Scheie Vision
Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania
Department of Ophthalmology
All In The Family
M
ary Flynn had never
had eye problems.
Her vision was great.
She read three newspapers a
day, played golf and tennis, and
traveled the world with her grandchildren. She was shocked to
learn that she had glaucoma.
Scheie Eye Institute
Volume 1 Issue 1
Mary Flynn (center) is the mother of 5 and grandmother of 14
Inside This Issue
All in the Family
Following the recommendation of Family is one of the reasons Dr. Looking Good
a family friend, Flynn came to the Miller-Ellis chose glaucoma as
Scheie Eye Institute for further
her specialty.
Residency Director
examination and treatment.
“I have several family members Protecting Cells
The Scheie Eye Institute is a lead- who have glaucoma,” Dr. Millerer in glaucoma research and clini- Ellis said. “And glaucoma is the Screening
cal care, and offers free glaucoma number one cause of preventscreenings in the community each able blindness among African- Peter Sterling
month. Screenings are strongly
Americans. I wanted to be able to
recommended for those at high
do something significant to help Resident Views
risk for developing the disease.
address that.”
More than 3 million Americans
have glaucoma, which has no noticeable symptoms. In most cases
there is no vision loss, no redness,
and no pain.
“If a parent or a sibling in your
family has glaucoma, you need
“I really didn’t notice anything,”
to get checked,” said Dr. MillerFlynn said in an interview at
Ellis, Director of the Glaucoma
the Scheie Eye Institute. “My
Service at Scheie. “Having a sibsight was fine. I would not have
ling with glaucoma increases your
known it had I not gotten a free
risk 10-fold.”
test.”
Sight Savers
Most glaucoma, can be treated
by lowering pressure in the eye. A New Link
Sometimes this is done through
eye drops, and in other cases
Mentoring
surgery is necessary. Treatment
depends on the individual and theChair’s Corner
type of glaucoma.
(Continued on page 2) Patient Perspective
Pg 2
Pg 2
Pg 2
Pg 3
Pg 3
Pg 4
Pg 5
Pg 5
Pg 6
Pg 7
Pg 8
Pg 8
New Director for Scheie Residency Program
Residency Director immediately following the completion
of his residency in July of 2003.
As a newly graduated resident,
he had some fresh ideas for
improving residency life.
have trained excellent surgeons,
but there is a backlog of surgical cases that we need to capitalize on, particularly at the VA
hospital.”
The quality of teaching and
Now, as the Residency Program supervision that goes into each
Director, Dr. Tapino continues
resident surgerical case is outto work to improve day-to-day standing, said Dr. Tapino, but
Dr. Tapino, Residency Director resident training, as well as
the number of surgeries can be
ncreased surgical volume
implement big-picture improve- improved.
and faculty mentors are
ments.
To allow more time for surgitwo big changes coming to
the Scheie Residency Program
“One of my goals as residency cal training, Dr. Joan O’Brien,
under the new leadership of
director is to increase the surChairman of the Department of
Paul Tapino, MD, Residency
gical volume at Scheie,” Dr.
Ophthalmology, and Dr. Tapino
Program Director.
Tapino said. “I feel that the
have created a plan to add adhigher the volume, the better
ditional surgical weeks in the
Dr. Tapino became the Assistant surgeons we’ll train. I think we senior year at the Philadelphia
I
Veterans hospital. They have
worked with Dr. Mike Sulewski
to increase staffing and and to
add additional surgical time
each week, as well as more
operating rooms.
The new plan will be a big
change from the current schedule, but Dr. Tapino is confident
that providing more surgical
experience for the residents will
be a great benefit to them.
Dr. Tapino is also organizing a mentorship program for
residents, to provide additional
guidance and learning opportunities. (Continued on page 2)
Scheie Vision 1
All In The Family (Continued from front page)
“The pressure in my eye didn’t
come down with the drops or
laser surgery, so we decided to
do a trabeculectomy.” Flynn
said, referring to filtering surgery, which removes a piece
of tissue in the eye to create an
opening and relieve elevated
pressure.
No matter what kind of treatment is necessary, patient education is essential to success.
Looking Good
T
he Scheie Eye Institute
is getting a new look.
The building, completed
in 1972, is undergoing renovation to reflect the cutting edge
research and patient care for
which Scheie is known.
“If your patients understand
their disease they are much
more likely to comply with
the medical management,” Dr.
Miller-Ellis said.
