CHAPEL HILL, N.C. – A study led by researchers at the University of North Carolina is the foundation for a promising new blood test to detect the progression of macular degeneration to its more serious form, which can lead to blindness.

Age-related macular degeneration (ARMD) is the most common cause of central vision loss in the western world. Those affected by macular degeneration find many daily activities such as driving, reading and watching TV increasingly difficult.

In the United States as many as 11 million Americans have some form of macular degeneration, including both early and later stages of the “dry” and wet” forms. The eye condition deteriorates the macula, the central area of the retina, causing blind spots and blurred or distorted vision.

“People with macular degeneration start out with the dry type, which we can detect with a simple dilated eye exam,” says Dr. Sai H. Chavala, Director of the Laboratory for Retinal Rehabilitation and Assistant Professor of Ophthalmology and Cell biology & Physiology at UNC School of Medicine. He practices at the Kittner Eye Center at UNC Health Care in Chapel Hill and New Bern.

“But about 20 percent of patients at some time in their life will develop wet macular degeneration, which is characterized by blood vessels that grow under the surface of the retina. These abnormal vessels can leak blood and fluid, which causes irreversible damage to the cells of the retina leading to irreversible vision loss.  Since we don’t have a way to predict the precise timing of this event, we have no way of preventing it.” he adds.

Currently, no test is available to predict the conversion from dry to wet ARMD. But the new paper, published on-line January 24, 2013, in the journal PLOS ONE describes how it could be accomplished. (http://dx.plos.org/10.1371/journal.pone.0055079)

The ability to predict the conversion from dry to wet age-related macular degeneration is one of the most coveted achievements in vision science, according to Chavala. “A clinical test that predicts impending conversion is the first step in developing treatments to prevent the switch to wet macular degeneration.”

In the study, the researchers used the Cell Search system, an FDA-approved technology for automated rare cell analysis (ARCA), which Chavala and colleagues applied to the identification and analysis of endothelial progenitor cells (EPCs). These cell types are rare compared to other blood cells.  EPCs are a stem cell subset that give rise to the endothelium found in the inner lining of blood vessels.  EPCs are liberated from the bone marrow and circulate in the blood in response to signals for new blood vessel growth.

Previous studies using fluorescence activated cell sorting (FACS), or flow cytometry, have demonstrated that EPCs are elevated in patients with wet macular degeneration compared to patients with the dry type.  However, FACS measurements are subject to substantial variability between observers, along with an element of subjectivity when measuring rare cell populations challenging its clinical use.

Chavala and colleagues thought that ARCA, a new technology capable of measuring rare cell populations reliably, was better suited as a diagnostic blood test. This technology is currently being used in clinical practice for cancer patients so the technology can be readily adopted for macular degeneration patients.

The study compared traditional FACS and ARCA in 23 subjects with age-related macular degeneration, both dry and wet. The samples were “masked” so that no one involved in the sample assessments at the two labs where the analyses were done knew the type of macular degeneration the patients had.

“We found a promising trend favoring the ARCA technology in detecting a higher number of EPCs in the wet macular degeneration group compared to the dry. And that trend was not observed with traditional FACS,” Chavala said.  “We were surprised that we needed to analyze relatively few patients to detect this trend.”

“Our ‘proof of concept study’ suggests that the ARCA technology could be a powerful tool for monitoring progression in macular degeneration.  Further study is required to validate this test for detecting and preventing the conversion from dry to wet macular degeneration.

“The next step is to do a prospective study in a greater number of subjects having the known criteria that puts them at higher risk of progressing from dry to wet macular degeneration,” Chavala said.”

Co-authors include lead author Emil Anthony T. Say, MD, at UNC Kittner Eye Center; Alex Melamud, MD, Retina Group of Washington, Washington, DC; Denise Ann Esserman, PhD, UNC Gillings School of Global Public Health; and Thomas J. Povsic, MD, PhD, Duke University Medical Center, Durham, NC.

Support for the study came from the Adler Foundation, Hope for Vision, and Research to Prevent Blindness grants.

Disclosure Statement: Dr. Chavala has filed a patent surrounding this technology and is founder of Serrata, LLC, a company that plans to market diagnostic testing for ocular disease.

-------------------------------------------

Dr. Chavala was also recognized in 2012 by the research funding organization, Research to Prevent Blindness (RPB), with a $250,000 Career Development Award to support his research.  The support is provided over a four-year period.

The RPB Career Development Award Fund was established in 1990 to attract young physicians and basic scientists to eye research.  To date the program has recruited over 164 vision scientists to research positions in departments of ophthalmology at universities across the country.

RPB is the world's leading voluntary organization supporting eye research.  Since it was founded in 1960, RPB has chanelled hundreds of millions of dollars to medical institutions for research into the causes, treatment, and prevention of blinding eye diseases. For information on RPB, RPB-funded research, eye disorders, and the RPB Grants Program, please go to www.rpbusa.org.

On August 21st, UNC Eye Care provided care to our first patients in our brand new 26,000 square foot off-campus facility, located at 2226 Nelson Highway, in Chapel Hill, NC.  This new location merges the services that had been provided at the Ambulatory Care Center (ACC) and UNC Eye at Chapel Hill North and is now home to the UNC Kittner Eye Center, UNC Optical Shop, and UNC Hospitals Macular Treatment Center.

UNC Kittner Eye Center is located at Carolina Crossing, off Interstate 40, exit 273A, across from the Mardi Gras Bowling Center, near the intersection of State Road 54 and Farrington Road.

Patients receiving care in this facility will experience the same world class eye care with a hometown touch that they've always known, now in a new and more convenient location that features free parking.

Appointment Scheduling Line: 919-445-2020

UNC Optical Shop Phone Number: 919-843-3937

Directions to UNC Kittner Eye Center:

UNC Eye Care Center at Carolina Crossing - view from NC 54 entrance

From West (Greensboro area):

• Drive east on Interstate 40 and take exit 273 for U.S. Highway 54 West.
• Turn right onto Highway 54 West.
• Turn right onto Huntingridge Rd at the stop light.
• Take an immediate right onto Nelson Highway.
• The Carolina Crossing building is two blocks up on the left.

From East (Raleigh area):

• Drive west on Interstate 40 and take exit 273A for U.S. Highway 54 West.
• Turn right onto Huntingridge Rd at the stop light.
• Take an immediate right onto Nelson Highway.
• The Carolina Crossing building is two blocks up on the left.

From South (Pittsboro area):

• Drive north on U.S. Highway 15-501.
• Bear right on to U.S. Highway 54 east/15-501 north (towards Durham).
• Take the exit for U.S. Highway 54 East (also known as Raleigh Road).
• Before reaching Interstate 40 and Farrington Rd, turn left on Huntingridge Rd at the stop light.
• Take immediate right onto Nelson Highway.
• The Carolina Crossing building is two blocks up on the left.

