2019 Kellogg Eye Center for International Ophthalmology Annual Report

The Kellogg Eye Center for International Ophthalmology (KECIO) carries out many missions to initiate and facilitate international collaborations.

1

TABLE OF CONTENTS

Brazil _____________________________________________ 2 Jamaica _________________________________________ 4 Ethiopia __________________________________________ 6 Ghana ___________________________________________ 9 India ____________________________________________ 10 Burundi __________________________________________ 12 France __________________________________________ 13 Indonesia ________________________________________ 13 Sri Lanka _________________________________________ 13 China ___________________________________________ 14 Bosnia ___________________________________________ 15 Pakistan _________________________________________ 15 Kenya ___________________________________________ 16 Taiwan __________________________________________ 17 Vanuatu _________________________________________ 18 Kellogg __________________________________________ 19

Collaboration

Education

Research

2

BRAZIL Rajesh Rao, MD, a Kellogg faculty member specializing in the genetics of tumors, collaborated on a study of conjunctival tumors with Suzana Matayoshi, MD, oculoplastics surgeon at the University of São Paulo (USP).

The paper describing their work received the award for the best original paper at the annual meeting of the American Academy of Ophthalmology in November 2019.

Rajesh Rao, MD with Suzana Matayoshi, MD in São Paulo, Brazil at the Congreso de Oftalmologia in November 2019.

Maria Fernanda Abalem, MD, adjunct professor at Kellogg, is developing an e-learning module in ophthalmic genetics and retinal dystrophy in conjunction with the Pan American Association of Ophthalmology.

Maria Fernanda Abalem, MD (center) with Rajesh Rao, MD (left) and Pedro Carricondo, MD in São Paulo.

Kellogg Faculty Lead: Jonathan Trobe, MD

3

BRAZIL Lev Prasov, MD, PhD, Kellogg faculty member, conducted a study of the genetics of nanophthalmos with Pedro Carricondo, MD, chief of emergency ophthalmology services at USP. UM medical student Rahul Iyengar (below) traveled to Brazil to collect the clinical data.

Lev Prasov, MD, PhD

UM medical student Gabrielle Lacy spent two weeks at USP in July 2019 studying the challenges of yellow fever and public health initiatives to control outbreaks.

Rahul Iyengar at USP

Gabrielle Lacy (second from left) in the mountains of the state of SĂŁo Paulo in July 2019. She is collecting mosquitos for a project with medical students at USP. Kellogg Faculty Lead: Jonathan Trobe, MD

4

JAMAICA Now in its 4th year, our collaboration in Jamaica is with the Eye Health Institute (EHI), directed by Joseph Myers, OD, chief of optometry at UM Health Services. Kellogg ophthalmology residents Joseph Grubbs, MD, MPH, and Eric Sweet, MD have been part of a team that includes Dr. Myers, Donna Wicker, OD and Manjool Shah, MD, Kellogg faculty member

Joseph Myers, OD (right) examining a patient in Jamaica.

specializing in glaucoma. They screen patients for ophthalmic problems and perform surgery.

Kellogg ophthalmology resident Erik Sweet, MD performs surgery in Jamaica in April 2019.

Kellogg faculty member Donna Wicker, OD (left) with a patient in Jamaica.

Tanziana Taylor, who spent time at Kellogg learning to screen patients, with school children in Jamaica.

Kellogg Faculty Lead: Manjool Shah, MD

5

JAMAICA An integral part of the Jamaican project is an eye clinic designed by Geoffrey Thun, associate professor at UM’s Taubman School of Architecture and Urban Planning. Shipped in a container across the Caribbean Ocean, it is assembled in Sandy Bay, Jamaica, where its equipment and air-conditioning are powered by solar panels. With each trip, the team is learning how to modify this “clinic-in-a-container” to become a prototype for eye clinics in other underserved sites. A larger and improved

Geoffrey Thun, UM architect, explaining the clinic-in-a-container at Kellogg International Night.

container clinic that includes an operatory suite is being readied for shipment to Jamaica.

Kellogg is studying whether this container model can be extended to other countries.

Manjool Shah, MD with a patient in Jamaica.

UM eye clinic delivered overseas in a container and assembled in Sandy Bay, Jamaica.