Many glaucoma patients have
difficulty administering the
correct dosage. Often patients
with a shaky hand squeeze out
too many drops and run out of
medication early.
the correct way to administer
eye drops and works with pharmacies and insurance companies to make sure patients
receive adequate medication to
last through the month.
Dr. Miller-Ellis shows patients
When asked what she likes
most about her work, Dr.
Miller-Ellis responded quickly,
“The patients. I love talking to
them, getting to know them,
and offering them excellent
care.”
The second floor renovation
is complete. Both the first and
fifth floor renovations include
new eye lanes, furniture, cabinetry, finishes wood floor and
carpet. The first floor will
feature state-of-the-art exam
rooms, designed with input by
Scheie physicians and technicians, to ensure maximum
comfort and efficiency for all
ophthalmic procedures. In addition, all three elevators will be
replaced, improving traffic to
all six floors. The roof has been
fully replaced, and the exterior
The warm feelings seem to go
both ways.
“Dr. Miller has been wonderful.” Flynn said. “I have such
confidence in my doctor that I
just don’t worry anymore.”
If she could share a message
with a newly diagnosed glaucoma patient, Flynn would tell
them:“It’s okay; you’re going
to be just fine.”
of the building will be chemically washed and resealed to restore it to it’s orgininal design.
We are excited about the
changes, and hope that our patients will be more comfortable
in this new setting.
New Director for Scheie Residency Program (Continued from front page)
and specialty of the faculty to find a good
mentoring match. Some of the faculty have
already formed relationships with Scheie
residents and have requested to work with
them as mentors.
“The response from the faculty has been
really great,” Dr. Tapino said. “I think this
program going very well.”
an attending, and qualities I try to instill in
our current residents.”
The fruit of Dr. Tapino’s efforts can be
seen in the successful match of all five
graduating residents at outstanding fellowship programs throughout the US.
Dr. Tapino is now preparing for the next
class of residents. After sorting through
hundreds of applications, and interviewing
Scheie residents at the 2011 AAO meeting Departmental support has made a big difference in Dr. Tapino’s work as Program
60 candidates, Dr. Tapino and the selection
“I’m always there to talk to,” Dr. Tapino
Director, he said.
committee have selected five new residents
said. “But talking it out with a faculty mento join the Scheie Residency Program July
tor could give residents a different perspec- “Dr. O’Brien is extremely supportive of the 1, 2012.
tive from my own.”
residency program,” Dr. Tapino said.
“The selection process went great this year.
Beginning this year with first year resiDr. Tapino and Dr. O’Brien meet with
We have five great residents that I’m very
dents, each resident will be assigned a
residents every six to eight weeks to learn
excited about,” Dr. Tapino said. “They
mentor who will act as an advisor and will about their rotations. Resident suggestions were our top choices and we are going to
meet with them twice a year to talk about
for improving training are taken seriously
have a strong first year class.”
goals, future career plans, fellowships, and and regularly implemented.
research opportunities.
When asked if today’s residents have it
“The faculty it also very supportive,” Dr.
easier than he did as a resident, Dr. Tapino
“Many residents are not sure what they
Tapino said. “I was a resident under many smiled and thought about it.
want to do after Scheie,” Dr. Tapino said.
of our current faculty members and I mod“Sometimes just talking about their interel my teaching style after them, because it “They have a lot of advantages over resiests, be it clinical work, research or eduwas very successful.”
dents of a few years ago,” Dr. Tapino said.
cation, and hearing all their options, can
“Technology has made information much
make a big difference. It can be especially Dr. Tapino remembers working hard and
more accessible, which helps residents
helpful if a resident wants to do a retina
being pushed to reach his potential as a
learn faster and work more effectively. I
fellowship and has a retina doctor as their
resident.
wouldn’t say they have it easier, but I think
mentor who can say ‘This fellowship prothey have it a little better now.”
gram may be a better fit for you than that
“There was a big pay off from all the hard
one.’”
work,” Dr. Tapino said. “We learned to be- As Dr. Tapino continues to direct and imcome more efficient, to multi-task, and to
prove the Scheie Residency Program, it is
Dr. Tapino will look at the interests and
become responsible for our patients. Those safe to say that each year Scheie residents
goals of the resident and the availability
are qualities that have carried over to me as will have it a little better.
Scheie Vision 2
Protecting Cells, Prolonging Vision
G
cells alive by preventing oxidative stress.
This could mean good news for
glaucoma patients.
