Why Eye Health is Important
Hey, it's your eye health experts, Prevent Blindness Texas, and welcome to Eyespiring, a conversation about all things vision and life.
Heather Patrick:Welcome to Eyespiring with Prevent Blindness Texas. We are inspiring a brighter future and vision. I'm your host, Heather Patrick, CEO of Prevent Blindness Texas. We are so glad you're with us and excited to be launching our podcast.
Heather Patrick:The mission of Prevent Blindness Texas is to prevent blindness and preserve sight. Our vision is vision, making healthy eyes a priority in Texas. For almost seventy years, Prevent Blindness Texas has provided critical vision care to Texas' most vulnerable citizens by providing early detection, screening, education, navigation, and financial resources.
Heather Patrick:We focus on vulnerable and underserved populations most at risk for vision issues. Last year, Prevent Blindness Texas served over 50,000 individuals and educated more than 80,000. We work to build strong continuums of care in each community we serve so that all children and adults have improved equity to access quality eye care.
Heather Patrick:We know that vision critically impacts learning and development, mobility, independence, and health. We advocate for the necessary attention and solutions to issues surrounding the aging eye, and we define success when all individuals who need eye care receive it. Our work improves the health and quality of life for thousands of individuals across our state.
Heather Patrick:I have been in nonprofit health care for over twenty years. I am passionate about improving access to care and advocating for our patients. This work is important to me because it's still a solvable problem. More than fifty percent of blindness can be prevented. I recently just completed a six month health coaching program. I'm a mom of two fabulous teenagers, and I lead the team here at PBT.
Heather Patrick:Now I'd like to introduce you to our guest, Doctor Misha Syed. Let me give you a little bit of her bio. It's extensive, so I'm gonna highlight some things. She completed her undergraduate studies at the University of Texas in Austin, then attended Baylor College of Medicine, where she earned her MD degree in 2001.
Heather Patrick:She became a faculty member at the University of Texas Medical Branch in Galveston in 2006 and was promoted to the rank of tenured professor in 2020. While practicing at UTMB, Doctor Syed completed a Master of Education in Health Professions degree from John Hopkins University in 2016.
Heather Patrick:She's been active as a clinician educator and a glaucoma specialist, serving over 20 committees locally and regionally and on over 10 national committees. She serves as the ophthalmology residency program director at UTMB from 2011 to 2022. Her leadership roles include being elected to the national OPPO, is that right?
Dr. Misha Syed:We call it AUPO.
Heather Patrick:Okay, well, Association of I
Dr. Misha Syed:like OPU though.
Heather Patrick:I like that. You created something new already.
Dr. Misha Syed:There you go.
Heather Patrick:Association of University Professors of Ophthalmology, Program Director Council and Co Founding Women's Professor of Ophthalmology, a national organization devoted to mentoring women in academic ophthalmology. She now serves as Assistant Dean for Educational Affairs, John Sealy School of Medicine at UTMB, and as a Vice Chair for Academic Affairs in the Department of Ophthalmology.
Heather Patrick:And she is a Galveston native and has enjoyed living close to her family friends in the beach while raising her two children with her husband. So clearly she doesn't have anything to do and she's not busy at all. All right, so tell us a little bit more about you and your story.
Dr. Misha Syed:Sure. Thanks, Heather. I loved hearing yours. I wasn't aware of the full path of your career, and hopefully we can get more into it as we're chatting over this next bit of time. But I'll reiterate that I am in kind of a quote unquote native of the area. I moved to Galveston when I was about four, between four and five. So all of my primary schooling was done on the island and I have a really strong connection to the island because of that. It was an amazing place to grow up.
Dr. Misha Syed:I still have many of my childhood friends that I'm close with and and I think that gives an extra special connection in my work as a glaucoma specialist serving the community of Galveston and the surrounding areas and I would say that the ties that I have made during that time in childhood and since I've come back to the island really strongly have shaped where I've gone with my training and my focus. I had the opportunity to volunteer a lot as a kid on the island.
Dr. Misha Syed:I think that being able to serve in those ways and seeing some of the issues that people in our community had really led me on the path towards first medicine, but then also this idea of prevention and public health was a seed that was planted early. Not aware of that at the time, don't think. Was really kind of growing that subconsciously almost as an important part of my later career, but understanding that true health starts with prevention of disease and having a strong health connection from an early age, having resources, having the ability to access care will completely change the trajectory of a person's life.
