James H. Hall Eye Center

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Jade Golden
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1 James H. Hall Eye Center Established in 1979 Annual Activity Report September, 2010 to September, 2011 COMMUNITY CARE STATISTICS Served 2,000 patients including pre and post-operative visits Our physicians performed over 900 surgeries this past year 20% increase in patients from physician-referral network 15% increase in Medicaid and indigent care cases Examined 120 indigent patients without Medicaid in 2011 Screenings for retinopathy of prematurity on 17 infants Examined 300 children for diabetic retinopathy, brain tumors, eyelid tumors, neurological trauma, nerve palsies, car accident injuries, nerve palsies, corneal ulcers and many other serious conditions Our medical team volunteered 130 hours to indigent patients equivalent to $104,000 of pro bono work BOARD OF TRUSTEES OUR MISSION The James Hall Eye Center devotes its efforts to preserve, rehabilitate and restore sight. The Center focuses on Prevention of Blindness in early childhood and provides a caring environment where indigent children can gain immediate access to the finest, state-of-the-art, ophthalmologic and surgical care. The Center makes significant contributions to American medicine by training highly qualified physicians as pediatric ophthalmologists and plays a critical role in the advancement of groundbreaking clinical research to develop more effective treatments and cures for diseases of the visual system that damage and destroy sight. Gerry W. Hall, Chairman Marc F. Greenberg, M.D. William S. Hagler, M.D. Thomas S. Harbin, Jr., M.D. William H. Jarrett, II, M.D. Alan M. Kozarsky, M.D. lliot L. Levine, M.D. Mark W. Mohney, M.D. Zane F. Pollard, M.D.

performed over 900 surgeries this past year 20% increase in patients from physician-referral network 15% increase in Medicaid and indigent care cases Examined 120 indigent patients without Medicaid

2 PEDIATRIC NEURO-OPTHALMOLOGY This several month old infant has eyes looking downward and bilateral upper eyelid retraction. We call this the "setting sun sign" as the eyes appear to be "setting". This child has nothing wrong with the eyes but this is a sign of increased pressure in the brain. This child was diagnosed with a brain tumor which has been operated on. It was benign. Sometimes children are sent to us with a problem which appears to be in the eyes but actually turns out to be a sign of something more ominous such as a brain tumor. We do a lot of pediatric neuro-ophthalmology at the Hall Eye Center. Parinaud's secondary to third ventricular tumor. 2

This child has nothing wrong with the eyes but this is a sign of increased pressure in the brain.

3 JUST A FEW OF OUR SUCCESS STORIES A mother is rewarded with a smile! Dr. Pollard examined a 3-year-old child with extreme nearsightedness. When the child was fitted with glasses for the first time, he looked at the doctor and smiled. Then he looked at his mother and gave her a big smile. His mother cried with emotion as she realized that her child was able to see clearly for the first time. Twins open their eyes at last! Dr. Pollard operated on twin girls born with severe ptosis (droopy eyelids) resulting in a slit-like opening of only 1-2 mm. Their parents had never been able to see their daughters eyes opened normally. After surgery on both girls, their eyelids are fully open, and they no longer have to tilt back their heads in order to see. A chemical injury is treated successfully! A 3-year-old boy accidentally sprayed both eyes with a cleaning solution. The chemical caused severe corneal abrasions. After the doctor irrigated the child s eyes with normal saline to neutralize the chemical, he recovered completely. Severe headaches are resolved! A 12-year-old boy with leukemia and thrombosis of several large veins in his brain complained of recurrent headaches. Initially, a spinal tap indicated that his intracranial pressures were normal. The headaches persisted. On a subsequent visit, our ophthalmologist diagnosed swollen optic nerves. He was referred to a neurosurgeon for surgery. His headaches were alleviated. Diagnostic expertise makes a difference! A 4-year-old child who had a corneal transplant performed elsewhere presented with orbital cellulitis. She was unable to open her left eye, indicating a condition called endophthalmitis. After an intravitreal injection with antibiotics, her condition was resolved. A traumatic injury is repaired! A teenage boy presented with a ruptured globe and a traumatic cataract resulting from an eye injury caused by a stick. His ruptured globe was repaired, followed by cataract surgery with lens implant. As he healed from surgery, his visual acuity improved dramatically. 3

His mother cried with emotion as she realized that her child was able to see clearly for the first time. Twins open their eyes at last! Dr.