After three weeks of inflammation, Dr. Shindler’s team evaluCurrent treatments often focus
“One problem with finding a
ated their results by measuring
on reducing the eye pressure
treatment for glaucoma is that it the number of retinal ganglion
that kills nerve cells.
is a long, slow disease, and you cells that survived and by testhave to treat a large number of ing visual acuity. The results
Dr. Ken Shindler, Assistant Pro- patients for years to know if a
were good.
fessor of Ophthalmology at the new drug is effective,” Dr ShinScheie Eye Institute, is taking a dler said. “Patients with optic
“What we’ve shown is that in
different approach.
neuritis have inflammation
animals with optic neuritis,
for a few weeks and we know
when we treat with these drugs,
Instead of focusing on eliminat- that their ganglion cells will
we can keep the ganglion cells
ing harmful pressure, Dr. Shin- die within three months of the
alive after the inflammation has
dler researches ways to protect onset of their disease. Within
come and gone,” Dr. Shindler
nerve cells and to help them
three to six months I can know said.
withstand harm. It is like forti- whether patients on a new drug
fying the walls of a castle rather have a better outcome than pa- Dr. Shindler emphasized that
than trying to prevent threats
tients not on the drug.”
this treatment does not block
from reaching the castle.
inflammation.
One drug Dr. Shindler is evalu“I set out to find treatments that ating is based on the compound “They are still being exposed to
might prevent the nerve cells
Resveratrol. This compound
that insult that normally causes
themselves from dying, once
activates a protein called SIRT1 the injury and kills them, yet
they were exposed to damage,” which then modifies other pro- they’re staying alive,” Dr.
Dr. Shindler said in a recent in- teins in the cell. Some of these Shindler said. “I think it is very
terview. “Even if inflammation proteins are involved in cell
exciting that we found this class
is still there, can we stop the
survival, specifically, keeping
of drugs that keeps the ganglion
nerve cells from dying?”
cells alive.”
“Glaucoma was always in my
mind for starting the research.”
Dr. Shindler said. “There are a
lot of common features in optic
neuritis when compared to
glaucoma. For example, there
are common mechanisms that
kill cells once they’re exposed
to damage. There are also
things that are toxic to the cells
in both diseases. And there is
certain oxidative stress that occurs in both eye diseases.”
nerve.
laucoma is one of
many eye diseases
that damages the optic
Control
To answer that question, Dr.
Shindler tested a new compound, and used the eye condition optic neuritis as a model.
Placebo
It may be a few more years
until the drug reaches clinical
trials, but the early results are
encouraging.
“I’m hopeful it’s going to work
in other disease models,” Dr.
Shindler said. “We are very
excited.”
Dr. Shindler’s most recent work
can be found in the December
2011 issue of Clinical and Experimental Ophthalmology.
Treated with SRT647
Dr. Shindler has
an MD in ophthalmology and
a PhD in neuroscience.
Retinal ganglion cells, shown in green, are destroyed by inflammation when treated with a
placebo, but survive inflammation when treated with the compound SRT647
The Importance of Screening- Dr. Prithvi Sankar
G
laucoma affects millions of people. Many
of those at high risk
for glaucoma live here in Philadelphia. Being able to diagnose
and treat glaucoma in its early
stages can help prevent blindness here in our community.
Glaucoma is really tricky.
It’s a disease that doesn’t hurt
when it happens. We can’t rely
on patients to tell us they have
loss of vision or they have eye
pain, because that’s not usually
how glaucoma presents. That’s
why screening is important. We
need to try to identify glaucoma
early, while patients still have
very good functional vision.
We do screenings through the
Students Sight Savers program
at health fairs and basketball
games, which is great. But we
also need the community to be
involved in these screenings, to
allow us to screen them. Many
of the people we need to screen
are not the kind of people who
would go to a health fair.
By working with other organizations within the community
we can reach a population we
might not reach otherwise.
Members of churches, temples,
synagogues, and mosques are
very helpful to us in spreading
awareness of this disease.
When people go back to their
church or temple or synagogue,
or mosque, they’ll see the same
people. They might say ‘Oh,
did you get your eyes checked
out? You need to get your eyes
checked out.’ It can feel more
like a community and it can
motivate people to make an
appointment with an ophthalmologist.
We have all the tools necessary
to diagnose glaucoma and prevent vision loss. With the help
of the community, we can help
people get diagnosed earlier
and help them keep to their vision longer.
Scheie Vision 3
Peter Sterling, In His Own Words
began to study the retina of tadpoles to learn if “fly detectors”
develop when the vegetarian
tadpole changes into the insectivorous frog.
