The James H. Hall Eye Center

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1 The James H. Hall Eye Center 2009 Year in Review Celebrating 30 Years of Success Our organization has experienced three decades of continued success thanks to the commitment and advanced skills of our team of ophthalmologists. Our story is not about the numbers it is about the children whose lives are transformed form darkness into light. The need for our services is greater than ever as we have become the primary source of ophthalmologic care for needy patients in metropolitan Atlanta. Many other eye clinics refuse to treat indigent or needy patients without the means to pay for their care, partially attributable to record unemployment, recession and the falling reimbursements to medical doctors. In Eye examination and treatment Testing of vision, stereopsis, binocularity and motility Patient/family education and counseling fact, the number of uninsured patients is increasing while the number of ophthalmologists available to care for them is decreasing. Other area practices are no longer accepting indigent patients without insurance and the Center receives hundreds of referrals which are given immediate medical attention. Without the Center, numerous children would go without eyecare. This does not mean just glasses and basic eye exams, but children with potentially devastating eye conditions such as cataracts, glaucoma, retinal diseases and potentially deadly eye issues, for example cancers in and around the eye Patient Care Services freely provided Preventative care Rehabilitation care Surgical and Postoperative Care Provision of extendedwear contact lenses like retinoblastoma and neuroblastoma. Our promise is to make sure that no child goes needlessly blind and has access to immediate ophthalmologic and surgical care. These children need good vision to succeed at school and live a normal life. Hospital care at Scottish Rite Hospital care at Piedmont Nursery Acute care in the Emergency Room The Center was established in 1979 when James Hall, our founder, realized that poor vision was adversely affecting thousands of indigent children in our state each year. We are committed to preserve and restore the sight of children through excellence in patient and surgical care, research and education News Briefs: Atlanta Magazine has consistently recognized Dr. Zane Pollard, our Pediatric Director, as one of Atlanta s Top Doctors, and a national survey publication has awarded him a designation as one of the Best Doctors in America. One of our graduates is currently the Pediatric section editor of the prestigious magazine " Ophthalmic Surgical News".

2 Recovery Rate The preservation and recovery of vision is the primary measure of success for the pediatric ophthalmologist. Often, the first goal is to save the eye and secondly to save sight. Our surgical improvement rate is as follows: Strabismus 90%, Tear Duct Procedures 90%; Lid/Plastics 80%. Regarding the newborn with a congenital cataract, we have enjoyed a large amount of success in this very difficult area. Many patients as well as difficult cases are referred to the Center or Scottish Rite Hospital because doctors know that an ophthalmologist is available 24/7 and because they also know that the patients will be treated effectively. This is not true in many other emergency rooms. We see patients from Georgia and surrounding states because it has become rare to have an ophthalmologist available Our intervention transform lives Amblyopic patients are followed and treated with patching techniques and glasses to achieve equal vision and hopefully develop good three dimensional vision. This is a lengthy process which requires diligent patching and exams until the child reaches 9 years of age. Patients born with cataracts and those who develop cataracts at an early age undergo surgery to remove the opacified lenses. Following surgery, they are given the proper corrective lenses to develop good vision. Some of these patients would become legally blind if they did not have the surgery and the visual rehabilitation. A 15 year old girl referred by Childspring International was operated for esotropia (crossed eye) and ptosis (droopy eyelid) and we received this acknowledgement: It was amazing to see her transform from a shy girl who hid behind her physical appearance to a strong lady who now exudes confidence. Her family is thankful at the new opportunity at life Dr. Pollard has given her Multidisciplinary approach The Center is closely associated with Scottish Rite Hospital which allows for multidisciplinary care. Children too sick for the outpatient surgery center are treated in the main operating room. The physicians from the Center work with neurologists, neurosurgeons, and neuroradiologists to discuss patients with complex issues affecting the brain, the eyes and the spinal column. Many of the patients we treat come from needy families, have failed school vision screening and have no means of obtaining a thorough eye examination anywhere else. A large percentage of these children are also developmentally delayed and are difficult to test and no one else knew how to check their vision. Others are severely mentally handicapped and get referred because the school or pediatrician do not know how to assess visual function. Page 2 The James H. Hall Eye Center

3 What would happen to indigent children if the Center did not exist? Children with considerable refractive errors but no glasses would not be able to excel in school or in extracurricular activities due to poor vision. Aphakic patients would not develop good vision if they were not provided the proper refractive correction in the form of specialized aphakic contact lenses. Children with crossed eyes may not only have abnormal vision, but also face the very real criticism of their peers due to their appearance. Before Surgery After Surgery Children served each year The medical team examined 475 patients at the Center and performed surgery on 15 children at no charge. This includes the work of some 18 doctors who devote a minimum of 915 hours each year to preserve and restore the sight of disadvantaged children in Georgia. We treat 1,300 emergency cases each year with a $40,000 annual budget. HALL EYE CENTER- PATIENT CARE $110,000 $105,000 $100,000 $95,000 $90,000 EXAM INATIONS DONA TED RA TE The importance of early intervention As the child grows, it becomes more difficult to positively affect the vision in cases such as amblyopia and early onset cataracts. A baby is not born with perfect vision; as the baby grows good vision is developed as the brain interacts with the outside world through the use of the eyes. If the eyes are not functioning or seeing properly, good vision will not develop. Children have a plasticity to their vision that does not exist in adulthood. With the proper treatment, a child's vision can permanently be improved; if the child does not receive treatment, the window of opportunity will pass and the child will never have the vision he or she could have obtained. We provide quality eye care to any child regardless of their circumstances or background. Newborn Retina Exams 30 exams/$200/per patient (donated) $6,000 Scottish Rite Hospital 300 Cases (trauma,infections neurologic) The James H. Hall Eye Center Page 3

4 Year in Review Meridian Mark Road Suite 220 Voice: Fax: jameshall/ The James Hall Post-Doctoral Fellowship in Pediatric Ophthalmology and Strabismus The program has graduated 34 fellows all of whom have passed the boards for certification in Ophthalmology. The fellowship deals with a high volume of patients, complicated pathology and extensive surgical management, over 600 surgeries as a primary and 400 surgeries as attending surgeon. Learned how to correctly diagnose multiple eye diseases and how to use diagnostic tools. He gained knowledge regarding numerous surgical techniques, performed hundreds of tear duct procedures and learned trauma management including eyelid lacerations sometimes involving the canallicular system and ruptured globes. Treated numerous cases ranging from trauma and infections to systemic illnesses and neurological conditions affecting the eye. Dr. Lange examined 123 patients at Fulton Health Department Clinic, 72 patients at the Center, responded to 43 emergency cases and applied surgical procedures for 15 indigent children which amounted to $31,860 worth of donated services this year. Dr. Lange stated: I was taught when to observe a condition and when to manage it with medication and also when surgery is the best option for the patient. Leadership Role in Pediatric Clinical Research We are working with a very experienced neuro-ophthalmologist who practices in Atlanta on a new paper called Unusual Presentations of Horner s Syndrome. The attached photo is of a 4 month old male who presented with ptosis ( droopy left upper eyelid) and miosis ( small pupil) on the left side. The combination of these two findings makes the diagnosis of Horner's Syndrome. A work -up revealed a malignant tumor in the neck called Neuroblastoma which was impinging on a nerve that led to the ptosis and miosis.the child was successfully treated with surgery and chemotherapy and now is tumor free for three years.

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