Dr. Misha Syed:So with that, I went bright eyed, bushy tailed, eager into medical school. I thought that I was going to go into preventive care in general. Know, I was very interested in actually obstetrics gynecology and did some research as a medical student in that area and particularly interested in cross cultural issues in medicine and how to treat people from diverse backgrounds, but things change. Somehow I went from a section to gynecology ophthalmology.
Dr. Misha Syed:There is a serendipitous story with that as well. And it does tie back to the idea of preventive care, believe it or not. A lot of people think of ophthalmology as a super specialized surgical specialty, which it is, but there's an incredible, incredible opportunity to really ensure optimal eye health throughout one's lifespan if you practice ophthalmology from a preventive aspect.
Dr. Misha Syed:So what ended up happening, I was going along in medical school and had no idea of ophthalmology, you know, as a specialty. Had my path and I actually got to do an elective rotation in ophthalmology just on a whim. I had kind of morphed from obstetrics gynecology to be interested in pediatrics and adolescent medicine, again with that preventive idea in mind how to optimize health from an early age, and I thought, well, I'll need to learn how to do a good eye exam.
Dr. Misha Syed:In most medical schools you don't get a lot of exposure or training in ophthalmology, and so I thought let me do a little two week rotation here and just fell in love with it. I'd always loved the OR, I loved the aspect of procedural care and being able to kind of have an immediate impact and a positive impact on patients through that.
Dr. Misha Syed:But I've kind of given that up with, no, that doesn't really fit in with what I want to do and how I want to help patients. But ophthalmology just beautifully tied both of those things in. You can take care of the whole patient from early age to late age, but you can also intervene and have really life altering impacts with procedural care.
Dr. Misha Syed:So that's how I pivoted and went on to residency. Loved ophthalmology, but I still had that thing in my head like how do we ensure that patients are not coming to us with vision loss already already in that you know, the downward trajectory of losing their eyesight. And I found the field of glaucoma. Glaucoma can often kind of sound like a it's a Debbie Downer in our specialty if you want to label it.
Dr. Misha Syed:There's a lot of challenge in treating the disease and often patients do come to us with irreversible vision loss with glaucoma, but there is a really, as of yet still, I think largely untapped opportunity to prevent glaucoma, to prevent that vision loss. If you have the right type of screening in place and community awareness and going back to that education piece, educating patients about getting their eye care regularly and early enough in life to catch diseases like glaucoma.
Dr. Misha Syed:That sparked my interest again in preventive care and how we can really affect that positive change as glaucoma specialists and ophthalmologists. So that is is how I how I started my career as a glaucoma specialist. I did my fellowship training in Houston. And in the meantime had gotten married when I was still out of state doing my residency. My husband was in the Houston area. I knew I wanted to get back to the area.
Dr. Misha Syed:I still have family in this area, so it kind of, you know, the stars aligned. It was really fortuitous that UTMB needed a glaucoma specialist, academic glaucoma specialist at the time I was finishing fellowship. So there I was, and I was that 18 year old kid when I left, I'm not going back here. Even though, as I mentioned, I loved Galveston, but as a young person, you're like, I'm not going back to my hometown. That's not happening.
Dr. Misha Syed:But I was there, starting in 2006, right out of fellowship, and I'm an anomaly in a way because that's been my only quote unquote real job since I got out of training. I've been at UTMB and have had a really, I think, invaluable opportunity to grow myself, grow my career, serve my community through my work at UTMB and I've never felt the need to go anywhere else, so here I am.
Heather Patrick:Yeah, they're a great institution, amazing. All right, so you've taught us a little bit why, how you got there, why eye health is important to you. So what inspires you now? So prevention was really important then and obviously still important to you, but what else inspires you? Because this role can be daunting.
Heather Patrick:It can be really hard when a patient walks in and you know there was more they could have done and now they've lost vision and they can't get it back, right? Those days are hard. So what inspires you? What brings you back to your why?
Dr. Misha Syed:I'll tell you that I think to be in medicine in general, you have to grow that ability to deal with the sad situations and the inevitable misfortunes that befall your patients. Regardless of what you can do, as you said, there are limits and unfortunately we are always going to see those cases that just can pull you down. I would say my antidote to that has really been teaching.