Dr. Peter Sterling, Professor
of Neuroscience and Professor of Ophthalmology at the
University of Pennsylvania, is
the recipient of the 2012 ARVO
Proctor Medal. Here Dr. Sterling describes highlights from
his 50-year career.
I
started medical school way
back in 1961, but soon realized that my interest was in
research, and for that the PhD
was better training.
What led me to research vision
was my reading of a now classic paper, “What the frog’s eye
tells the frog’s brain”, by Jerome Lettvin, Humberto Maturana and colleagues.
This paper showed that neural
circuits within the retina (which
is actually part of the brain) can
accomplish sophisticated computations.
For example, one type of neuron in the frog’s retina identifies
a small, dark, moving object
that is likely to be a fly. The
study so fascinated me that I
cuit (although this was before
such silicon circuits had been
built).
use far less space and energy.
This turns out to be a general
principle of brain organization:
to save space and energy, send
The approach was to slice a
information as slowly as possmall piece of mammalian
sible. This is the subject of my
I made little progress with
retina (for example the primate most recent laboratory report to
this project as a first year grad
fovea) into ultra-thin sections
be published this month in the
student, but was gratified when and photograph them in the
Journal of Neuroscience.
later investigators confirmed
electron microscope. Then we
my hypothesis.
traced the neural processes
Now retired from laboratory
through hundreds of sections
studies and teaching, I have
My PhD research concerned
onto plastic sheets and entered more time to digest and ponthe structural organization of
them into a computer which
der the mountain of facts that
the spinal cord (because no
could display them as three-di- neuroscience has accumulated.
one was available to supervise
mensional reconstructions. This This has led me to write a small
me in visual studies), but for
was slow work, but it produced book with Prof. Simon Laughmy postdoctoral work I joined
a comprehensive, quantitative
lin (Cambridge University),
the laboratory of David Hubel
“wiring diagram” that we could tentatively titled, “Principles
and Torsten Wiesel, who were
begin to “read” -- like electrical of Neural Design,” which we
studying visual cortex, work
engineers.
hope to submit for publication
that later earned them a Nobel
shortly after ARVO 2012.
Prize.
Our structural diagrams raised
numerous functional questions, I am frequently asked, “How
Arriving at Penn in 1969 I
and to answer them we began
will your research impact pawas greeted warmly and supto study the live retina in a cul- tient care?” the simple answer
portively by Ophthalmology’s
ture chamber.
is, “I do not know.” It is for othProfessor Alan Laties. This was
ers – the next generation – to
the first of many constructive
We recorded electrical signals, pick up the threads of our disand pleasant interactions with
initially from one neuron at
coveries and weave something
Ophthalmology colleagues,
a time, but later from tens of
useful. Since humans are endsuch as Richard Stone, Jean
neurons simultaneously – while lessly inventive, I expect that
Bennett, and Eric Pierce, as we projecting video clips of natural basic principles will eventually
collaborated to develop the Vi- scenes onto the retina through a lead to something practical.
sion Center and Vision Training microscope.
Programs.
As advice for beginners: I canThis allowed us to measure the not recall learning anything
At first in my own lab I studrates at which particular neuron except through my own errors,
ied visual-motor systems, but
types send information, leading and the fastest way to discover
eventually focused exclusively to our report, titled in homage
them (though painful) was via
on the retina. My particular
to Lettvin and Maturana, “How criticism from others. Therebig idea was to discover how
much the eye tells the brain.”
fore, seek criticism and sift it to
the retina’s 60 different types
find what needs improvement
of neurons are interconnected
We found that neurons sendin your work and your life.
– like “reverse-engineering” a
ing information at lower rates
very large-scale integrated ciruse finer wires (axons) which
Scheie Alumni Reception at AAO Meeting
Thanks to all those who attended the Scheie Alumni Reception at the annual meeting of the American Academy of
Ophthalmology. It was a great oppotunity to catch up with colleagues and meet new Scheie residents.
We look forward to seeing everyone again next year!
Scheie Vision 4
Resident Views on Resident Life
Marc H. Levin, MD, PhD- 3rd Year Resident
Residency has provided me with a diverse array of learning opportunities, both clinical and
surgical. It truly has been an apprenticeship--a
steady progression from highly supervised instruction and mentorship to more independent
decision-making and exposure to advanced
procedures. It has felt safe and at the same time
empowering.
We are exposed to mentors who demonstrate passion for and skill
in carrying out important clinical and basic research. We encounter a balance of common and rare disorders We learn how to comanage complicated patients with physicians from other specialties. Most importantly, we learn to value the process of learning
from and teaching our colleagues.
