First-year students at UC Irvine’s medical school are carrying a lighter load on their shoulders than their predecessors. Thanks to an initiative by the school that provides each incoming student with an iPad, they now have at their fingertips a virtually endless supply of medical reference textbooks they would otherwise have to physically lug around campus in heavy book bags.

While this initiative has lightened the strain on their backs, some are concerned that the hours spent reading on the electronic tablet may cause a significant amount of strain on the eyes. To address this concern, R. Wade Crow, MD, Assistant Professor of Neuro-Ophthalmology at the Gavin Herbert Eye Institute, has launched a research project exploring what effects this new method of reading will have on students’ eye health.

“The study will have two arms,” says Dr. Crow. “We are essentially trying to assess the amount of eye strain that occurs when reading on an iPad compared to traditional reading on paper.” The study will be conducted in a controlled environment where subjects will be asked to read on either the backlit tablet or on a printed page. Dr. Crow will take into consideration each student’s eye health as well as other factors to determine the difference in strain from either experience. Although research is still pending and subjects are still being enrolled, one of Dr. Crow’s initial thoughts is that customization on the display settings of the iPad may be the key to reducing eye strain.

“The iPad has a really high-contrast display that’s black on white,” says Dr. Crow. “Right now, you can adjust the brightness of the display to your comfort level, and there is an auto-brightness setting that will adjust to the amount of light in the room. There is also a Kindle application, which provides a low-contrast display. Perhaps in the future, they can take it a step further and make it possible to effectively change colors to help people with light sensitivity.”

Dr. Crow hopes that this focus on medical students—who read constantly—will lead to more broad studies with wider ranges of subjects. He feels that with the growing popularity of the iPad and other e-readers, it is important to understand how the use of this technology affects us.

“This is a pilot project in a field that has not been researched much,” says Dr. Crow. He recalls other studies like this one that have been conducted, such as in the 1800s when eye strain was first being defined and more recently when computers were developed. “I am hoping this will spur other research projects, which will allow us to receive funding for more detailed studies on much more diverse groups of people. This type of innovative research is made possible only through the generous philanthropic support of Gavin Herbert Eye Institute patients.”

roundbreaking research on new technology and its effects on eye health

Spring 2012

Breakthrough in Retinal Stem Cell Therapy

The Buzz on Botox and Fillers

Long-lasting Glaucoma Care

A Visionary Night

In This Issue

G

TAKING IT EASY

ON THE EYES

www.eye.uci.edu/spring

Thank you for supporting the Shine The Light Campaign Gifts of $25,000 and above received since July 2011 to support construction of the Gavin Herbert Eye Institute:

Abbott Medical Optics

Anne and William Brownstein

Argyros Family Foundation Arnold and Mabel Beckman Foundation

Carol and Budge Collins

Esther and James H. Cavanaugh

Judith and Charles David Fritch, MD

Kratz Foundation

Ninetta K. and Gavin S. Herbert, Sr.

Gifts of $25,000 and above received since July 2011 for research:

Discovery Eye Foundation

Geneva M. Matlock, MD

Josephine Herbert Gleis Foundation

Judith and Charles David Fritch, MD

Polly and Michael C. Smith

For more information about the Gavin Herbert Eye Institute, please call (949) 824-0091.

SHINETHE

L IGHT

We are on schedule for the exciting day when we can finally move into our new building during Memorial Day weekend in 2013. Currently, we have raised an incredible $28.6 million, which is closer and closer to our goal of $37 million. We are now offering hard hat tours for the community, so you can see and experience what we are building together. I’m truly proud of our community in establishing the future of eye care here in Orange County. Sincerely,

Roger Steinert, MDChair, Department of Ophthalmology Please contact Janice Briggs, Senior Development Director, Health Advancement, at (949) 824-0091 for more information on how you can help and to let us know that you desire a hard hat tour.

BREAKTHROUGH IN RETINAL STEM CELL THERAPY

FIRST THE FOUNDATION, AND NOW THE SUPPORT

THAT STEMS FROM WITHIN

euroregeneration, the idea that

damaged tissue and cells in the

brain and spinal cord can be repaired

or replaced, has long been a distant

hope of doctors for their patients with

diseases without cures or treatment.

