Duke Ophthalmology Discoveries and Achievements

The 2021 issue of VISION is now available! Despite many challenges over the last year, Duke Eye Center successfully navigated COVID-19 and made tremendous strides in research and education that are changing patient care. Don’t miss our most notable achievements and discoveries of 2020.

Read VISION 2021

In January 2020, the world naively watched on as the city of Wuhan, China locked down to stop the spread of an unidentified virus, now universally known as COVID-19. Uncertain of the potential impact on the United States population and the medical community at-large, Duke Eye Center formed the COVID-Response Executive Task Force. Learn more Duke Eye Center responded to the COVID-19 pandemic. 

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A First at Duke

Leon W. Herndon, MD, professor of ophthalmology and glaucoma division chief, has worked as a glaucoma specialist at Duke Eye Center for over 25 years. Despite his decades of experience, he recently experienced a first in his career - his first OR day with an all-Black trainee team. Only around 6% of practicing ophthalmologists are minorities, and only 3% of ophthalmologists are Black. Duke’s department of ophthalmology had only had three Black residents in its entire history until last year, when there was one Black member in each residency class. Herndon’s team decided to take a picture to commemorate the historic moment, which later received an overwhelmingly positive reaction on social media. “I’m not a social media kind of person, but it’s been really amazing to see how the picture has generated so much buzz” Herndon said.  As part of Duke Health’s broader Moments to Movement anti-racism initiative, leaders at Duke Eye Center like Herndon are working to continually improve these statistics through initiatives to recruit and mentor medical students and residents from traditionally underrepresented backgrounds and fight against racism and discrimination in their everyday work. 

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Ruth Albert, generous benefactor and patient of Duke Eye Center, passed away in March 2021 at the age of 97.  Ruth and her husband, Herman, lovingly known as “Hy,” were impactful donors to Duke Eye Center. In 2002, they bestowed an $8 million dollar gift to support a new eye research building.  Ruth and Hy were honored by the building being named the Albert Eye Research Institute (AERI), which opened in 2005. 

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Flow Cytometry Could Offer New Insights into Complex Eye Disease

A new flow cytometer in Duke’s Department of Ophthalmology is giving researchers a new way of looking at ocular tissue samples and the unique biomarkers associated with certain diseases—a view that will someday lead to a diagnostic tool for complex eye diseases and better insights into treatment strategies.

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AI Model Uses Retinal Scans to Predict Alzheimer’s Disease

 A form of artificial intelligence designed to interpret a combination of retinal images was able to successfully identify a group of patients who were known to have Alzheimer’s disease, suggesting the approach could one day be used as a predictive tool, according to an interdisciplinary study from Duke University. The novel computer software looks at retinal structure and blood vessels on images of the inside of the eye that have been correlated with cognitive changes. “Diagnosing Alzheimer’s disease often relies on symptoms and cognitive testing. Additional tests to confirm the diagnosis are invasive, expensive, and carry some risk. Having a more accessible method to identify Alzheimer’s could help patients in many ways, including improving diagnostic precision, allowing entry into clinical trials earlier in the disease course, and planning for necessary lifestyle adjustments.”  - senior author Sharon Fekrat, MD

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Becoming ASCRS President in a Time of COVID-19

Terry Kim, MD, professor of ophthalmology and division chief of cornea, refractive surgery and external disease at Duke Eye Center, began his term as the American Society of Cataract and Refractive Surgery (ASCRS) president during an unprecedented time at the virtual annual ASCRS Meeting in May, 2020.  

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Unrelenting Advocacy

A Parent’s Love and Tenacity Leads to Duke Eye Center, and an Appeal to Innovate. After a normal pregnancy and delivery, new parents welcome their baby daughter. However, within minutes of her birth, medical staff observed that her body was covered with wide-spread wine marks and other potential abnormalities. It was uncovered that she also had several ongoing issues in her left eye, including elevated eye pressure, as well as mild haziness of the left cornea and possible accelerated left eye growth. During this discovery and assessment period, several of the nation’s leading pediatric ophthalmologists suggested they seek insight and treatment from our own Sharon Freedman, MD – a world renowned expert and foremost authority on childhood glaucoma.

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The Forgotten Stroke

People who suffer from sudden vision loss caused by retinal artery occlusion or eye stroke should be treated with the same urgency as those who suffer a stroke affecting the brain. While considered a rare stroke (under 1% of all strokes), eye stroke causes permanent vision loss and devastating quality of life challenges. About one-third of those who have an eye stroke also have a brain stroke at the same time and remain at elevated risk for another stroke in the future. A new multidisciplinary clinic at Duke plans to provide more seamless treatment for those who have suffered eye strokes. A collaboration between Duke Neuro-ophthalmology Division Chief, Chantal Boisvert, OD, MD, and Duke neurologist Brian Mac Grory, MB BCh BAO, MRCP (UK), the clinic will be the only one of its kind in the country. 

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Robotic Optical Coherence Tomography System Demonstrates Potential to Improve Patient Care

Duke has a long history of pioneering Optical Coherence Tomography (OCT) technology that has revolutionized patient care for adults and pediatric patients. Duke clinician scientist Anthony Kuo, MD, Associate Professor of Ophthalmology and corneal specialist; and research scientist Ryan McNabb, PhD have developed a robotically aligning OCT system that captures a three-dimensional image of the entire eye, all while allowing the system operator to maintain a safe physical distance from the patient. 
 