The thing that distinguishes the Scheie residency program the
most is that it prioritizes resident education above all else. The
hierarchy and low-yield “scut work” associated with training in
many high-powered academic programs is notably absent here.
And yet there is an appropriate amount of clinical responsibility
to ensure that we finish our training as well-rounded, competent,
and independent physicians.
Dr. Tapino is one of my greatest advocates and confidants. It
seems as though each resident has a unique, but equally meaningful relationship with him. He considers each resident’s strengths
and personalities and finds the best way to support their individual goals. He is on the front lines as a clinical instructor, watching
and redirecting our clinical development. He strives to help each
of us attain our individual professional goals while maintaining
happiness and balance in our lives outside of training.
Luxme Hariharan, MD, MPH-2nd Year Resident
Someone once told me that residency is the
longest days of your life but the shortest years
of your life. That is definitely the case. I feel
very privileged to be a resident here at Scheie.
I particularly love the camaraderie amongst
the residents, the faculty and the staff. I have
also appreciated how steep our learning
curves have been since we began in July.
One of the most challenging parts of residency is time management. I have found it is very hard to balance other aspects of a
healthy lifestyle. I do think it gets better as you feel more comfortable with your skill set and knowledge base.
The Scheie residency places emphasis on each resident’s personal interests and career aspirations in a very non-malignant
and supportive environment. We are lucky here at Scheie to have
the support to pursue our career goals. Furthermore, we are very
fortunate to have accomplished faculty and staff in every department and ample research opportunities. We are able to continually improve and develop clinically, surgically and academically. Dr. Tapino is truly one of the greatest people I have come to
know, admire and respect at Scheie. We all feel fortunate to have
him as our residency director. He has already gone out of his
way to make our residency better in the little time he has served
as program director. Early in the year we brought it to his attention that often our resident clinic schedules were too busy for us
to learn much. Within a few weeks, he had resolved this issue by
adding one resident to see emergency patients on busy days and
one resident to just see scheduled patients. Thank you Dr. Tapino
for all you do for each of us on a daily basis.
Student Sight Savers Program
basketball games and other
community events to check for
glaucoma.
“These screenings help people
who would never think they
have eye problems,” said Joan
DuPont, a project manager at
the Scheie Eye Institute.
Roland Sheldon recieves a free
eye screening.
A
ccording to the National Health Institute,
less than 50% of people with glaucoma are aware of
their disease. So how do you
treat someone for a disease they
don’t know they have? You
bring the clinic to the people.
That is the idea behind the
Scheie Student Sight Saver
Program. Penn medical students and Scheie ophthalmologists hold screenings at Penn
The screening process is quick
and painless:
A bit of paperwork: participants fill out a brief form, including their demographics and
medical history.
Two quick vision tests: Medical students perform a Visual
Acuity test to check central
vision and a Visual Field test to
check peripheral vision.
A few moments with the doctor: The supervising doctor
looks at the eye with an oph-
thalmoscope to check the optic
nerve for damage. The doctor
administers numbing drops and
then gently touches a tonopen
to the center of the eye to gauge
eye pressure.
The recommendation: After
evaluating vision, optic nerve
and eye pressure, the doctor
advises those with abnormal
symptoms to come in for a
more thorough examination.
The whole screening process
takes about 10 minutes.
“The goal of screening is not to
diagnose someone with glaucoma,” said Dr. Prithvi Sankar, an
Associate Professor of Clinical
Ophthalmology. “The purpose
of every screening, whether it’s
a diabetic screening or a screening for eye disease, is to find
those at risk and to help them
take action.”
Screenings also help raise community awareness of glaucoma.
“People get screened and then
talk to their families and
friends,” DuPont said. “They
spread the knowledge.”
The program, which is funded
by a grant from the Friends of
the Congressional Glaucoma
Caucus Foundation, benefits the
medical students as well as the
those they examine.
“It is good clinical experience,”
said Bridgette McCabe, a medical student who participated in
the program. “I’ve learned that
each patient is an individual,
and you have to approach them
that way.”
Whether identifying an eye disease or simply providing some
peace of mind, getting screened
is a good idea for everyone.
Scheie Vision 5
Vision Walk
On a crisp fall morning, dozens of Scheie faculty, staff, and friends, turned out to participate in the 5th annual Foundation for Fighting
Blindness VisionWalk. Dr. Jean Bennett, the keynote speaker for the event, shared her experience using gene therapy to restore vision
to 11-year old Corey Haas, who was legally blind. Corey attended the event with his parents and shared his feelings on life before and
after his gene therapy surgery. More than one thousand members of the community walked through historic Philadelphia and raised
awareness for eye disease. The event generated more than $233,000 which will be used to fund vision research.