While some parts of the body are able

to heal by growing back tissue that has

been damaged, such as skin that is cut

or a broken bone, the adult brain is not

able to produce new cells. This is because

stem cells in the central nervous system

that were active in fetal development

become less active and can no longer

make new cells.

While it is found in the back of the eye,

the retina is connected to the brain

and develops as an integral part of that

organ. When the retina is damaged, it

is difficult to regain vision because the

damage does not spontaneously heal

and can’t be repaired with currently

available treatments. As such, there is no

accepted therapy for retinitis pigmentosa

(RP), a genetic disease that is caused by

progressive damage to cells in the back

of the eye that detect light. RP can cause

blindness at any age.

When first hearing about the potential

for stem cell therapies in medical

school, Henry Klassen, MD, PhD, was

excited that neuroregeneration could

soon be possible. Trained as a clinical

physician, Dr. Klassen, Associate

Professor of Ophthalmology at the Gavin

Herbert Eye Institute, has now been

researching a transplantation-based

therapy for RP for nearly 30 years. “As

a doctor seeing patients come in with

retinitis pigmentosa, I couldn’t offer any

treatment,” says Dr. Klassen. “My patients

were in a hopeless situation. When I

heard about the potential for stem cells

to repair and make new cells, I decided

to focus on using them to tackle the

complex challenges of RP.”

How stem cells can help Before using stem cells to treat RP,

Dr. Klassen studied both how they work

in the immature eye and how they could

be received as a transplant. When first

developing, an eye is microscopic and

cells are dividing rapidly to make the eye

big enough to see. There are retinal stem

cells present that divide and mature into

specialized cells like rods and cones. After

completing this task, these cells likely

turn off since they are no longer needed.

Because the cells in the retina are

organized in a specific way and work

together with the brain to interpret

images, damage to the retina can make

visual information lose accuracy and

become warped. Fixing this kind of

N

www.eye.uci.edu/spring

Dr. Henry Klassen in his lab at the Sue and Bill Gross Stem Cell Research Center.

Watch the building being constructed in real time with the EarthCam, which can be found

on our website: www.eye.uci.edu/spring.

THAT STEMS FROM WITHIN

damage as a surgeon requires delivering

replacement cells to exactly the right

place and making sure they perform

the same job as before. Dr. Klassen

discovered that transplanted retinal cells

can repair damage in adult eyes and

automatically organize the cells in the

correct manner.

Using fluorescent-coded retinal stem

cells, Dr. Klassen and his lab tested the

transplants in mice. The cells integrated

so well that they were indistinguishable

from the other retinal cells apart from

their green glow. Translating therapies

from mice to a human level is not often

a direct path, so Dr. Klassen then moved

to more complex animals like pigs and

cats. At each stage of testing, the results

have been very promising, with the

repaired retinal cells responding to light

in previously blind subjects.

As with transplants for other parts of

the body, Dr. Klassen had to consider

if rejection of the cells would occur.

However, the eye does not reject foreign

cells as readily as most other organs,

and therefore transplants there tend

to survive better. Other researchers

have been able to transplant similar

cells clinically without a serious

immune response, which confirms

Dr. Klassen’s findings.

Last year, a $3.85 million dollar grant

was awarded by the California Institute

for Regenerative Medicine (CIRM) to

Dr. Klassen for his retinal stem cell

transplant research. The grant will help

translate the earlier animal models to

human testing and fund work that will

ultimately ensure that the retinal stem

cells will be pharmaceutical-grade when

clinical trials are ready to begin.

“Since medical school, I have been

waiting for a breakthrough treatment

that could use neuroregeneration to help

repair the central nervous system—in

this case, the retina,” says Dr. Klassen.

“This research and treatment for RP

could be what I envisioned and pave

the way for other stem cell therapies.

With the grant, we’ve been able to grow

cultures of retinal stem cells much

more rapidly by changing cell culture

conditions. We’ve also worked on our

implantation approach so that we can

treat the entire retina instead of a small

sector. We’re now a couple years ahead

of schedule and will soon have the cells

tested outside of our lab in preparation

for an FDA application for clinical trials.