To read our latest UNC Eye Newsletter, click here.  Topics include:

• New UNC Kittner Eye Center
• Chairman's Corner
• Facility Comparison
• 2013 Spring Symposium
• Multidisciplinary Surgical Skills Lab
• Tri-Residency Cataract Course
• UNC Eye Receives Grant
• Construction of Carolina Crossing
• Faculty News
• Directions to UNC Eye Care Center at Carolina Crossing

To view and download an archive of past editions of the UNC Eye Newsletter, please click here.

On August 21st, our new location will merge the services currently provided at the Ambulatory Care Center (ACC) and UNC Eye at Chapel Hill North and will be the home of the Kittner Eye Center, UNC Optical Shop, and UNC Hospitals Macular Treatment Center.

UNC Eye Care Center will be located off Interstate 40, exit 273A, across from the Mardi Gras Bowling Center at State Road 54 and Farrington Road.

Patients will experience the same world class eye care with a hometown touch that they've always known, now in a new and more convenient location that features free parking.  We can’t wait for you to experience our vision for the future of eye care.

For more information about the Kittner Eye Center or to schedule an appointment, please call 919-966-2061.

Time lapse photo progression of construction of UNC Eye Care Center at Carolina Crossing (Photos and layout: Sarah Moyer and Rona Lyn Esquejo)

David Eric Eifrig, 78, of Chapel Hill, North Carolina, passed away peacefully on October 9, 2013. He was born in Oak Park, Illinois and graduated from Carleton College in 1956. He was a loving husband, father, and a retired ophthalmologist.

He attended medical school at The Johns Hopkins University and residency in Surgery and Ophthalmology at The Wilmer Eye Institute in Baltimore, Maryland from 1956-1967. He was a Lieutenant in the U.S. Navy and served in the Medical Corps from 1962-64. His retina fellowship was served in Los Angeles at The Jules Stein Eye Institute from 1967-68.

Dr. Eifrig began practicing ophthalmology in 1968 in Lexington, Kentucky. He later moved his family to Minnesota and practiced there from 1970 to 1977, becoming Associate Professor. He moved to Chapel Hill, North Carolina in 1977 where he founded the UNC School of Medicine’s Department of Ophthalmology. He was the chairman of the department from then until his retirement in 2000.

Dr. Eifrig was well-loved as an academic and clinician at UNC. He was best known for his love of and caring for patients, especially those of lesser means. He has served on multiple medical missions, donating his time and money to programs in Africa, Costa Rica, Jamaica, and Saudi Arabia. During one trip to Jamaica, he stood for nearly 14 hours without a break to treat patients who had waited for days to see him and his team. By the end of the day, most nurses and residents serving with him were too tired to stand.

He is survived by his wife of 34 years, Kathryn C. Eifrig. He is also survived by his four children; David E. Eifrig Jr., Elizabeth Ann Hietala, Catherine Marie Eifrig, and Charles William Gustav Eifrig.

A memorial service will take place on November 24, 2013 at 3:30 p.m. at Chapel Hill Country Club, 103 Lancaster Drive, Chapel Hill, North Carolina, 27517. Telephone: 919-967-8201

In lieu of flowers, friends, family, and those touched by this wonderful doctor are asked to make donations to the David E. Eifrig Ophthalmology Fund at UNC- Chapel Hill School of Medicine. The fund sponsors the annual David E. Eifrig Lecture in Ophthalmology. The fund selects a visiting lecturer each year who embodies Dr. Eifrig’s spirit of devotion to patients, and a passion for helping research disease. The address is: David E. Eifrig Ophthalmology Fund, Sandy Scarlett Development Director, UNC Eye, Campus Box 7040, Chapel Hill, North Carolina 27599.

UNC Eye faculty member, Dr. Bruce Baldwin, Optometrist, PhD, was elected President of the Scleral Lens Education Society (SLS) at the Global Specialty Lens Symposium in Las Vegas on January 24.  The SLS is a nonprofit 501(c)(3) organization committed to teaching eye care practitioners and patients about the benefits and availability of ocular prosthetic devices known as scleral contact lenses.

These devices are used to treat and manage severe eye conditions related to disease, trauma, or surgery. The rigid, gas permeable lenses can be very large, up to the size of a quarter, and fit over the entire front portion of the eyeball.  “It is extremely gratifying for me and often life changing for a patient to be fit with a scleral lens.  I have treated people who were legally blind who have obtained a driver license, or who have had eye pain for years and are nearly pain free while wearing these devices,” said Dr Baldwin.

Dr. Baldwin was a founding board member of the SLS in 2010 along with Drs Greg DeNaeyer and Christine Sindt. The Society now has over 1,200 members from thirty two countries.  He has conducted scleral lens lectures and workshops around the United States, teaching eye doctors to fit the devices.  He has also hosted international live webinars, which were presented to eye doctors around the world.

Dr. Baldwin, Assistant Professor of Ophthalmology, manages the Contact Lens Clinic at UNC and sees patients Monday - Friday.  Referring doctors can arrange an appointment through the Ophthalmology website.  Patients can make an appointment through the Ophthalmology appointment system at 919-966-5509.

More information on scleral lenses is found at the SLS website www.sclerallens.org.

This patient is almost legally blind in the right eye from severe scarring after eye trauma. He can read magazine print while wearing the scleral lens (arrows). He is blind in the left eye.

UNC Eye Care is pleased to announce that Dr. Jonathan Dutton has been named the 2013 recipient of the Spinoza Chair in Medicine at the University of Amsterdam in the Netherlands.  As a result of this honor, Dr. Dutton will spend a week in Amsterdam delivering lectures to the University faculty, local ophthalmologists, and the general public in Spring 2013.

In addition to providing his lectures, Dr. Dutton will also present a Master Class to students and residents during his time in Amsterdam.  "I am honored to receive this award and to represent as best as I can the UNC Ophthalmology Faculty," said Dr. Dutton, who has pioneered research in orbital reconstruction and treatment of spastic eyelid disease while at UNC.

"This is quite an honor for not only Dr. Dutton, but also for the UNC Department of Ophthalmology.  We take great pride in sharing Dr. Dutton's success and look forward to announcing more about his and our other faculty members' endeavors in the coming months," said Dr. Donald Budenz, Chairman of the UNC Department of Ophthalmology.

Dr. Dutton expects to begin his visiting professorship in Amsterdam in April, 2013.

About the Spinoza Chair in Medicine:

The Spinoza Chair was established in 1995 by the then Faculty of Humanities of the University of Amsterdam. The Spinoza Lectures are given by high-profile thinkers of our time. They are intended for a wide audience that would like to keep abreast of current developments in philosophy and medicine.

Named in honor of Baruch Spinoza, the 17th Century Dutch philosopher, this prestigious visiting professorship includes two Annual lectureships, one in Philosophy, the other in Medicine.