Dr. Misha Syed:The education piece again, is, I kind of fell into teaching, it wasn't intentional. I knew I really enjoyed being in the academic setting, which is part of why I took the job at UTMB, but I don't think I fully understood why I really enjoyed the academic setting. Part of it is the collegiality you have when you do have difficult cases and you know those patients you're just not sure how best to treat. You have a colleague, down the hallway that you can pull in and say, what would you do here? That's not always the case in the private practice setting.
Dr. Misha Syed:So that has been a real positive aspect and a growth opportunity for me as a glaucoma specialist. But what I didn't realize is as I had the residents and medical students working with me day in, out, the ability to instill in them the values and the understanding of what we're talking about here, which is preventing disease in whatever way we can, educating patients, educating their families, having that role as kind of the steward of their care, I think has really filled my cup in a way that I don't know that I could.
Dr. Misha Syed:Like you said, it's hard. Days are hard. You have difficult cases in the OR. There's always those challenges and you think, gosh, this is draining and it's sad.
Dr. Misha Syed:And without that piece of being able to pull in the next generation and say, yes, this is hard, but this is what you can do to make things as good as possible for your patient, and this is how you treat people, not just the disease, but treating the patient, treating their family, and helping that next group of physicians who are coming up and who are going be taking care of us, quite frankly, helping them learn those values and understand that part of who they are as a physician. That's what helps me.
Heather Patrick:I love the phrase, we're the steward of their care. I love that. Really And I love your philosophy, I wish all doctors had it. It's more about treating the person, right? Okay, so who inspires you?
Dr. Misha Syed:Wow, that is a huge list. I'll say, you know, I had a really interesting conversation actually before we started podcast this morning. Earlier this morning, I had an incredible opportunity to connect with one of my high school teachers. It's a long story, but going back to the Galveston connection. She and I had almost an hour long conversation earlier today.
Dr. Misha Syed:And I told her I said you and all the other teachers I had in K through 12 have no idea how much you inspired me to again go this route of teaching. I had no idea that I would end up being an educator when I was going through those grades in school, but I do know that their ability to interest and inspire their students and to make us love learning. I don't know that I had any better inspiration than that. And it was again a subconscious thing.
Dr. Misha Syed:And now that I have the years behind me, every year I feel like I learn more about kind of how these seeds were sown. But it was my teachers, I think collectively. And my husband and kids laughed me. They're like, you're so weird. You remember all your teachers. I literally can name off my teachers from kindergarten.
Dr. Misha Syed:Talking to you. Okay, so I'm not the only one. They think that's bizarre and I'm like, no, I mean, I can even remember instances from, you know, first or second grade where a teacher said something to me, gave me an opportunity, and something that small is actually something huge.
Heather Patrick:Huge.
Dr. Misha Syed:So teachers, God bless them. And they have a really hard job, but I hope that, and I wish that they all knew how influential they are.
Heather Patrick:Yeah, I mean, my second grade teacher changed the course of my path. She saw something in me and talked to my parents about putting me in the honors program at that time, and they did. And that just set me on a different pathway. So they definitely have the ability to really change our course.
Dr. Misha Syed:Yeah. Yep, for sure.
Heather Patrick:Okay, so we've talked a little bit about community, and obviously the Galveston community is important to you. Is there a larger community too that really kind of drives you? I know you're involved a lot with supporting women in women's health, so maybe talk a little bit about that community and how you got involved and what keeps you going there, and what you see kind of changing or evolving as you're part of that community.
Dr. Misha Syed:Yeah, love that question. So I entered medicine at an interesting time. I think I was right on kind of the bubble of when medical school enrollment started to shift from majority male to closer to a fiftyfifty, not quite, but it was starting to turn. Now it's fiftyfifty, even a little above 50% in a lot of medical schools of female versus male enrollment. So at the time there weren't many female role models, particularly in the surgical sub specialties.
Dr. Misha Syed:So ophthalmology being included among those. I really felt that when I was going through medical school and then starting my residency, I could count on one hand, you know, the number of women faculty that I worked with and that was striking. I don't think that it was negative per se. I had amazing male mentors. Like I never felt like it was somehow, I think affecting my training or my education at that time.
