The UAB School of Optometry 2017 Dean's Report by UAB School of Optometry

DeanĘźsReport UAB School of Optometry

2017 Edition

DEAN KELLY K. NICHOLS, OD, MPH, PHD EDITOR BRETT BRALLEY, MA CONTRIBUTING WRITERS MELISSA BROWN, OLIVIA MCMURREY CONTRIBUTING PHOTOGRAPHERS NIK LAYMAN, ANDREA MABRY, BRUCE SOUTHERLAND

Executive Committee CHRIS BOUTWELL, MAC DIRECTOR, ADMINISTRATION AND FISCAL AFFAIRS ADAM GORDON, OD, MPH DIRECTOR, CORNEA AND CONTACT LENS SERVICES TIMOTHY KRAFT, PHD CHAIR, DEPARTMENT OF OPTOMETRY AND VISION SCIENCE JOHN LAURENT, OD, PHD ASSOCIATE DEAN FOR ACADEMIC AFFAIRS JASON J. NICHOLS, OD, MPH, PHD UAB ASSISTANT VICE PRESIDENT FOR INDUSTRY RESEARCH AND DEVELOPMENT STEVEN J. PITTLER, PHD DIRECTOR, UAB VISION SCIENCE RESEARCH CENTER LAWRENCE SINCICH, PHD ASSOCIATE PROFESSOR ELIZABETH STEELE, OD ASSOCIATE DEAN FOR CLINICAL AFFAIRS MICHAEL TWA, OD, PHD ASSOCIATE DEAN FOR RESEARCH AND GRADUATE STUDIES

Right: Thompson Spence receives vision therapy in UAB Eye Care's newly renovated Vision Therapy Clinic. Learn more on page 8.

Table of Contents

2 Dean’s Message

11 Faculty Update

Dean Kelly K. Nichols shares her thoughts on the successes and accomplishments of students, faculty and staff.

The UAB School of Optometry welcomed two new clinical assistant professors to its faculty.

3 Strategic Plan The UAB School of Optometry focuses on five strategic pillars—areas where we have demonstrated excellence in the past and hope to grow in the future.

4 Quick Facts See a by-the-numbers breakdown of 2017 for the UAB School of Optometry.

36 Leaders in Optometry Our alumni are improving and advancing the profession of optometry. Take a look at some of their accomplishments in 2017.

37 Ways to Give We’re grateful for your continued support. Here’s how you can help us keep moving forward.

FEATURES

6 In Focus Catch a glimpse at some of our favorite moments of the year.

8 Clinic Growth UAB Eye Care sought to meet its community’s needs last year by increasing access to specialty services and expanding community outreach.

12 Dual Degree Programs for a Changing World Optometry students are pursuing additional degrees to diversify their career options thanks to partnerships with other UAB schools and departments.

10 School News

14 Transforming for the Future

From curriculum changes to passing our accreditation review with flying colors, here are a few quick updates from 2017.

Renovations of the Henry B. Peters Building gained momentum in 2017, and overall plans focus on the student experience.

18 Hope for the Myopia Generation Years of research at the UAB School of Optometry led to the opening of the Myopia Control Clinic to fight the impending epidemic of nearsightedness.

26 Dealing with Dry Eye The UAB School of Optometry is helping lead the way in dry eye research and treatment with a myriad of clinical trials and research studies in addition to a Dry Eye Relief Clinic.

32 BlazerVision Optometry students and faculty are providing UAB student-athletes with comprehensive eye care, acute gametime care and stateof-the-art concussion baseline testing.

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

Letter from the Dean

If Walls Could Talk Much has happened within walls of the Henry B. Peters Building in 2017—and I am not just talking about the progress we’ve made on the building’s ongoing renovations. I’m also talking about the growth, achievements and successes of our students, faculty and staff. When I consider all that has happened in a year, I am reminded that while we are small, we are indeed mighty. 2

2017 EDITION

“

Over the last 49 years, we have earned respect from our peers for our contributions to optometry and vision science education and research.

”

Growth at the UAB School of Optometry in 2017 can be seen in a number of areas, including decades of exciting vision research translated into patient-centered clinical care for the greater Birmingham community. Our Myopia Control Clinic opened this past year, and we are helping to slow the progression of nearsightedness for many of our patients (Learn more about this on page 18). And our Dry Eye Relief Clinic is providing care tailored to the needs of individual patients and is backed by the research of many of our faculty members and graduate students (See page 26). Some of this past year’s accomplishments took place in our community. We expanded our presence at Western Health Center in Midfield, Alabama, so that more patients can have access to affordable eye care and students can have more patient encounters during their clinical education (See page 8). Students are also learning by joining our faculty and a team of researchers on the sidelines of UAB football games and other UAB athletic events as part of BlazerVision, a partnership between the School of Optometry, the UAB Department of Ophthalmology and UAB Athletics that provides student-athletes with comprehensive eye care, acute game-time care and state-of-the-art concussion baseline testing (See page 32). We, of course, are continuing to forge ahead in the makeover of our building, which is named after our founding dean (Learn more about the renovation on page 14). Over the last 49 years, we have earned respect from our peers for our contributions to optometry and vision science education and research. With that respect and recognition comes the responsibility to ensure that students are learning in the best environment possible. And so we are working to make the Henry B. Peters Building the best it can be for future optometrists and vision scientists who we know will make lasting impacts in their fields. Thank you for your continued support of the UAB School of Optometry. We look forward to all that 2018 will bring!

Kelly K. Nichols, OD, MPH, PhD DEAN, UAB SCHOOL OF OPTOMETRY

EDUCATION

GROWTH

DISCOVERY

PARTNERSHIP

PERSONALIZED CARE

The Strategic Plan at the UAB School of Optometry focuses on five strategic pillars: education, growth, discovery, partnership and personalized eye care. These are areas where we have continually demonstrated excellence and where we hope to collaborate with internal and external partners in accomplishing our goals. Throughout this report, see how our programs and initiatives are aligning with our strategic plan for the future.

UAB School of Optometry Strategic Plan

Education

Growth

Discovery

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Our goal is to

The UAB

We want to

Partnership

Personalized Eye Care Our goal is

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optimize the

to advance the

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highest level of

use of existing

knowledge and

collaborative

personalized eye

evidence-based

resources in

science of vision

relationships

care through a

patient care

order to achieve

through research

with diverse

practice model

and discovery.

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we can achieve

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our vision and

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scientific inquiry.

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

Quick Facts 2017

Education by the numbers

10 members of the class of 2017 entered competitive residency programs across the U.S.

195 Number of optometry students 30

Number of graduate students

Number of dual degree students

Number of residents

368

optometrists have successfully completed residencies at the UAB School of Optometry.

Incoming Class of 2021

82% female

323

Number of applications

2017 EDITION

150

Number of interviews

Number of students

3.59 Average GPA

317

Average OAT score

COMPILED BY CHIRIHANE OUAOUA

Second highest percentage of women out of all North American colleges and schools of optometry

Quick Facts 2017

Patient care by the numbers

260 21,388

Number of patient visits at UAB Eye Care

COMPILED BY CHIRIHANE OUAOUA

Research by the numbers

Eye exams and glasses provided for underserved individuals during the annual Gift of Sight event

551

Number of patient visits at Western Health Center

In 2017, the UAB School of Optometry received

The UAB School of Optometry is ranked 3rd nationally

$4.65 million in research funding.

in vision research funding to schools and colleges of optometry and second in basic biomedical research funding.

Development and Alumni

1,556

OD graduates since 1973

913 Total donors

81%

Donors who are alumni

UAB School of Optometry gifts from the start of the Campaign for UAB through 2017

$9,687,803

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

2017 In Focus

1 White coats were presented in March to the Class of 2020 (a great year to become an eye doctor, we might add). 2 Andrew Ho (Class of 2017) provided a free eye examination in April to a young patient as part of InfantSEE, a public health program in optometry designed to ensure that eye and vision care are an essential part of infant wellness. 3 Shannon Kirchmer (Class of 2019) qualified for the Boston Marathon after running a personal record of 3:20:25 (a 7:39-mile pace) in the CNO Financial Indianapolis Monumental Marathon in November. It was a challenge training while in optometry school, but worth it, she says. “Having a reason why you’re doing it—and some great training partners—makes it easier to get up before 5 am,” she says. 4 Students and faculty celebrated the end of the academic year at the annual Eye Ball, held in April at the Alabama Theatre in downtown Birmingham. The event is hosted each year by the UAB chapter of the American Optometric Student Association. 5 Nathania Nhouyvanisvong (Class of 2017), gave remarks at the UAB School of Optometry’s inaugural Scholarship Luncheon in April. Recipients of 53 scholarships and the donors who established the awards were honored. Also recognized at the event were the donors of three new scholarships. 6 In between presenting research and learning about trending vision science topics, graduate students had fun at the 2017 Annual Meeting of the Association for Research in Vision and Ophthalmology (ARVO), held in May in Baltimore, Maryland.

2017 EDITION

7 A student examines a patient during the 2017 Gift of Sight event this winter, which provided free eye care and glasses to 260 patients. Learn more on page 9. 8 As part of its facelift, the Henry B. Peters Building got a new sign in July. Our faculty, staff and students had some fun with the signage before it ascended six stories. 1

9 Congratulations to the Class of 2017! The 37 graduates recited the optometric oath before faculty, staff, friends and family in the Alys Stephens Performing Arts Center on May 12. !0 Caroline Beesley Pate, OD (right), associate professor and director of residency programs, is a 2017 recipient of the UAB President’s Award for Excellence in Teaching. She was recognized at the Faculty Convocation Ceremony, held in September at the UAB National Alumni Society House and was joined by Kelly K. Nichols, OD, MPH, PhD (left), dean of the School of Optometry.

!1 Students, faculty and staff donned safety eyewear to view the solar eclipse at the Henry Peters Building’s Hire Plaza for a viewing party on Aug. 21. Leading up to the event, Tamara Oechslin, OD, PhD, assistant professor, served as a go-to source for the community on safe viewing practices. !2 We showed our Blazer Spirit during the 2017 UAB Homecoming Building Decoration Competition, which earned the UAB School of Optometry fourth place!

2017 In Focus

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

EDUCATION

GROWTH

DISCOVERY

PARTNERSHIP

PERSONALIZED CARE

Clinic Growth

The UAB School of Optometry’s clinical impact spread wide in 2017. From increasing special services to expanding outreach programs, UAB Eye Care, the School of Optometry’s clinical operation, sought to meet its community’s growing needs.

