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A Look Inside the Donald K. Johnson Eye Institute
Every 12 minutes, a Canadian is diagnosed with a visual impairment or disease, such as glaucoma, retinopathy and cataracts, and this number will double over the next 20 years.
People with vision loss are three times more likely to experience depression and four times more likely to have a hip fracture.
More than 75 per cent of vision loss is preventable or treatable and that is where the scientists and clinicians at the Donald K. Johnson Eye Institute at UHN come in.
They are working diligently every day, from basic science labs all the way to patient-facing care, to deliver the best, most innovative treatments and therapies to patients. Scientists work alongside doctors, in a multi-disciplinary approach that has already proven fruitful.
Read about many of these breakthroughs in the new 2020 Vision magazine and below, learn how vision specialists at the Donald K. Johnson Eye Institute are giving back to communities around the world.
A world of good
In January 2020, Dr. Allan Slomovic and a team of six eye specialists from Canada arrived at La Anexión Hospital in Nicoya, Costa Rica, ready to work with local doctors. The week ahead would be intense. More than 80 people – some nearing 100 years old – needed care for corneal disease and cataracts, with some issues requiring corneal transplants and stem cell treatment.
In addition to performing the procedures, Dr. Slomovic would be doing morning teaching rounds each day, a boon for the hospital's residents. An ophthalmologist, Owen & Marta Boris Chair in Stem Cell Vision Research, Research Director of the Cornea/External Disease Service and Director of the Ocular Stem Cell Transplantation Program at UHN's Donald K. Johnson Eye Institute, Dr. Slomovic is an internationally recognized leader in the field. Over the years, he has trained scores of residents and fellows from across the globe, including the U.S., Israel, Australia, Thailand and Saudi Arabia.
So perhaps it wasn't surprising that when the team arrived, a welcome banner hung above the door that displayed maps of Costa Rica and Canada.
"It's about building good will and good feelings with people from all around the world," says Dr. Slomovic of UHN's ongoing outreach initiatives.
But the global connectivity doesn't end when Dr. Slomovic heads back to Toronto. As an expert in corneal and external disease treatment, he and ophthalmologist Dr. David Rootman lead six fellows from countries from Brazil to Bahrain.
Dr. Nizar Din, who arrived at the Donald K. Johnson Eye Institute from London, U.K., in early summer 2020, says he was fortunate to land one of the coveted two-year fellowships, which many consider the most comprehensive in the world. Dr. Slomovic's impact also goes beyond medicine, Dr. Din adds.
"Dr. Slomovic has a very rare personality," he says. "He has a very genuine and caring heart. He wants you to do well. Not just as a supervisor, but as a human being."
This past year, Dr. Slomovic and fellow University of Toronto faculty members provided free eye exams and treatment at a weekend clinic for more than 100 Syrian refugees. His wife and daughter – who is currently in medical school – also helped out, taking histories and directing patients. People received much-needed care for cataracts, glaucoma and even an undiagnosed tumour.
Dr. Slomovic says he grew up in a family with a strong culture of charitable work, in gratitude for one's own success and good fortune.
"We are so blessed," he says. "It's really important to give back."
Heading off diabetic retinopathy
Diabetic retinopathy is the leading cause of severe vision loss and blindness in working-age Canadians. Yet in Ontario, close to 40 per cent of people living with diabetes have not had their annual screening eye exam in two years, despite the fact that early intervention can prevent it.
Dr. Michael Brent, retinal specialist, Milton Harris Chair in Adult Macular Degeneration and principal investigator for Diabetes Action Canada's retinopathy screening program with the Donald K. Johnson Eye Institute, is harnessing new technologies to get screening out into communities where diabetic retinopathy screening rates are low.
Mobile units visit inner city and remote Indigenous communities. People who choose to be screened have their vision and eye presuure checked, and a special digital camera is used to take images of their retinas. These images are uploaded to a secure server and Dr. Brent accesses the information remotely. He then grades the images for the level of eye disease and makes recommendations, which could range from scheduling their next eye screening exam, to an office visit, all the way to the need for surgery.
To date, almost 10 per cent of people screened through mobile units have required specialized retinal care, Dr. Brent says. "The program is definitely reaching the right demographic and helping to prevent vision loss in vulnerable communities," he says.
The ultimate goal is to have a program in every province and territory, connected through a common database. "With a rigorous screening program, diabetic retinopathy could be removed from the top of the list of the causes for severe vision loss and blindness."
Toward vision care for all
Imagine waking with eye pain, blurred vision and redness. Yet despite the discomfort, visiting an ophthalmologist or optometrist is out of the question because you can't afford to take time off or even pay for parking.
For those who struggle to make ends meet, routine eye care may seem out of reach. The Donald K. Johnson Eye Institute's Dr. Ya-Ping Jin, a researcher with expertise in epidemiology, biostatistics and medicine, along with a team of UHN scientists, is uncovering how deep the problem goes – while laying the foundation for accessible, databased eye care.
"In Canada, vision care is part of a publicly funded healthcare system. However, for those aged 20 to 64, routine eye visits are not funded by any province," says Dr. Jin. "This barrier likely contributes to our studies, which find socioeconomic status influences access to eye care."
For example, Dr. Jin and her team identified that the removal of routine eye-care services from provincial insurance in 2004 has meant that socially disadvantaged adults aren't always getting the vision care they need to avoid treatable sight loss, such as the blindness caused by glaucoma.
In another study, Dr. Jin showed that children receiving care for amblyopia, colloquially known as "lazy eye," at Toronto's SickKids were more likely to come from wealthier neighbourhoods. Parents with well-paying jobs and benefits encounter fewer barriers to attending multiple appointments.
There are ways to combat these challenges though, Dr. Jin says. For example, she recommends targeting low income neighbourhoods for glaucoma education and treatment.
"I'm interested in health policy and the impact this has on people's lives," she says.