By John Darling
for the Mail Tribune

When he was 17 years old, Bala Ambati became the youngest doctor ever. Ambati, who is now 34, was in Medford last week to get certified at Medical Eye Center to operate the latest generation of laser eye-surgery devices.

Read the full artilce here.

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Dr. Spitellie and Dr. Tilahun Kiros Tilahun doing a DCR.

In April, HCP volunteer ophthalmologist Dr. Pete Spitellie traveled to Quiha for a seven-day visit. Dr. Spitellie specializes in ophthalmic plastic and reconstructive surgery, also known as Oculoplastics. Dr. Spitellie worked with Dr. Tilahun and Dr. Yared, the head of ophthalmology training program in Gondar to perform 26 corrective eye surgeries, including 15 DCRs (dacryocystorhinostomy), which is a surgery to re-route a tear drainage blockage.

Dr. Tilahun assisted the first four cases of DCRs and was later able to perform them by himself. Dr. Tilahun was left with the medical instruments donated by HCP so he can continue to provide this method of surgery.

Read a short article about Dr. Paul Imperia’s experience in Africa where he’s helping train local doctors to perform advanced cataract surgeries.

Read the full article here.

Our doctors are deeply passionate about international service. Learn more about one of the charities they partner with to help cure Blindness around the world.

Read the full article here.

FIELD NOTES / BY BARRY EVANS

From The Journal

(DEC. 2, 2010)  LASIK, that is, laser surgery to precisely reshape the cornea — the outer transparent part of the eye — has become commonplace, with over a million procedures performed each year in the U.S. Instead of wearing glasses (in front of the eyes) or contact lenses (on the eyes), many people can now have poor vision corrected by reshaping the cornea below the surface of the eye.

The system used nowadays has its roots in Colombia in the 1950s, where Spanish-born ophthalmologist Ignacio Barraquer (“father of modern refractive surgery”) pioneered keratomileusis, or corneal reshaping. He showed that it was possible to “carve” the outer layer of the cornea after slicing it off and freezing it. Once sculpted to the required shape, the layer was replaced on the eye where natural healing then took place.

Viewing the patient’s eye on a high-definition video monitor, ophthalmic surgeon Paul Imperia adjusts the position of the Intralase that will create the corneal flap. PHOTO BY BRIAN PRECHTEL

Barraquer’s basic procedure for reshaping the cornea became much easier and safer with the invention of the excimer laser in the 1970s, which can ablate (disintegrate by disrupting surface molecular bonds) organic tissue without heat damage. Today, eye surgery typically uses high-energy pulses of ultraviolet light from an argon-fluoride (193 nanometer) laser.

The first US patent for LASIK (Laser-Assisted In-Situ Keratomileusis) surgery was granted in 1989, for a procedure in which the surgeon cuts a corneal flap with a fine blade and pulls it clear (leaving a hinge of tissue) to expose the cornea’s lower layer, the stroma. A computer-guided laser then precisely reshapes the stroma by ablating a thin layer of tissue — typically less than the thickness of a page of the Journal — after which the flap is replaced.

More recently, a femtosecond ( 10-15 second) laser has replaced the mechanical knife. This laser creates a plane of closely-arranged “dots” of air bubbles in the tissue below the surface of the cornea. The end result is the same — the surgeon still lifts a flap, exposing the stroma below — but the process, known as IntraLASIK, is safer and more precise. The entire procedure takes about 15 minutes. In the future, eye surgeons may be able to avoid the flap altogether. In an experimental procedure known as FLEX, for Femtosecond Lenticule EXtraction, a femtosecond laser does the whole job by cutting a thin lens-shaped layer within the cornea, for removal through a small incision.

Why this column now? After spending roughly a year of my life looking for my glasses, I just had the IntraLASIK procedure. I’m thrilled with the result.

Barry Evans (barryevans9@yahoo.com) appreciates the fact that eye surgery no longer means “going under the knife.” Eureka Books carries his (what else?) books, while his travel photographs are on display during December at Old Town Coffee and Chocolates.

Join hosts Paul Akers and Jon Lussier of “The American Innovator” radio show (KGMI-AM Bellingham, WA) as they talk with SightLife’s president and CEO, Monty Montoya. Learn about this organization’s vital work restoring sight to thousands of blind people around the world. Working both domestically and abroad, SightLife harvests corneas, creates eye banks, conducts surgeries, and trains doctors in third world countries to conduct these life altering treatments. Medical Eye Center’s own Dr. Matt Oliva travels with SightLife on numerous sight-restoring expeditions and was host Paul Akers’ surgeon for the very same procedure. Find out how simply checking the donor box on your driver’s license can improve the quality of life for others.