Community Eye Care expands presence at Western Health Center

Vision Therapy Clinic expands, more than doubles patient capacity

The School of Optometry increased access to eye exams for underinsured and low-income residents of Birmingham in 2017. Community Eye Care, or CEC, the community outreach arm of the School of Optometry, increased its presence at the Western Health Center in Midfield, Alabama, from three days a week to four. The health center is operated by the Jefferson County Department of Health. CEC also improved its technology at Western Health Center to provide more efficient care. Seven new computers were installed in September, replacing laptops, and a direct network connection to UAB campus replaced a VPN connection. In addition to seeing patients at Western Health Center, CEC also provides eye care at the United Cerebral Palsy of Greater Birmingham Adult Day Program at LINCPoint in Homewood, The Foundry in Bessemer, the LoveLady Center in East Lake along with care to underserved residents in the Black Belt communities across the state and in the Birmingham metropolitan area. T

UAB Eye Care expanded its Vision Therapy Clinic, enabling more than twice as many patients with conditions affecting eye teaming, visual tracking and focusing to be treated. Now Kristine Hopkins, OD, MSPH, associate professor and chief of the clinic, and Tamara Oechslin, OD, PhD, assistant professor, along with a team of third-year optometry students, can see up to 57 patients a week, which is a 63 percent increase. “When I started at UAB, it was my goal to bring therapy services to our patients and to give School of Optometry students an education that would allow them to provide vision therapy services to their patients after graduation,” Hopkins says. “Since moving to the new space, the Vision Therapy Clinic now has the capacity for up to 2,500 therapy visits per year, and third-year optometry students with an interest in binocular vision can elect to have two therapy rotations during their third professional year.” T

2017 EDITION

Clinic Growth

ɍɍ

Gift of Sight event provides 260 patients with free eye care

LEFT: KRISTINE HOPKINS, OD, MSPH, ASSOCIATE PROFESSOR AND CHIEF OF THE UAB VISION THERAPY CLINIC, PROVIDES VISION THERAPY TO THOMPSON SPENCE IN THE NEWLY RENOVATED SPACE.

⊲⊲ RIGHT: STUDENTS VERIFY LENSES FOR A PATIENT DURING THE 2017 GIFT OF SIGHT EVENT WITH OVERSIGHT FROM AMI MARSH, OD,

The School of Optometry and the Jefferson County Department of Health partnered for the fourth consecutive year to bring free comprehensive eye exams and glasses to low-income and underinsured Birmingham residents. Altogether, 260 patients were seen during the Gift of Sight event, held Nov. 29 - Dec. 2, at the Western Health Center in Midfield, Alabama, and at UAB Eye Care. Some patients were scheduled for follow-up appointments for retina issues, glaucoma and specialty contact lenses, says Janene Sims, OD, associate professor.

“Gift of Sight offers us the chance to provide quality eye care to those who otherwise would not receive it,” Sims says. Since the program began in 2014, nearly 1,000 patients have been provided with eye exams and glasses at no charge. The annual event is coordinated by Community Eye Care, the outreach arm of the School of Optometry. Gift of Sight is sponsored by VSP, Remote Area Medical, Alabama Lions Sight and Allergan. T

MS (CLASS OF 2010). THE EVENTPROVIDED FREE EYE EXAMS AND GLASSES TO 260 PATIENTS.

Faculty practice relocates to UAB Eye Care The School of Optometry’s faculty practice, University Optometric Group, or UOG, relocated from its 9th Avenue South location to UAB Eye Care in the Henry B. Peters Building on University Boulevard. The practice, comprised of seven School of Optometry faculty, joined UAB Eye Care in December after UAB made the decision to demolish the UOG building as part of its campus master plan. UOG patients have kept their same optometrists and are greeted and cared for by the same UOG staff. Patients now have access to UAB Eye Care’s electronic medical records, patient portal and increased access to specialty clinical services. T

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

School News

School of Optometry accredited through 2025 The UAB School of Optometry received accreditation for the next eight years by the Accreditation Council on Optometric Education—the longest time period permitted by ACOE policies. The School of Optometry was visited by the ACOE in April 2017 and received a final report in July 2017. The next on-site visit will occur in April 2025. “While we are monitored via progress reports annually, to have our next site visit in 2025—the longest allowable time under the ACOE rules—speaks to the quality and consistency of our program,” says Kelly K. Nichols, OD, MPH, PhD, dean of the School of Optometry. “Our strength is in our people—faculty, staff and students, and that was evident in the ACOE report.” No recommendations were made for several standards identified by the ACOE, including Curriculum, Research and Scholarship, and Clinical Management and Patient Care, meaning no suggested changes or required improvements were made in these areas. T

Clinical skills introduced earlier in curriculum The School of Optometry made changes to its curriculum that allow students to see patients at UAB Eye Care a half-semester earlier than before. The Class of 2020 was the first to begin its Clinical Evaluation of Visual Systems, or CEVS, courses at the end of the first year rather than at the beginning of the second year of optometric education. The reason for the change was to provide students with more time seeing patients in the clinic and more time to hone clinical skills beforehand, says Nicole Guyette, OD, clinical assistant professor and course master of CEVS. The schedule shift occurred in spring 2017, when first-year students began the courses towards the end of the spring semester. They worked through the summer term and will complete the courses halfway through the spring semester of their second year. Before the change, students entered the clinic at the beginning of their third year. “The more clinic time we can give them, the better,” Guyette says. “They’re getting more patient encounters this way.” The courses are less rushed, and students have more time to practice their skills—especially tough ones like retinoscopy and binocular indirect ophthalmoscopy, which Guyette introduced earlier in the course.

2017 EDITION

Image: Worrell

“I’ve gotten feedback that students are already doing really well with those skills,” she says.

Worrell building closes, P30 cores relocate

ɊɊ ABOVE: TWO OF FOUR VISION SCIENCE RESEARCH CORES SUPPORTED BY A P30 NATIONAL EYE

All four vision science research cores supported by a P30 National Eye Institute grant are now located in UAB’s Volker Hall, which will facilitate further collaboration among researchers, says Steven J. Pittler, PhD, professor of vision science and director of the UAB Vision Science Research Center. Two of the four cores were relocated from UAB’s Worrell Building in September 2017 after UAB made the decision as part of its campus master plan to close and demolish Worrell. The four cores devoted to interdisciplinary research in ocular disease at UAB include Molecular and Cellular Analysis, Instrumentation, Research Programming and Computational Analysis, and Ocular Phenotyping. The Molecular and Cellular Analysis and Ocular Phenotyping cores had already been in Volker Hall. The Instrumentation core is divided into two parts: the Machine Shop and Electronics, the latter of which relocated to Volker Hall along with Research Programming and Computational Analysis in September. The Machine Shop will follow in early 2018. T

INSTITUTE GRANT WERE RELOCATED FROM UAB'S WORRELL BUILDING TO VOLKER HALL. UAB CLOSED AND MADE PLANS TO DEMOLISH WORRELL AS PART OF ITS CAMPUS MASTER PLAN.

Faculty Update

The UAB School of Optometry welcomed two new clinical assistant professors to its faculty in 2017.

ɍɍ FROM LEFT: MAGGIE BAILEY, OD, AND KIM DUONG, OD, MS, BOTH JOINED THE UAB SCHOOL OF OPTOMETRY AS CLINICAL ASSISTANT PROFESSORS IN 2017.

Maggie Bailey, OD Bailey sees patients and works with students in Pediatrics Optometry Service, Primary Eye Care Service and Community Eye Care at UAB Eye Care, the School of Optometry’s clinical operation. She received her bachelor’s degree in economics from the University of Alabama and then received her Doctor of Optometry degree from the UAB School of Optometry. She also completed a residency in binocular vision and pediatric optometry at the Illinois College of Optometry. Before joining the School of Optometry, Bailey provided clinical care and supervised optometry students as an attending at the Illinois College of Optometry. She also provided care in specialty clinics, including Community Eye Care at Chicago Public Schools and the Illinois School for the Visually Impaired.

Bailey has researched topics such as esotropia and uveitis and presented a case study at the American Optometric Association's Meeting 2017. She also has presented at the College of Optometrists in Vision Development Annual Meeting and at the American Academy of Optometry annual meeting in 2016. As a student at the School of Optometry, she participated in the Student Volunteer Optometric Services to Humanity and was a member of the National Optometric Student Association. She was also a student member of the American Academy of Optometry and the American Optometric Association and served as the president of her class from 2012-2013. T

Kim Duong, OD, MS Duong sees patients in Pediatric Optometry Service, the Vision Therapy Clinic, Primary Eye Care Service and the Myopia Control Clinic at UAB Eye Care. She also helps instruct students in pediatric care and in labs. After receiving her bachelor’s degree from the University of Virginia, Duong earned both a Doctor of Optometry degree and master’s degree in vision science from the State University of New York College of Optometry. While at SUNY, Duong conducted research focused on contact lenses and ocular inflammation, and ocular health in children with Type 1 diabetes mellitus. She has presented her research at the American Academy of Optometry and at the Association for

Research in Vision and Ophthalmology annual meetings. During her externship, she provided clinical care at the Baltimore VA Medical Center and at the Walter Reed National Military Medical Center. She was the recipient of the Optometric Center of New York Academic Scholarship, the American Academy of Optometry Vision Care Institute Student Travel Grant and the NIH T35 Summer Training Grant. Duong also participates in community service, which includes working with children with Type 1 diabetes and volunteering at screenings with other health professionals. T

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

EDUCATION

GROWTH

DISCOVERY

PARTNERSHIP

PERSONALIZED CARE

Dual Degree Programs for a

Changing World BY MELISSA BROWN PHOTO BY ANDREA MABRY

As the health care market changes and evolves, students at the UAB School of Optometry are choosing to diversify their education. 12

2017 EDITION

An eyeglasses fitting in the sixth grade was the first time Conner Robbins considered optometry as a career. Robbins, a third-year student at the UAB School of Optometry, is now well on his way to becoming just like the “friendly neighborhood optometrist” who he says prescribed his first pair of glasses. But Robbins, like many of his peers, is going one step beyond earning the four-year Doctor of Optometry degree. He is taking simultaneous coursework to graduate with a master’s degree in vision science. “I thought at first it would be this thing that only the super students would do, or certain people who just really want to do research, but I was convinced that there are more than just the traditional forms of optometry than you might think,” Robbins says. “I realized that it would help me clinically, as well.” As the health care marketplace changes and evolves, optometry students like Robbins are looking for ways to diversify and fortify their coursework. The School of Optometry, in partnership with the UAB School of Public Health and the UAB Collat School of Business, now offers three dual degrees— OD/MS, OD/MBA and OD/MPH—for optometry students interested in research, a career outside of the traditional optometric practice or simply enhancing their clinical work.

ɊɊ ABOVE: FROM LEFT, NICOLE RODDY (CLASS OF 2020), CONNER ROBBINS (CLASS OF 2019) AND CAITLYN STEEDLEY (CLASS OF 2020) ARE THREE OF 17 STUDENTS AT THE UAB SCHOOL OF OPTOMETRY WHO ARE ENROLLED IN DUAL DEGREE PROGRAMS.