Dr. Misha Syed:And then as I went through and became a young faculty member and started to build this academic community, going to meetings, joining different organizations, the topic kind of would come up, particularly with other women and kind of talking about, well, how are you getting this opportunity or how are you being mentored? And it really did become apparent that there is a difference.
Dr. Misha Syed:Women in medicine have different challenges and kind of unique situations that really require a connection with those who are having the similar experience to help them grow. And again, not to say that there are many men who are avid supporters of women in medicine and I have many, many really strong male mentors. So again, they'll never fully understand the experience, I think is the thing and finding that niche of women who have kind of been through similar things and have done it before you.
Dr. Misha Syed:The value of that cannot be overstated. So with that in mind, I started to try to join various organizations that that. Kind of allowed me to interact with women who had had a similar path. Joining the Association of University Professors of Ophthalmology, which you had mentioned earlier, that's an academic ophthalmology organization. Essentially, you're a chair of a department or residency program director, a medical student educator, a research director, that's kind of the home for you, that professional organization.
Dr. Misha Syed:And those are that's your tribe, you know? And it really felt that way. When I became a young program director. I was really given that job very in a very interesting way. My chair basically called me one night and he was famous for doing that.
Dr. Misha Syed:And when he called, you picked up the phone and I had my, you know, five month old daughter and my three year old son at the time. And actually, I remember the date, the night he called. We were going out for the first time pretty much since I had had my daughter and we're going to this loud Mexican restaurant and it's chaos and you know she's throwing her food and then my son is running around the table and I see the phone ringing and I'm like, my god, okay, I have to take this call. And I answered and said, yes, hi, how are you? Blah, blah.
Dr. Misha Syed:And my chair was a very amazing chair, very strong supporter of my career, but did not beat around the bush. So basically, the next words out of his mouth after he said hi were, how would you like to be residency program director? And big job. I don't know how I can really explain that job, but it's essentially you're in charge of the residency training for all the residents in your program, and it's very tightly wound around keeping the program accredited.
Dr. Misha Syed:You have to follow all the rules from the National Accreditation Body, which is the ACGME for short, but essentially, if you don't follow those accreditation guidelines, your program can close, and there are big ramifications for that. So anyway, it's a difficult position.
Dr. Misha Syed:Yeah very big job. And I was at this time, I think I was four years into being a faculty member. So literally, still getting my feet wet, still understanding my clinical practice. And I think a recurring theme has been for me and my career growth is when the door opens for an opportunity, you know, walk through it. Might be scary, but you know, walk through and see where it takes you.
Dr. Misha Syed:So I had a conversation with my husband, I said, Look, this is gonna be crazy pants, we have these kids. And he was busy with his work and he was like, Look, if you think this is gonna be something good for you and you think you can do it, go for it. So that's what I needed to hear. I think it helped me to take that, you know, the nudge and go and it changed the trajectory of my career, absolutely. And becoming a clinician educator, I found within that that group of women who are going through the same thing.
Dr. Misha Syed:AUPO supported our efforts about. How long maybe? Fourteen years later, so 2020, we'll fast forward, a colleague and I were chatting one day and we'd both just been made professor and she's in Chicago, so you know we had connections obviously through the organization, etc. And I said, did you do it? She's like, I don't really know.
Dr. Misha Syed:It's like, Me either. So the path was circuitous and we both got there, but we thought, how much better would it be for the people coming behind us to have some kind of scaffolding somewhere where they can go in this very kind of small part of the academic world, academic ophthalmology, women going through these paths. And there are national statistics, particularly in ophthalmology, that there is still quite a gender disparity in women who achieve the full professor rank.
Dr. Misha Syed:Actually inverts by the time you get to full professor as people enter their career. Assistant professors is actually slightly more women than men, and as you get to associate and full professor it flips on its head and there are, I think the latest statistics I don't want to misquote, but it's probably around 10 to 15% of full professors are women. So if you think about that, yeah, it's an inverted pyramid, or it's a pyramid I guess, but it is a problem. Gender equity in this field, in our area, is a problem.