Kellogg Faculty Lead: Manjool Shah, MD

6

ETHIOPIA

Tsedeke Alemu, MD (left), Christine Nelson, MD (second from left), Scott Lawrence, MD (second from right) and Bezawit Tadegagne, MD (far right), former chairperson of SPHMMC’s department of ophthalmology, at the graduation ceremony of the first class of ophthalmology residents at SPHMMC on September 1, 2019.

Christine Nelson, MD, Kellogg faculty member, traveled to Addis Ababa, Ethiopia for the graduation of the first class of ophthalmology residents at St. Paul’s Hospital Millennium Medical College (SPHMMC) in September 2019. The 4-year residency program is a collaboration between Kellogg and the Ethiopian Ministry of Health. Dr. Nelson directs Kellogg’s efforts in coordination with Scott Lawrence, MD, a Kellogg adjunct faculty member who practices ophthalmology in Addis Ababa, and with Tsedeke Alemu, MD, an ophthalmologist in Ethiopia who has developed medical education programs and spent 3 months at Kellogg as an International Council of Ophthalmology fellow.

The UM Global REACH program has funded Kellogg to organize a training program for ophthalmic technicians at St. Paul’s Hospital.

It is meant to serve as a continent-wide model for non-physician eye

care education.

Kellogg faculty member Wayne Cornblath, MD (second from left) teaches neuro-ophthalmology to ophthalmology residents at SPHMMC in Ethiopia in March 2019.

Kellogg Faculty Lead: Christine Nelson, MD

7

ETHIOPIA UM medical student Curtis Heisel participated in a population study of proptosis in Addis Ababa in collaboration with SPHMMC ophthalmology residents and under the mentorship of UM faculty member Christine Nelson, MD. Two peer-reviewed publications emerged from that work.

Bernadete Ayres, MD, Kellogg faculty member and director of ophthalmic ultrasound, transmitted her skills to SPHMMC ophthalmology residents in Addis Ababa.

Curtis Heisel takes exophthalmometry measurements at SPHMMC in March 2019.

Bernadete Ayres, MD (second from right) and SPHMMC ophthalmology residents in Addis Ababa.

Kellogg Faculty Lead: Christine Nelson, MD

8

ETHIOPIA UM medical students Alec Bernard, Sahal Saleh, and Tochukwu Ndukwe, and Kellogg ophthalmology resident Jara Crear, MD traveled to Ethiopia in early 2020 as part of a funded research project to screen children and adults for ocular abnormalities with a cell phone photography application developed by Kellogg faculty member Hakan Demirci, MD. The results of this project will guide Kellogg faculty member Christine Nelson, MD and colleagues in the development of a coordinated care center for retinoblastoma, which will have five locations in

Hakan Demirci, MD developed the cell phone application used to screen for retinoblastoma in Ethiopia.

Africa. This effort will unite ophthalmic providers throughout the country in the care of this blinding and life-threatening disease of young children.

Tochukwu Ndukwe (left) teaches a member of the new retinoblastoma team in Ethiopia how to use the cell phone application in screening for retinoblastoma.

Sahal Saleh (right) uses a Beanie Baby to capture a child’s attention in the process of photographing the eye with a special phone application developed at Kellogg.

Kellogg Faculty Lead: Christine Nelson, MD

9

GHANA In collaboration with the Ghana College of Physicians (GCPS) and with a start-up grant from the University of Michigan, Kellogg has launched the first pediatric ophthalmology fellowship training program in Ghana. Our partner in Ghana is Vera Essuman, MD, who received the Eye Health Hero 2018 Award from the International Agency for Prevention of Blindness. Dr. Essuman is collaborating with Kellogg faculty members Grace Wang, MD, PhD and Monte Del Monte, MD.

Vera Essuman, MD (third from left) with Kellogg faculty member Joshua Ehrlich, MD, MPH (second from left) and members of the GCPS in Accra, Ghana in December 2019.

If the program is successful, GCPS has asked Kellogg to help develop fellowships in other ophthalmic subspecialties.

Vera Essuman, MD (center) with Grace Wang, MD, PhD (left) and Monte Del Monte, MD during Dr. Essuman’s 2-month visit to Kellogg in April 2019 to learn our training process for pediatric ophthalmology fellows.

Kellogg Faculty Leads: Monte Del Monte, MD and Grace Wang, MD, PhD

10

INDIA The Aravind Eye System, based in Madurai, India, is the largest provider of eye care in the world. Based on a long association with Kellogg, Aravind’s leaders are working with Kellogg faculty members Joshua Ehrlich, MD, MPH and David Musch, PhD, MPH who have submitted a grant to the U.S. National Institutes of Health. The grant would underwrite a unique collaboration to build clinical and epidemiological research capacity at Aravind.