The idea of an OD/MBA program, the first of its kind in the nation, began to take shape five or six years ago. John Laurent, OD, PhD, associate dean for academic affairs at the School of Optometry, polled his business of optometry class on their interest in an additional degree. He said nearly a fourth of his students were interested in an MBA or MPH, which, at the time, meant an additional year of school. “I think, historically, the average optometry student wanted to be a clinician, see patients,” Laurent says. “They probably thought business would take care of itself or they’d figure it out down the road. I was certainly in that category in optometry school. But it is a business. If you’re in private or a group practice and seeing patients, you’re in business.” The idea took hold. Karen Kennedy, PhD, senior associate dean at the Collat School of Business, says the OD/MBA program took around two years to fully develop through their partnership with the School of Optometry. The program is now in its second year. “I think with any partnership program within higher education, having key players with a shared vision is a critical piece of the puzzle,” Kennedy says. “It’s a good example of schools coming together to serve their students better.” A key to the success of the program, Kennedy says, was streamlining the curricula to shave off that extra year Laurent’s students would have had to take on. This not only reduced tuition costs, but also allowed students to enter the workforce promptly after obtaining their OD. “The key principles that typically have been just ‘business’ are now the kinds of skills that optometrists, dentists, physicians and researchers all need to understand,” Kennedy says. UAB organized the 30-hour MPH degree to be customizable according to students’ goals and needs. Students can complete all their coursework online, in the classroom or through a combination of the two. Students in the OD/MPH program specialize in environmental health science, epidemiology, health care organization and policy, or a combination. “Public health is unique because it is interdisciplinary,” says Angela Sullivan, director of enrollment engagement at the School of Public Health. “An individual qualified both in optometry and public health is expected to have the capability to develop, administer and evaluate eye and vision health programs in research projects; design and conduct epidemiological field studies; use statistical methods in data analysis of case-control and cohort studies; develop and implement vision health education programs; and develop occupational health and eye safety programs.”

The OD/MPH program is why second-year optometry student Caitlyn Steedley chose to attend UAB for her optometric education. “[The dual degree program] is allowing me to tailor my public health education to be relevant to my eye care career,” Steedley says. “I believe that everyone working in healthcare should have some background in public health. For an optometrist, it can help you to better understand patient needs and barriers to care.” An additional degree doesn’t necessarily “increase an optometrist’s ability to treat patients,” Laurent says. But it does provide an additional facet and nuance to an optometrist’s practice, as well as giving students a competitive edge in an increasingly competitive workforce. The industry is shifting from the time when most optometrists’ business came from the sale of optical goods, Laurent says. “The optometric practice has changed,” he says. “We’ve become much more medically and health oriented. We prescribe drugs and treat diseases that we wouldn’t have 40 years ago.” OD/MBA student Nicole Roddy graduated from Auburn University with an undergraduate degree in biomedical science, a useful background for optometry school, but with few business prerequisites. Roddy, the second-year optometry student, aims to go into private joint practice, and she says she wants to be an “informed and active member” of the office. After encouragement from mentors, Roddy signed on for the dual degree. Though it takes balance, she’s been pleasantly surprised with how tailored the curriculum is for her needs. “I love that it’s been health care focused,” Roddy says. “They do a wonderful job of making sure that it’s applicable to us and to what we’re going to be experiencing. We’re learning about electronic health records and how you can use IT to your advantage, for example.” As the business of practicing optometry becomes “trickier and trickier,” as Laurent says, additional coursework is allowing optometrists to be more flexible and creative with their career paths. MPH degree holders can work for government agencies or within the insurance business, while MBA holders can shift into managerial roles or confidently run their own business. Although the OD/MS degree is typically a precursor to PhD work and often precedes a career in academia or research, Robbins says he plans to be a practicing clinician. He’ll continue his research with patients in a clinical setting. “I want to be involved in whatever community I end up settling down in,” Robbins says. “That’s non-negotiable.” T

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

EDUCATION

GROWTH

DISCOVERY

PARTNERSHIP

PERSONALIZED CARE

Transforming

for the Future

Stemming from faculty input and a studentcentered approach, renovations of the Henry B. Peters Building gain momentum in 2017. BY OLIVIA MCMURREY, PHOTOS BY ANDREA MABRY AND NIK LAYMAN

When the UAB School of Optometry marks its 50th anniversary in 2019, it will celebrate in a newly renovated building befitting its status as a world-class institution for educating optometrists and vision scientists. After years of thoughtful team planning, several major projects were started or completed in 2017. “We really wanted to ensure our building reflected our goals and our mission and where we are as we close out our first 50 years,” says Kelly K. Nichols, OD, MPH, PhD, dean of the School of Optometry. “By 2019, we’ll be moving into a renovated building with a fresh start for our next 50 years.” Updates to the Henry B. Peters Building, constructed in 1974 and named for the School of Optometry’s founding dean, are being completed in phases. The first phase—a new building façade, including 12 additional windows — was finished in 2015. Within the next few years, all five floors of the building will be transformed.

Student-focused upgrades

⊲⊲ PICTURED CLOCKWISE FROM TOP LEFT: THE FIRST PHASE OF THE HENRY B. PETERS BUILDING RENOVATION WAS A NEW FAÇADE, WHICH INCLUDED 12 ADDITIONAL WINDOWS THAT WILL ADD NATURAL LIGHT TO STUDENT SPACES. A NEW SIGN WAS ADDED IN 2017. PLANS FOR THE

Students are the impetus for many of the renovations. While the credentials of the School of Optometry's incoming classes continue to represent the highest academic standards, administrators were starting to hear that aging facilities were part of the reason some students were going elsewhere, Nichols says. Many of the top optometry schools with whom the School of Optometry competes boast new or newly renovated structures. “Having students’ first impressions be of something fresh was really important,” Nichols says. “We wanted to upgrade our facilities to ensure we could continue attracting and maintaining the highest quality students, faculty and staff.” In 2017, a student lounge and kitchen area on the first floor were completely revamped, with new flooring, appliances, cabinetry, tables, seating and more. Research space on the fourth floor was refurbished, as well. “It looks a lot more modern now,” says Cameron Postnikoff, MASc, a vision science doctoral student. The pre-clinical teaching lab where students learn to conduct eye exams was refurbished and fitted with state-of-the-art equipment, and a small classroom adjacent to the lab was added for pre-lab meetings and demonstrations. On Dec. 18, 2017, overhauls of the second and third floors—the main student spaces—commenced. A student locker room will be constructed, and lockers

2017 EDITION

THIRD FLOOR INCLUDE A STUDENT LOUNGE, REVAMPED CLASSROOMS AND AN EXPANDED LOCKER ROOM. THE FIRST-FLOOR UPDATES WERE COMPLETED IN EARLY 2017. A STUDENT BREAK AREA WAS AMONG

will be larger than the current hallway lockers to accommodate all the equipment students must keep with them on a daily basis. A second student lounge will be added on the third floor, giving students better access to the Student Affairs office, also on the third floor. When, at Nichols’ request, windows were added to the building in 2015, she had them placed strategically in areas that eventually would be devoted to students. Student lounges, the new locker room and the second-floor classroom will benefit from natural light.

Modern classrooms and meeting spaces

THE RENOVATED SPACES, WHICH FEATURE A SOPHISTICATED, MODERN INTERIOR DESIGN.

Two large classrooms and one smaller classroom on the second and third floors will be remodeled, with much

“We really wanted to ensure our building reflected our goals and our mission and where we are as we close out our first 50 years. By 2019, we’ll be moving into a renovated building with a fresh start for our next 50 years.” Kelly K. Nichols, OD, MPH, PhD, dean of the UAB School of Optometry

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

Moving along:

1 974

1974 HENRY B. PETERS BUILDING CONSTRUCTED

A timeline of renovations to the UAB School of Optometry’s Henry B. Peters Building 2005

2005 GROUND FLOOR HOUSING UAB EYE CARE CLINIC RECEIVES FACELIFT

Phase II

Phase I

February 2017

2015

FIRST FLOOR, INCLUDING STUDENT LOUNGE AND KITCHEN AREA AND ADMINISTRATIVE OFFICES

NEW BUILDING FAÇADE, INCLUDING 12 ADDITIONAL WINDOWS, BRINGING TOTAL TO 24

June - October 2017

CLINICAL EYE RESEARCH FACILITY (CERF) ON FOURTH FLOOR

MINOR MODIFICATIONS TO UAB EYE CARE CLINIC (TILE WORK AND MURAL ADDED IN PEDIATRIC AND VISION THERAPY AREAS)

2015

HALLWAYS OF FOURTH AND FIFTH FLOORS, WHERE FACULTY OFFICES LOCATED

November 2017 PLANNING FOR SECOND-AND THIRD-FLOOR RENOVATIONS COMPLETED

Below: A rendering offers a glimpse of the third-floor student lounge. The space will provide students with a place to eat lunch, study in groups and relax in between classes.

December 2017 INFRASTRUCTURE AND RESEARCH SPACES ON FOURTH FLOOR

December 2017 SECOND- AND THIRD-FLOOR RENOVATIONS INITIATED (TO INCLUDE THREE REVAMPED CLASSROOMS, A NEW STUDENT LOUNGE AND A STUDENT LOCKER ROOM) Below: Third-floor renovations began in December. The first step was demolishing the existing space before preparing for new construction.

2017

Phase III 2018 and Beyond 2018

REMAINDER OF FOURTH AND FIFTH FLOORS, INCLUDING FACULTY OFFICES ADDITIONAL UPGRADES, INCLUDING A NEW CLINICAL SUITE, TO THE GROUND-FLOOR CLINIC

2017 EDITION

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attention given to technology needs and the ways in which students and faculty members use the spaces. One large classroom will have stationary seating, while the other two classrooms will feature a flexible design in which seating can be rearranged for small-group activities. “We’ve thought through these modern details of learning in terms of both the flex classroom idea, where breakouts can occur, as well as a more traditional classroom where students have access to better multimedia, for example,” Nichols says. Outlets for students’ electronic devices are implemented in plans for both types of classrooms. “The renovation of the classrooms and the pre-clinical teaching lab will allow incorporation of new technology and teaching tools that the previous space could not accommodate,” says Elizabeth Steele, OD, associate dean for clinical affairs and one of many faculty members who provided input and participated in discussions with architects throughout the planning process. “Projection screens for demonstrations will maximize learning opportunities. While mastering clinical skills, students will have access to electronic-health-record training software, fostering a seamless transition to actual patient-care settings.” Kristine Hopkins, OD, MSPH, associate professor of optometry, says classrooms will feature the latest audio-visual equipment, giving faculty more flexibility in the types of media they can use for instruction. New classroom designs will offer students more opportunities to interact with each other and instructors, she says. “Team-based learning can be a useful teaching strategy to enhance student engagement,” agrees Anna Ablamowicz, OD, clinical assistant professor of optometry. In clinical classes, having discussions about cases and patients is imperative, she says, and small-group seating arrangements facilitate that. The updated second and third floors also will contain spaces for students to gather and study outside of classrooms, something the current design lacks. “Communal space provides students areas to relax, study, and connect with others,” Ablamowicz says.