4 PEDIATRIC OPHTHAL- MIC CARE PROVIDED OFFICE CONSULTATIONS: Testing of vision, stereopsis, binocularity and motility Patient/family education and counseling Preventive care Aftercare and rehabilitation SPECIALIZED SERVICES Glaucoma care Neuro-ophthalmology Ocular trauma care Outpatient surgery Strabismus and amblyopia Diagnostic photography and ultrasound SURGICAL MANAGEMENT & POST-OPERATIVE CARE: Cases included correction of ptosis, removal of orbital tumors, excision of chalazions and molluscum, cataract extraction with vitrectomy, strabismus, and tear duct repair. We experienced a 20% increase in patients from the previous year because of an increasing number of patients without insurance. HOSPITAL AND EMERGENCY ROOM: Inpatient care at Children s Healthcare of Atlanta at Scottish Rite Newborn nursery at Piedmont Hospital Acute care at Scottish Rite Emergency Room (Scottish Rite s ER handles more outpatient visits than any other children s hospital in the United States.) LEADERSHIP IN PHYSICIAN TRAINING: Our fellowship is one of 35 training programs approved by the American Association of Pediatric Ophthalmology and Strabismus. Our program provides a unique mentorship experience with training in advanced surgical techniques, clinical care, and research opportunities. 35 fellows trained since program s inception in 1982 Hall Center fellows now practice throughout the United States in both community private practices and academic positions at universities. CLINICAL RESEARCH: Published Strabismus Precipitated by Monovision in the American Journal of Ophthalmology, September 2011 Dr. Zane Pollard was the first ophthalmologist to publish a paper introducing the surgical use of a silicone expander to both superior oblique tendons in patients with nystagmus who have a chin-up position in which the nystagmus slows in downgaze. Drs. Zane Pollard and Marc Greenberg have published medical papers on surgery for inferior oblique palsy using a silicone expander to the superior oblique tendon. The Center has had numerous papers published concerning the diagnosis and treatment of ocular toxocara (ocular larva from dogs found in the eyes of children who ingest contaminated dirt.) We pioneered the ELISA blood test for toxocara, developed in conjunction with the Center for Disease Control in Atlanta, Georgia. Dr. Pollard and his associate, Dr. William Hagler, taught a course on the diagnosis and treatment of ocular toxocara at the American Academy of Ophthalmology. RECOGNITION FOR EXCELLENCE Drs. Pollard, Kozarsky and Greenberg cited in Atlanta magazine s list of Atlanta s Top Doctors in their specialties. In December 2010, the James Hall Eye Center passed the Triennial Review and received the Certificate of Fellowship Program Compliance in the subspecialty of pediatric ophthalmology and strabismus. We are the only accredited pediatric fellowship in North America not located at a university. The James Hall Eye Center received a letter of appreciation from the Association of University Professors of Ophthalmology Fellowship Compliance Committee for its valuable contribution to the education of the next generation of pediatric ophthalmologists. 4

POST-OPERATIVE CARE: Cases included correction of ptosis, removal of orbital tumors, excision of chalazions and molluscum, cataract extraction with vitrectomy, strabismus, and tear duct repair.

5 APHAKIC REHABILITATION: This is a critical service provided by The Hall Eye Center. Newborns and children who undergo cataract surgery require rehabilitation with contact lenses. Medicaid does not pay for these costly lenses. The Hall Center provides these extended-wear lenses for our patients. Patient and family receive important educational support to facilitate compliance with contact lens use. Our physicians performed over 900 surgeries this past year This three year old girl was flown here to the James Hall Eye Center from Tajikistan in Central Asia. The first picture shows her with bilateral excessive tearing due to a tear duct obstruction on both sides. She also has esotropia -crossed eyes. The second photo shows her without tearing after bilateral surgery on her tear ducts. It was important to clear up her tear duct obstruction before operating on her crossed eyes as a blocked tear duct would be a source of infection which would compromise any muscle surgery. The second photo shows her after her successful eye muscle surgery for her esotropia-crossed eyes. 5

Patient and family receive important educational support to facilitate compliance with contact lens use.

6 James H. Hall Eye Center 5445 Meridian Mark Road - Suite 220 Atlanta, GA E: halleyecenter@bellsouth.net T: (404) F: (404) For more information please visit our website at: foundationcenter.org/ grantmaker/jameshall/ mission.html INDIGENT CARE PROVIDED SERVICE (50% without Medicaid) Clinic visits 250 Emergency cases 30 Fulton County Health Dept. Clinic 120/month Referrals 100 Surgical procedures 45 WHY THE CENTER MATTERS: We are the largest pediatric ophthalmology group in the state of Georgia accepting Medicaid patients. We provide medical care to indigent pediatric patients who might otherwise go untreated The James Hall Eye Center needs your help to advance our efforts against preventable blindness. With your support we can help hundreds of needy Georgia children with visual challenges. The Center is often the only place where these children can receive treatment for eye diseases. BRIGHT SUNSHINE OR ENDLESS NIGHT

html INDIGENT CARE PROVIDED SERVICE (50% without Medicaid) Clinic visits 250 Emergency cases 30 Fulton County Health Dept.

Fourth Nerve Palsy (a.k.a. Superior Oblique Palsy)

Fourth Nerve Palsy (a.k.a. Superior Oblique Palsy) Hypertropia Hypertropia is a type of strabismus characterized by vertical misalignment of the eyes. Among the many causes of vertical strabismus, one of the most common is a fourth nerve palsy (also known