Joshua Ehrlich, MD, MPH (second from right), and Emily Schehlein, MD (right) with R. Venkatesh, MD (fourth from right), Chief Medical Officer of the Aravind Eye Hospital, Dr. Dayakar, (Champion of the EMR study), and other Aravind staff members at an Outreach Eye Camp in Chengam in July 2019.

Kellogg ophthalmology resident Emily Schehlein, MD traveled to Aravind in July 2019 to study whether adding digital fundus photography and implementing an electronic medical record in rural eye camps would enhance detection of certain vision-threatening disorders at reasonable cost. She presented her findings at the 2020 American Glaucoma Society annual meeting.

Emily Schehlein, MD, Kellogg ophthalmology resident, at an eye camp in India with Aravind mid-level ophthalmic assistants.

Kellogg Faculty Lead: Joshua Ehrlich, MD, MPH

11

INDIA Kellogg ophthalmology resident Annie Wu, MD traveled to Madurai in January 2020 to study whether operating late in the day results in adverse outcomes in a high-volume cataract center. In her suitcase was a set of tonometry tips, which Aurolab will try to reproduce at low cost. She also worked on an important project evaluating whether technicians providing preoperative drops from multiuse containers was safe.

Naheed Khan, PhD (right) and Pankaja Dhoble, MD teach electrophysiology to one of Aravind’s technicians.

Kellogg faculty member Naheed Khan, PhD is collaborating in Pondicherry with Aravind’s Pankaja Dhoble, MD, who spent a month at Kellogg learning advanced retinal electrophysiology techniques.

Kellogg ophthalmology resident Annie Wu, MD at Aravind eye camp in Pondicherry, India.

R. Kim, MD, chief medical officer and retina specialist at Aravind Eye Hospital in Madurai and Usha Kim, MD, chief of the oculoplastics service at Aravind, gave ophthalmology grand rounds at Kellogg in October 2019.

R. Kim, MD (third from left), and Usha Kim, MD (fourth from left), with Paul Lee, MD, JD (second from left), chairperson of ophthalmology at Kellogg, Christine Nelson, MD (far left), Joshua Ehrlich, MD, MPH (second from right), and Monte Del Monte, MD (right) at Kellogg in October 2019.

Kellogg Faculty Lead: Joshua Ehrlich, MD, MPH

12

BURUNDI John Cropsey, MD, Kellogg adjunct faculty member, opened an ophthalmology service at Kibuye Hope Hospital in Burundi in 2014.

Trained as an ophthalmologist in the USA, he now lives and works in Burundi. His hospital is the only such facility within hundreds of miles, serving Burundians who otherwise might not receive any eye care.

Dr. Cropsey will soon receive Kellogg ophthalmology trainees to assist him. They will gain medical experiences they might not get in America.

John Cropsey, MD at Kibuye Hope Hospital in Burundi.

John Cropsey, MD (left) with Dan Kiage, MD (center), director of the Kisii Eye Hospital in Kisii, Kenya, and Kellogg oculoplastic surgeon Christine Nelson, MD at the 2019 meeting of the College of Ophthalmology of Eastern Central and Southern Africa (COECSA) in Rwanda, August 2019.

Kellogg Faculty Lead: John Cropsey, MD

13

FRANCE

SRI LANKA

Kellogg has an ongoing collaboration with the Institut de la Vision in Paris, France, among the largest ophthalmic research centers in the world. Four UM medical students have conducted research there. The director of the Institut, José-Alain Sahel, MD, PhD, gave Kellogg’s prestigious Farjo Lecture in September 2019 and met with medical students and ophthalmology residents interested in the diverse projects conducted at the Institut.

K. Thiran Jayasundera, MD leads the diabetic retinopathy screening project in Sri Lanka.

Kellogg faculty member K. Thiran Jayasundera, MD, and other Kellogg faculty members Thomas Gardner, MD, MS, Yannis Paulus, MD, Julie Rosenthal, MD, and Joshua Ehrlich, MD, MPH are part of a UM team conducting diabetic retinopathy screening in an underserved region of Sri Lanka using a novel cell phone application developed at Kellogg.