Listen to the podcast here.

by Dr. Matt Oliva

Blindness exerts an incredible toll in the Tigray region of Ethiopia, in terms of both human suffering and adverse economic impact. Due to environmental conditions, malnutrition and vitamin deficiency, ocular infections, trauma and lack of access to care, some of the world’s highest rates of blindness exist in this arid and mountainous area, with a 1.5% estimated prevalence rate. The majority of this blindness is caused by cataract and corneal opacification, both of which are treatable conditions, often for as little as $20 per surgery.

The Himalayan Cataract Project (HCP) is working to eradicate preventable and treatable blindness in the developing world. Beginning in 2007, in partnership with the Millennium Cities Initiative, we joined forces with the Quiha Zonal Hospital in Mekelle, Ethiopia, and the Tigray Regional Health Bureau to dramatically expand access to high volume, high quality, modern cataract and corneal surgery in northern Ethiopia.

HCP and Ethiopian physicians perform sight-restoring surgeries.

The results have been stunning. Over the last two years, Quiha has provided more than 1,000 sight-restoring surgeries per month – both at the hospital in Mekelle, as well as through extensive outreach work at community health centers staffed by ophthalmic nurses. A particular highlight has been five high-volume cataract programs over the last two years. Most recently, in July 2010, a staggering 973 surgeries – cataract, corneal transplant and glaucoma – were performed over the course of one week. Patients were screened throughout the region over the preceding three-week period, with ophthalmic nurses traveling to remote villages and finding bilateral blind patients, who were then transported to Quiha. Patients from as far as Eritrea traveled over 600km to seek care. In seven long days of surgery, I worked side-by-side to restore sight with Ethiopian surgeons Dr. Tilahun Kiros, Dr. Zerihun and Dr. Yewubnesh, and American surgeon Dr. Paul Jorizzo. Careful follow-up care was provided by the network of ophthalmic nurses.

Examining a patient.

HCP has made significant investments in training and infrastructure at Quiha as we strive to make it a model center of excellence for eye care and training in Africa. Medical Director Dr. Tilahun Kiros was an HCP Fellow in 2009, studying cornea in the United States, with follow-up training provided in Mekelle by visiting faculty. Staff surgeons Dr. Zerihun and Dr. Yewubnesh recently returned in June 2010 from a six-week training course in Nepal, where they honed their high-volume/high-quality cataract skills at the Tilganga Institute of Ophthalmology in Kathmandu. A continuous stream of U.S. eye surgeons and support staff instructors from Tilganga have visited Mekelle to help Quiha reach its goal of replicating the high-efficiency comprehensive eye care delivery systems that have been so successful in reducing blindness in Asia.

Patients recover post-surgery.

As we look to the future, a modern state-of-the-art eye teaching hospital is being built next to the existing Quiha structure, slated to open in 2011. The ophthalmic nursing program, which graduates 12 nurses per year to serve Ethiopia and East Africa, is expanding, in collaboration with Mekelle University and HCP. Additional doctors will join Quiha as permitted, with subspecialty training in pediatrics and retinal disease.

The new hospital under construction.

The quality of care and surgical outcomes at Quiha is as good as I have seen anywhere in Africa. This past July, when we removed each morning the eye bandages of more than 150 patients from the previous days’ surgeries, a chorus of ululating patients would give thanks to the Quiha team who helped restore their sight. As these patients return home to their villages or towns with their new sight and broadened horizons, we expect the demand for eye care services in Tigray to continue to expand.

Please visit the Himalayan Cataract Project website (www.cureblindness.org) for further photos and videos of HCP’s work in Ethiopia.

Dr. Paul Imperia and Dr. Matt Oliva treat hundreds of cataract patients in Ethiopia.

One hundred blind patients in threadbare robes sit shoulder to shoulder against the wall in a converted warehouse in rural Ethiopia. They wait for surgery that will allow them to see again.

Tomorrow, a new group of a hundred will wait.

An ophthalmologist makes quick incisions into the eye of a patient and removes a cataract. The procedure is efficient, sterile and takes about seven minutes. Medford doctors Matthew Oliva and Paul Imperia recently worked side by side in this fashion with an Ethiopian doctor, treating hundreds of patients over the course of a weeklong visit.

Dr. Oliva and Dr. Imperia volunteer their time and expertise for the Himalayan Cataract Project, a nonprofit organization founded in 1995 dedicated to creating a model for sustainable eye care in the developing world.

Read the full article here
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Visian Implantable Collamer Lens provides U.S. Bobsled Pilot with the vision to lead his Team to first Olympic Gold in 62 Years.