“The Gavin Herbert Eye Institute is a

place where people really appreciate

research for eye therapies. Everyone

comes together to collaborate, and the

conditions have been right for some

amazing advancements in vision care.”

“The new Gavin Herbert Eye Institute

building will be a great place to begin

the clinical trials for retinal stem cell

transplants. My plan, as the research

progresses, is to take this treatment

from bench to bedside—from the lab to

those with RP who currently do not have

any hope of a cure or treatment.”

FACULTY MEMBERS

TO CONTACT FACULTY MEMBERS OR TO MAKE AN APPOINTMENT, CALL (949) 824-2020 (IRVINE) OR (714) 456-7183 (ORANGE)

George Baerveldt, MD

Lbachir BenMohamed, PhD

Swaraj Bose, MD

Donald J. Brown, PhD

Robert Wade Crow, MD

Marjan Farid, MD

Sumit (Sam) Garg, MD

Ronald N. Gaster, MD

James V. Jester, PhD Jack H. Skirball Endowed Chair

Tibor Juhasz, PhD

Maria Cristina Kenney, MD, PhD

Henry Klassen, MD, PhD

Baruch Kuppermann, MD, PhDVice Chair of Clinical Research

Ron Kurtz, MD

Robert W. Lingua, MD

Linda S. Lippa, MD

Stephanie Lu, MD

Sameh Mosaed, MD

Anthony B. Nesburn, MDVice Chair of Research

Jennifer Simpson, MD

Roger F. Steinert, MDIrving H. Leopold Professor and

Chair of Ophthalmology Professor of Biomedical Engineering Director, Gavin Herbert Eye Institute

Jeremiah Tao, MD

Steven L. Wechsler, PhD

“This research and treatment for RP could be what I envisioned and pave the way for other stem cell therapies.”

— Henry Klassen, MD, PhD

oday, many know Botox® as a

minimally invasive way to reduce

wrinkles. But did you know that Botox

was first used by ophthalmologists to

treat muscular eye disorders?

Since the 1980s, Botox has been used

to treat blepharospasm, a medical

condition that causes uncontrollable,

constant blinking that can occur 20 to

50 times a minute, or can force eyelids

to remain closed for several hours.

Unable to drive or perform normal

tasks, people with blepharospasm

can be functionally blind.

Botox injections, given a few times a

year, help relieve these eyelid spasms

so patients can resume daily activities.

Ophthalmologists also use Botox to treat

another eye condition called strabismus,

or misaligned eyes.

The use of Botox for these eye disorders

led oculofacial (eye and face) specialists

to notice that wrinkles near their

patients’ eyes softened and became less

noticeable. Botox was later investigated

for cosmetic use. Today, Botox injections

are one of the most common aesthetic

procedures performed.

What is Botox?

Botox is an injectable drug that

blocks a chemical called acetylcholine

that helps muscles to contract. Botulinum

toxin is the main active ingredient

in Botox. Because the muscles are

weakened, wrinkles are less apparent.

Botox is commonly used as a nonsurgical

treatment for facial wrinkles.

Botox is also used to treat eye disorders,

migraines and muscle stiffness. The

results typically last an average of

three months.

What are fillers?

Like Botox, the active ingredient

hyaluronic acid in fillers such as

Juvéderm® and Restylane® has been

used for decades in eye surgeries.

Used to maintain space inside the eye

during cataract removal and other eye

surgeries, hyaluronic acid is a moldable

and nonpermanent substance that can

be found naturally in the skin, muscles

and tendons of mammals.

While botulinum toxin stops muscles

from contracting, hyaluronic acid fills in

the deeper lines and folds of wrinkles.

It can also be used to plump the lips

or cheeks. Hyaluronic acid is slowly

absorbed by the body, so the results

from fillers can last from six months

to a year.

Doctors at the Gavin Herbert Eye

Institute perform thousands of Botox

and fillers injections each year, both for

medical and cosmetic purposes. There

is a great advantage to having cosmetic

procedures performed at the institute

because of the high standard of care and

www.eye.uci.edu

EDUCATION FOCUS:

BOTOX AND FILLERS

Using Botox and fillers, Jeremiah Tao, MD, Director of Oculofacial Plastic Surgery at the Gavin Herbert Institute, treats wrinkles and vision disorders.