INDONESIA José-Alain Sahel, MD with UM medical student Nita Valikodath, who studied at the Institut de la Vision in Paris.

Kellogg faculty member Joshua Ehrlich, MD, MPH is working with Helen Keller International on assessment of school vision screening programs.

Kellogg Lead: Donna Donato

14

CHINA Under a research grant with the UM Global REACH and Peking University, Kellogg faculty member David Zacks, MD, PhD is working on retinal detachment research with Liu Yang, MD, PhD, ophthalmologist at Peking University.

Dr. Zacks is receiving MD/PhD students from Xiangya School of Medicine to work in his laboratory.

Tiantian Wang (left), a medical student from Xiangya School of Medicine, with David Zacks, MD, PhD.

Lin Jia, MS, a research specialist (left), with Tiantian Wang in Dr. Zacks’ laboratory.

Kellogg faculty member Yannis Paulus, MD, is working with four Chinese researchers in the Paulus Advanced Retinal Imaging and Laser Laboratory, using photonics, optics, ultrasound, and nanoparticles to develop novel retinal imaging systems and laser therapies.

Yannis Paulus, MD (right) with Wen Fan, MD (at microscope), and, from left to right, Yixin Yu, MD, Tianye Zhu, a medical student, and Yanxiu Li, MD. Kellogg Lead: Donna Donato

15

BOSNIA

PAKISTAN

Alon Kahana, MD, PhD, Kellogg faculty member specializing in oculoplastics, received a grant from the World Eye Mission to travel to Bosnia in January 2020. He is collaborating with

Kellogg faculty member Shahzad Mian, MD has

Nina Jovanovic, MD, a Bosnian ophthalmologist,

linked with Wajid Ali Khan, MD, Chief of Medical

to initiate clinical services in oculoplastics in

Services and Dean of Al Shifa Trust Pakistan

Sarajevo. Dr. Jovanovic, who spent 3 months at

Institute of Ophthalmology in Rawalpindi, Pakistan,

Kellogg learning oculoplastics, is acting as the

to develop a research project in eye banking.

in-country coordinator.

In 2019, Kellogg received two ophthalmologists, Dr. Tayyab Afghani and Dr. Nadeem Qureshi, as observers. Four more ophthalmologists from Pakistan will be arriving in 2020.

Shahzad Mian, MD (right) with Stephen Armenti, MD, Kellogg chief ophthalmology resident.

Nina Jovanovic, MD (right)with Alon Kahana, MD, PhD at Canton Hospital Zenica in Bosnia.

Tayyab Afghani, MD

Nadeem Qureshi, MD Kellogg Lead: Donna Donato

16

KENYA Kellogg has begun to train physicians and nonphysicians involved in eye care at Kisii Eye Hospital in western Kenya. Supported by a start-up grant from the UM Global REACH program, Kellogg faculty members Joshua Ehrlich, MD, MPH, Sherry Day, OD, and H. Kaz Soong, MD have formed a team that will travel to Kenya to collaborate on clinical research projects.

Patrick Ruhagaze, MD (right), who visited the cornea service at Kellogg for three months with support from the International Council of Ophthalmology (ICO), receives the ICO certificate from H. Kaz Soong, MD. Kellogg welcomed two doctors from Kisii, Kenya in 2019. Patrick Ruhagaze, MD observed in corneal and external diseases for three months.

Daniel Mochere, OD trained in low vision for six weeks.

Dan Kiage, MD, director of the Kisii Eye Hospital, (right) with Joshua Ehrlich, MD, MPH in Kenya.

Daniel Mochere, OD (center) receives a certificate from program directors Sherry Day, OD (left) and Donna Wicker, OD after completing the Low Vision Rehabilitation Course at Kellogg.

Kellogg Faculty Lead: Joshua Ehrlich, MD, MPH

TAIWAN

17

TAIWAN In October 2019, Kellogg ophthalmology resident Olivia Killeen, MD spent four weeks at National Taiwan University (NTU) in Taipei, Taiwan. She compared visual outcomes in corneal transplants that used imported or domestic corneal tissue. Under a Memorandum of Understanding with NTU, coordinated by Kellogg faculty member H. Kaz Soong, MD, Kellogg has received 12 medical students from that institution, with two more students scheduled to arrive in 2020.