Sophisticated-yet-playful design The color scheme of new design elements is inspired by UAB’s signature green and gold, but draws on earth-tone versions of the colors as well as grays, browns and splashes of chartreuse. “It’s not at all traditional,” Nichols says. “It’s a modern, playful take.” Furniture and fixtures have a Swiss, simplistic style, and vision elements are incorporated throughout the spaces. For example, an eyeshaped tile pattern appears on walls and desks, and the concept of light is represented by a wall-to-floor beam that will line some hallways.

Eye on Design Elements of the interior design play off UAB’s signature gold and green, using earth-tone versions of the hues, and pull vision motifs into the mix.

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quartz conference table appears in the first-floor conference A room and other meeting spaces. 2 A tile backsplash with olive green and other earth tones is featured in kitchen and break spaces for students, faculty and staff. 3 Variations of green, like this earthy hue, is on the walls of hallways, clinic spaces and student areas. 4 Plenty of colors and fabrics appear throughout waiting spaces, meeting areas, break rooms and offices, such as this olive green velvet that can be found on armchairs. 5 An ombre pattern is seen on modern footstools in the waiting area where prospective students visit the school with their families. 6 An eye-shaped tile pattern on walls and desks adds a vision element to the design. 7 Dark granite countertops accent meeting rooms and break spaces. 8 Simple geometric patterns are featured on modern, Swissinspired furniture. 9 Dark cabinets are found in the kitchen, break and meeting areas. 1

“We wanted to incorporate light and vision because we are eye people,” Nichols says. Glass panels in doors and walls transfer natural light into spaces previously lacking it, making areas more open and inviting, she adds. Even though the renovation project is taking place in phases and will incorporate updates of the ground floor finished in 2005, the building interior will have a unified look once the work is complete. “Our designer didn’t want people to feel like they were traveling through the decades as they moved from floor to floor,” Nichols says. While the project is actively moving forward, contributions are welcome. To learn how you can help, contact Sommer Thompson, senior director of development, at sommerthompson@uab.edu T

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

EDUCATION

GROWTH

DISCOVERY

PARTNERSHIP

Hope for the Myopia

Generation BY OLIVIA MCMURREY PHOTOS BY ANDREA MABRY AND BRUCE SOUTHERLAND

2017 EDITION

PERSONALIZED CARE

Pioneering research at the UAB School of Optometry leads to opening of the Myopia Control Clinic and helps fight impending public-health crisis.

In Elena Chesnokova’s fourth grade music class, the teacher often wrote song lyrics on the board for children to sing. One day the lyrics were too blurry for Elena to read. After a couple classes spent squinting at the board and worrying her teacher would notice she wasn’t singing, Elena told her parents about the problem, and her father brought her to a UAB School of Optometry clinic, where she was diagnosed with myopia, or nearsightedness. Elena is part of the “myopia generation,” which has been described as a publichealth time bomb. Myopia in American children increased approximately 66 percent between the 1970s and early 2000s, when 33 percent were found to be myopic. In Asia, myopia has risen to epidemic levels, with 80 to 90 percent of children in some countries requiring vision correction. Once a child is diagnosed with myopia, his or her vision is likely to worsen at a steady rate for about nine years. Because people with myopia have higher risks for glaucoma, cataracts and retinal detachment, these children— and health-care systems around the world—will face additional challenges as they age. Refractive (Lasik) surgery, a procedure for adults, can correct vision, but does not reduce risks for potentially blinding eye diseases.

Unlike most kids with myopia, Elena isn't waiting for her myopia progression to stop with her growth. She began myopia-control treatment offered through the School of Optometry a couple years after her diagnosis. “I’m caring for my eyes and my vision,” says Elena, now 16 and an aspiring physician. “I think there is potential in the myopia control, and I sure hope it helps me out. I’m glad I’m a part of it.” With the May 2017 opening of the Myopia Control Clinic at UAB Eye Care, operated by the School of Optometry, more Birmingham-area children like Elena now have the opportunity to try myopia-control treatments. While research has shown three methods—multifocal contact lenses, orthokeratology lenses and low-concentration atropine drops—can slow myopia progression by

ɍɍ LEFT: ELENA CHESNOKOVA, 16, IS A PATIENT AT UAB EYE CARE'S MYOPIA CONTROL CLINIC. THE CLINIC OPENED IN MAY 2017 AND PROVIDES ITS PATIENTS WITH THREE METHODS OF CONTROL TREATMENT: MULTIFOCAL CONTACT LENSES, ORTHOKERATOLOGY CONTACT LENSES AND LOWCONCENTRATE ATROPINE DROPS.

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

ɊɊ ABOVE: A COUPLE OF YEARS AFTER ELENA WAS DIAGNOSED WITH MYOPIA, SHE BEGAN USING MULTIFOCAL CONTACT LENSES TO CONTROL ITS PROGRESSION. HER EYE CARE NOW INCLUDES ROUTINE EXAMINATIONS THAT MONITOR THE GROWTH OF HER MYOPIA AND THE EFFECTIVENESS OF THE LENSES.

50 to 60 percent, very few clinics offer them. “We’re trying to lead the way in helping general physicians, eye doctors and families understand that we may be able to decrease one’s final amount of nearsightedness,” says Andrew Pucker, OD, PhD, who directs the Myopia Control Clinic and is an assistant professor of optometry and vision science. “There’s a big need to get the word out.” Pucker has begun giving public lectures on the topic, including one at the Global Specialty Lens Symposium in Las Vegas in January 2018. The Myopia Control Clinic also shows fourthyear optometry students how they can incorporate myopia control into their practices and gives them necessary training. Decades of research, in both animals and humans, at the School of Optometry contributed significantly to myopia-control development and led to the opening of the clinic. With many questions about myopia still unanswered, researchers continue seeking knowledge that could lead to prevention and better control of myopia progression.

VIP service at the Myopia Control Clinic The Myopia Control Clinic is held twice a month, and optometrists in UAB Eye Care’s pediatric

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clinic as well as clinicians across the community can refer patients. While myopia control is not new at UAB Eye Care—clinicians have been discussing it with patients and parents since the 1990s—the dedicated clinic time makes more individualized care possible. “It provides those most interested with VIP service,” says Katherine Weise, OD, MBA, professor of optometry, who helped develop the Myopia Control Clinic and is director of UAB Eye Care’s Pediatric Optometry Service. “Fewer patients are scheduled, so we can spend more time with each.” Pucker and a team of students talk with parents and patients about why controlling myopia is important, perform tests to measure eye length and determine which control method or methods would be best for each child and then discuss options. Pucker also created a consent form that explains myopia and myopia-control goals and provides information about each control method. “One of the biggest things I’ve realized is how much patient education is required,” says Jonathan Davis, a fourth-year optometry student. “You really have to start at a very high-level view of what myopia or nearsightedness is, and then talk about how it progresses and the risks associated with that. And then you can discuss myopiacontrol options.”

Treatments offered at the clinic are:

• M ultifocal contact lenses, which studies show reduce myopia progression approximately 50 percent by improving image focus in the retinal periphery. • Orthokeratology contact lenses, hard contact lenses typically worn at night that reshape the cornea, allowing a person to see clearly during the day without glasses or contact lenses. Research has shown orthokeratology contact lenses also slow myopia progression an average of 50 percent by improving peripheral retinal-image focus. • Low-concentration atropine (0.01 percent), which studies have shown reduces myopia progression an average of 60 percent. Full-strength atropine (1 percent) is an eye drop that typically dilates the pupil, causing light sensitivity and blurring near vision. At 0.01 percent concentration, however, pupil size does not increase and near vision is not dramatically affected. Patients are encouraged to return to the clinic every six months for treatment evaluation. “Close monitoring of the success of these treatments is important,” Pucker says. “We’ve developed a patient-recall system to make sure we’re contacting them when we need to and checking up to make

sure they’re happy with their treatment.” All this could help with patient adherence, he says. “If you’re coming to this clinic specifically to slow eye growth, you’re more likely to follow the treatment,” he says. Student education was another driving force in the decision to open the Myopia Control Clinic. It is one of several clinics at UAB Eye Care that expose students to specialty areas and current hot topics in the field. In groups of three or four, students attend the Myopia Control Clinic four times over half a semester. Pucker gives a one-hour lecture before each clinic, then students spend the next two to three hours working with patients. “They’re getting education beyond what they would get in class—more clinically oriented education.” Davis says he had considered offering myopiacontrol treatments in his practice, but thought he would need additional training to become proficient. “I assumed I would cross that bridge when I got out there in my practice and decided to begin treatment,” he says. “But I feel like this course has caused that not to be necessary. I definitely have enough experience and knowledge now to be comfortable at least getting it started in my clinic.” Emma Wilhite Scott, another fourth-year optometry student, says she learned an easier method of

ɊɊ ABOVE: ELENA IS EXAMINED BY HER OPTOMETRIST, KATHERINE WEISE, OD, MBA, PROFESSOR OF OPTOMETRY AND DIRECTOR OF UAB EYE CARE'S PEDIATRIC OPTOMETRY SERVICE. WEISE HELPED DEVELOP THE MYOPIA CONTROL CLINIC AND HAS PLAYED AN INTEGRAL ROLE IN RESEARCH OF MYOPIA CONTROL METHODS.

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

ɌɌ FROM TOP, TIMOTHY GAWNE, PHD, ASSOCIATE PROFESSOR OF VISION SCIENCE, AND THOMAS NORTON, PHD,

fitting orthokeratology lenses. She plans to offer her patients myopia-control treatments as well. “They should always be given all the options,” she says.

Past research: Laying the foundation

PROFESSOR EMERITUS OF VISION SCIENCE

In the late 1950s, when he was at the University of California, Berkeley, Henry B. Peters, founding dean of the School of Optometry, led the Orinda study, pioneering research exploring myopia prevalence and progression in children. At UAB, he strongly advocated for both basic and clinical research as a basis for developing treatments, says Thomas Norton, PhD, an emeritus professor who joined the School of Optometry faculty in 1978. Norton says Peters encouraged him to apply for grants for animal research because he understood animal models were important. “Animal models have driven the idea that you could control

myopia,” Norton says. “Many people thought it was only genetic.” Wendy Marsh-Tootle, OD, MS, who served as director of UAB Eye Care’s Pediatric Optometry Service from 1994 to 2004, recruited clinical faculty and got them involved in myopia-related clinical research through the National Institutes of Health and other funding agencies, Norton says. “We have a strong pedigree in the nearsighted world here at UAB,” says Weise, who filled Marsh-Tootle’s position after her retirement.

Early animal studies

Animal models were—and still are—essential for myopia-control research because it’s the only way to get data fast enough, says Tim Gawne, PhD, associate professor of vision science. He says that human trials are great, but ideally, kids would be followed up to at least age 16 because nearsightedness tends to grow between the ages of 7 and 16.

Myopic mystery: why is nearsightedness increasing? Based on current trends, half the world’s population—5 billion people— are likely to be myopic by 2050 and approximately 1 billion will fall into the high myopia category, according to researchers at the Brien Holden Vision Institute. Why is myopia advancing at such a shocking pace? It depends on who you ask, says Katherine Weise, OD, MBA, professor of optometry and director of UAB Eye Care’s Pediatric Optometry Service.

