The Lifetime Engaged Ophthalmologist (formerly Senior Ophthalmologist) Committee recently held its annual retreat and among the agenda items, and likely our favorite, albeit most challenging, is to select the recipient of the Artemis Award.
Each year since 2014 the award has been presented to one Young Ophthalmologist (YO) Academy member who has demonstrated compassionate care and service so exemplary as to be beyond any level of expectation. Candidates are nominated by academic program directors, department chairs, and subspecialty/specialized interest, state, and international societies.
The mythological Greek goddess Artemis had many attributes. She was the protector of the vulnerable and suffering, and so the award is given in her name. The 10th awardee was honored in 2023, and I was curious to learn what path earlier recipients had followed and how they were affected in receiving the award.
Although recipients may be recognized for domestic or international accomplishments, by happenstance the two initial winners traveled to separate locations in Africa after their training and ultimately established teaching programs and eye care facilities for very needy and greatly underserved populations. Their work progressed and expanded over time.
The remarkable stories of John Cropsey, MD, and Wendy Hofman, MD, the first two awardees, were captured in an article in 2023, “Artemis Alumni: Where Are They Now?.”
I continue the review of previous winners in highlighting the contributions of Paula Anne Newman-Casey, MD; Jeff Pettey, MD, MBA; and Camila Ventura, MD, PhD; the third, fourth, and fifth Artemis awardees. As the reader will easily note, these are beyond remarkable young physicians who have continued on the path of helping those most in need, not only as individuals, but in developing community service programs that have perpetuity. They are truly inspirational.
2016: Paula Anne Newman-Casey, MD
Dr. Newman-Casey with her research team.
Paula Anne Newman-Casey, MD, was raised with a sense of the importance of community building and community service from her parents. She graduated from Reed College, where she thrived in a liberal atmosphere and humanitarian programs, stimulating her to consider how others experience life, including medical care.
Dr. Newman-Casey spent six months in Ecuador working in literacy development and public health hygiene measures. In addition to learning to speak Spanish, she developed a keen interest in problems related to health care access domestically and on a global scale. Upon reaching medical school at the University of Michigan, she developed a further sense of what she hoped to accomplish with respect to expanding healthcare access. In addition, during her glaucoma fellowship she did a nonclinical year, earning a master’s degree in Health Services Research, further deepening her interest in access to care and social determinants of health.
During her fellowship she was integral in developing a program to provide eye care services at a nearby free clinic, the Hope Clinic in Ypsilanti, Mich. The departments of dermatology and plastic surgery at the university had relationships with the clinic and through volunteers would provide care on a limited basis.
The Hope Clinic also had a backlog of 250 patients who needed eye care. She helped create a similar program in the Department of Ophthalmology where University volunteers provided free care to those referred from Hope Clinic. She was able to stimulate and organize in excess of 100 volunteers (faculty, trainees, and staff) to provide eye exams on occasional Saturdays, and working with a local optical shop prescriptions were filled in frames that were donated by the University, resulting in no charge to the patients.
Dr. Newman-Casey with a Hope Clinic patient.
This alone alleviated a great unmet need. Initiated in 2011, the program continues but has “morphed” significantly and sizably to benefit a greater number of needy patients. As she related, most of the volunteer providers were ophthalmic subspecialists, but roughly 80% of the patients seen at the clinic had no meaningful pathology outside of refractive error, so the severity of illness was not matched to the level of provider training. Subsequently, Dr. Newman-Casey was able to obtain a Centers for Disease Control and Prevention (CDC) grant that provided for telemedicine screening, employing external and retinal photographs and a detailed history; these were obtained by qualified technicians.
The grant enabled the Hope Clinic to evaluate a far greater number of patients and refer only those patients to the Saturday clinics at the University who needed to see an ophthalmologist or subspecialist. The telemedicine screening program was then extended to a federally qualified health center in Flint, Mich., a distinctly different care model from the Hope Clinic. Having skilled techs at both locations enabled her to serve far more patients than having volunteer ophthalmologists on occasions.
The telemedicine screening exams are subsequently read by a small number of volunteer ophthalmologists, primarily glaucoma specialists, who make recommendations for whether and what type of follow-up care is needed. What a remarkable transformation from the initial Saturday clinics 13 years earlier! Among the attributes that the Lifetime Engaged Ophthalmologist Committee appreciates in evaluating candidates for the Artemis Award are the reach of the project in terms of volume of patients served, but even more so, the project’s growth and perpetuity. We are grateful for our choice of Dr. Newman-Casey for the 2015 award.