Dr. Misha Syed:So that was our point, our pivotal point, where we said we need to create this, and that's how women professors of ophthalmology was born. We didn't have a home for it. We ran it through our laptops basically for a year or two, planned our Zoom meetings, had to get a listing of all the full women professors in the country, somehow kind of put together a group of women who were interested in joining the effort, and AUPO ended up supporting us and putting us under the umbrella of AUPO, which has been amazing, and we have some wonderful sponsorship.
Dr. Misha Syed:AbbVie has supported us for the last few years through AUPO. So really, it's been an amazing chance to give back to the academic community and help those who are coming up behind us. Incredibly rewarding.
Heather Patrick:Yeah.
Dr. Misha Syed:I don't know if I answered the question. Feel like I went off
Heather Patrick:Let's go back to that training and teacher, right? Support, that needs support. All right, so let's shift a little bit, to PBT and Talk about how you got here and then why you stayed. And then also to your journey in the organization, landing with, last but certainly not least, as chair. What does that mean to you and your path?
Dr. Misha Syed:Also count PBT as a very pivotal and serendipitous moment in my career. Talking about how we have today, how building ties to community and finding ways to prevent disease, eye disease glaucoma in our patients, and how I was able to work on that from my perspective as a clinician, I did feel like something was missing in that I didn't have that larger framework of support and understanding of how do we create this community partnership where we can really tie patients into access to care education.
Dr. Misha Syed:I can do my piece in my exam room in my clinic and do that individual teaching, but how do we make it a bigger positive change, right? And a and a effect that's more. Community oriented and long standing. So enter Doctor Murphy, Kathleen Murphy at UTMB, who I know has been a long time PBT supporter and heavily involved in the organization. So she and I were an academy of master teachers meeting that we have at UTMB. It's a community of educators within UTMB and people who have really shown interdisciplinary commitment to teaching.
Dr. Misha Syed:So Doctor Murphy is in the School of Nursing, I'm in School of Medicine. So that group has really allowed me to make so many connections with people outside of the little niche and silo of medical school and medicine. She kind of said, Hey, Misha, do you know about Prevent Blindness Texas? And I don't think so. Which is crazy to think that I wasn't aware, but it speaks to, you know, our job is to really make all our providers aware of this organization and a big part of our mission.
Dr. Misha Syed:So I said, No, I don't really, she said, We'll look into it. They are looking for board members and I think you'd be great. And this was, I think, around must have been around 2015 or '16. Somewhere around there. So I. I was pretty well established in my clinical practice by then, and I had kind of gotten the residency program director thing in hand, more or less, and I felt good about where I was career wise.
Dr. Misha Syed:So it was perfect timing for me to start looking at that, like, how do I get more connected with the larger vision community and find a way to effect that change at that level for my patients and for our community? So I looked into it, I thought, this is what I've been looking for. And was fortunate enough to come on board at the same time within a few months of when you came on as CEO, Heather. And I still remember those board meetings in Houston sitting around the long table in our old PBT and really just being amazed at who was in that space.
Dr. Misha Syed:Know, who were the board members and people I never would have had the chance to meet and connect with otherwise. I think that's what hooked me. Thought this is really cool. All of these people have the same goal in mind and we're all coming from such different perspectives and directions, but this is unifying us. Then I was sold.
Dr. Misha Syed:And seeing how you developed the organization from the time I joined and what you did to really take us to a whole other level and become highly functioning, cohesive, driven in our efforts. I have learned so much from being able to participate as I have as a board member and being It was funny, you know, when I was trying to pick what committee to join when I came on, I thought I need to stretch my wings a little bit.
Dr. Misha Syed:And as academic physician, business, marketing, I don't have a bone in my body. Was part of the reason I went into academics quite frankly, is that I don't want to run a business. I'm not really interested in that. And I thought, let's do it with the development and marketing committee. I have to stretch myself. And I am so glad that I did that because understanding how to sell is a huge skill, a very important skill to have. PBT has really helped me understand that part of my job and how to do that.
Dr. Misha Syed:So thank you for that PBT. And I think as I did that and kind of moved into the executive board member roles, being able to serve as vice chair, seeing that I could actually do it, I think there was a bit of me in the imposter syndrome was rearing its head, but this is so out of my element. I don't know if I'm the right person. I said, I'm happy being on the board, but I don't know if it's in me to lead this group of people. Again, amazingly talented, diverse people who make up our board. And I thought, I don't know if this is me, but I appreciate you, Heather, kind of giving me the little nudge and the yes, you know, I think you can do it.