2017 EDITION

Research has provided a few agreed-upon facts:

Beyond this, theories abound. Here are some:

• Genetics plays a role. A child with no myopic parent has a 10-percent chance of developing myopia; a child with one myopic parent has a 25-percent risk; and a child with two myopic parents has a 50-percent risk. • Higher education levels are linked to an increased risk for myopia. • More time spent outdoors correlates with decreased risk of becoming myopic.

• Near work: For a long time, near work was thought to contribute to myopia, with use of electronic devices perhaps accounting for accelerated prevalence in the past few decades. But recent studies show near work alone isn’t likely the issue. • Looking at shorter distances indoors compared to the distances seen outdoors. • Less vitamin D or ultraviolet light as a result of more time spent indoors. • Less intense light indoors: “Light outdoors is orders of magnitude brighter than it is inside,” says

Tim Gawne, PhD, associate professor of vision science. Even on a cloudy day, light outside can be 25,000 to 35,000 lux vs. 500 lux inside. • Less dopamine because of less time spent outdoors: More light could cause an upregulation of dopamine receptors, and retinal dopamine is thought to reduce myopia. • Artificial light indoors and from electronic devices: Natural light has a broad, smooth spectrum, but artificial light spectra are choppy and spiky, Gawne says. “We might see colors fine, but the emmetropization system might not get it,” he says. T

“You just couldn’t do many different human trials in a lifetime,” he continues. “Whereas with an animal that develops quickly, like a chick or a tree shrew, in a year you could test a dozen different combinations of things to see what their effects are.” Myopia-related animal research at the School of Optometry began in the early 1980s, and most of it has been conducted with tree shrews, squirrel-like mammals that were once classified as primates. Unlike monkeys, they mature quickly, so studies in the juvenile phase—when eye growth occurs—can be completed fairly rapidly. “The tree shrew has a lot of advantages that no other current, commonly used model has,” Gawne says. “They are the closest non-primate species to a primate. They’re diurnal, like humans, and they have good vision—20 times better than a mouse.” When Norton left Duke University for UAB, he drove from North Carolina to Birmingham with about 20 tree shrews in the back of his car. The 100 animals in UAB’s current tree shrew core—one of only three tree shrew research colonies in the United States—descended from those animals. Norton had discovered, by accident, in 1976 that myopia could be induced in tree shrews. He was doing unrelated neuroscience research that involved raising animals with one eyelid closed. The closed eye elongated, resulting in nearsightedness. “Having realized we can cause the eyes to get long, then that becomes a test bed for, how can you stop it?” Norton says. As humans and other animals are growing, the normal eye uses signs of defocus to adjust its length to its optics, keeping vision accurate. Early animal studies demonstrated this active emmetropization process. When researchers put a minus lens on an animal, the eye would adapt to achieve good focus with the lens in place. When they removed the lens, the myopic eye would recover by slowing its growth. In human myopia, the eye responds inappropriately to defocus, growing longer when growth should be slowed. Traditional glasses and contact lenses correct focus on the fovea, sharpening central vision, but fail to correct blur on other parts of the retina, in fact worsening defocus in the visual periphery. Animal studies showed correcting the refractive error in the periphery can slow down myopia, Norton says.

Milestones in human research

This animal science at the School of Optometry laid the groundwork for two large, NIH-funded studies of children at UAB and other sites across the country: the Collaborative Longitudinal Evaluation of Ethnicity in Refractive Error (CLEERE) study, which involved 4,927 kids and took place from 1989 to 2009, and the Correction of Myopia

How does overnight corneal reshaping help slow myopia progression?

H Image Shell

UNCORRECTED MYOPIA

CONVENTIONAL CORRECTION

CORNEAL RESHAPING CORRECTION

Traditional glasses and contact lenses correct focus on the fovea but fail to correct blur on other parts of the retina. Orthokeratology contact lenses—hard contact lenses worn at night—reshape the cornea, allowing a person to see clearly without glasses or contact lenses. In addition to correcting focus on the fovea, the lenses correct the refractive error in the periphery, which can slow myopia progression. Adapted from: Lipson, Michael. "Overnight Corneal Reshaping in 2014 and Beyond." Contact Lens Spectrum, Volume: 29, Issue: May 2014.

Evaluation Trial (COMET), which included 469 children and lasted from 1996 to 2015. These studies provided much-needed basic information about myopia development—for instance, nearsightedness grows at an average rate of about 0.50 diopters per year for about nine years and stops by age 18 for about 75 percent of children. In addition, the COMET study proved that correcting defocus on the peripheral retina could slow myopia development in children as it had in animals. “We came up with the idea for the COMET study and put it together with three other schools of optometry,” Norton says. Kids ages 6 to 12 were recruited in Birmingham, Philadelphia, Boston and Houston, and half were given regular glasses while the other half were given glasses with progressive-addition lenses that regionally improved peripheral focus. After five years, myopia had slowed 20 percent in kids with the progressive-addition lenses compared to the control group. “It was definitely a cornerstone study for optometry, and UAB was leading the way,” Weise says. “We laid the groundwork for a lot of future nearsightedness studies. We showed proof of concept for using multifocal contact lenses to slow down nearsightedness.”

“

We laid the groundwork for a lot of future nearsightedness studies. We showed proof of concept for using multifocal contact lenses to slow down nearsightedness.

”

Katherine Weise, OD, MBA, professor of optometry

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

⊲⊲ RIGHT: ANDREW PUCKER, OD, PHD, MEASURES THE CORNEAL SURFACE OF A YOUNG PATIENT IN UAB EYE CARE'S MYOPIA CONTROL CLINIC. IN ADDITION TO CONDUCTING RESEARCH STUDIES THAT EXAMINE HOW THE CILIARY, OR FOCUSING, MUSCLE IS INVOLVED IN MYOPIA DEVELOPMENT, PUCKER HELPED TO JUMP-START AND NOW DIRECTS THE MYOPIA CONTROL CLINIC.

Multifocal contact lenses are better than glasses at controlling myopia because they improve focus in more of the visual periphery. The use of orthokeratology lenses in myopia control also stemmed from COMET research because flattening the cornea improves peripheral focus as well. Weise and the School of Optometry are playing an integral role in another large NIH-funded study that began in January 2018. Weise is the protocol development chair for the Myopia Treatment Study 1, through the Pediatric Eye Disease Investigator Group, a consortium of 300 pediatric optometrists and ophthalmologists dedicated to facilitating multicenter clinical research in eye disorders affecting children. The group chose to investigate nearsightedness and atropine, and the School of Optometry is one of 10 sites selected for the 2.5-year study that will include 200 children. Past research shows atropine slows myopia in children, but most large studies have been conducted in Asia. The eye drop hasn’t been studied in the United States in a concentration with fewto-no side effects. The study will recruit an ethnically diverse group of children, reflective of the U.S. population, and two-thirds of them will use 0.01 percent atropine while the others use a placebo. “The big hot topic in the United States now is atropine,” Weise says. “Part of our question is, in U.S. kids, whether they’re Asian or African-American or Hispanic or Caucasian, does atropine slow down the progression of nearsightedness to a meaningful degree?”

Current animal research: clues to a confounding question It’s known that the juvenile retina, without input from the brain, is interpreting the pattern of images throughout the day and trying to guess whether the eye is too long, too short or just right, and adjusting growth accordingly, Gawne says. “We know it’s visual,” he says. “The secret is what is the retina looking at and what is it getting wrong? And that’s the thing that has been surprisingly hard to understand.” Much of current myopia-control research centers on better understanding this system— or finding ways to override it.

Light studies

Most of Gawne’s research involves tree shrews and ambient light. One way he’s hoping to fool the retina takes advantage of the fact the eye suffers from longitudinal chromatic aberration—meaning it focuses light of different wavelengths at different points. Long-wavelength, red light is focused farther back in the eye than short-wavelength, blue light. Therefore, if the red light were in better focus than blue light, this might signal the eye that

2017 EDITION

it is long enough. “Maybe we could trick the eye,” he says, by giving it only red light. “It would say, ‘hey, I see sharp red, but nothing blue at all.’ Maybe that would tell the eye, ‘I need to stop growing.’” The experiment worked in tree shrews, with even one hour per day of red light having about a 1-diopter effect. In late 2017, he submitted an NIH grant proposal for a large study in tree shrews that could move the therapy closer to human trials. He hopes to evaluate parameters including timing, spectral purity and intensity to arrive at a practical therapy for kids. “Maybe if we could get it down to 15 or 20 minutes of red light, maybe they could read during that time,” he says. “We need to flesh it out with animal experiments.” Gawne is already conducting a small-scale study of tree shrews exposed to high-intensity red light—15,000 lux instead of 1,000 lux. Preliminary findings of the study, begun in June 2017, are promising, he says. Red-light studies in monkeys show success as well, he notes. Another study he began in 2017 involves 7-methylxanthine, a substance similar to caffeine that thickens the posterior sclera and has been shown to slow myopia in monkeys and Danish children. Gawne is testing it in tree shrews in combination with other therapies, including red light. Recent research also has examined the function of dopamine in relation to myopia. Increased time spent outdoors correlates with a decreased risk of myopia, although why is unclear. More light is thought to cause an upregulation of dopamine receptors, Norton says, and dopamine could help reduce elongation of the eye. A study Alexander Ward, a PhD student at the School of Optometry, Norton and two others published in 2016 showed injecting a dopamine-like substance in tree shrews reduced myopia.

Genetic pathways and the ciliary muscle

Pucker is working on three studies to see how the ciliary, or focusing, muscle is involved in myopia development. Association studies have shown the ciliary muscle in humans with longer eyes is bigger and doesn’t function as well compared to ciliary muscles in normal, emmetropic eyes. In one study, Pucker is inducing myopia in guinea pigs and monitoring effects on their ciliary muscles as well as whether genes are turning on or off in ways that could affect the muscle’s growth. In another study, he’s using a device to stretch guinea-pig eyes, simulating exaggerated eye growth, so he can look at mechanically induced genetic pathways. In a third study, which will begin soon, he’ll put human ciliary-muscle cells in a dish, stretch them and then compare them to unstretched cells to see what genetic pathways are affected. “A specific pathway could be upregulated, causing

the ciliary muscle to grow bigger and thicker,” Pucker says. “A bigger muscle could be restricting equatorially eye growth, which would only allow the eye to grow longer, a disproportionate growth that could be causing nearsightedness. If we understand this mechanism, we could potentially deliver a drug to the front of the eye, where that muscle is located, and potentially stop that muscle restriction from happening, which would allow the eye to grow proportionally and avoid becoming myopic.” Norton says patients at the Myopia Control Clinic will eventually benefit from research currently taking place at the School of Optometry. “As we learn more about how this works, other treatment options are likely to come forward, and I’m sure one of the first places to adopt them— once they’ve been shown to work in clinical trials— would be the Myopia Control Clinic,” he says. Elena Chesnokova looks forward to that future. “It’s really exciting,” she says. “I’m glad that we’re coming up with new ways to combat myopia. I hope that in the future people won’t have to deal with myopia as much.” T

How to talk with patients about myopia (say ‘nearsightedness’) The general public doesn’t have a good understanding of myopia. That’s the finding of a 2017 publichealth survey conducted by Andrew Pucker, OD, PhD, assistant professor of optometry and vision science, and Stephanie Cox, OD, clinical assistant professor of optometry, and they say it has implications for myopia-control treatment. In the electronic survey of 330 people who had visited UAB Eye Care, only 68 percent could accurately define nearsightedness

and myopia. “We found that nearsightedness is more commonly correctly answered than myopia is, so if you’re talking to patients, maybe you want to say the word nearsighted,” Pucker says. “There were no predictors of who would get it right, not education, age or income.” Clinicians need to explain the basics to improve chances patients will comprehend and follow treatment plans. “If you want to have your patients do your treatments, and do them consistently and correctly, they first need to understand what myopia is,” he says. T

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

EDUCATION

GROWTH

DISCOVERY

PARTNERSHIP

PERSONALIZED CARE

Dealing with Dry Eye BY OLIVIA MCMURREY PHOTOS BY ANDREA MABRY

Through groundbreaking research and advanced patient care, the UAB School of Optometry’s faculty, students and clinicians help lead the charge against a growing malady.