Dr. Seema Garg's research on Telemedicine and Retinal Imaging was recently featured online at the "Archives of Internal Medicine" website.  According to the research:

The full article can be found here.

Many important advances have taken place in oculoplastic, lacrimal, and orbital surgery during the last 20 years.  Unlike other books of its kind, the new Atlas of Oculoplastic and Orbital Surgery offers detailed, step-by-step instructions from initial skin marking and cut to final closure for more than 90 commonly performed oculoplastic, lacrimal, and orbital surgeries. Each step also includes a matching illustration inverted to accommodate the surgeon’s actual position during the surgery.

In addition to clear instruction, the text for each surgery covers preoperative evaluation discussions, postoperative care instructions, and how to avoid and manage potential complications.

FEATURES

• More than 1,000 detailed color illustrations
• Text and matching illustration are presented side-by-side for easy reference
• Key points help reader plan the most appropriate operation and minimize complications
• Surgeons can follow each step and perform the procedure even if they aren’t familiar with it.

Dr. Dutton's other published textbooks include:

• Atlas of Clinical and Surgical Orbital Anatomy (JJ Dutton). 2nd edition, 2011, Elsevie Saunders, available on Amazon, Barnes & Noble, etc.
• Radiology of the Orbit and Visual Pathways (JJ Dutton), 2010, Saunders, available on Amazon, Barnes & Noble, etc.
• Diagnostic Atlas of Common Eyelid Diseases (JJ Dutton, GS Gayre, AD Proia), 2007, Informa Helathcare, available on Amazon, Barnes & Noble, etc.
• Thyroid Eye Disease (JJ Dutton, BG Haik), 2002, Marcel Dekker, available on Amazon, Barnes & Noble, etc.
• Diagnostic Atlas of Orbital Diseases (JJ Dutton, SF Byrne, AD Proia), 2000, Saunders, available on Amazon, Barnes & Noble, etc.
• Atlas of Ophthalmic Surgery, Vol. II, Oculoplastic, Lacrimal, and Orbital Surgery (JJ Dutton), 1992, Mosby Year Book, out of print
• A Color Atlas of Ptosis. A Practical Guide to Evaluation and Management (JJ Dutton). 1989,  PG Publishing, out of print

Click here to visit WRAL.com and learn more:

To make an appointment with Dr. Fowler or any UNC Eye MD, please call 919-445-2020.

Two hundred seventy-seven (277) UNC Health Care physicians are included in the latest compilation of The Best Doctors in America® database.

In addition, many of these doctors are also listed in the December 2012 issue of Business North Carolina Magazine, as part of its annual compilation North Carolina’s Best Doctors.

Only about 5 percent of physicians in the U.S. are included in the Best Doctors database. The Best Doctors database contains the names and professional affiliations of more than 45,000 doctors in the United States, all chosen through an exhaustive peer-review survey that asks: “If you or a loved one needed a doctor in your specialty, to whom would you refer them?” The peer review process as well as additional research conducted by Best Doctors determines selections for each list.

The five UNC Eye Ophthalmologists included in a group of 277 UNC physicians listed in the Best Doctors database are:

• Donald L. Budenz, M.D., M.P.H. - Professor and Chairman (Glaucoma)
• Kenneth L. Cohen, M.D. - Professor (Cataract and Intraocular Lens Implant Surgery, Corneal Transplant Surgery and External Diseases of the Eye)
• Jonathan J. Dutton, M.D., Ph.D., F.A.C.S. - Professor (Ophthalmic Oncology, Ocuplastic Reconstructive Techniques)
• W. Craig Fowler, M.D. - Associate Professor (Cornea Transplantation, Cataract Surgery, Laser Vision Correction Surgery, External Eye Disease and Anterior Segment)
• Travis A. Meredith, M.D. - Professor & Chairman Emeritus (Medical Retina, Diabetic Retinopathy, Macular Degeneration)

Best Doctors, Inc. is based in Boston and provides highly specialized medical services to nearly 10 million people in over 30 countries. Best Doctors’ global database is updated continuously through a peer-review based evaluation of the medical profession, and includes 50,000 doctors worldwide named “best,” in over 40 specialties and 400 subspecialties of medicine. Best Doctors, Best Doctors in America and the star-in-cross logo are registered trademarks of Best Doctors, Inc. in the United States and other countries, and are used under license.

As we observe Healthy Vision Month this May, we invite you to take this interactive vision quiz to find out how much you know about your eyes.

As we prepare to celebrate our nation's Independence, the month of July has been designated as Fireworks Eye Safety Month by the American Academy of Ophthalmology (AAO).

"Fireworks are a common cause of severe eye and hand injuries that can permanently ruin lives and turn a joyous celebration into a horrible nightmare," UNC Eye Care Center Chairman Donald L. Budenz, MD, MPH said. "That is why most states have correctly outlawed the sales of fireworks to the public."

Here are some safety tips from the AAO for preventing eye injuries related to handling and viewing fireworks this 4th of July:

• Never handle fireworks without protective eyewear and ensure that all bystanders are also wearing eye protection.
• Never let young children play with fireworks of any type. If older children are permitted to handle fireworks, ensure they are closely supervised by an adult and wear protective eyewear.
• Clear the area of flammable materials and view fireworks from at least 500 feet away.
• Leave the lighting of professional-grade fireworks to trained pyrotechnicians.

For those who attend professional fireworks displays and/or live in communities surrounding the shows:

• Respect safety barriers at fireworks shows.
• Do not touch unexploded display (show) fireworks; instead, immediately contact local fire or police departments to help.

Related Articles:

Click here to learn more about Fireworks Eye Safety from the AAO

Officials warn about fireworks dangers with dramatic display

Chapel Hill’s Fourth of July Fireworks Celebration at Kenan Stadium

Summertime means more time spent outdoors, and studies show that exposure to bright sunlight may increase the risk of developing cataracts, age-related macular degeneration (AMD) and growths on the eye, including cancer.*

This June, UNC Eye joins the American Academy of Ophthalmology (AA0) in observing UV (ultraviolet light) Safety Awareness Month. Through its EyeSmart™ campaign, the AAO wants to remind Americans of the importance of protecting their eyes from the sun's harmful rays by wearing proper protection.  We also want to remind you of the importance of protecting eyes from indoor UV light when using tanning beds.

The AAO offers these tips to protect your eyes from the sun:

During UV Safety Month, remember to schedule your eye exam appointment with a UNC Eye MD by calling 919-966-5509.

* Source: American Academy of Ophthalmology

Click here to access the UNC Eye Living with Low Vision Resource Guide

Bob Baillie, founder of MIRA USA, and several members of his staff visited Dr. Amy Fowler and UNC Eye staff at Chapel Hill North recently.  MIRA USA is an Aberdeen, NC-based organization which is the only one in the United States whose mission is to provide guide dogs to children between the ages of 11 and 17.   Mr. Baillie founded MIRA USA in 2008 after losing his sight as a result of complications from coronary bypass surgery.