There is a great advantage to having cosmetic procedures performed at the institute because of the high standard of care and treatment expertise in and around the eyes.

www.eye.uci.edu/spring

T

treatment expertise in and around the

eyes. Experienced oculofacial surgeons

can prevent risks and complications.

Often, these cosmetic procedures can be

performed during your initial visit and can

even be scheduled during a lunch hour.

Make an appointment today

To schedule an appointment with an

oculofacial specialist, contact the

Gavin Herbert Eye Institute at

(949) 824-2020. For dates and times of

upcoming patient education seminars

or to learn more details about cosmetic

procedures and other state-of-the-art

ophthalmic services, visit our website at

www.eye.uci.edu/spring.

ACETYLCHOLINE: The chemical in muscles that

allows them to contract and produce wrinkles

BLEPHAROSPASM: An eye condition that can cause

uncontrollable blinking or the inability to open the

eyelids for several hours

BOTULINUM TOXIN: The active ingredient in Botox

that blocks the chemical that makes muscles contract

and causes wrinkles to form

HYALURONIC ACID: A clear, moldable substance

used in fillers to fill in facial lines and folds or to

plump the lips or cheeks; also used in eye surgery

to maintain space

STRABISMUS: Eye misalignment that causes crossed,

lazy or squinting eyes

Jeremiah Tao, MD

There is a great advantage to having cosmetic procedures performed at the institute because of the high standard of care and treatment expertise in and around the eyes.

GLOSSARY OF TERMS

eremiah Tao, MD, specializes in

ophthalmic plastic and reconstructive

surgery and oculofacial cosmetic surgery at

the Gavin Herbert Eye Institute. He is highly

experienced in using Botox and fillers both

for eye conditions and cosmetic procedures.

How can I prepare for a cosmetic procedure?

We tell our patients to avoid aspirin and

other blood thinners for a couple of weeks

before their procedure. This will help to

minimize bleeding and bruising around

the eyes after Botox or fillers are injected.

Also, women will want to remove makeup

before the procedure so that the needle

entering the skin is as clean as possible.

How will I look and feel after the procedure?

There can be some redness, swelling

and bruising around the injection site

for a few days. Fillers can make skin

appear lumpy for a couple of days after the

procedure, but this will even out to soften

frown lines and smile lines. Likewise, Botox

injections will result in the appearance of

fewer wrinkles in about three days.

Is it safe?

The surgeons at the Gavin Herbert Eye

Institute have tremendous experience with

Botox and fillers. Since these substances

can profoundly impact the function of

the eyelids and health of the eyes, it is

very reassuring to have your oculofacial

cosmetic procedure performed by a

specialist that is also board certified

in ophthalmology.

What is the future of Botox?

While we administer Botox with needle

injections now, it may become available

as a topical cream in the future.

Researchers are also working on using

Botox for muscular disorders in the

face, back and other muscles.

The doctors at the institute are ready

to help more patients look, feel and

see their best as new treatments

become available.

J

ASK THE EXPERT

MAKE A GIFT OF SIGHT

Through your generous support, The Gavin Herbert Eye Institute will continue to develop new therapies and cures for blindness. Your gifts advance eye research, help retain and attract doctors and build state-of-the-art eye care facilities.

Visit www.eye.uci.edu/spring to see a motion picture of The Gavin Herbert Eye Institute and for more information. To make a donation, go to the Campaign Overview page in the Philanthropy section. At the bottom of the page, click on To make an online donation and follow the instructions. You can also contact Janice Briggs, Senior Development Director, Health Advancement, at (949) 824-0091.

Thank you for helping us find cures for blindness and improve vision for people in Orange County, the nation and the world.

or glaucoma specialist Sameh

Mosaed, MD, caring for patients is a

long-term commitment. She plays a key

role in restoring and preserving vision to

improve quality of life for her patients.

“I chose to go into glaucoma because it

is a lifelong disease that patients have,”

says Dr. Mosaed, who is a recipient of

the Best Doctor in America Award since

2009 and was elected to America’s Top

Ophthalmologists by the Consumer

Research Council of America in 2007.

“I have patients now that I’ve been

following for close to a decade. Our goal is

to help our patients manage this disease

so that they can move on with their lives.”