In a historic moment for the United States bobsled team, Steven Holcomb piloted bobsled USA-1 to the Olympic gold medal in the four-man event, ending a 62-year Olympic medal drought for the American. Holcomb’s heroic mastery of the treacherous track is made even more significant by the fact that not long ago, he had 20/500 vision — "profound visual impairment" caused by keratoconus — that very nearly ended his bobsledding career. Contact lenses could no longer provide the level of visual acuity required for Holcomb to compete. Finally, with the help of U.S. bobsled coach Brian Shimer, he was deemed a good candidate for the Visian ICL. Holcomb said. "I couldn't wear contacts the day of the surgery, so they literally had to walk me around the room. And then they did it, I got up, and just like that, I was 20/20. It's incredible. I call it an eye-opening experience."

Dr. Matt Oliva is a board-certified cornea specialist with fellowship training from the highly-esteemed Royal Victorian Eye and Ear Hospital in Melbourne, Australia. Beyond training for an additional three years after medical school to become a general ophthalmologist, his fellowship entailed an additional year of intense training in cornea diseases and conditions, cornea transplants, and refractive surgery. His expertise led him to a four year post as the official eye doctor for the NBA’s Seattle SuperSonics. Dr. Oliva is passionate about international service. For a decade he’s served as a volunteer instructor and corneal service consultant at the Tilganga Eye Center in Nepal, and he’s the associate medical director for Sightlife, the country’s largest eye bank. At Medical Eye Center, Dr. Oliva is available to treat a broad spectrum of eye conditions including cataracts, cornea disease, glaucoma, diabetic retinopathy and macular degeneration. He’s recently moved here from Seattle and Matt looks forward to enjoying many outdoor activities like whitewater kayaking, hiking and running marathons.

FOR IMMEDIATE RELEASE

Contact: Reine McIntyre
Marketing Director, Medical Eye Center
541-779-4711
reine@imperiavision.com

BRIDGING THE GAP: MEDFORD TO AFRICA

Medical Eye Center Doctor Restores Eyesight in Africa And Trains African Doctor to Do the Same Here in Medford

(Medford, OR) – October 30, 2008 – It takes a village—a global village—to improve health care around the world. And Medford doctor Matt Oliva of Medical Eye Center (MEC) is doing his part. Together with the Himalayan Cataract Project (HCP), he is striving to promote self-sufficient eye care in impoverished nations by restoring eyesight to thousands in Africa and teaching African doctors—one of whom he’ll host right here in Medford—to do the same.

Dr. Oliva has teamed up with HCP and the Earth Institute at Columbia University on the Millenium Villages Project, which involves finding the most cost effective health, agriculture, and education interventions in order to help rural African villages lift themselves out of poverty and meet the millennium development goals set forth by the United Nations.

As part of this effort Dr. Oliva is in western Kenya for a week conducting comprehensive eye care programs. Working with Kenyan ophthalmologist, Dr. Ciku Mathenge and her team of Kenyan ophthalmic nurses, Dr. Oliva will be performing cataract surgery, examining all 5000 members of the village and treating any eye disease present, mass treating for Vitamin A deficiency, and providing glasses for patients that need them.

Sauri, Kenya is a farming community plagued by hunger, AIDS, and malaria. Between sixty and seventy percent of the population live on less than a dollar per day. With limited access to medical care and poverty preventing residents from buying what little medicine is available, malnutrition and poor health run rampant.

After completing his work in Sauri, Dr. Oliva will travel to Nairobi, the capital of Kenya, to host a corneal transplant workshop with Dr. Dan Kiage, a corneal specialist at Aga Khan Hospital. The ten corneas provided for transplantation during Dr. Oliva’s trip come from the SightLife eye bank in Seattle, which provides the tissue used in MEC’s corneal transplants. SightLife is in the process of establishing a functioning eye bank in Kenya to support the massive need for corneal transplantation.

Upon returning to Medford, Dr. Oliva will be joined by Rwandan doctor John Nkurikiye who arrives on November 17 to spend 10 days observing MEC doctors and learning more about their modern eye care techniques. Dr. Nkurikiye’s visit is part of the HCP American-standard residency training program in ophthalmology, established in 2004. This program is a joint effort of the Tilganga Eye Centre and the Nepal Eye Hospital under the National Academy of Medical Sciences. It is designed to train young ophthalmologists to operate at the highest international level of ophthalmology and adheres to the curriculum established by the American Academy of Ophthalmology.