Bob Baillie (left), Eric St. Pierre (center), and MIRA USA Staff arrive at Chapel Hill North

After appearing on several local Triangle television news outlets to spread the word about the need for young people who are without sight to have the opportunity to have guide dogs and the work of MIRA USA, Mr. Baillie brought about 10 of his most recently completely trained guide dogs to UNC Eye at Chapel Hill North.  He and his team, led by MIRA head trainer Eric St. Pierre, conducted demonstrations on what it's like to be without sight and rely on a guide dog to do everyday things that many people take for granted, such as walk down the sidewalk in a busy shopping center.

Dr. Amy Fowler, First-Year UNC Eye Resident Dr. Drew Hunter, and UNC Eye Fellow Dr. Lyndon Lee, along with several other staff members participated by walking blindfolded with a trained guide dog along the crowded walkway outside the UNC Eye office at Chapel Hill North, under the watchful supervision of the MIRA staff.  All of the participants marveled at the sophisticated level of training the guide dogs received and what a unique experience it was to rely on them for help in navigating their way.

MIRA USA Founder Bob Baillie chats with Dr. Amy Fowler

"Wow! What an experience to just trust this dog," Dr. Fowler said after taking a 100 yard walk down the sidewalk at Chapel Hill North, while blindfolded and led by Fiona, the guide dog that MIRA USA provided for the demonstration.  An additional 8 children were introduced to their guide dogs for the first time in a ceremony in Pinehurst, NC on March 17th.  For more information on MIRA USA, visit www.mirausa.org.

Dr. Amy Fowler and two MIRA USA seeing eye dogs

Dr. Lyndon Lee receives instruction from MIRA USA trainer

Click here to hear Eric St. Pierre talk about his experiences in training seeing eye dogs.

As UNC Eye continues to follow the American Academy of Ophthalmology (AAO) Calendar of Monthly Observances, March is designated as Age-Related Macular Degeneration Awareness & Low Vision Awareness Month.

According to the AAO:

Age-related macular degeneration (AMD) is a deterioration or breakdown of the eye's macula. The macula is a small area in the retina — the light-sensitive tissue lining the back of the eye. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly.

Click here to learn more about AMD from the American Academy of Opthalmology.

The following UNC Eye MDs specialize in treating AMD:

• Sai H. Chavala, MD
• Odette M. Houghton, MD
• Travis A. Meredith, MD
• J. Niklas Ulrich, MD

To schedule an appointment with any UNC Eye MD, please call 919-966-5509.

The American Academy of Ophthalmology (AAO) recommends an eye disease screening for all adults as they age.

The Academy now recommends that adults with no signs or risk factors for eye disease get a baseline eye disease screening at age 40 — the time when early signs of disease and changes in vision may start to occur.

Based on the results of the initial screening, an ophthalmologist will prescribe the necessary intervals for follow-up exams.

Don't miss out on reading, driving, and watching children and grandchildren grow.  During Healthy Vision Month, remember to schedule your eye exam appointment with a UNC Eye MD by calling 919-966-5509.

Share these important tips from the AAO's www.geteyesmart.org website with your friends and loved ones.

Vision is our most precious sense. Protect your sight by getting regular eye exams with an ophthalmologist.

June 14, 2013

Written by Laura Alderson for UNC Health Care

BALTIMORE, MD – UNC Eye Chairman Emeritus, Travis Meredith, MD addressed the 72nd annual meeting of the Wilmer Residents Association, one of the oldest residents’ associations in the country, giving a presentation on retinal vasculitis and tracing his time at Wilmer – almost at the halfway mark in its distinguished 88-year history.  Dr. Meredith was a student at Wilmer in 1968 and a resident from 1970 to 1975.

“We had a technologic explosion. The diseases we treat are still the same, but now we just have so much more we can do. We’ve adopted clinical trials methodology as a way of proving new therapies," said Dr. Meredith.

"There was also a trend toward subspecialization within ophthalmology. About that time, sections were developed devoted solely to one subspecialty, such as retina, pediatrics, glaucoma or cornea. The young faculty there at the time built their careers on that.”

Media contact: Tom Hughes, (919) 966-6047, tahughes@unch.unc.edu

Thursday, May 9, 2013

CHAPEL HILL, N.C. – A large new study finds that taking omega-3 fatty acid supplements has no effect on slowing the progression of age-related macular degeneration (AMD).

However, for people with low levels of lutein or zeaxanthin in their diets, supplementation with lutein and zeaxanthin may slow the progression of AMD, the study found.

Four researchers in the Department of Ophthalmology in the University of North Carolina School of Medicine contributed to the Age-related Eye Disease Study (AREDS) 2. Results from AREDS 2 were published online May 5 in the Journal of the American Medical Association.

“Many patients ask whether they should be taking lutein and omega-3 fatty acids for their age-related macular degeneration (AMD),” said Odette Houghton, MD, associate professor and one of the UNC researchers. The others were Seema Garg, MD, PhD, Maurice B. Landers III, MD and Travis M. Meredith, MD, chair emeritus of the Department of Ophthalmology.

“The AREDS 2 results indicate that if you have low levels of lutein or zeaxanthin in your diet, or if you take the original AREDS vitamins without beta-carotene, then supplementation with lutein and zeaxanthin may slow the progression of AMD. However, omega-3 fatty acids appear to have no beneficial or harmful effect on AMD,” Houghton said.

The AREDS2 study  suggests that lutein and zeaxanthine are safer alternatives to beta-carotene in those people who have a history of smoking. There was a higher incidence of lung cancer in participants that had a history of smoking and who took AREDS supplements with beta-carotene.

“We have no control over some of the major risk factors for the advancement of AMD, such as age and family history,” Houghton said. “Regular dilated eye exams, avoidance of smoking and taking AREDS2 supplements when indicated are ways we may be able to reduce the risk of blindness from AMD.”

However, the AREDS supplements have only been shown to be effective in people who already have an intermediate stage of AMD. These supplements do not benefit people who have no AMD or mild AMD. A dilated eye exam by an eye care provider is the only way to detect AMD, Houghton said.

The American Academy of Ophthalmology recommends that adults get a baseline eye disease screening at age 40. The necessary interval for follow-up exams can be based on the results of this screening. Everyone age 65 and over should have complete eye exams every one to two years.

UNC Eye Department Chair Donald Budenz, MD, MPH, was one of only ten Johns Hopkins Bloomberg School of Public Health alumni selected to the Alpha Chapter of Delta Omega, the most prestigious society in Public Health.

"Dr. Budenz has been a leader in the fields of glaucoma and public health and it is terrific that he has been chosen to receive this well deserved honor by his peers in the public health community" said Kuldev Singh, MD, MPH, Professor of Ophthalmolgy, Director of the Glaucoma Service at Stanford University and current President of the American Glaucoma Society.