Dr. Misha Syed:And walking through that door again, and taking that, the roles that I did and now ending in chair, I mean, can't say enough how it's helped me grow as an individual, team dynamics, working on the inevitable challenges that come up in an organization and a nonprofit in particular, understanding the financial side of things more clearly and how that plays such a big role in being able to accomplish the mission. So seeing that from the chair perspective building what we have with our board members and the PBT staff, you know, again, I couldn't have asked for a better addition to my career path.
Heather Patrick:Well, it's been amazing having you as a board chair. Met when we had our board meeting and it's in this role as CEO, that board chair position is really important. The executive committee is really important just because it changes. If you don't have a good relationship, it definitely impacts the day to day, but to have incredible relationships and work so well as a group and really challenge each other to think about how to do it differently.
Heather Patrick:You just look at the growth of the organization over the last three years, it has been amazing, but it really is because of the leadership at that board level that we trusted each other to be able to come and say, Hey, this is the issue, or What do you think about this? Or How do we do it differently? Or How do we push the board? So it's just been an amazing experience.
Dr. Misha Syed:Yeah, couldn't agree more. It's really fun. The events are fun. I'm gonna add that too.
Heather Patrick:The events are fun.
Dr. Misha Syed:I really love being a part of those and helping plan and had to put on my party planner hat, which is fun.
Heather Patrick:So if you were going to tell someone why to be a part of PBT, what would you tell them?
Dr. Misha Syed:So I would say if you want a growth opportunity that gives you as much as you give it, I think PBT is the absolutely absolutely right place to be. I think you have to understand what you bring to the table and us being intentional as the board. I think with recruiting people who bring different skill sets and perspectives is the first part of that.
Dr. Misha Syed:But if someone is considering being a board member, has been asked to be a board member, think about that because bringing yourself to the table and being willing to grow and participate in that way is just as important as what the organization is going to provide you. So absolutely have that duality, that understanding, and it really is a win win when you have that connection, the right connection.
Heather Patrick:All right. Okay, so let's talk a little bit about eye health. So what's the first thing that comes to mind for you when someone says eye health?
Dr. Misha Syed:I'm going to go back to the prevention piece. So eye health, I think is something that people don't consider when they think about health in general, and it is part of the PPT mission to bring eye health as a piece of overall health to that forefront. But I do firmly believe in pushing forward screening, regular eye exams. I think far too many people don't get that at least first baseline eye exam or screening until they're already in that. Point in life where those those preventable causes of vision loss have already started, so I think our our.
Dr. Misha Syed:System does a pretty good job of screening in the younger school age population. But I think where that maybe falls down is once that initial screening happens, is enough being done to make sure that those children who screen in who may have an issue, are they plugged into the right resources to go that next step? And that is extremely important.
Dr. Misha Syed:And I would say the other piece that we need to think more about is if you have any family history of any eye disease, making sure that you and your family members understand that that in and of itself means that you have to, even if you're not having any vision problems and you're not having eye pain and you're cruising along, you need to get screened earlier than we say roughly the age of 40 you should start having an eye exam every one to two years. But that doesn't hold for if you have any family history.
Dr. Misha Syed:So getting that message out, I think would help prevent a lot of disease. And as a glaucoma specialist, you know, I get it all the time. People may get diagnosed with glaucoma the first time they're sitting in my clinic in in an exam room and they say, how did this happen? I have no pain. I have no vision loss and glaucoma is the silent thief of sight. Know it will not give you those clues that anything is happening. The only way to catch it is getting that screening exam.
Heather Patrick:So let's talk a little bit about disease and risk as related to eye health, because I've been in this position for almost eight years and I still amazed, in not in a good way, that there's this disconnect between chronic diseases and even some medications that we take and the impact to vision. So talk a little bit about how when you first came into the profession, profession, what it looked like, and now what do you think has changed? Do you think we've done a better job of making that connect? What else still needs to be done for people to really understand how important it is to know that connection between chronic disease and eye health?