A New Link Means New Hope for Glaucoma Patients
Dr. Laties and Dr. Mitchell found that ATP
concentration in patients with chronic angle-closure glaucoma was 14 times greater
than ATP in controls with normal intraocular pressure. The ATP stimulates the nerve
cells, triggering the severe pain associated
with angle-closure glaucoma.
Alan Laties, MD
N
ew research by Dr. Alan Laties,
Research Professor of Ophthalmology, and Dr. Claire Mitchell,
Associate Professor of Anatomy and Cell
Biology, may provide a link between intraocular pressure and ganglion cell death
in glaucoma patients.
While an increase in intraocular pressure is
the biggest risk factor for the loss of ganglion cells, despite many years of research,
the exact connection between pressure and
ganglion cell death remains unclear.
“It is similar to blood pressure,” Dr. Laties
said. “Just like some people get a stroke
when their blood pressure is borderline,
other people can handle tremendously high
pressure.”
Dr. Laties and Dr. Mitchell are investigating the mechanisms triggered by elevated
pressure.
“We know that cells in our body respond
to pressure,” Dr. Laties said. “And that
response is to release a neurotransmitter
called ATP. For example, your bladder,
when it fills with fluid, causes pressure.
That pressure causes the release of ATP,
which stimulates the pain nerves.”
The very same thing happens in the eye.
Scheie Vision 6
The second piece of the puzzle is a receptor found on retinal ganglion cells. Dr. Laties and Dr. Mitchell found that the majority
of ganglion cells express the P2X7 receptor. Because of their presence on healthy
cells, these receptors are believed to have a
beneficial contribution. However, when the
neurochemical environment in the retina
becomes unbalanced, P2X7 receptors can
have a detrimental effect.
ATP released from elevated pressure binds
to the P2X7 receptor. Studies conducted
by Dr. Laties and Dr. Mitchell, found that
in both mouse models and human eyes,
when P2X7 was stimulated by the manmade agonist BzATP, which acts only on
select receptor types, it elevated calcium
levels and killed retinal ganglion cells.
Their research has shown that ATP can be
dephosphorylated into adenosine, which
has proven to be neuroprotective. When
tested directly, adenosine blocks the calcium channel and limits damage to retinal
ganglion cells.
plained. “We have a reasonable window of
opportunity to stop cell death by blocking
the P2X7 receptor.”
Dr. Laties and Dr. Mitchell are investigating ways to block these P2X7 receptors
pharmaceutically and also through the
body’s own processes.
“Your body has not designed these cells to
die,” Dr. Mitchell said. “There are lots of
steps put in place to protect these cells.”
One of these is the enzyme ecto-ATPase
which converts ATP into adenosine. Dr.
Laties and Dr. Mitchell believe that when
eye pressure is too high the ecto-ATPase
enzymes are overwhelmed, allowing more
ATP to stimulate the P2X7 receptor. They
are looking at ways to improve the clearance of ATP, possibly by improving the
enzyme that eliminates it.
It is still unclear if ATP is released at normal pressure, but Dr. Mitchell and Dr.
Laties have found that any acute elevation
of pressure releases it. Dr. Laties and Dr.
Mitchell are evaluating whether the threshold for release varies by patient.
Dr. Laties and Dr. Mitchell are also investigating the role of inflammation and inflammatory cytokines in relation to ATP. They
believe that in addition to killing ganglion
cells, an increase in ATP may lead to sickIdentifying the P2X7 receptor as a link
ness in ganglion cells by initiating an
between elevated pressure in glaucoma and inflammatory response.
death of ganglion cells opens up new treatment possibilities. Along with lowering
“Glaucoma is a multi-factorial disease,”
pressure, now physician-scientists can also Dr. Mitchell said. “And this is just one
look at eliminating excess ATP and block- component. But we think that this may
ing P2X7 receptors to treat glaucoma.
open the gate to many other possibilities.”
“In the most common open-angle glaucoma there is some time between elevated
pressure and cell death,” Dr. Mitchell ex-
The most recent work from Dr. Laties and
Dr. Mitchell can be found in the October
2011 issue of Experimental Eye Research.
Mentoring in Ophthalmology
“Sometimes you feel like you
don’t really know enough to
mentor somebody, but the WIO
teaches you how to better support yourself and other women
in your department,” Dr. MillerEllis said. “It showed me that I
could actually offer something
in that area.”