Budenz, who graduated with his MPH from Johns Hopkins in 2004, was nominated and selected for his ongoing contributions to research in ophthalmology, including the medical testing of glaucoma, epidemiology of eye disease in West Africa, and clinical trial leadership.

Since the establishment at Johns Hopkins of the Alpha Chapter, the Society has expanded nationally to 59 local chapters with about 6,000 members, including the Theta Chapter at UNC Chapel Hill's Gillings School of Public Health.

Dr. Budenz and his research group worked for 2-1/2 years in Tema, Ghana, West Africa, where they performed eye examinations with ancillary testing and photography on over 5,600 randomly selected adults age 40 and over. They found the highest prevalence of glaucoma in the world (6.8%) and a startlingly high prevalence of blindness and visual disability in this group.

Glaucoma is the leading cause of irreversible blindness worldwide, but it is preventable if identified early enough. The study will be used to heighten awareness of the glaucoma problem in people of African descent and to direct resources to glaucoma screening and treatment in Africa.

The studies, entitled "Tema Eye Survey" and "Tema Glaucoma Prevalence," were published in the top two clinical ophthalmology journals, Ophthalmology and JAMA Ophthalmology, respectively.

In reference to the Tema Eye Survey, Jeffrey Liebmann, MD, the immediate past president of the American Glaucoma Society said, "Hopefully this study will cause other organizations to focus resources on this difficult problem."

Dr. Budenz recently returned to Chapel Hill from his most recent annual trip to Ghana, where he and his team continued their glaucoma research and performed eye examinations.

Click here to read more about Dr. Ulrich from the UNC Health Care and School of Medicine Newsroom.

- Written by Nathan Clendenin for UNC Health Care -

Michelle Cabrera, MD and Odette Houghton, MD, met as colleagues in the UNC Department of Ophthalmology.  Both are surgeons - one helps give sight to children, the other helps to save the retina. They share a love of rock climbing and started climbing together.

I've done a little bit of climbing myself. Just enough to know how challenging and how demanding it is. You use every muscle in your body, but of particular worth are your eyes and your brain as you make sense of the mystery before you, deciding which hold to grab onto next, all while working with your increased heart rate and blood pressure due to fear of falling.  It's a challenge for sure, and one that these two welcome as they hone their critical and creative thinking skills together.

Houghton, who is actually afraid of heights, pushes past the uncomfortable feeling, sweaty hands and clinched teeth, to reach new heights, both literally and figuratively, as she relishes the feeling of accomplishment after reaching the top of a cliff.

Whether you're into clinging to the side of a mountain or not, you'll definitely want to watch this month's real doctors, real people for the natural beauty captured at Pilot Mountain, N.C.

The UNC Department of Ophthalmology will celebrate Residents' Research Day on June 15th, 2013 in the UNC Lineberger Building - Joseph S. Pagano Conference Room (450 West Drive; Chapel Hill, NC 27514).  The Annual Research Day presentations will feature 15-minute presentations of research performed by UNC Eye Ophthalmology residents and fellows, along with a Visiting Professor lecture and a Distinguished Alumnus lecture.

For additional information, contact Chris Postlethwait via email or via phone at 919.843.0264.

The Visiting Faculty will be:

• S. Dace McPherson, Jr. Memorial Lecturer: D. Rex Hamilton, MD, MS, FACS of Jules Stein Eye Institute, University of California at Los Angeles, keynote address: "Advanced Corneal Tomography and Biomechanics"
• Distinguished Alumnus Lecturer: Evan H. Black, MD, FACS, UNC Eye Class of 1998

Click here for directions.

Click here to view a printable Schedule of Events.

A UNC Eye researcher is finding ways to reduce vision loss from Diabetic Retinopathy by taking advantage of advances in telemedicine.  The March 2013 edition of Retinal Physician magazine features an article by UNC Eye MD Seema Garg about her research on how the use of telemedicine can help treat Diabetic Retinopathy.

Per the article:

Telemedicine for Diabetic Retinopathy evaluation "establishes a logical partnership between primary care physicians and retina specialists by facilitating the identification of patients who are at high risk of vision loss from diabetes and who may not seek the recommended annual evaluation by an ophthalmologist... This could make a major public health contribution by ultimately reducing barriers to care and preventing vision-threating DR."

Click here to read the article.

To schedule an appointment with Dr. Garg or any of our UNC Eye MD's, please call 919-966-5509.

UNC Eye is now scheduling appointments for refractive eye surgery featuring LASIK at UNC Laser Vision Center, located inside the Kittner Eye Center.  If you're considering refractive surgery, take advantage of the highest-quality laser solutions and the best technology available at UNC Laser Vision Center. Our renowned and experienced team can recommend the procedure best suited for your individual needs.  

At the Kittner Eye Center, you can be assured of comprehensive care for the long term health of your eyes so no matter what the future holds, you'll always know you made the right decision.  

Call 919-445-2020 now to schedule your free consultation to find out which solution is best for you.

Our experienced staff features:

Richard M. Davis, MD

Karl G. Stonecipher, MD

Nisha P. Mehta, OD, FAAO

An excerpt from the article:

Steven Gray used to spend long hours in the lab for the simple love of science. As a postdoctoral researcher, he was tinkering with a virus in search of ways to shuttle genes into nerve cells for gene therapy. Then, in 2008, his adviser sent him to a meeting held by a non-profit organization called Hannah's Hope Fund, and Gray found a new inspiration.

Hannah's Hope Fund is a charity based in Rexford, New York, that supports research on giant axonal neuropathy (GAN), a fatal nerve disorder. At the meeting, Gray met Hannah Sames, a clumsy four-year-old with tight curls and a sweet smile whose disease had inspired her parents to start the charity. He launched a GAN project after the meeting. “I looked at her and saw my own daughter,” says Gray, whose child was then also four. “Now I'm focused on finding a treatment, almost as I would for my own child.”

Click here to view the full article.

Top Toy Safety Tips, according to the American Academy of Ophthalmology:

• Avoid purchasing toys with sharp, protruding or projectile parts.
• Make sure children have appropriate supervision when playing with potentially hazardous toys or games that could cause an eye injury.
• Ensure that laser product labels include a statement that the device complies with 21 CFR (the Code of Federal Regulations) Subchapter J.
• Along with sports equipment, give children the appropriate protective eyewear with polycarbonate lenses. Check with your Eye M.D. to learn about protective gear recommended for your child's sport.
• Check labels for age recommendations and be sure to select gifts that are appropriate for a child's age and maturity.
• Keep toys that are made for older children away from younger children.

If your child experiences an eye injury from a toy, seek immediate medical attention from an ophthalmologist – an eye medical doctor.  To make an appointment with a UNC Eye MD, call 919-966-5509.

