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Jules Stein Eye Institute leads way in patient care and research

When Adam Shapiro turned 5 months old, his right eye rolled inward, permanently stuck gazing at his nose. His mother, Geri Shapiro, noticed that her baby repeatedly turned his head sideways in order to look to the right.

Adam was diagnosed with strabismus, a condition affecting up to 4 percent of Americans and caused by a disruption in the brain’s control of the eyes.However, Adam suffered from a rare form of the disorder called paralytic strabismus, in which the eye’s misalignment results from paralysis of the muscles on one side of the eye.

After extensive research, Geri and her husband found Dr. Arthur Rosenbaum, a UCLA strabismus specialist who performs 300 muscle-correction surgeries a year at UCLA’s Jules Stein Eye Institute.He led a painstaking procedure to sever and then reattach the delicate muscle from the center of Adam’s eye to the right side, enabling the boy’s eye to move to the right.A second surgery months later loosened the muscle on the inner corner of Adam’s eye, freeing it to look farther to the right.

Now 5, Adam is an outgoing kindergartner who enjoys playing basketball with his classmates and brothers.

“What Dr. Rosenbaum was able to do with Adam’s eye exceeded our wildest expectations,” Geri said. “We were thrilled to see how successful the surgery was.We had a really positive experience at the Jules Stein Eye Institute that made the negative situation with our son’s vision much easier for us to deal with.”

Adam was one of the youngest patients Rosenbaum had ever seen with paralytic strabismus.The disfiguring disorder is more common in adults and older children but can strike at any age, resulting in blurred or double vision, headaches and dizziness. In Adam’s case, Rosenbaum emphasized, there was a lot at stake.

“The younger the patient, the more sensitive the brain’s developing visual system is to disruption,” explained Rosenbaum, who holds the Brindell and Milton Gottlieb Chair in Pediatric Ophthalmology at the Jules Stein Eye Institute.“If a child loses the ability to use his two eyes in sync, the brain can forfeit its ability to coordinate the use of both eyes together, resulting in loss of depth perception and some peripheral vision.

Considered one of the foremost clinicians in the field of strabismus, Rosenbaum recently concluded his role in a study on the paralytic form of the disorder. The research explored how to feed signals from the patient’s normal eye muscles to stimulate the eye’s paralyzed muscles. Funded by a grant from the National Institutes of Health, the work led to the attempted firebombing of a vehicle at Rosenbaum’s residence by animal rights extremists and numerous demonstrations at his home. The Animal Liberation Front claimed repsonsibility for the attempted firebombing.

The work by Rosenbaum, who no longer is affiliated with research involving animals, will help advance new forms of treatment for children and adults suffering from paralytic strabismus. The findings also hold far-reaching implications for treating other conditions affecting pairs of opposing muscles, such as paralysis resulting from vocal-cord disorders and stroke.



“Since its birth in 1966, the Jules Stein Eye Institute quickly evolved into a world-class facility recognized for providing the best in eye care, surgery, research and education,” said Dr. Bartly Mondino, director of the institute.“UCLA faculty members have made solid and lasting scientific contributions that have produced a clearer understanding of eye disease and led to new treatments.”

Though one of the youngest eye centers in the country, the Jules Stein Eye Institute has been ranked by U.S. News & World Report as the best in the western United States for 19 consecutive years.Ophthalmology Times has also ranked the facility among the top three eye centers in the country.

Rosenbaum is one of many star physicians who have contributed to the institute’s distinguished reputation over the past 42 years. Among other milestones, UCLA ophthalmologists:

• Performed surgery on the infant son of the Anaheim Ducks hockey team’s star goalie, Jean-Sebastien Giguere, to correct a deformed right eye.Rosenbaum diagnosed the boy with persistent fetal vasculature syndrome.

• Uncovered new clues that may explain why Graves’ disease attacks the muscle tissue behind the eyes, causing them to bulge painfully from their sockets; researchers discovered defects in the infection-fighting T-cells of patients’ immune systems, deepening understanding of how this autoimmune disorder damages the body and offering a new target for treating the disfiguring disease.

• Wrote the first paper describing how AIDS reveals itself in the eye.

• Developed special MRI techniques to image eye muscles for more precise diagnosis of complicated strabismus cases.

• Pioneered many plastic surgery techniques, including the Madame Butterfly procedure, the transcaruncular orbitotomy and the deep lateral orbital decompression.

• Identified extended contact-lens wear as a risk factor for corneal infections.

The Jules Stein Eye Institute also has made great strides in educating future generations of ophthalmologists. Institute faculty members have trained thousands of UCLA medical students, hundred of residents and hundreds of fellows in clinical ophthalmology and vision science.

The institute has provided free ophthalmic care to hundreds of individuals who otherwise could not afford contact lenses, glasses, eye care or surgery, including uninsured families, economically disadvantaged youth and children who require contact lenses for congenital and infantile cataracts.

In addition, the institute’s telemedicine program provides ophthalmic screening services to diabetic retinopathy patients at the Venice Family Clinic; the Jules Stein Eye Institute Affiliates volunteer network offers free preschool vision screening and in-school educational programs about the eye; and the UCLA Mobile Eye Clinic provides free eye exams to underserved populations throughout Southern California, typically seeing 4,000 children and 1,000 adults a year.

Established in 1966, the Jules Stein Eye Institute represents the culmination of a dream shared by Dr. Jules Stein, an ophthalmologist, businessman and philanthropist, and his wife, Doris, of creating a world-renowned center dedicated to the preservation of vision and the prevention of blindness.

The institute has earned national and international recognition for its comprehensive programs for the care of eye disorders, research in the vision sciences, education in the field of ophthalmology, community outreach and state-of-the art facilities.