For many people, dry eye disease is more than a minor irritation; it can affect almost every aspect of their lives. “It can be really debilitating,” says Cameron Postnikoff, MASc, a vision science doctoral student at the UAB School of Optometry. “One subject I saw recently is putting in eye drops every five minutes because his eyes are so dry and he’s so uncomfortable.” 26

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ɌɌ BELOW: KELLY K. NICHOLS, OD, MPH, PHD, DEAN OF THE SCHOOL OF OPTOMETRY, AND JASON J. NICHOLS, OD, MPH PHD, UAB ASSISTANT VICE PRESIDENT FOR INDUSTRY RESEARCH, WERE PART OF THE STEERING COMMITTEE THAT DEVELOPED THE REPORT ON THE DRY EYE WORKSHOP II.

Dry eye disease can cause chronic pain and blurred vision, decrease productivity at work— sometimes even resulting in job loss—and interfere with driving ability. The number of people with the often-undertreated condition is growing, with increased screen viewing a dominant factor, and more children are being diagnosed than in the past. Globally, the prevalence of dry eye is 5 to 50 percent, depending on location, according to a report published in The Ocular Surface journal in 2017. Dry eye affects up to 20 million Americans, says Kelly K. Nichols, OD, MPH, PhD, dean of the School of Optometry. An expanding team of faculty, students and clinicians at the School of Optometry are helping to lead the way in dry eye research and treatment by collaborating to improve understanding of the disease and bring relief to patients. Kelly Nichols and Jason J. Nichols, OD, MPH, PhD, professor of optometry and vision science and UAB assistant vice president for industry research development, are two of the world’s foremost experts in the field. Faculty and students have led more than two dozen studies related to dry eye since their arrival at UAB in 2014. UAB Eye Care, the School of Optometry’s clinical operation, recently launched the Dry Eye Relief Clinic, which offers patients cutting-edge diagnostic tools and treatments as well as opportunities to participate in clinical trials and other research. This setting is what drew Postnikoff, a Canadian, to the School of Optometry. “I wanted to make sure the work I was doing was applied and relevant,” he says. “The expertise and opportunities I was looking for all existed here and wouldn’t have existed in the same capacity in other places. I think the work I’m doing is going to be very important for dry eye disease, but also in terms of overall ocular health.”

This was the second time researchers and clinicians came together to assimilate knowledge of dry eye disease. The first report was published in 2007, and Jason Nichols says the 2017 document represents a significant increase in understanding, along with better diagnostic and treatment guidelines. The volume of dry eye research publications has been picking up over the past 20 years and was significantly higher in the last 10 years compared to previous time periods. “When I started in the field 20 years ago, there were no pharmaceuticals and little treatment options,” Jason Nichols says. “We knew dry eye was frequent, but we didn’t have good epidemiological studies that showed incidence or prevalence. All that has since changed. We understand quite a bit about the epidemiology of the disease and we understand a lot more about the multifactorial nature of the disease—the different types of dry eye and different root causes.” Treatment recommendations have improved as well, largely because better diagnostic guidelines and tools can help clinicians pinpoint the types and potential causes of dry eye, he says. But there’s still a long way to go. While two pharmaceuticals are now FDAapproved for dry eye disease and there are device-based treatments that stimulate glands to express more tears and lipids, and a myriad of other options exist as well, a large group of patients don’t respond to any current treatments, says Jillian Ziemanski, OD, MS, clinical assistant professor and head of the Dry Eye Relief Clinic. “There’s still a lot we don’t know about the disease,” Jason Nichols says. “We don’t necessarily understand the molecular basis of dry eye and many of its sub-types.”

Knowns and unknowns: status of the dry eye field

Dry eye research at the School of Optometry runs the gamut, from basic research examining pathophysiology to clinical research aimed at finding new diagnostics and treatments. Jason Nichols is leading a study into possible molecular markers of meibomian gland dysfunction through a five-year, $1.9 million National Institutes of Health R01 grant. He has built a patent-pending device as part of the research, which could lead to a targeted diagnostic for the most common form of dry-eye disease. Other research in 2017 includes: one of the first large studies of kids and dry eye disease, with a look at possible connections to screen time; a study that follows dry eye development in young adults; and pioneering research into the role of neutrophils in dry eye disease. To read more about these studies, see page 30.

The year 2017 marked the end of a massive, two-year undertaking in which 150 leading clinical and basic researchers from around the world used evidence-based review to update everything that is known about dry eye. The resulting report on the Dry Eye Workshop II is 1,000 pages long and contains 1,000 references in the diagnosis chapter alone. Kelly Nichols and Jason Nichols were part of the Tear Film & Ocular Surface Society steering committee that developed the report. “It’s an encyclopedia of dry eye,” Kelly Nichols says. “This document is the status of where the field is currently. It can be a roadmap for new research, but it can be a foundation for clinicians and scientists as well.”

Key research

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

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FDA trials

RIGHT: THE DRY EYE RESEARCH TEAM AT THE SCHOOL OF OPTOMETRY. TOP ROW FROM LEFT, WILLIAM NGO, OD, PHD, POSTDOCTORAL FELLOW; JIANZHONG CHEN, PHD, ASSISTANT PROFESSOR OF VISION SCIENCE; JASON J. NICHOLS, OD, MPH, PHD, UAB ASSISTANT VICE PRESIDENT FOR INDUSTRY RESEARCH; KELLY K. NICHOLS, OD, MPH, PHD, DEAN OF THE SCHOOL OF OPTOMETRY; KWAKU OSI, PHD STUDENT; AND BOB BAI, PHD, POSTDOCTORAL FELLOW. BOTTOM ROW FROM LEFT: CONNER ROBBINS, THIRD-YEAR OPTOMETRY STUDENT; ANNA ABLAMOWICZ, OD, PHD STUDENT AND CLINICAL ASSISTANT PROFESSOR; JILLIAN ZIEMANSKI, OD, MS, PHD STUDENT AND CLINICAL ASSISTANT PROFESSOR; AND CAMERON POSTNIKOFF, MASC, DOCTORAL STUDENT.

The School of Optometry is often a clinical trial site for regulatory studies associated with therapeutics and medical devices. “It’s important to be recognized as a site that is a leader in clinical research and that is selected from all the places in the United States where that can happen,” Kelly Nichols says. “We feel honored to have been included in a number of FDA clinical trials in the area of dry eye.” UAB was a clinical trial site for Xiidra, the first FDA-approved pharmaceutical for dry eye disease in 14 years. The FDA approved Xiidra in 2016. The only other FDA-approved pharmaceutical for dry eye disease is Restasis, which was approved in 2002. Ziemanski says being a clinical trial site often allows UAB Eye Care to offer patients early access to treatments that might ease their symptoms. For instance, research participants were able to use Xiidra prior to FDA approval. During most of 2017, the School of Optometry was involved in a trial of a steroid-based eye drop intended to treat acute flare-ups of dry eye. Trial results are not yet available. In early 2018, clinical trials of a new device and a medication for dry eye are expected to begin. The medication, which is injected under the skin, is already approved for other conditions and is aimed at people with severe dry eye who have not had success with other treatments. Other practitioners in the Birmingham community can refer patients for clinical trials at UAB Eye Care, as well. “One benefit of study participation is that for patients who don’t find adequate therapy for their dry eye, this is a chance to find something that works and to help contribute to the scientific process along the way,” Jason Nichols says.

Why dry eye disease is on the rise Dry eye disease rates have increased substantially, and Jillian Ziemanski, OD, MS, clinical assistant professor at the UAB School of Optometry, says modern society is partly to blame. “Using electronic devices reduces our blink rates, and blinking is what restores the tears,” she says. Prolonged exposure leads to changes in the eyes’ ability to produce and distribute tears. 28

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World-class patient care The Dry Eye Relief Clinic, part of UAB Eye Care, also gives patients access to optometrists aware of the latest clinically-applicable research and to advanced, specialty equipment that might not be available in most standard practices.

Specialty diagnostic devices clinicians at the Dry Eye Relief Clinic use are:

• T earLab, which measures salt concentration in tears. • InflammaDry, which detects elevated levels of MMP-9, an inflammatory marker. • LipiView II, which takes detailed images of the meibomian glands and monitors the thickness of different parts of the tears. • Keratograph 5M, which measures multiple ocular-surface parameters. “These different types of diagnostic devices help us differentiate among the various types of dry eye so we can better target a treatment,” says Ziemanski. The Dry Eye Relief Clinic is one of few practices in Alabama to offer patients access to an FDAapproved device for evaporative dry eye treatment: LipiFlow. This instrument applies heat and pressure to the eyelid so thick, blocked oil in glands can melt down and express more freely onto the eye surface. Clinicians in the Dry Eye Relief Clinic also perform a procedure called lid margin debridement, which exfoliates dead skin on the eyelid that can interfere with delivery of oil to the eye. For more severe types of dry eye, amniotic tissue grafts can be applied to the cornea to help calm inflammation. Scleral lenses are available as well. “Our Contact Lens Clinic has scleral contact lens experts, so we have really easy access to offer

Screen viewing also can stress the eye and fatigue the muscles, says Jason Nichols, OD, MPH, PhD, professor of optometry and vision science and UAB assistant vice president for industry research development. Awareness and education can help combat the effects of screen viewing. Advising patients to take eye breaks by looking away from the screen for a few minutes every half hour is one common approach, Nichols says. Changes in environment are playing a role as well, he says. Sick building syndrome, for instance, affects eye health. “The ocular surface is a mucous membrane, so chemicals, molds, arid conditions—all those things can contribute to ocular-surface disease,” he says. T

that to patients,” Ziemanski says. In addition to the two FDA-approved prescriptions for dry eye, other possible treatments the clinic offers range from topical steroids and antibiotics to nutritional supplements, warm compresses to artificial tears, all tailored to the individual patient. “It’s always a combination of treatment, and we customize it based on the outcomes of the different diagnostic tests we use,” Ziemanski says.