Duke Retinal Researchers Identify a Previously Undetected Form of CRB1

Unexpected Findings Could Lead to Future Gene Therapy for Patients Battling Retinal Degeneration. In a recent paper, published by Nature Communicatons1, Jeremy Kay, PhD, associate professor of neurobiology and associate professor in ophthalmology, detailed a new method for identifying the mRNA isoforms produced by individual genes. Their study revealed that as many as 90% of CNS isoforms were previously unknown and overlooked by scientists as they try to understand gene function.  

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First-of-its-Kind Implant Shifts Glaucoma Treatment Landscape 

Standard first-line glaucoma treatments to lower intraocular pressure (IOP), such as eye drops, commonly have poor patient adherence, which may result in inadequate pressure control and lead to optic nerve damage and loss of vision over time. However, results from two phase 3 studies indicate that a new FDA-approved intracameral biodegradable sustained-release implant—the first of its kind—could provide better long-term control of IOP in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). Felipe Medeiros, MD, PhD, a Duke glaucoma specialist and principal investigator for the study of the sterile intracameral implant (DURYSTA, Allergan: Dublin, Ireland), says this new treatment has the potential to shift the paradigm for treating glaucoma, which affects more than 80 million people globally. 

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Light Perception: A Sestina

Inspired by a patient with end-stage glaucoma, Duke glaucoma fellow Christos Theophanous, MD describes the poignant moment when the doctor-patient relationship transitions towards comfort in a poem he wrote.

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Driving Research to New Treatments for AMD

Decades ago, Tom Cabaniss watched as age-related macular degeneration (AMD) robbed his newly retired father of his independence. His father became legally blind in both eyes within a year and had to give up driving—a significant blow to a man who worked with and loved cars.  Last year, Cabaniss himself was diagnosed with AMD, but his experience is markedly different than his father’s, due to new treatments available at Duke Eye Center. His vision, while not perfect, has improved since he was first diagnosed and he is still able to drive and enjoy cars—which is important to him since he’s a car aficionado like his dad. In place of dread, he now feels gratitude. “I’m very lucky,” he says. 

Duke Partners with LCI to Serve the BVI Community

Duke Eye Center has had a longstanding partnership with LC Industries (LCI), a manufacturing, distribution and retail company that is one of the largest employers of blind and visually impaired people in the U.S.  Diane B. Whitaker, OD, division chief, vision rehabilitation & performance at Duke and the occupational therapists in her clinic have provided care for LCI employees at the Research Triangle Park site for many years. Earlier this year, LCI donated eSight devices - a head mounted electronic video magnifier, designed to offer the best visual acuity for those with visual impairment to Whitaker’s low vision patients. 

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Duke Ophthalmic Technician Program

Duke Eye Center is proud to have offered the Duke Ophthalmic Technician Program in partnership with Duke University School of Medicine for 35 years.  The 51-week accelerated, affordable program strives to provide an exceptional education that prepares students for the certification exam for ophthalmic technicians and to excel once on the job. Those interested in the program should feel at ease knowing they have many career options after receiving a certified ophthalmic technician (COT) certification.  Program graduates have become team leads, clinical operations managers, ophthalmic photographers among other eye care and leadership roles.  

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Introducing The Duke Manuals of Ophthalmic Surgery

The Duke Manuals of Ophthalmic Surgery is a series of five step-by-step, highly illustrated educational books to guide the common and challenging surgical procedures. The series offers a full spectrum of ophthalmology subspecialties, covering cornea and cataract, glaucoma, oculofacial, pediatric, and vitreoretinal surgery. “The goal of The Duke Manuals is to contribute to the knowledge base while having a positive impact on fellow surgeons and trainees as well as the entire clinical team which ultimately translates into improved patient outcomes,” said Sharon Fekrat, MD, FACS, series editor. 

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Ophthalmic Trauma in Basketball

Duke experts explain the prevalence of basketball-related eye injuries and when an ophthalmologist evaluation is necessary. Terry Kim, MD, Consultant Ophthalmologist for the Duke Men's Basketball Team, Professor of Ophthalmology, and Chief of Division of Cornea and Refractive Surgery, along with C. Ellis Wisely, MD, MBA, Chief Resident for the Department of Ophthalmology, published a chapter titled "Ophthalmic Trauma in Basketball" as part of the recently published textbook: Basketball Sports Medicine and Science.  

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Implementing Teleophthalmology in Response to COVID-19 Pandemic

To maintain the continuity of care during the unprecedented and sudden change in practice patterns due to the COVID-19 pandemic, teleophthalmology was rapidly implemented at Duke Eye Center in late March 2020. Duke ophthalmology faculty Dilraj Grewal, MD, associate professor of ophthalmology and Divakar Gupta, MD, assistant professor of ophthalmology initiated a study to report the initial experience with teleophthalmology, using existing infrastructure, in a large tertiary care academic eye center during the first 4 weeks of the North Carolina statewide stay at home order.  

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