She retains a keen interest in access to and social determinants of health care and recognizes those challenges are concerning regarding common chronic eye diseases, glaucoma, macular degeneration, and diabetic eye disease as examples. She hopes that continued expansion of Medicaid will allow more people with chronic eye conditions to obtain better access to care and more support for management of their diseases.
Her professional life includes glaucoma patient care and teaching, and she also runs a federally funded laboratory dedicated to better engaging people in glaucoma care. She runs the original CDC telemedicine initiative described above, another trial evaluating whether personalized glaucoma coaching improves glaucoma medication adherence, and she collaborates with a multi-disciplinary team from engineering and motor control to create novel ways to monitor glaucoma medication use. In her personal life, she and her husband Kevin have two daughters, Eva, 9, and Rona, 7, with whom they love to laugh, play, eat, and go on adventures.
To her, the Artemis Award signified that the Academy values community work and health care disparities and novel health care delivery models to address these disparities in addition to other priorities of the Academy. It made her believe in pursuing what is possible.
2017: Jeff Pettey, MD, MBA
I am enamored with the fact that serendipity may induce a paradigm shift in one’s life and Jeff Pettey’s legacy speaks directly to that point. As legend has it, on a rainy day in Salt Lake City, while driving his VW bus he noted an acquaintance waiting at a very wet bus stop and offered him a ride.
The rider asked if Dr. Pettey then a freshman Russian literature major at the University of Utah, was looking for part-time work. Apparently, the rider’s colleague had just vacated the position in question. The job entailed learning to be a scrub technician at the Eye Institute of Utah where Alan Crandall, MD, was the principal anterior segment surgeon.
Dr. Pettey with staff and volunteers at Dodoma University in Tanzania.
Although Dr. Pettey knew nothing of the necessary skill set, he jumped at the opportunity and shortly thereafter began assisting Dr. Crandall at surgery. Given the latter’s great talents, compassionate patient care, and interest in global outreach programs, he was “hooked” and set out to become an ophthalmologist. Having been mentored by Dr. Crandall in those very important formative years, Jeff insists that “he was born on third base,” and, as is often stated, the remainder is history.
He then went to medical school at Ohio State and while there as a first-year student he tutored inner city, underprivileged, mostly minority middle school children in science. Working with them he noted that they were bright and eager to learn but had no exposure to medicine as a potential career. As a result of his own serendipitous opportunity, he developed a summer camp program for the youngsters; he organized top lecturers, taught CPR, gave the young students white coats, and brought them on clinical rotations.
The program was very well received and highly successful. In some sense it was a forerunner of the Academy’s Minority Ophthalmologist Mentoring Program. In fact, Dr. Pettey was singled out by Ohio State and was honored with the University’s Distinguished Diversity Enhancement Award that was given during halftime of an Ohio State football game along with a souvenir football that remains on the bookshelf in his office to this day.
After training at Utah with Drs. Crandall, Geoff Tabin, and Randy Olson, Dr. Pettey continued to pursue domestic and global outreach programs in Tanzania, Micronesia, Trinidad and Tobago, and the Navajo Nation in Southern Utah. His working model is to train local physicians rather than provide care and leave. Among the challenges that he faces is the significant lack of personnel. As an example, in Tanzania he estimates that there is one ophthalmologist for every million people.
Dr. Pettey examines a post-operative patient in Dodoma, Tanzania.
Most recently, starting in 2019, Jeff has helped develop the Global Ophthalmology Summit, a consortium of 19 academic programs in partnership with the Academy to share experiences and expose YOs and others to international and domestic outreach programs. As Dr. Pettey mentioned, it is remarkable to note the growing interest in this arena. In 2023, Dr. Pettey was awarded the Dumke Endowed Chair for Global Ophthalmology Education from a generous donor family. The gift provides ongoing support for global eye health and capacity building through education initiatives.
I asked Dr. Pettey what receiving the Artemis Award meant to him. He indicated that it gave assurance to him that the early career path that he chose has value and that it helped him deal with the “imposter syndrome” that he sensed while surrounded by the “giants” in the department at the University of Utah. He also noted that the Award serves to let the young in our profession know that they can be confident in choosing the less traveled and less traditional paths of professional life.
There is no doubt that the committee chose wisely in selecting Jeff Pettey to be the fourth Artemis Award recipient in 2017.