The research will be directed by Donald L. Budenz, M.D., M.P.H., Chairman of the Department of Ophthalmology at the University of North Carolina at Chapel Hill School of Medicine.  This grant is structured to be automatically renewed annually in the amount of $110,000, then subject to periodic review by RPB starting in 2016.

RPB is the world's leading voluntary organization supporting eye research.  To date, the organization has awarded grants totaling $1,630,500 to the University of North Carolina at Chapel Hill School of Medicine.

"Research to Prevent Blindness provides unrestricted research funding to the top research departments of ophthalmology in the US," Dr. Budenz said. "UNC Eye’s program to prevent and cure blindness through gene therapy and stem cell research will benefit greatly from this generous grant."

Since it was founded in 1960, RPB has channeled hundreds of millions of dollars to medical institutions throughout the United States for research into all blinding eye diseases.  For information on RPB, RPB-funded research, eye disorders and the RBP Grants Program, go to www.rpbusa.org.

Click here to view the Program Agenda.

Keynote speakers were:

• S. Dace MacPherson, Jr. Memorial Lecturer: D. Rex Hamilton, MD, MS, FACS
• David E. Eifrig Distinguished Alumnus Lecturer: Evan H. Black, MD, FACS (UNC Eye Class of 1998)

UNC Eye Chairman Donald L. Budenz, MD, MPH said, “Thanks to the hard work of the residents and fellows and our two visiting professors, Drs. Hamilton and Black, I heard from faculty and alumni that this was the best UNC Residents' Day ever.”

Please enjoy the following photos from the Residents' & Fellows' Research Day Lectures and Dinner:

2013 Residents' Day Awards:

• Resident of the Year: Robert van der Vaart, MD
• Senior Surgical Excellence Award: Jonathan Zoghby, MD
• Arthur C. Chandler Outstanding Resident as Teacher Award: Kevin Gertsch, MD
• Frederick W. Stocker Research Award: David Fleischman, MD
• Resident Clinical Excellence Award: James Wrzosek, MD

UNC Eye Resident Video Senior Video 2013:

UNC Eye hosted the 2013 Spring Symposium on Saturday, April 13th at the Rizzo Conference Center in Chapel Hill.  Visiting Professors and UNC Faculty presented the latest in the areas of:

• Retina
• Glaucoma
• Cornea
• Neuro-ophthalmology
• Pediatrics
• Plastics

Participants were able to claim 8.5 AMA PRA Category 1 Continuing Medical Education credit(s).

Featured speakers included Visiting Professors:

John G. Clarkson, MD - Keynote Speaker

American Board of Ophthalmology

University of Miami Miller School of Medicine

Bascom Palmer Eye Institute

Eduardo Alfonso, MD

University of Miami Miller School of Medicine

Bascom Palmer Eye Institute

Oscar A. Cruz, MD

St. Louis University School of Medicine

St. Louis University Eye Institute

Steven E. Feldon, MD, MBA

University of Rochester School of Medicine & Dentistry

Flaum Eye Institute

Philip J. Rosenfeld, MD, PhD

University of Miami Miller School of Medicine

Bascom Palmer Eye Institute

M. Bruce Shields, MD

Yale University School of Medicine

Yale Eye Center

Craig M. Greven, MD

Wake Forest University

Wake Forest University Eye Center

Douglas J. Rhee

Associate Professor of Ophthalmology

Harvard Medical School

Symposium participants are invited to provide UNC Eye with feedback on the symposium by clicking here and completing the survey provided.

UNC Eye recently hosted the first-ever Tri-Residency Cataract Course, in which faculty and residents from The University of North Carolina at Chapel Hill, Duke University, and Wake Forest University gathered together for lectures and case discussions about cataract treatments.  Faculty from each institution gave lectures on cataract surgery and then residents had the opportuthnity to practice under supervision in the newly opened NC Eye Bank Surgical Skills Lab at UNC.

UNC Eye Department Chair Donald L. Budenz, MD, MPH said, "The ability to teach microsurgery to residents in a state-of-the-art laboratory is a huge advance in residency training. In addition to weekly training in cataract surgery, we will be holding courses in every subspecialty monthly to teach surgical techniques to treat glaucoma, corneal disease, retinal disease, oculoplastics, and strabismus surgery. This will be excellent preparation for our trainees before they begin operating on real patients."

Dr. Budenz continued, "In addition, we are in the process of organizing weekend training courses in the implantation of newly approved implants for the management of glaucoma. These courses will be open to practicing ophthalmologists who may not have received training in the implantation of devices that were not available when they did their residency training."

First-year resident Bradley King, MD

Residents and Fellows in Surgical Skills Lab

The cross-University participation was greatly appreciated.  UNC Eye Professor Kenneth L. Cohen, MD said, "To me, the exciting part of our first phacoemulsification training course was the educational experience received by ophthalmology residents from not only UNC, but Duke and Wake Forest. As state-of-the art as our facility is, our successful course could not have happened without expert participation by faculty from Duke and Wake Forest, vendors, teaching by our very own third year residents, and support from our department."

Dr. Cohen provides instruction and leadership

UNC Eye Residents were very excited to have this new resource at their disposal.  Chief Resident, Kevin Gertsch said, "The Surgical Skills Lab is an amazing new addition to our residency program. This first-class facility demonstrates the clear focus on education at UNC.  The Surgical Skills Lab allows us to master the skills necessary to become excellent surgeons. Residents can learn and be observed through monitors at individual stations to provide one-on-one instruction.  This training is invaluable for both the residents and their patients enabling residents to become proficient and confident with procedures prior to going to the operating room.  We currently have access to the lab for both large group instruction as well as individual practice time. This allows for a variety of learning opportunities."

Dr. Gertsch continued, "We have weekly lab time to work on surgical procedures of our choice and monthly conferences with faculty members teaching specific procedures in the various subspecialties within ophthalmology.  We have the chance to practice techniques required for corneal transplants, glaucoma procedures, eye muscle surgery, complicated anterior segment procedures and even practice retinal lasers.  The facility has more than enough room and stations for our entire residency program to practice at the same time.  We have enjoyed sharing the facility with our colleagues in Otolaryngology and Neurosurgery as we all benefit from the available technology and training resources.

Our recent tri-residency cataract course was a success for all who attended.  Residents from UNC, Duke, and Wake Forest were able to be instructed by faculty from all three residency programs and then put the new principles learned into action in the wet lab.  Using pig eyes and artificial eyes from the KITARO wet lab system, first year residents practiced the multiple steps of cataract surgery under the supervision of faculty experts and upper-level residents.

Chief Resident Kevin Gertsch, MD, first-year Resident Rob van der Vaart, MD, and second-year Resident Adam Dao, MD instruct fourth-year medical student Ronald Milam

The cataract course for first-year residents reflects the strong tradition at UNC to begin learning surgical skills early in residency training to encourage a more in-depth and comprehensive understanding of the principles of ophthalmic surgery.  We plan to hold similar courses in the future and hope expand to invite upper-level residents from all three NC programs to participate as well.  We also hope that the new lab will be a center for education for other surgeons in the community."