New treatments on the horizon Ziemanski says she’s excited about another new treatment, in addition to the pharmaceuticals and device that are in FDA clinical trials. The TrueTear device (Allergan) is inserted through the nasal passages and applies electrical current to stimulate the nerves that produce tearing. “That one I’m really looking forward to because it’s so different from anything we currently have available,” Ziemanski says. T

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2017 Research Highlights

ɊɊ ABOVE: JASON NICHOLS, OD, MPH, PHD,

Research topic: Potential molecular markers in meibomian gland dysfunction Lead researcher: Jason Nichols, OD, MPH, PhD, professor, UAB assistant vice president for industry research development Possible outcome: Targeted therapy to relieve the most common form of dry eye In late 2016, the National Eye Institute awarded Jason Nichols a five-year, $1.9 million R01 grant to study potential molecular markers in meibomian gland dysfunction, a type of evaporative dry eye disease. Evaporative dry eye is the most common type of dry eye disease, and meibomian gland dysfunction is the most widespread form of evaporative dry eye. Millions of Americans suffer from MGD, and study findings could lead to a targeted therapy. In MGD, the quantity or quality of oil the meibomian glands secrete into tears is deficient, causing tears to evaporate too quickly. Nichols’ study is examining both the structure of the tear film and its function in 200 patients split into two groups—those with normal ocular-surface health and those with meibomian

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gland dysfunction. To measure the thickness of tears and how they thin and spread, Nichols and his research partners built a patent-pending device that combines optical techniques in a unique way. The tear film is typically 4 microns thick; the diameter of a human hair is 100 microns. “You need high-resolution equipment to measure tears on the front of the eye and their thickness and flow and spread,” Nichols says. To study the biochemistry—or function—of the tear film, researchers are examining the lipids in tears they collect from the ocular surface and eyelids. Compared to knowledge about the normal eye, much less is known about the types and levels of lipids present in the tears of people with dry eye, Nichols says. “Clinicians kind of fall in the mindset that you have a deficiency,” he says. “That might not be the case. It could be there are some lipids produced in too much degree and they overwhelm the other lipids, so they’re out of balance.” Information gleaned from the study could lead to multiple treatments. “We could potentially design a pharmaceutical that would lead to an increase or decrease in the lipids depending on if they’re good or bad,” Nichols says. “Or we could consider supplementing a particular lipid itself if it were deficient. But we’d need to know what the species were before we could do that.”

AND HIS RESEARCH PARTNERS BUILT A PATENT-PENDING DEVICE TO MEASURE THE THICKNESS OF TEARS AND HOW THEY THIN AND SPREAD AS PART OF A FIVE-YEAR, $1.9 MILLION R01 GRANT TO STUDY POTENTIAL MOLECULAR MARKERS IN MEIBOMIAN GLAND DYSFUNCTION.

Research topic: Kids, dry eye and screens Lead researcher: Anna Ablamowicz, OD, clinical assistant professor Possible outcome: Better guidelines for diagnosing dry eye in kids and improved understanding of how electronic devices affect children’s eyes Ablamowicz's study evaluated 225 children ages 8 to 17 for dry eye disease and gathered information about lifestyle factors such as electronic-device usage, sleep habits and time spent outdoors. It included a questionnaire about dry eye symptoms and a clinical examination to document ocular-surface characteristics and look for signs of dry eye. “There hasn’t been much attention on looking at dry eye in kids,” Ablamowicz says. “Now, with more kids using smart phones and computer screens, and schools bringing in technology and having laptops for students, we wanted to look at a large sample of kids to capture their baseline characteristics.” Looking at screens reduces blink rate, which can cause dryness and damage to the ocular surface. Because clinicians have noted an uptick in kids complaining of dry eye symptoms, Ablamowicz will look for possible correlations between dry eye and screen time. She also hopes to identify effective screening methods clinicians can easily use. Ablamowicz says more kids than she expected complained of dry eye symptoms and had signs on the ocular surface. “We can use these findings to say: ‘Doctors out there, ask these questions to your young patients because you might uncover something that with earlier detection and better management, if appropriate, might result in reduction of symptoms and difficulties long term,’” says Kelly K. Nichols, OD, MPH, PhD, dean of the School of Optometry.

Research topic: The role of neutrophils in dry eye disease Lead researcher: Cameron Postnikoff, MASc, vision science doctoral student Possible outcome: Eye-washing techniques and therapeutics to alleviate dry eye symptoms Postnikoff is leading a study into the role of neutrophils, a type of white blood cell, in dry eye disease. When people sleep, white blood cells flood the tear film. They typically shed quickly once the eye is open.

The closed eye, on average, contains 750 million white blood cells compared to 700 in the open eye. Neutrophils kill pathogens. When they do this, they can release granules that contain matrix metalloproteinase-9, or MMP-9. Increased levels of MMP-9 in tears indicates dry eye disease. Excessive neutrophils and/or increased degranulation could be promoting the disease pathogenesis, Postnikoff hypothesized. In the first phase of his study, completed in 2017, subjects with dry eye collected twice as many neutrophils when washing their eyes upon waking as subjects without the disease. The study’s second phase will examine the eye-washing method and split patients into a group that washes every day and one that washes every two weeks. “We want to see if the technique itself can actually be a therapy,” Postnikoff says. If neutrophils are shown to be important, developing therapeutics to target them is a possibility as well, Postikoff says.

ɌɌ FROM TOP: ANNA ABLAMOWICZ, OD, CLINICAL ASSISTANT PROFESSOR (LEFT) IS LOOKING FOR CORRELATIONS BETWEEN SCREEN TIME AND DRY EYE SYMPTOMS IN KIDS. CAMERON POSTNIKOFF, MASC, VISION SCIENCE PHD STUDENT (RIGHT), IS STUDYING THE ROLE NEUTROPHILS PLAY IN DRY EYE DISEASE. JILLIAN F. ZIEMANSKI, OD, MS, CLINICAL ASSISTANT PROFESSOR, IS TRYING TO BETTER

Research topic: Prospective assessment of dry eye in optometry students

UNDERSTAND DRY EYE DEVELOPMENT IN YOUNG ADULTS BY FOLLOWING OPTOME-

Lead researcher: Jillian F. Ziemanski, OD, MS, clinical assistant professor

TRY STUDENTS FOR THREE YEARS.

Possible outcome: A better understanding of dry eye development in young adults This study is a longitudinal assessment of the meibomian glands in a young adult population subject to intensive near work. Optometry students are enrolled for up to three years and evaluated on an annual basis. At the conclusion of the overall project, significant knowledge will be gained in this group of young adults regarding the frequency of dry eye and the natural history of the meibomian gland morphology in health and disease. To date, there have not been studies that have tracked the ocular health in this age group, especially with the intense near work UAB optometry students experience over time. Participants will complete dry eye surveys and clinical assessments and the relationships between symptoms, staining, structural and functional assessments of the meibomian glands will be determined. Approximately 150 optometry subjects were recruited in the first year of the project and these subjects will be followed annually thereafter for up to three years. “We will be able to follow the current students while they are in optometry school, and perhaps even extend the study after graduation via survey or examination to determine whether dry eye develops,” Ziemanski says. “Understanding why, when and how dry eye first develops will help future dry eye management in this age group.” T

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Program that provides comprehensive eye care, acute game-time care and stateof-the art concussion baseline testing to student-athletes kicks off in 2017.

BlazerVision BY MELISSA B ROWN, PHOTOS BY ANDREA MABRY

ɍɍ LEFT: THIRD-YEAR OPTOMETRY STUDENT DANIEL CASON EXAMINES

The tools range from a Popsicle stick and an iPad to a state-of-the-art video tracking rotational chair, but the goal is the same: to keep UAB student-athletes safe and their eyes healthy.

UAB FOOTBALL PLAYER CRAIG KANYANGARARA WITH A PUPILOMETER, A DEVICE THAT MEASURES A PUPIL'S RESPONSE TO LIGHT, WITH OVERSIGHT FROM MARK SWANSON, OD, MSPH, PROFESSOR OF OPTOMETRY.

BlazerVision combines the expertise of the UAB School of Optometry, UAB Athletics and the UAB Department of Ophthalmology to provide student-athletes with comprehensive eye care, acute game-time care and state-of-the-art concussion baseline testing. The program has been years in the making. In 2013, the School of Optometry began working with Children’s of Alabama on concussion and vision issues, a growing concern among athletes and health care professionals. Through working relationships with Heath Hale, MD, lead team physician for UAB Athletics, and Katherine Weise, OD, MBA, optometry professor and director of UAB Eye Care Pediatric Optometry Service, the two realized the level of care the School of Optometry could offer Athletics. “We could take something off their plate and manage the visual system,” Weise says.

After Weise pitched the program in late 2016, BlazerVision became a reality in early 2017. The School of Optometry provides the first line of defense for student-athletes with comprehensive, preseason eye exams at UAB Eye Care, which is the School of Optometry’s clinical operation. Maximum visual acuity and eye health are determined. Then, athletes are provided with contact lenses, eyeglasses or protective eyewear, if needed. If a surgical eye injury or condition is ever encountered, student-athletes are referred to the Department of Ophthalmology. In addition to providing top visual performance, which helps student-athletes both on the field and in the classroom, faculty and students at the School of Optometry also gather baseline concussion data for each athlete. To do this, a student-athlete’s eye tracking, alignment and teaming are assessed in ways

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

that have been shown to be consistently associated with impact exposure. Gathering clinical baseline data allows the School of Optometry to provide a more accurate assessment of the impact of a potential concussive event. If it appears that a student-athlete is concussed during a game, Weise, who was on the sidelines throughout the 2017 football season at UAB, can run tests immediately and compare the results to the baseline data gathered. “Some of the tests on the sidelines can be influenced by the player’s attitude about getting back in the game, so any testing that we have that’s objective is very helpful,” Weise says. Though UAB optometrists have regularly screened student-athletes in the past, Weise says BlazerVision is providing layers of data for the athletic trainers and team physicians, and she hopes to reach all athletes on campus. “BlazerVision is kind of a paradigm shift to focus our world-class expertise on each of our UAB athletes,” Weise says. “Now, every player on campus has the opportunity to receive comprehensive vision care and concussion baseline testing before the season. And each team on campus got its own on-call team eye doctor for the most efficient and focused eye care during the season.” In addition to clinical care, data is also being gathered to develop more objective methods of concussion testing through the research component of BlazerVision. UAB student-athletes can opt to participate in the research within the UAB Eye Care VORClinic, or Vestibular Ocular Research Clinic. The VORClinic was established by a UAB grant and brings the UAB Department of Physical Therapy (Jennifer Christy, PT, PhD, VORClinic co-director, and Graham Cochrane, MD, PhD student) and the School of Optometry (Claudio Busettini, PhD, professor of vision science,