“Black ophthalmologists represent about 2% of all ophthalmologists,” she said. “But there
are a lot of AFrican-American
patients with glaucoma and
diabetic retinopathy, and having
more diversity in the physician
pool would really be a good
thing.”
“Mildred and I realized this
program could be so much
more,” Dr. Miller-Ellis said.
“Our vision was to have a program where the students would
not just come and present, but
would come and learn.”
Dr. Miller-Ellis is the co-director of the Rabb Venable ExcelEydie Miller-Ellis, MD
lence in Research Program,
which is conducted through the
r. Eydie Miller-Ellis,
National Medical Association,
Professor of Clini“In medicine, and particularly
and funded by the National Eye
cal Ophthalmology
ophthalmology, it is easy to feel Institute. The program is geared
at Scheie, loves her job. She
isolated,” she said. “I thought
toward increasing the number
Dr. Miller-Ellis has also helped
works hard to succeed in ophit was important to let women
of underrepresented minorities the program become recognized
thalmology, and she works to
know that if they needed help,
in ophthalmology.
and funded by the NIH.
help others, particularly women surgically or with other quesand minorities, excel as well.
tions, that I would be glad to
“The best way to improve
“Before, we had donations from
help them.”
diversity is to start at the medi- pharmaceutical companies to
Dr. Miller-Ellis recently recal student level and get them
support the program.” she said.
ceived the Suzanne Troutman
Dr. Miller-Ellis also helps colinterested in the field,” Dr.
“But, you can’t always rely on
Award from the Women in
leagues connect with others in
Miller-Ellis said.
industry to support you. We
Ophthalmology (WIO) organi- the field who can help them.
knew the NEI is interested in
zation, which recognizes the
Dr. Miller-Ellis and co-director increasing diversity in mediwoman who has done the most “I think it is important to exDr. Mildred Olivier encourage
cine, so we applied for an R13
over the past year to further the pand a person’s network,” she
medical students and residents
program grant.”
careers of women in our field.
said. “If you know that they are to submit abstracts for the opinterested in something, and
portunity to present at the anThe original grant for three
The WIO honored Dr. Milleryou know of someone who is
nual meeting. If students don’t years has been renewed for an
Ellis at the American Academy also interested in that idea, you know much about ophthalmol- additional five years, and proof Ophthalmology meeting in
can bring them together.”
ogy, Dr. Miller-Ellis invites
vides funds for travel for all the
October, calling her “a piothem to come to the meeting as residents and medical students
neer in enhancing the position
And Dr. Miller-Ellis is always
observers.
who attend these meetings.
and involvement of women in
looking for ways to get female
ophthalmology locally and na- ophthalmologists more in“Most meetings are designed
While the number of students
tionally,” and “a strong female volved. As program chair for
for students who do a project,
involved is small, the results
voice in the ophthalmology
two sections of the American
but if you never do a project,
are good. Nearly 75% of stucommunity.”
Academy of Ophthalmology
you never get the chance to
dents in the program go on to a
meeting last year, she made
go.” she said. “This program
career in ophthalmology.
Dr. Miller-Ellis remembers atsure that at least half the people gives all students the opportending her first WIO meeting
who spoke were women.
tunity to come and observe,
“I think reaching out to these
eight years ago, and leaving
learn about ophthalmology as a groups is essential,” Dr. Millerempowered to not only advoDr. Miller-Ellis also works to
career, and talk to other physiEllis said. “Each person is imcate for herself, but also reach
increase African-American
cians in the field.”
portant to our organization, and
out to her female colleagues.
involvement in ophthalmology. Since she became co-director of our field.”
D
Dr. Miller-Ellis has worked
throughout her career to provide professional support to the
women around her.
the program four years ago, Dr.
Miller-Ellis has helped it grow
to include training workshops,
Q&A with NIH representatives
to discuss funding opportunities, and organized networking
with ophthalmologists from
around the country.
Alumni Updates
This year we are working to update our
records and keep alumni better informed of
news and events happening here at Scheie.
To facilitate faster and more cost-effective
communication, we’d like to use email as
much as possible. Please send your preferred
email address to [email protected] or [email protected]
Your email address will not be shared with
outside organizations and will only be used
for Scheie Eye Institute communications.