Using vision-saving treatments available

at the Gavin Herbert Eye Institute—

including trabeculectomies and aqueous

shunt devices—Dr. Mosaed is able to

give patients the best possible solutions

for their vision. She continues to help

each of them live with glaucoma well

after their procedures. It’s this long-term

commitment to cataract and glaucoma

patients, along with the innovative

research and treatments to help them,

that attracted Dr. Mosaed to her role

at the institute.

Dr. Mosaed’s focus in glaucoma is

extensive. She leads the 12-month

Glaucoma Fellowship program at

the Gavin Herbert Eye Institute that

begins every July. While exposed

to all aspects and subspecialties

throughout ophthalmology during

her training, she delved deeply into

glaucoma after studying under one of

the most widely published glaucoma

specialists in the world, Robert Weinreb,

MD, at UC San Diego. From there,

Dr. Mosaed began her practice with

UC Irvine right out of fellowship and is

enthusiastic about the glaucoma research

at the Gavin Herbert Eye Institute, the

only academic-affiliated eye institute

between San Diego and Los Angeles.

“We’re pushing the field forward,”

she says, crediting the institute’s

younger dynamic with promoting

innovation in ophthalmology. “This

institute is a major center for academic

care, which means that a lot of

groundbreaking research is taking

place here. It’s a great place to start

a career. The newness allows you to

mold your experience to best fit your

career path.”

F

LONG-LASTING CARE

Sameh Mosaed, MD, is committed to long-term care for her glaucoma patients.

www.eye.uci.edu/spring

“The Gavin Herbert Eye Institute is a major center for academic care, which means that a lot of groundbreaking research is taking place here.”

— Sameh Mosaed, MD

O

A VISIONARY NIGHT

(From left) Lifetime Achievement Award honoree Richard Kratz, MD, DSci,

UC Irvine Clinical Professor of Ophthalmology, Beckman Laser

Institute board member and Ophthalmology Steering Committee member; and honorees Stephen J. Ryan, MD, President of the Doheny Eye Institute; and Tibor Juhasz,

PhD, Professor of Ophthalmology and Biomedical Engineering at the Gavin Herbert Eye Institute, were recognized

for their profound achievements and commitment to sight-saving

technologies and innovation.

(From left) Event co-chairs Roger F. Steinert, MD,

Irving H. Leopold Professor, Chair of Ophthalmology, Professor of Biomedical Engineering and Director of the Gavin

Herbert Eye Institute; James V. Mazzo, President, Abbott Medical Optics;

and William J. Link, PhD, Managing Director and Cofounder of Versant Ventures, joined forces to ensure a highly memorable evening for

the attendees.

Dr. Steinert presents Dr. Kratz (on left) with the Lifetime Achievement Award for his enormous contributions

to modern cataract surgery. His belief in and defense of what were

considered fringe procedures are now widely accepted mainstays in cataract

procedures—phacoemulsification and intraocular lens implants.

ike many teenage boys with

athletic ability, Christopher

Gallina entered high school with

promise. He was a football player and

did well in class, but his bright future

was suddenly blurred when he was

diagnosed with glaucoma at the age of

14 during a routine eye exam. His road

from diagnosis to tube shunt surgeries

and subsequent recovery was a long

and arduous one.

“I didn’t really know what glaucoma

was until I was told I had it,” says

Gallina, now 21 years old. “I had to

make weekly doctor visits, and there

was a time when I was on four different

eye drops at once. It was a lot to handle

at that age.”

Gallina was diagnosed with pigmentary

glaucoma, which is when the pigment

layer of the eye rubs onto the lens,

causing the iris pigment to shed

into the aqueous humor and onto

neighboring structures. At first, the

disease was manageable for Gallina

and his family. But by the time he

was 16 years old, it became so out

of control that he was forced to quit

football. He was losing his vision at an

accelerated rate and suffering

from pressure pain in the eyes.

After multiple unsuccessful

interventions, he was referred to Sameh

Mosaed, MD, of the Gavin Herbert Eye

Institute. She recommended implanting

aqueous shunts, which are silicone

tubes implanted into the eye to drain

the aqueous humor. Upon weighing

the potential risks and benefits,

Gallina and his family decided almost

on the spot to move forward with the

procedures, which were performed

successfully and have restored his

quality of life.