Dr. Nkurikiye is the most well trained and proficient ophthalmologist in Rwanda. He will be spending three months doing a corneal fellowship in America. In addition to his stay at MEC, he will be spending two months at the Moran Eye Center in Utah and also spending a week at SightLife in Seattle, to learn more about eye banking. SightLife is in the process of starting an eye bank in Rwanda so that Dr. Nkurikiye will have corneas available to treat the large burden of corneal blindness.

Medical Eye Center is excited to be attracting doctors from all over the world, and proud of the work its doctors are doing to improve the quality of eye care in impoverished countries. Dr. Oliva will be making a similar trip to Nepal in February, also through the Himalayan Cataract Project. This past summer, Dr. Paul Jorizzo and his daughter spent 12 days in Peru to perform 100 cataract surgeries on indigent patients, and prior to that, Dr. Paul Imperia traveled to Honduras to perform 49 sight-restoring surgeries in seven days—both through Surgical Eye Expeditions (www.seeintl.org). To learn more about MEC doctors and their charitable programs and travels, please call 541-779-4711.

About Millenium Villages Project:

The Millennium Villages project offers a bold, innovative model for helping rural African communities lift themselves out of extreme poverty. The Villages are proving that by fighting poverty at the local level through community-led development, rural Africa can achieve the Millennium Development Goals—global targets for reducing extreme poverty and hunger by half and improving education, health, gender equality and environmental sustainability—by 2015, and escape the extreme poverty that traps hundreds of millions of people throughout the continent.

About Himalayan Cataract Project:

The Himalayan Cataract Project (HCP) is establishing a sustainable eye care infrastructure in the Himalaya that empowers local doctors to provide high-quality ophthalmic care through skills-transfer and education. The HCP responds to a pressing need for eye care in the Himalayan region. Our programs in Nepal, Tibet, China, Bhutan, India, Sikkim, and Pakistan have restored sight to tens of thousands of blind people every year since 1994.

About SightLife:

SightLife, operated by the Northwest Lions Foundation for Sight & Hearing, is one of the leading eye banks in the nation. In 2007, they provided more than 2,800 corneas for transplant, meeting regional needs and helping fill gaps across the United States and in 25 other countries.

About Medical Eye Center:

MEC first opened its doors in 1914 with a commitment to making patient health and well-being a top priority. MEC provides comprehensive medical eye-care services from routine vision exams to the latest in the medical and surgical treatment of eye diseases—including cataract microsurgery and laser vision correction. MEC also features a new Facial Aesthetics and Medical Spa. For more information call 541-779-4711.

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FOR IMMEDIATE RELEASE

Contact: Reine McIntyre
Marketing Director, Medical Eye Center
541-779-4711
reine@imperiavision.com

MEDFORD FATHER/DAUGHTER TEAM
RESTORES SIGHT TO THE POOR IN PERU

(Medford, OR) – July 30, 2008 – It’s not every 17-year-old who can say they helped restore sight to a hundred impoverished individuals in a remote area of Peru, but Kristin Jorizzo of St. Mary’s High School can. Along with her father, ophthalmic surgeon Paul Jorrizzo of Medical Eye Center (MEC), Kristen recently spent 12 days in Huamachuco, Peru, as part of a medical expedition coordinated by Surgical Eye Expeditions International (SEE)—a non-profit humanitarian organization that provides medical, surgical, and educational services by volunteer ophthalmic surgeons with the primary objective of restoring sight to disadvantaged blind individuals worldwide.

‘The people of Huamachuco were some of the most amazing and caring people that I have ever met,” says Kristen. “Being able to help them was a gratifying experience which I will hold with me forever.” She prepared for the trip by working at MEC for the past few summers, assisting in research projects and as well as helping in the role of ophthalmic technician and surgical technician.

Inspired by her father’s involvement, Kristen has developed a strong commitment to international aid. “I plan on getting my school involved with the town of Huamachuco and the people in surrounding villages,” she says. “While it may not be the most impoverished place on earth, the people there could truly use our help and that's what is most important. The experiences that I had there will be with me forever and guide me through future expeditions. The fact that I was able to share this experience with my dad made it even more special.”

The Jorizzos, joined by MEC Surgical Assistant Nolan Sargent and a team of eye surgeons and technicians, traveled to the Andes Mountains on July 6 to perform cataract surgery on approximately 100 indigent patients. A cataract is a cloudiness that develops in the otherwise clear crystalline lens of the eye, deteriorating the vision to blindness. Patients in developing nations who could otherwise be productive members of their families and society become a burden when cataracts disable them. By performing modern cataract operations, SEE volunteers are able to return vision to those who generally do not even have access to basic health services. After a quick recovery these patients can return to work and become productive again. Additionally, the traveling surgeons teach the local Peruvian doctors the techniques they can use to help many more needy patients in their country.