Upcoming Events
May 11, 2012-May 12, 2012
Scheie Eye Institute 40th Anniversary
Department of Ophthalmology 138th Anniversary
Philadelphia, PA
CME Credits Available
Registration FREE
Dinner Friday May 11, Rittenhouse Hotel
Nov 9, 2012-Nov 13, 2012
AAO Annual Meeting
Chicago, IL
Subspecialty Day Nov 9-10
Joint Meeting Nov 10-13
Learn more at www.aao.org/annual_meeting
Rittenhouse Hotel, Philadelphia
Scheie Vision 7
Patient Perspective
Catherine Selby is no stranger to eye doctors. She has
gone in for regular ophthalmology visits since she was a
child. Still, when she was diagnosed with glaucoma, she
didn’t quite believe it.
51 N. Myrin Circle
Philadelphia, PA 19104
“I told them they were out of their minds,” Selby said in
a recent interview at Scheie. “I had never even heard of
that disease before. I didn’t want to accept it.”
Ten years later Selby has learned a lot about glaucoma and acceptance.
“At first it was hard,” Selby said. “Then I gained so much confidence in Dr. Miller-Ellis, I felt better. I still get tired of putting the drops in my eyes, but I know that it is important, so I do it.”
When she was first diagnosed with glaucoma, Selby didn’t know where to go. Her sister and a friend from church recommended the
Scheie Eye Institute.
“I’m real glad I came here,” Selby said. “I’ve been coming here for ten years now. I’ve had a glaucoma surgery and I’ve had some
cataracts removed. The people here take care of you. They are wonderful. And I wouldn’t trade Dr. Miller-Ellis for anything.”
Dear Friends, Chair’s Corner
I hope 2012 finds you happy and well. We are looking forward to another great year here at Scheie. Our building is undergoing renovations, which will improve both efficiency and comfort, and we will be celebrating the
40th anniversary of the Scheie Eye Institute, with Alumni lectures and an evening gala.
Our winter edition of Scheie Vision focuses on glaucoma, a disease particularly relevant to the African-American community here in Philadelphia. Glaucoma is six times more common among African-Americans and usually develops ten years earlier. Many people in our own neighborhood are currently undiagnosed and untreated.
Dr. Shindler’s research, featured on page 3, offers new insight into treating eye conditions, like glaucoma, that
damage the optic nerve. The research of Dr. Alan Laties and Dr. Claire Mitchell, on page 6, explores the connection between intraocular pressure and the death of retinal ganglion cells. This issue also highlights Dr. Eydie Miller-Ellis, a glaucoma specialist, who recently received the Susan Troutman Award for mentoring women in Ophthalmology and an NEI grant to increase diversity in our field. Dr.
Peter Sterling, Professor of Neuroscience and Ophthalmology at the University of Pennsylvania is the recipient of this year’s Proctor
Medcal. He describes his extraordinary work on page 4.
I am grateful for the dedicated Faculty and Staff at the Scheie Eye institute, who work tirelessly to apply the newest research to glaucoma treatment, and for the support of Scheie friends and colleagues who help move us closer to our goal of eliminating blindness.
All my sincere regards,
Joan M. O’Brien
The Scheie Eye Institute
The Scheie Eye Institute, founded by Harold G. Scheie in 1972, is a leader in the field of ophthalmological research, education and patient care.
Our physician-scientists focus on translational research ranging in topic from age-related macular degeneration to
glaucoma to retinitis pigmentosa. The Scheie Eye Institute is ranked #1 in funding from the National Eye Institute.
Our full time residency and fellowship program is devoted to training 15 residents and 8 fellows to become leaders
in the future of ophthalmology. In fact, Scheie is now the first institute to receive a training grant in Ocular Genetics and Bioinformatics from the National Institutes of Health. This will enable us to train scientists and ophthalmologists to interpret the huge amount of
genetic information which will become available to us within the next five years.
The Scheie Eye Institute employs 60 physicians and researchers to consult and treat eye problems of every kind. Last year alone
Scheie received 81,129 patient visits. We have three locations in the city of Philadelphia, and locations in Radnor, and Media Pennsylvania.
For more information about the Scheie Eye Institute, look us up online at www.uphs.upenn.edu/ophthalmology or call 215-662-8415.
Your support is the key to our success
Private contributions have helped propel the Scheie Eye Institute to the forefront of research and patient care. Many of our greatest
breakthroughs have been made possible through donations from individuals and organizations. These gifts benefit vision saving therapy for those in our community as well as people around the world. If you would like to make a donation to the Scheie Eye Institute,
please visit us online at www.pennmedicine.org/ophth/giving or send a check to Scheie Eye Institute, Attn. Camille Metcalf, 51 N.
39th Street, Philadelphia, PA 19104.