2018: Camila Ventura, MD, PhD
Similar to the history of her 2017 predecessor, serendipity played a key role in the early professional life of Camila Ventura, MD PhD, and led to the (still ongoing) project that earned her the fifth Artemis Award.
Shortly after completing fellowship training in medical retina, uveitis, and ocular oncology in Sao Paulo, Brazil in 2015, she returned as a surgical retinal fellow to the Altino Ventura Foundation (FAV), a large public service clinic initiated by her grandparents in Recife, Brazil. However, based on her interest in pediatric retina, she continued to evaluate premature children in a public hospital maternity/NICU ward.
On one occasion in mid-2015, a nurse asked her to see a child with microcephaly and other abnormalities which was puzzling to the staff, as known conditions, and infectious diseases (TORCH) had been ruled out. In addition to several other findings, the baby was noted to have chorio-retinal scarring and atypical maculopathy.
Zika atrophic maculopathy as described by Dr. Ventura and other researchers in an article in The Lancet.
Those retinal findings were noted in only one of every five cases of what eventually became congenital Zika syndrome (CZS), a group of birth defects associated with Zika infection during pregnancy. By positive serendipity the retinal lesions were present in that first child who was examined. Dr. Ventura was unmarried at the time and living with her family (all widely recognized ophthalmologists). She mentioned the unusual findings noted in the child at a family dinner and subsequently learned from her mother that a pediatric neurologist had noted 20 new cases of microcephaly in a referral public NICU in Recife. Intellectual curiosity ignited a spark in Camila and she and her mother organized a free screening day at the FAV and advertised it via radio.
In October 2015, she examined along with the pediatric neurologist 55 children; 40 were positive for microcephaly and 10 to 15 of them had fundus findings. Eventually, she and co-workers fit the pieces of the puzzle together and recognized that these findings were due to uterine transmission of the Zika virus to the unborn fetus.
Along with her colleagues she reported in The Lancet the constellation of findings of what was referred to at the time as “presumed congenital Zika syndrome,” since it had not been described in the past. Zika virus was first discovered in monkeys in Africa in 1947 and shortly thereafter in adult humans and later in Micronesia, but no cases of congenital Zika syndrome were reported prior to her publication.
The outbreak of Zika virus in northeast Brazil in 2015 was presumably associated with immigration from Central America and the Caribbean, as determined later by researchers. Eventually her team diagnosed 325 cases of CZS at the FAV; most of the cases were from extremely poor regions of the state, as the living conditions associated with poverty combined with stagnant water allowed mosquitos to spread the virus.
Dr. Ventura’s team was able to obtain donations and support from partners to help the involved families and mothers. The FAV received an R01 grant from the National Institute of Child Health and Development (NICHD) in partnership with an RTI International Grant from the Research Triangle in North Carolina. These grants helped support families and research from 2018 through 2023. Families received various medical and nonmedical goods, food, psychological support, wellness sessions, and professional sewing course to caregivers that allowed them to stay at home with the involved children while learning a marketable skill so that they could earn money.
A recent reunion of Zika virus patients and families at the Ventura Foundation.
Among the significant challenges Dr. Ventura now faces is that the grants have run their course, and she has no new funding. She believes that it is because Zika is very rare and that there have been no new outbreaks. As she suggests, the Zika baby mothers feel as though they have been forgotten. Dr. Ventura retains great interest and sensitivity to the human aspects of congenital Zika virus syndrome and remains dedicated to doing all she can to support the children and their families.
Dr. Ventura continues to devote a half a day per week on Zika research, allowing her to continue to apply for grants to fund the children and their mothers. She and her colleagues at the FAV continue to follow the cohort once a year for ocular and general examinations. Moreover, the children continue to be given a diversity of therapies, including music therapy; they appear to have a great affinity for music, given that their receptive communication is the least impaired as shown by the research performed at FAV. Also of interest, and still under investigation, is that when these children reach 8 years old, they appear to have endocrine dysfunction. Some reach early puberty at 7 or 8 years old.
It is evident that the committee chose wisely in presenting the Artemis Award to Dr. Ventura in 2018. When asked how it affected her, she indicated that the Academy’s recognition brought a responsibility for her to do more. It gave her work recognition outside of Brazil and afforded her a voice to become more involved in the political side of ophthalmology. In particular, she served on the Academy’s YO International Subcommittee from 2019 to 2022, and with the Pan-American Association of Ophthalmology, where she is now associate secretary of the Portuguese language region.
Dr. Ventura continues to work clinically at the foundation and has been the director of research since 2017. She is married to a retina specialist and has a 1-year-old son.