Putting together an air-transportable, modern surgical package was a huge undertaking that required a cohesive surgical team and support personnel who gave of their time selflessly. National medical supply companies such as Johnson & Johnson, Bausch & Lomb, and Alcon donate almost all the equipment and supplies needed for the free medical clinics. The volunteers donate their time and pay for all of their own travel expenses.

“Our time in Peru was truly special for me,” said Dr. Jorizzo. “The town of Huamachuco has no access to eye care. Many patients had such severe cataracts that they could only perceive light, and several walked for four hours to see us. The changes that we were able to make in their lives were extremely gratifying, and being able to share this experience with my daughter, Kristen, was certainly something that I will always treasure.”

Dr. Jorizzo plans to be part of future SEE expeditions, next time bringing along his 15-year-old son, Matthew, and his wife, Vera. Other MEC surgeons have also participated in the program—Dr. Paul Imperia traveled to Central America in 2006 and Dr. Matt Oliva has done several surgical expeditions and is on the board of the Himalayan Cataract Project—and they will continue to volunteer in the future.

About Surgical Eye Expeditions International (SEE):

In 2007, SEE International held 72 expeditions, and sent an additional 29 support packages worldwide. Through the efforts of their affiliates, staff, and other volunteers, 40,610 patients were screened and 9,308 received much needed surgery. To learn more about SEE, visit www.seeintl.org.

About Medical Eye Center (MEC):

MEC first opened its doors in 1921 with a commitment to making patient health and well-being a top priority. As Oregon’s first eye surgery center fully accredited by the Accreditation Association for Ambulatory Health Care, MEC provides comprehensive medical eye-care services from routine vision exams to the latest in the medical and surgical treatment of eye diseases—including cataract microsurgery and laser vision correction. For more information on MEC’s eye care providers, call 541-779-4711 or visit www.medicaleyecenter.com.

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FOR IMMEDIATE RELEASE

Contact: Reine McIntyre
Marketing Director, Medical Eye Center
541-779-4711
reine@imperiavision.com

MEDICAL EYE CENTER BREAKS GROUND
ON NEW, STATE-OF-THE-ART FACILITY IN MEDFORD

(Medford, OR) – May 30, 2008 – Medical Eye Center is excited to announce that they are breaking ground on a new 37,000-square-foot building at the corner of Barnett Road and Highland Avenue, just a half mile from their current location. The official groundbreaking ceremony will take place on Friday, June 6 at 12:30pm. Highlights include opening remarks by Drs. Paul Imperia and Paul Jorizzo, the unveiling of a 3-D rendering of the new building, and a reception with refreshments to follow the ceremony. Medical Eye Center’s CEO, Keith Casebolt, and builder Reid Murphy will be on hand to answer questions.

The new, custom-designed facility—set to open in October 2009—will further improve and expand the services that Medical Eye Center (MEC) offers. Thanks to some thoughtful planning, the new building will allow for expansion of MEC’s surgical capacity and create more room for new state-of-the-art diagnostic equipment, a larger optical department featuring the latest styles in fashion eyewear, special LASIK and oculoplastics suites, and more.

Bursting at the seams after the recent addition of two new doctors, it became apparent that MEC required a larger facility to accommodate the increased number of procedures now available to their growing patient base. In the meantime, the practice has been renting 3,000 square feet of office space in the nearby Black Oak Shopping Center to use for the overflow.

Joining MEC last year, Dr. Pete Spitellie is a fellowship-trained ophthalmologist specializing in oculoplastic and reconstructive surgery. He is Southern Oregon’s first and only oculoplastic specialist, performing procedures such as lid, brow, and mid-face lifts, and reconstruction around the eyes after skin cancer removal or trauma.

MEC’s newest surgeon, Dr. Matt Oliva, is a board-certified cornea specialist with fellowship training from the highly esteemed Royal Victorian Eye and Ear Hospital in Melbourne, Australia. His expertise led him to a four-year post as the official eye doctor for the NBA’s Seattle SuperSonics.

The change of address will mean an even more convenient location for patients, located directly across from the off-ramp of I-5’s new South Medford interchange, with increased accessibility to free parking.

Medical Eye Center first opened its doors in 1921 with a commitment to making patient health and well-being a top priority. MEC is Oregon’s first eye surgery center fully accredited by the Accreditation Association for Ambulatory Health Care, providing comprehensive medical eye-care services from routine vision exams to the latest in the medical and surgical treatment of eye diseases—including cataract microsurgery and laser vision correction. For more information, visit www.medicaleyecenter.com or call 541-779-4711.

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