Olivia Killeen, MD (center) with Fong-Rong Hu, MD, former chair of the ophthalmology department at National Taiwan University (NTU) (left), and Stephanie Chu, MD, ophthalmology faculty member at NTU, who studied eye banking at Kellogg in 2013.

Professor Shan Chwen Chang, MD (left) Dean of NTU Medical College of Medicine) H. Kaz Soong, MD, Fong-Rong Hu, MD, (second from right), and Stephanie Chu, MD.

Kellogg Faculty Lead: H. Kaz Soong, MD

18

VANUATU Kellogg is launching the second phase of a

Our in-country coordinator is Alexis Cullen,

research program begun in 2018 in

a former Kellogg photographer and later

Vanuatu, a tiny island in the South Pacific.

a Peace Corps volunteer in Vanuatu, who

Under the supervision of Kellogg genetic

has now taken up residence in Vanuatu.

counselor Dana Schlegel, MS, UM medical

Faculty supervision comes from Kellogg

student Juan Caceres completed a study

faculty member Julie Rosenthal, MD.

of patient understanding of betathalassemia, a life-threatening disorder endemic in Vanuatu.

Juan Caceres is returning to Vanuatu with UM medical student Yibing Zhang to study the effectiveness of detection of diabetic retinopathy with a portable fundus camera developed at Kellogg.

Alexis Cullen, former Kellogg photographer, in Vanuatu.

UM medical student Juan Caceres examines a patient in Vanuatu.

Kellogg Faculty Lead: Julie Rosenthal, MD

19

KELLOGG Senait Fisseha, MD, JD, director of International Programs at the Susan Buffett Foundation, keynoted the 7th International Night at Kellogg in October 2019. The event drew over 150 people, including almost 100 UM medical students.

A former UM professor of obstetrics and gynecology, Dr. Fisseha urged her listeners to participate in global health and to focus training efforts on capacity building of nonphysician caregivers.

Senait Fisseha, MD delivers the keynote address at the 7th International Night at Kellogg.

International visitors gather with Kellogg faculty member Jonathan Trobe, MD (fifth from left) for the annual Sunday brunch.

In 2019, Kellogg received 38 ophthalmologists from 19 countries for periods of 1 to 12 months. During that period, six international medical students came for 4-week elective rotations. Ophthalmic care providers from around the world attended courses in low vision, specialty contact lens care, and ophthalmic ultrasound.

Kellogg Lead: Donna Donato

KELLOGG

20

KELLOGG

Kellogg maintains enthusiastic support of international agencies involved in vision care, including the International Agency for the

In 2020, Kellogg will welcome our first fellow in international ophthalmology. After completing his ophthalmology residency in the United States Air Force (USAF), Timothy Soeken, MD will spend the first year as a fellow in corneal and external ocular diseases. He will transition into a 1-year fellowship

Prevention of Blindness (IAPB), the International Council of Ophthalmology (ICO), the World Association of Eye Hospitals (WAEH), ORBIS Flying Eye Hospital, Himalayan Cataract Project (HCP), and Vision 2020.

designed to prepare him for international ophthalmic activities conducted by the USAF.

Beth Slade, director of Leader Dogs for the Blind, shares her ambassador dog Coco with Kellogg adjunct professor Scott Lawrence, MD at World Sight Day 2019.

Kellogg’s first international fellow Tim Soeken, MD (left) being handed the ophthalmology pager after arriving in Afghanistan in February 2020.

Kellogg faculty member Christine Nelson, MD moderates a session at the WAEH meeting in London, England in June 2019.

WITH THANKS

Kellogg Lead: Donna Donato

WITH THANKS The many activities you have read about in this report have enriched and broadened our vision of worldwide ophthalmology and reminded us of how much more needs to be done. In the six years of its existence, the Kellogg Eye Center for International Ophthalmology could never have done so much without the financial and moral support of the Jacobson Foundation.

Kellogg Eye Center for International Ophthalmology Co-Directors Joshua Ehrlich, MD, MPH Christine Nelson, MD H. Kaz Soong, MD Jonathan Trobe, MD International Ophthalmology Program Coordinator Donna Donato Graphic Design Ava Dwyer

Kellogg Eye Center for International Ophthalmology University of Michigan, Kellogg Eye Center Department of Ophthalmology and Visual Sciences 1000 Wall Street Ann Arbor, MI 48105

https://medicine.umich.edu/dept/ophthalmology/kellogg-eye-center-international-ophthalmology