The multidisciplinary UAB team provided baseline vestibular-ocular research exams and followed any football or women’s soccer player who was later removed from play due to impact exposure. Joining in on the research and on the sidelines was Daniel Cason, a third-year optometry student. Cason is a lifelong sports fan and was intrigued by the program because he believes it could lead to research with a “big impact.” Sideline testing involves a pupilometer, a handheld device that measures a pupil’s response to light. A second test uses a simple popsicle stick to determine how well an athlete can coordinate his eyes to cross, which has been shown to be frequently associated with concussion. A third test, administered using an iPad, measures reaction time with a cognitive task and different types of eye movements that might be affected by a concussion. A fourth method is led by faculty and students from the Department of Physical Therapy called the “Bucket Test,” which involves placing a plastic bucket in front of a potentially concussed athlete’s head. The athlete is asked to signal when he or she believes a line drawn within the bucket is vertical. “People with concussions have been noted to have reduced ability or altered ability on all these tests and having a multi-system approach to concussion is important,” says Cason. “Hopefully, the results of this study will play a big role in helping to diagnose concussions and, from there, reduce concussions and potential complications from them. If optometrists or athletic trainers could use these objective tests to add to the diagnosis of concussion, it could really help keep players safe.” BlazerVision represents an optimistic and proactive approach to vision health not just due to groundbreaking research, Cason says, but because

“

Hopefully, the results of this study will play a big role in helping to diagnose concussions and, from there, reduce concussions and potential complications from them. If optometrists or athletic trainers could use these objective tests to add to the diagnosis of concussion, it could really help keep players safe. Daniel Cason (Class of 2019)

VORClinic co-director and grant co-principal investigator; Mark Swanson, OD, MSPH, professor of optometry and lead statistician; and Weise) along with the UAB Department of Pediatric Neurosurgery (James Johnson, MD, co-principal investigator) to study concussions like few others in the country can. The team of vestibular-ocular experts hopes to use state-of-the-art research-level equipment used by few to create sideline testing that can be used by many.

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of the relationships he sees it encouraging between student-athletes and their optometrists. “As we did more sideline testing as the season went along, I noticed that there were a lot of conversations between the players and optometrists about not just head injuries and concussions, but also about their eyes, so I think that’s really encouraging,” Cason says. Craig Kanyangarara, a redshirt junior who joined the UAB football team in 2017, says that

⊲⊲ RIGHT: BLAZERVISION RESEARCHERS ARE GATHERING DATA TO DEVELOP MORE OBJECTIVE METHODS OF CONCUSSION TESTING. FROM LEFT, SARAH GALT, OD, PEDIATRIC OPTOMETRY RESIDENT; MARK SWANSON, OD, MSPH, PROFESSOR OF OPTOMETRY; KATHERINE WEISE, OD, MBA, PROFESSOR OF OPTOMETRY; CRAIG KANYANGARARA, UAB FOOTBALL PLAYER; TAMARA OECHSLIN, OD, PHD, ASSISTANT PROFESSOR OF OPTOMETRY; DANIEL CASON, THIRD-YEAR OPTOMETRY STUDENT; AND MAGGIE BAILEY, OD, CLINICAL ASSISTANT PROFESSOR OF OPTOMETRY.

simply having his concussion data gathered encouraged him to be more aware of the aftermath of concussions and how they can be prevented. “Implementing [BlazerVision] shows that we are being kept safe as a team and that we are understanding the importance of that safety—that it is not being pushed aside,” he says. For the Athletics department, BlazerVision is an example of the advantages UAB’s research and science expertise can offer its students.

“BlazerVision is another way that UAB is cuttingedge and looking at every avenue to improve the lives of tomorrow,” said Dan Carlson, senior associate athletic director for administration in Athletics. “When we sit down with a young man or woman and their families to recruit them, one of the things we have to offer here at UAB is worldclass medical care in every area imaginable.” T

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Leaders in Optometry

Many of our alumni are working hard across the country to improve and advance the profession of optometry. Here are some of their accomplishments and leadership roles in 2017. ɍɍ FAR LEFT: LYNN HAMMONDS, OD, WITH MELANIE CHWALEK (CLASS OF 2020) AT THE SCHOOL OF OPTOMETRY'S INAUGURAL SCHOLARSHIP LUNCHEON IN APRIL. HAMMONDS WAS ELECTED PRESIDENT FOR SECO

NATIONAL AND INTERNATIONAL RECOGNITION Elizabeth Steele, OD, named AOA’s Optometric Educator of the Year The American Optometric Association named Steele (Class of 2003), associate dean for clinical affairs for the School of Optometry, its Optometric Educator of the Year. Steele was honored for her “outstanding service on behalf of the profession, optometric education and the visual welfare of the public,” says the AOA.

INTERNATIONAL IN 2017. LEFT: ELIZABETH STEELE, OD, WAS HONORED IN JUNE AS THE AMERICAN OPTOMETRIC ASSOCIATION'S OPTOMETRIC EDUCATOR OF THE YEAR.

STATE LEADERSHIP AND AWARDS State Association Presidents

Lifetime Achievement Award

South Carolina Optometric Association 2017-2018: Johndra McNeely, OD (Class of 2009) Alabama Optometric Association 2016-2017: Allen Dunn, OD (Class of 1983) 2017-2018: Rob Pate, OD (Class of 2007)

Alabama Optometric Association Jim Marbourg, OD (Class of 1977)

Optometrist of the Year Alabama Optometric Association Michael Hooks, OD (Class of 1983)

Young Optometrist of the Year

State Board Membership Alabama Board of Optometry Executive Director, Fred Wallace, OD (Class of 1982), President, Robert Svensen, OD (Class of 1987), Mississippi Board of Optometry Dewey Handy, OD (Class of 1979), President

Alabama Optometric Association Ryan Price, OD (Class of 2007)

South Carolina Board of Optometry James Vaught, OD (Class of 1983), President

Kentucky Optometric Association Leslie Cecil, OD (Class of 2010)

We want to hear from you! Share your news about jobs, promotions, leadership roles, honors and achievements, marriages, births and deaths. Email items to Sommer Thompson at sommerthompson@uab.edu or visit uab.edu/optometry/alumni. T

Educator of the Year Alabama Optometric Association Mark Swanson, OD, MSPH (Class of 1985)

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Lynn Hammonds, OD, elected as second female president for SECO International Hammonds (Class of 1991) was elected president of SECO International in March—the first woman to hold the role since 1933. “I’m honored to serve SECO International in this capacity,” Hammonds says. “We will continue to focus on new ways of delivering education to our attendees.”

Several alumni nominated for AOA’s Young OD of the Year Nearly one-fourth of the nominees for the American Optometric Association’s Young Optometrist of the Year were alumni. The award recognizes young optometrists who show leadership in the profession and their communities. The alumni nominees were: Kristin Sullins, OD (Class of 2007), for Alabama; Ryan Wally, OD (Class of 2008), for Mississippi; Katherine Osborn, OD (Class of 2006), for Missouri; Scott Sikes, OD (Class of 2009), for North Carolina; Johndra McNeely, OD (Class of 2009), for South Carolina; Amber Hurley, OD (Class of 2012), for Virginia; and Jennifer Stevens, OD (Class of 2010), for West Virginia. T

Ways to Give

ALUMNI ASSOCIATION OFFICERS The annual meeting of the UAB School of Optometry Alumni Association was held in August. At the meeting, the membership elected the following officers for 2017-2018:

Alumni Board President Zach Steele, OD (Class of 2003) Trussville, Alabama

The UAB School of Optometry is grateful for the generosity of our alumni and friends. Our continued growth and success is only possible with your support. Here are ways to support the UAB School of Optometry as we continue to grow in 2018. ɌɌ BELOW: CATHERINE AMOS, OD (CLASS OF 1974) AND JOHN AMOS, OD,

President-Elect Caleb Gardner, OD (Class of 2008) Greenville, Alabama

PROFESSOR AND DEAN EMERITUS FOR THE SCHOOL OF OPTOMETRY, WERE RECOGNIZED AT THE

Secretary/Treasurer Bill Tillman, OD (Class of 1986) Andalusia, Alabama

INAUGURAL SCHOLARSHIP LUNCHEON, HELD IN APRIL 2017, WITH MAGGIE OVERSTREET (CLASS OF 2020), THE

Immediate Past President Zach McCarty, OD (Class of 2006) Chattanooga, Tennessee

Members-at-Large Kristin Sullins, OD (Class of 2007) Huntsville, Alabama Jamie Crockett, OD (Class of 2008) Prattville, Alabama Glenda Brown, OD (Class of 1981) Suwanee, Georgia

Optometry Building and Renovation Fund One of the School of Optometry’s top priorities is to secure funding for renovations of the Henry B. Peters Building. Learn more about the renovation of the building on page 14. Through this fund, the School of Optometry seeks to invest in better facilities and technology that will provide the following benefits: • The attraction of high quality students, faculty and staff • The enhancement of the school’s ability to educate students through optimizing leading edge technology and optometric education • The enhancement of faculty, staff and student interactions

2017 RECIPIENT OF THE DRS. JOHN & CATHERINE AMOS ENDOWED SCHOLARSHIP.

Optometry Fund for Excellence Through this fund, the School of Optometry is able to meet its most pressing needs and support special projects that keep it in the forefront of optometric education, while developing great clinicians and researchers. Gifts support strategic initiatives such as scholarships to attract and assist exceptional students, recruit and retain high-caliber faculty as well as develop and enhance curriculum and programs. Make your gift by visiting uab.edu/optometry/giving or contact Sommer Thompson, senior director of development, at sommerthompson@uab.edu or 205-934-9838. T

Rob Pate, OD (Class of 2007) Auburn, Alabama Candice Turner, OD (Class of 2003) Birmingham, Alabama David Britton, OD (Class of 2009) Haleyville, Alabama Sharon Day, OD (Class of 1987) Birmingham, Alabama Susan Persall, OD (Class of 2001) Hartselle, Alabama James Hill, OD (Class of 2009) John’s Island, South Carolina

UAB SCHOOL OF OPTOMETRY DEAN'S REPORT

Vision Statement TO UNDERSTAND, PRESERVE, RESTORE AND ENHANCE THE PRECIOUS GIFT OF SIGHT.

Mission Statement OUR MISSION IS TO EDUCATE OPTOMETRY STUDENTS, RESIDENTS AND FUTURE VISION SCIENTISTS; DISCOVER AND BROADLY COMMUNICATE NEW PRINCIPLES AND CONCEPTS IN EYE CARE AND VISION RESEARCH; TRANSLATE THESE IDEAS INTO CLINICAL PRACTICE; AND PROVIDE CARE WITH INTEGRITY AND COMPASSION. The UAB School of Optometry Deanâ&#x20AC;&#x2122;s Report is published annually. Send address changes and correspondence to Sommer Thompson, UAB School of Optometry, HPB 124C, 1720 2nd Ave South, Birmingham AL 35294, or sommerthompson@uab.edu.

UAB.EDU/OPTOMETRY