“When I first met Christopher,

glaucoma was dominating his life,” says

Dr. Mosaed. “Since the surgeries, he’s

been able to forget about it and move

on. It’s as if he is disease free.”

Now completing his undergraduate

studies in biology, Gallina hardly

thinks of the difficulties he had prior

to the procedures, and he attributes

his improved quality of life and success

to Dr. Mosaed and the Gavin Herbert

Eye Institute.

“I can’t sing their praises enough,”

says Gallina. “The procedures

really impacted my life for the better.

I can’t imagine where I would be

without them.”

L

n March 22, 2012, the Gavin Herbert Eye Institute and the Foundation Fighting Blindness recognized local eye care

leaders and innovators for their contributions to protecting sight during the 6th annual Shine the Light Visionary

Award Gala. Proceeds from this event will support research for sight-saving preventions, treatments and cures for people

affected by diseases of the eye.

HOW TO FORGET ABOUT GLAUCOMA

nne Brownstein knew she needed help with her vision when the

French windows in the North Orange County home she shares with her husband, Bill, started to look curved. She was diagnosed with wet macular degeneration, which affects central vision. Anne’s daughter would drive her to Los Angeles for regular treatment, but the long commute and a resulting speeding ticket convinced Anne that she needed to be treated closer to home.

For the last three years, Anne has been a patient of Barry Kuppermann, MD, PhD, Director of Retina Service at the Gavin Herbert Eye Institute. She visits the institute two out of every three weeks for injections to treat her vision. “I was very surprised by how much Dr.

Kuppermann cares for his patients,” says Anne. “He doesn’t give up in finding treatments that can help them to see as much as possible. And Dr. Roger Steinert performed Bill’s cataract surgery, which has helped Bill stay active and take care of our businesses and our family.

“Bill and I came from humble beginnings and worked hard to achieve success. We are more than happy to help give the Gavin Herbert Eye Institute a new home by supporting the new building.”

Anne grew up during the Great Depression. As World War II began, she joined the workforce as a bookkeeper while studying at a junior college in

Chicago. At Northwestern, she was introduced to her husband. After a deep Chicago snow in 1969, the Brownsteins left behind their wholesale electrical business and moved to California. They then began a successful restaurant franchise, still run by their family today. They have been happily married for over 60 years and are graced with wonderful children and grandchildren.

“The eye care specialists at the Gavin Herbert Eye Institute are comparable to any top team in the world,” says Anne. “The exceptional patient care and research of new therapies at the institute hit home for me. And even more can be done, not just for Bill and me, but for our children and grandchildren as well.”

A

NONPROFIT ORG. U.S. POSTAGE

PAIDSanta Ana, CA

Permit No. 1106118 Med Surge 1

Irvine, CA 92697-3953

RETURN SERVICE REQUESTED

SUPPORTING A NEW

HOME FOR VISION CARE

NEWS

Dr. George Baerveldt was honored by the American Glaucoma Society with the second annual Innovator Award for extraordinary contributions to his field on March 1 for his work in developing the Baerveldt glaucoma implant and the Trabectome, a minimally invasive treatment for open-angle glaucoma.

The UC Irvine School of Medicine held their annual gala on April 14 at the Disney Grand Californian Hotel, in which all proceeds from the exciting event benefited the UC Irvine Medical Center.

The Life Without Limits Gala, a yearly fundraising event of the United Cerebral Palsy of Orange County, honored James V. Mazzo, President, Abbott Medical Optics, for his support and commitment. Jennifer Simpson, MD, Pediatric Ophthalmologist at the institute, serves on the medical board and volunteers her time to this foundation that serves the children of Orange County.

UPCOMING EVENTS

Hard hat tours of the Eye Institute began this spring in May, occurring every first Wednesday of the month at 3 pm. Space is limited, so please RSVP to Ariel Korn at korna@uci.edu or 949-824-9021. See a better future with the Gavin Herbert Eye Institute. Watch our new video about the exciting and inspiring developments. Scan the QR code to view the short video on your smartphone.

www.eye.uci.edu/spring

Download a QR reader from the app store and scan the QR code with your smartphone.