Dr. Misha Syed:That's such a great question. I think the education piece, certainly we need to let patients know. When they have systemic diseases like diabetes or high blood pressure, both of which are extremely common in our population, right, in the general population, having them understand that they have to get their eyes screened as part of those disease processes is part of it. And I think we're doing a so so job, to be honest, on It's national just that the numbers aren't there for patients getting appropriately screened. But it's not just the patient education piece.
Dr. Misha Syed:We have to educate our colleagues. We have to educate our primary care providers about getting these patients into a proper complete eye exam as soon as they're diagnosed with these several systemic diseases like we talked about. That also I think is getting better. I think PBT is actually playing a really important role in that, and not only us as an affiliate chapter, but the National Prevent Blindness Organization is really working hard to do that. I think our healthcare system makes that access tricky.
Dr. Misha Syed:We move into that whole idea of patients being insured, partially insured, uninsured, you know, and the system kind of falls apart to plug them into the resources they need when they have these varying levels of access. Incredibly important for PBT and other nonprofit organizations to help fill that gap when it's there. I think we're getting better, but there's a lot more we can do.
Heather Patrick:Yeah, agreed. So what are some risks? What puts you at higher risk for eye disease? Walk through some of those needs.
Dr. Misha Syed:Right. So there are some things that are kind of inevitable. You know, age is one. Tell my patients
Heather Patrick:Unfortunately it is.
Dr. Misha Syed:Yep. If you are on this earth long enough, there are some eye conditions that are gonna happen, particularly cataracts. We can start with that. A very common process in the eye, I'm not gonna call it a disease, it's actually an aging process. And so especially living in environments, climates that are more sunny, closer to the Equator, UV exposure is one of the risk factors for developing cataracts along with age.
Dr. Misha Syed:So we're in our Sunbelt area, we are definitely at relatively higher risk for developing cataracts. So that is one thing, one disease. I would say some of the other diseases, you know, remind me again, you wanted me to talk about risk factors?
Heather Patrick:Yeah, so what are some of the risk factors for some of the most common eye diseases?
Dr. Misha Syed:Right, so cataracts, you know, sun exposure, smoking can increase your risk of developing cataracts earlier in life. Going back to that systemic connection, diabetes is actually a risk factor for cataract development, and I see patients who are sometimes in their 30s and 40s, you know with with diabetes and developing cataracts when normally you would expect it maybe a few decades later. Patients being on certain medications, particularly steroids, can cause a cataract formation earlier in life.
Dr. Misha Syed:Glaucoma is another disease that's age related, so again getting that regular screening, particularly after the age of 40. If you have no other risk factors for glaucoma such as family history, which we mentioned, you know that's really a key to preventing vision loss. Many of my patients who were caught in time with glaucoma or who I follow as what we call glaucoma suspects, they will hopefully never develop any visual loss from that disease process because we can manage it.
Dr. Misha Syed:We can control it if it's caught in time. Very similar to diabetes and the complications from ocular complications from diabetes. If the diabetes is managed really well and caught again in time and the eyes monitored, you may have diabetes for more than half your life but never get ocular complications. That's the best case scenario, But the only way that happens is being plugged in to a provider and making sure you're getting those annual screenings.
Heather Patrick:So when you think back over your career and your practice, are there certain patients that stand out to you and why? Good or bad, right? Challenging, hard case, or someone that just made a lasting impression on you? Wow.
Dr. Misha Syed:Yeah, you know, it's funny as we've been talking, I actually have had particular patients flash in my mind as we talk about certain things. Know I. I'll go to glaucoma first. I've had some really memorable glaucoma and cataract patients, but with glaucoma. It's one of those really kind of hard situations like we talked about that can be really challenging mentally, emotionally to deal with.
Dr. Misha Syed:I had a colleague actually who's a physician came in saying I'm just not seeing as well. Not sure why. It's just things are just quite as clear as I would expect. And I proceeded to check them and they were actually in a very advanced stage of glaucoma in one eye. Very advanced.
Dr. Misha Syed:So this is clearly someone who has had access to health care, right? Insured their whole life in the medical field. Yeah. Understands, you know, all of the things that we're talking about, but still this was not caught. And just tragic, you know?
Dr. Misha Syed:Thank goodness the other eye really is not that affected yet, so we are managing, we're controlling, but having to explain to them every time I'm really sorry but we cannot bring that back, what you've already lost. And it affects their professional work, it affects their personal life, know. They've talked about people coming up on one side and not realizing that someone's there till they're right there, and you know that can be jaunting, know.
