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Eyes Wide Open

Q&A with Roy S. Chuck, M.D., Ph.D.

Dr. Chuck is professor and chair and the Paul Henkind Chair in the department of ophthalmology and visual sciences at Einstein and Montefiore. A native of Berkeley, CA, Dr. Chuck started his career as an engineer, working on lasers that later formed the technological basis for LASIK refractive eye surgery. He switched careers in the mid-1980s and earned medical and doctoral degrees at Columbia University’s College of Physicians and Surgeons. But Dr. Chuck never left lasers far behind, becoming one of the nation’s top
LASIK surgeons.

He is now also internationally renowned for his contributions to corneal stem-cell surgery, corneal transplant surgery and the study and treatment of dry eye. Dr. Chuck joined Einstein and Montefiore in 2009.

What’s the most exciting recent development in eye care?

I’d single out the new injectable drugs for age-related macular degeneration, which clouds central vision through abnormal blood-vessel growth and bleeding in the retina. It’s a leading cause of vision loss in people over age 50. The new drugs for treating this condition were originally developed to treat cancer. They work by inhibiting vascular endothelial growth factor, or VEGF, a signaling protein that stimulates blood-vessel formation. A bonus is that these anti-VEGF drugs are also effective for treating diabetic retinopathy.

Given the high incidence of diabetes in the Bronx, could these drugs have a significant impact on the local community?

Yes. Diabetic retinopathy is the leading cause of blindness in the Bronx. But unfortunately, we see a lot of advanced cases in our clinics, since many people aren’t diagnosed or treated until very late.

What’s the best way to prevent diabetic retinopathy?

Through regular checkups, starting in childhood. Ophthalmologists are often the first to diagnose diabetes, since the earliest signs of the disease tend to appear in the retina. We just opened our first two school-based eye clinics as part of the Montefiore School Health Program. We’ll roll out clinics to other public schools in the Bronx if these two are successful. Beyond that, we need to prevent the development of diabetes in children in the first place, by encouraging them to eat more healthily and to exercise so they can ward off obesity, a major risk factor for diabetes.

Many workers spend all day in front of a computer screen. Is that a cause for concern?

The most common issue is eyestrain, which leads to a condition called dry eye. Taking frequent breaks can help, and so can using artificial tears or eye drops. More-serious cases can be treated with topical prescription eye drops containing cyclosporine or lifitegrast.

Kids also spend endless hours looking at screens of one type or another. Are they suffering the consequences, too?

Yes, but not in the same way. About half of all kids today are nearsighted—almost double the percentage that we saw just a generation ago. It’s not clear why. Some people blame too much device time, but evidence suggests that the biggest culprit is lack of outdoor play. Exposure to light and physical activity somehow lessen the likelihood that kids will develop myopia.

LASIK surgery was a major advance, allowing people to do without eyeglasses. But many people are hesitant to undergo surgery to correct their vision. Are there alternatives?

We’re developing a noninvasive treatment for myopia based on corneal cross-linking. Rather than using a laser to reshape the eye’s surface, we apply photosensitive eye drops containing the B vitamin riboflavin. When activated by UV light, the riboflavin molecules initiate reshaping of the eye. The basic concept was developed elsewhere, but our innovation was to package all the technology into a device the size and shape of a contact lens. We have also added real-time ultrasound sensing, which allows precise control of the amount of correction. The treatment can be done in a half hour while the patient is sitting in a chair in an outpatient setting. The whole system is portable, low cost and simple to use, which would make it ideal for use in underserved populations around the world.

Would the correction be long-lasting?

We think so. But if your eye does change shape as you age and you need a touch-up, the procedure can be repeated.

When will this be available?

That’s hard to say. We’ve launched a startup company called TECLens that will be testing the technology in a pre–phase I, or safety, trial.

Were you always an entrepreneur?

I sold my first patent application when I was a medical student at Columbia. Mehmet Oz—better known these days as television’s Dr. Oz—and I developed a new laser technology for welding tissues. We handed over our invention to Columbia’s technology transfer people, who licensed it to Johnson & Johnson. Dr. Oz and I were each paid $10,000 for our efforts. We’re trying to encourage similar entrepreneurial efforts here on campus.

What do you do for fun?

Life gets put on hold when you have three young children!

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