Christian Hester, MD
Christian Hester, MD,is an ophthalmologist at Little Rock Eye Clinic, Arkansas, specializing in cornea and refractive surgery.
Please share with us your background.
I grew up in Magnolia and Camden, Arkansas, a rural area in South Arkansas, where my father has served as the community’s ophthalmologist for 30 years. Growing up, I played competitive tennis and had a job as the house musician at the local coffee shop. If you are looking for something a little different, you might search YouTube for “Christian Hester The Phaco” to hear a country song about a complex cataract surgery, where the ghost of Charles Kelman, MD, visits the operating room.
I attended Hendrix College, where I served as president of the student senate and founded a grassroots organization and political action committee that united the student governments from all 19 4-year colleges and universities in Arkansas to play a key role in successfully lobbying for the reinstatement of $32 million in state scholarships. In this role, I learned more about public speaking, lobbying, and how to get things done in general. During my medical training, I had the opportunity to work in the American Academy of Ophthalmology’s Washington, DC, and San Francisco offices.
During my last rotation in medical school, I met my wife and the love of my life, Tammy. We now have two daughters, Catherine and Caroline.
What drew you to ophthalmology and, specifically, to your field of interest?
My ophthalmologist father and practice manager mother, Joe and Sharon Hester, were the biggest influences on my career choice. We have so much fun talking about ophthalmic topics that it borders on pathologic. During my residency, David Chang, MD, opened my eyes to what is possible in ophthalmic surgery when practiced at the highest level. After spending time in his operating room, I decided I wanted to be a higher-volume surgeon proficient in complex cases. Also during my residency, I did an externship with Warren Hill, MD, who may be the smartest person I have ever met. His friendship led me to the Baylor College of Medicine Fellowship in Cornea, Refractive, and Anterior Segment Surgery with Douglas Koch, MD; Bowes Hamill, MD; Stephen Pflugfelder, MD; Mitch Weikert, MD; and Elizabeth Yeu, MD. While I admit that I am highly biased, I think it is the best cornea/anterior segment fellowship in the United States. You would likely be hard-pressed to find a place where you can get such a rich mix of cornea, refractive, and complex anterior segment surgery in 1 year while working with a group of great people.
Please describe your current position.
I am in practice at the Little Rock Eye Clinic in Little Rock, Arkansas, where I specialize in cornea, refractive, and complex anterior segment surgery. I joined the cornea practice of Mike Roberson, MD, who has been one of the highest-volume corneal transplant surgeons in the United States for years. We operate at Baptist Hospital in Little Rock, which provides a tremendous number of resources for complex and routine ophthalmic surgery. In my opinion, Baptist Hospital plays the most important role in complex eye surgery for the state.
Who are/were your mentors?
Undoubtedly, if I have enjoyed any success in ophthalmology, it has been due to a number of mentors. In addition to my mentors mentioned earlier, as a medical student at the University of Arkansas for Medical Sciences, I admired Dr. Thomas Cannon’s sincerity and devotion to patient care; I strive to emulate him but know that I fall short. Susan Day, MD, who was Chair when I was a resident at the California Pacific Medical Center (CPMC), has been an inspiration to me. Her life story is one of making the seemingly impossible possible. I consider most of the faculty at CPMC important mentors of mine—can I list them all? Finally, I am indebted to Dr. Roberson, who I joined at the Little Rock Eye Clinic, for his teaching and support. I learned so much about cornea and external disease from him during my first year in practice that I essentially did a second fellowship.
What has been the most memorable experience of your career thus far?
I don’t have one specific most memorable experience. I practice 2.5 hours from where my dad practices, but I get to see patients in his clinic once a month. Those days are memorable and fun.
I’ve done a lot of work on iPhone photography and videography. I remember one day when I discovered several key steps that took the pictures and videos from being fairly good to great (in my opinion). This led to me publish a number of articles on the topic. At the 2013 American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting, my mentors and I gave one of the highest-rated lectures, won a Best Paper of Session Award, and received the People’s Choice and Best in Category Award at the ASCRS Film Festival.
What are some new technological advances that you
have found particularly exciting? Which advances in the pipeline are you most enthusiastic or curious about?
I think Dr. Koch, Dr. Weikert, Dr. Li Wang, and Dr. Yeu’s work on posterior corneal astigmatism is extremely exciting and useful. Undoubtedly, ophthalmologists are achieving better outcomes with toric IOLs because of their work. I probably drive Dr. Koch crazy by continually asking him questions about his work. I am also appreciative of Mark Terry, MD; Michael Straiko, MD; and Dr. Hamill’s work in making DMEK a better and more reproducible procedure.
What is the focus of some of your research?
I have enjoyed working with Clifford Terry, MD; Dr. Weikert; and Dr. Pflugfelder to make iPhoneography better and easier. You can Google “Christian Hester iPhone” to find a number of articles on the subject. Dr. Chang was kind enough to help me develop an online course that is available at the ASCRS Phaco Fundamentals Classroom (phaco.ascrs.org).
Dr. Pflugfelder has given me several research opportunities related to ocular surface disease. I’m currently involved in a prospective clinical trial for which he is the medical director. Dr. Pflugfelder comes up with the most innovative and creative treatments for ocular surface disease.
What is a typical day in your life? What keeps you busy, fulfilled, and passionate?
I seem to find myself working very hard most days. My work is gratifying because it is challenging and I get to make some people better physically and others better emotionally if there is not a good physical cure. I am constantly working on creating quicker, more affordable, and better ways of taking care of complex medical and surgical problems. My favorite part of the day, though, is going home to my wife and daughters. I just love it when my 2-year-old daughter tackles me as soon as I set foot in the door. I can’t wait until my 7-month-old daughter can do the same.
What advice can you offer to individuals who are just now choosing their career paths after finishing residency or fellowship?
If you are not failing or if you do not feel stressed, you probably aren’t realizing your full potential. Don’t ever let yourself become too comfortable. The support of mentors is important when pushing yourself to the next level. Having a mentor like Dr. Hamill has helped me tremendously. If you want to do complex surgeries, make sure that your clinic and operating room will be supportive. These cases can be time- and resource-intensive and are not a good fit for most places outside of a university setting. Start off by limiting yourself to one complex case a day and then increase the load as you become more proficient.
Tell us about an innovative procedure you are performing or a new imaging/diagnostic tool that has improved your practice.
I’m currently working on a new technique where I use the iPhone to precisely identify the steep axis of the cornea. I hope it will be helpful for toric IOLs, limbal relaxing incisions, and laser vision correction. Dr. Weikert and I are currently working on a big-bubble DALK technique to make the procedure easier and more reproducible. I hope to share more on this in the future.