Dr. Misha Syed:It's just those are little things, things we don't think about, but they are actually very much built into our quality of life. Driving, you know, obviously this person needs to drive around. They're a busy clinician and having that understanding that they do not have as great peripheral vision and how to compensate for that when they're doing those kind of activities like driving and walking around. Very memorable, challenging. And it really should be a best case scenario, but it's not, you know, even with all the resources that that that individual has had.
Dr. Misha Syed:And I'd say you know at cataracts I had a really interesting patient years ago who was an artist and had come in, had really not had regular insurance and access to health care, we actually took care of them at UTMB with our years ago we had a kind of a grant fund called the Indigent Care Fund, and so I was able to see this patient through that and he had very advanced cataracts, very advanced. And he said, I can't paint anymore.
Dr. Misha Syed:And you know for him it was just His life! Exactly, his life, you know, life altering, very depressing, of course, and not only quality of life, but being able to function, you know, from a work aspect wasn't able to do his livelihood. So we had the conversation, you know, these are cataracts that are significant. When they do come out. They were so significant that I actually couldn't see well in the back of the eye to ascertain if there was any other eye disease.
Dr. Misha Syed:You know we always have to have that conversation with our patients with advanced cataracts. Sometimes we don't know what we're going to find once the cataract comes out, so I said hopefully you're not going to have any other problem in the back of your eyes, but we just can't see till we get the cataract out. So if you're wanting to go ahead, we can provide the cataract surgery and see how well we can get you seen. You know he was of course on board and thankfully he had an amazing outcome, didn't have other eye pathology, and I mean just to have his reaction.
Dr. Misha Syed:I still remember seeing him in the post op day one visit and he was floored, he was ecstatic and being able to make that kind of change in someone's life that immediate coming back into the world. Had lost his footing in a way of his life as an artist and just being able to contribute the way he wanted.
Dr. Misha Syed:I think that going back to why I went into ophthalmology and remembering that I really saw that piece, it's not only prevention of disease, but being able to make these incredible life changing interventions for a patient, it just kind of was like full circle my thought. I mean, the gift that we have to be able to do that for patients. So I still remember his name, I could picture him, you know, and it was just amazing.
Heather Patrick:What really touches on, I think, we try to convey so often is vision is complicated and it's so tied to so many things in our life that we don't even think about, right? The mental health component when you have vision loss, other parts of our body, disease, the quality of life. And I just think those are really important pieces as we continue to talk about vision and eye health. It's all those pieces. It's this web that's all connected and how important it is to really prevent vision loss, and we can.
Heather Patrick:We really can. So one piece of advice you'd give as people are thinking about their eye health, like what's the most important, what's the takeaway you want them if they remember nothing else about our conversation? What's the one thing you want them I to keep
Dr. Misha Syed:I would say, you know the saying, if it ain't broke, don't fix it? Ignore that when it comes to your eyes. You've got to get in before it's broken and make sure that you are plugged in so you don't have to fix it. We talked about, so much is preventable, but you've got to be checking for these things.
Heather Patrick:Yeah, yeah. All right, so we talked a little bit about why people should get involved with Prevent Blindness Texas, And we are always, always looking for people to engage with us at all different levels, board, event committees, helping us screen in the community, helping us educate in the community. So there are all different ways to engage with us. But I do think it's an incredible experience at all different levels and to come in. And it's just an organization filled with amazing people, and like you said, from all different backgrounds, all different perspectives, but it really is, I think, like a family.
Heather Patrick:We really do have a great group that are involved in moving this mission forward. Thank you so much for being a part of today and the conversation. It was great, and thank you for sharing your expertise and your insight. We deeply appreciate everything you do and everything you do for PBT.
Dr. Misha Syed:Thank you, Heather. It was an honor.
Heather Patrick:Well, it's great to work with you. You know you're not going anywhere even though you are rolling on the board. You're still not going anywhere.
Dr. Misha Syed:I appreciate that. I don't want to go anywhere.
Heather Patrick:And for all of you listening, we appreciate you spending your time with us. Don't forget, please subscribe to I Spire with Prevent Blindistexes. And always let us know what your vision is.