Second-year UNC Eye Resident, Adam Dao, MD was somewhat surprised by his experience during the course, saying, "The UNC Cataract Course was the most educational, efficient, and dare I say it, fun(!) educational activity that I have had since I have been an ophthalmology resident. It was great to get formal instruction and feedback from faculty from a myriad of institutions. It was also nice to meet other residents from other programs and to share (and commiserate about) our experiences in learning cataract surgery. The course was as professional and high caliber as the new North Carolina Eye Bank surgical skills laboratory."

Third-year UNC Eye Resident, Jim Wrzosek found the course extremely valuable, stating, "Overall, being able to first see lectures from experienced faculty on basic phaco techniques followed by an immediate opportunity to practice those techniques under the supervision of the faculty and advanced residents showcased the one of the main strengths of both the training course and the new practice lab.  The availability of top end phaco equipment from AMO and the new cataract simulation equipment from Kitaro also helped make the course valuable for the residents."

For more information on the North Carolina Eye Bank Surgical Skills Lab at UNC, please contact lab manager Matt Pillsbury at matthew_pillsbury@med.unc.edu.

Chief Resident Kevin Gertsch, MD provides instruction

2014 UNC Eye Tri-Residency Phaco Training Course

2014 UNC Eye Tri-Residency Phaco Training Course pt 2

Here are some quotes from participants in this year's Tri-Residency Phaco Training Course:

Kenneth L. Cohen, MD - Sterling A. Barrett Distinguished Professor of Ophthalmology, UNC Eye

Cassandra White, MD - First Year Resident, UNC Eye

Robert van der Vaart, MD - Second Year Resident, UNC Eye

Veronica Kon-Graversen, MD - First Year Resident, UNC Eye

Michael Compton, MD - Chief Resident, UNC Eye

Catherine Reppa, MD - First Year Resident, UNC Eye

UNC Eye faculty member Seema Garg, MD, PhD recently spoke about the importance of the North Carolina Area Health Education Centers (AHEC) Program in a feature on the University of North Carolina at Chapel Hill main website.

Dr. Garg is a retina specialist who has been flying via AHEC’s Medical Air Operations to a retina clinic in New Bern for the past eight years. She is also pioneering a statewide telemedicine program for diabetic retinopathy evaluation by working with the Mountain, Eastern, Southern Regional and Greensboro AHEC primary care residency programs.

Here are a few highlights of Dr. Garg's conversation:

Why do you do what you do through AHEC?

Garg: AHEC helps me reach the UNC Department of Ophthalmology’s retinal clinic in New Bern, N.C., via AHEC’s Medical Air Operations. In addition, the infrastructure of the AHEC sites across the state facilitates our medical services to patients we wouldn’t normally be able to help, for instance, through telemedicine.

How have you influenced people through AHEC and what influence do you hope to have in the future?

Garg: Diabetes-related retinopathy is the leading cause of blindness in North Carolina, and this promising new collaboration we’re working on with AHEC will greatly benefit patients who may have poor access to sub-specialty eye care geographically and financially.

The North Carolina Area Health Education Centers (AHEC) Program, based at Carolina, sends out hundreds of faculty members to towns across the state to teach, to care for patients and to look for ways to improve how each center serves the local community. Nine regional centers serve all 100 counties in North Carolina.

Back in 2011, UNC Health Care shared the story of Baby Adam here.

The interdisciplinary effort to help Baby Adam resumes at UNC Health Care in mid-August, with several UNC Eye MDs as part of the team. "Baby Adam's care has been a huge multidisciplinary effort, pooling resources to give Adam the best possible chance at having a meaningful life, including the use of his vision, said Assistant Professor of Ophthalmology, Michelle T. Cabrera, MD.

"Several UNC ophthalmologists have been involved in the effort, including Dr. Jonathan Dutton, who reconstructed his eyelids, Dr. Richard Davis, who gave Adam a corneal transplant and myself, who provides Adam with ongoing medical and refractive management."

To read our latest Newsletter, click here.  Topics include:

• Chairman's Corner - Donald Budenz, MD, MPH
• 25 Year Faculty Member
• Meet Our First Resident
• 2012 Spring Symposium
• Intermediate Historical Perspective - David Chesnutt, MD
• New Optical Shop Manager
• Dutton Appointed Spinoza Chair
• 2013 CME Calendar
• Resident & Fellow Update

Since 1990, the donations and commitment of North Carolina Lions and Lions Clubs International have helped UNC Eye improve vision to the visually impaired children, youth, and adults of North Carolina and others whom we serve.

Press "play" on the video below to learn more:

Thanks to our relationship with this generous service organization, Michelle Cabrera, MD and J. Niklas Ulrich, MD are training two visiting ophthalmologists from China to treat Retinopathy of Prematurity (ROP), a disease that renders many children in their homeland blind, with no qualified individuals or means to treat the condition.

UNC Eye is also providing a more comfortable patient experience by using the Electroretinogram (ERG) machine, donated by NC Lions, to evaluate the function of the retina.

On February 26, 2014, UNC Eye Chairman Donald L. Budenz, MD, MPH and Glaucoma Fellow O'Rese J. Knight met with US Senator Kay Hagan for an event that the Senator calls "Carolina Coffee" to discuss the critical importance of funding from the National Institute of Health for glaucoma research.  

Senator Hagan's office is open every Wednesday morning, when the Senate is in session, for North Carolinians to come by and talk with her and her staff.

Drs. Budenz and Knight meet with US Senator Kay Hagan to discuss the importance of NIH funding for glaucoma research.

Here are some facts about Glaucoma, from the American Academy of Ophthalmology:

Glaucoma is a disease that damages the eye’s optic nerve. The optic nerve is connected to the retina — a layer of light-sensitive tissue lining the back of the eye — and is made up of many nerve fibers, like an electric cable is made up of many wires. It is the optic nerve that sends signals from your retina to your brain, where these signals are interpreted as the images you see.

• Among Americans, higher-risk groups include those of African or Hispanic heritage and others with a family history of the illness.
• Elderly people with African ancestry are five times more likely to develop glaucoma and 14 to 17 times more likely to become blind than similarly aged people with European ancestry.
• The risk for Hispanic Americans rises markedly after age 60.
• Those of any ethnicity who have a family history of the illness are four to nine times more susceptible.

If you have symptoms of or are at risk for eye diseases like glaucoma, the American Academy of Ophthalmology recommends seeing your ophthalmologist to determine how frequently your eyes should be examined. If you are age 65 and older or have high risks for glaucoma, you may qualify for an eye exam at no out-of-pocket cost through EyeCare America. Those with no symptoms or risk factors for eye disease should get a baseline screening at age 40, when the signs of disease and change in vision may start to occur.

To schedule an appointment with Dr. Budenz or Dr. Knight, please call 919-445-2020.

The UNC Science Expo was held along Cameron Avenue on the campus of the University of North Carolina at Chapel Hill on Saturday, April 12th.  Pediatric Ophthalmologist Michelle Cabrera, MD and Senior Marketing Manager James Harris represented UNC Eye with an interactive exhibit that taught visitors about the structure of the eye, 3D vision, and color blindness just across from UNC campus icon The Old Well.  

"Participating in this event was really special. It was such a joy to help educate young kids from our community about the eye and vision," Dr. Cabrera said. "I hope it inspired some future ophthalmologists!"

"The energy at the Science Expo was infectious," Harris said. "The young people who stopped by our booth were surprisingly knowledgeable about the structure of the eye and very interested in learning more about vision.  We had a continuous flow of interested visitors at our booth from the time the Expo opened until it ended."

There were also displays that highlighted the research programs in progress at UNC Eye along with the new UNC Laser Vision Center.

Harris continued, "It was also very rewarding to be able to spread the word about our research programs and LASIK practice.  UNC Eye looks forward to participating in the Science Expo in 2015 and beyond."

Sept. 9, 2013

Media Contact: Tom Hughes, tahughes@unch.unc.edu, 919-966-6047

CHAPEL HILL, N.C. – Researchers at the University of North Carolina School of Medicine today published new findings in the hunt for a better treatment for macular degeneration. In studies using mice, a class of drugs known as MDM2 inhibitors proved highly effective at regressing the abnormal blood vessels responsible for the vision loss associated with the disease.

“We believe we may have found an optimized treatment for macular degeneration,” said senior study author Sai Chavala, MD, director of the Laboratory for Retinal Rehabilitation and assistant professor of Ophthalmology and Cell Biology & Physiology at the UNC School of Medicine. “Our hope is that MDM2 inhibitors would reduce the treatment burden on both patients and physicians.”

The research appeared Sept. 9, 2013 in the Journal of Clinical Investigation.

Normal adult mouse retinal vasculature. Credit: Chavala Lab.

As many as 11 million Americans have some form of macular degeneration, which is the most common cause of central vision loss in the western world. Those with the disease find many daily activities such as driving, reading and watching TV increasingly difficult.

Currently, the best available treatment for macular degeneration is an antibody called anti-VEGF that is injected into the eye. Patients must visit their doctor for a new injection every 4-8 weeks, adding up to significant time and cost.

“The idea is we’d like to have a long-lasting treatment so patients wouldn’t have to receive as many injections,” said Chavala. “That would reduce their overall risk of eye infections, and also potentially lower the economic burden of this condition by reducing treatment costs.” Chavala practices at the Kittner Eye Center at UNC Health Care in Chapel Hill and New Bern.

All patients with age-related macular degeneration start out with the “dry” form of the disease, which can cause blurred vision or blind spots. In about 20 percent of patients, the disease progresses to its “wet” form, in which abnormal blood vessels form in the eye and begin to leak fluid or blood, causing vision loss.

While anti-VEGF works by targeting the growth factors that lead to leaky blood vessels, MDM2 inhibitors target the abnormal blood vessels themselves causing them to regress — potentially leading to a lasting effect.

Chavala and his colleagues investigated the effects of MDM2 inhibitors in cell culture and in a mouse model of macular degeneration. They found that the drug abolishes the problematic blood vessels associated with wet macular degeneration by activating a protein known as p53. “p53 is a master regulator that determines if a cell lives or dies. By activating p53, we can initiate the cell death process in these abnormal blood vessels,” said Chavala.

MDM2 inhibitors also have conceivable advantages over another treatment that is currently being investigated in several clinical trials: the use of low-dose radiation for wet macular degeneration. Radiation works by causing DNA damage in cells leading to an increase in p53 and cell death. MDM2 inhibitors activate p53 without causing DNA damage. Also, MDM2 inhibitors can be given by eye injection, which is advantageous over some forms of radiation treatment that require surgery to administer.

Co-authors include Younghee Kim, Nagaraj Kerur and Jayakrishna Ambati of the University of Kentucky; Laura Tudisco, Valeria Cicatiello and Sandro De Falco of the Institute of Genetics and Biophysics in Napoli, Italy; Till Milde, Nidia Claros and Shahin Rafii of Weill Medical College of Cornell University; Susan Yanni and John S. Penn of Vanderbilt University; Victor H. Guaiquil of the Hospital for Special Surgery in New York, N.Y.; William W. Hauswirth of the University of Florida; and Thomas C. Lee of Children's Hospital Los Angeles.

Disclosure Statement: Dr. Chavala has filed a patent for the use of MDM2 inhibitors for treating ocular conditions and is founder of Serrata, LLC, which plans to commercialize novel treatments for ocular disease.

Jennifer Williamson (UNC School of Medicine Class of 2013), a medical student and future resident (starting in July 2014) working on a rotation with UNC Eye MD Dr. Sai Chavala, recently had an article published in the The Lancet, one of the most prestigious journals in all of medicine.  Click here to read the article.

Said Sai Chavala and Jennifer Williamson, "We are delighted that The Lancet has chosen to publish these clinical images.  Sturge-Weber syndrome is a disorder that requires multidisciplinary care, and awareness of its ocular complications, including retinal detachments, by multiple specialties is necessary to prevent vision loss.  We hope that these images will help readers make the association between the “port wine” stain of Sturge-Weber syndrome and its ocular manifestations in order to re-emphasize the importance of ocular exams in these patients."

For more information on Sturge-Weber syndrome, please visit the Sturge-Weber foundation website or call 919-966-5509 to schedule an appointment with Dr. Chavala.

Dr. Richard Davis is an Associate Professor of Ophthalmology at UNC Chapel Hill and a researcher at the N.C. Translational and Clinical Sciences Institute (NC TraCS). He was recently interviewed by the Raleigh News & Observer website, to whom he explained what causes – and what is contained within – the tears that frequently surface during the holidays.

Here is an excerpt:

Q. Why do people cry when they are sad?

A. It is difficult to answer exactly why tears form when a person is struck by emotion. It is much more intuitive to understand that when your eyes are dry, they tear. Or when something gets in your eye, you cry. Crying is typically an emotional response to situations that may be happy or sad. On a physiological level, we know that the connections between emotion and crying are governed by specialized almond-shaped structures deep within the brain called the amygdala, which play a role in emotional states such as depression and alcoholism.

To read our latest UNC Eye Newsletter, click here.  Featured topics include:

• Preserving Vision - Efforts in Regenerative Ophthalmology Address the Common Causes of Blindness
• Chair's Corner
• We've Moved!
• Community Low Vision Center Opens in Kittner Eye Center
• Donor Gifts Help Fight Blindness
• Celebrating Our Donors
• Laser Vision Correction Services Added in 2014
• Telemedicine's Role in Preventing Diabetes-Related Blindness
• Faculty News