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One To Watch | Jan/Feb '20

One to Watch: Monisha Mandalaywala Vora, MD

Dr. Vora is a comprehensive ophthalmologist and glaucoma specialist at Vantage Eye Care. She serves as a Clinical Instructor on the Glaucoma Service at Wills Eye Hospital in Philadelphia.

Please share with us your background.

I was born on Long Island but grew up in Canton, New York, a small town located near the US-Canadian border. I attended Clarkson University in Potsdam, New York, as part of my final year of high school. There, I was able to earn enough college credit to complete my undergraduate degree in 3 years. I attended Carnegie Mellon University in Pittsburgh, Pennsylvania, and graduated summa cum laude with a Bachelor of Science in chemistry and a minor in Hispanic studies. I knew in high school that I was destined for a career in medicine, and I was thrilled to return to Long Island to attend medical school at Stony Brook University. Upon graduating, I stayed on Long Island for another 4 years at Northwell Health (formerly North Shore Long Island Jewish Medical Center) to complete an internship in internal medicine and a residency in ophthalmology. In 2014, I matched into a glaucoma fellowship at the University of Pennsylvania’s Scheie Eye Institute.

What drew you to ophthalmology and, specifically, to your field of interest?

I always knew I wanted to do surgery of some kind. My dad was a general surgeon, and growing up I was fascinated by what his work entailed. When I got to medical school, I explored ophthalmology as an elective and loved the mix of technology, office- and OR-based work, and the ability to maintain long-term relationships with patients. Glaucoma seemed to be a great fit for my personality and passion: I knew I wanted to have an impact on patients in a life-altering way, by having the ability to save their vision from this complex and progressive disease.

Please describe your current position.

I am currently in private practice in the greater Philadelphia area. I operate every week and see patients in my office on the days I am not operating. I also spend time lecturing and precepting the glaucoma clinic for the residents at Wills Eye Institute.

Who are your mentors? 

I have been fortunate to have many mentors throughout my training. My first mentor was Robert Honkanen, MD, at Stony Brook University. As a glaucoma specialist himself, he was the first person to get me involved in the subspecialty when I was a first-year medical student. In residency, I most looked up to Arnold Prywes, MD; Craig Marcus, MD; Robert Rothman, MD; and Allison Angelilli, MD—all glaucoma specialists who shaped my ultimate desire to pursue glaucoma for fellowship. Michael Sable, MD, and Jules Winokur, MD, taught me how to perform cataract surgery, and I still often discuss cases with them to this day.

In fellowship, I was privileged to work with Eydie Miller-Ellis, MD; Prithvi Sankar, MD; and Amanda Lehman, MD, who taught me the art and patience of glaucoma surgery and postoperative management. I have also found mentorship in Iqbal Ike K. Ahmed, MD, FRCSC; Robert Osher, MD; William Trattler, MD; and Jonathan Myers, MD, who provided guidance while I navigated my first 5 years of being an attending. I am grateful to all of these individuals.

What has been the most memorable experience of your career thus far?

During my first 6 months as an attending, I took care of a 55-year-old monocular patient who had lost his eye to neovascular glaucoma. When he was referred to me, his other eye had an IOP of 50 mm Hg, 20/25 vision, and a ≤10° visual field. In a span of 4 years, I performed more than five surgeries on this patient. At his most recent visit, he remains 20/25 with a well-controlled IOP and relatively stable visual field. Every time I walk in the room, he shakes my hands and says, “Your hands saved my vision and my life. I can’t thank you enough for everything.” Moments like this bring me joy and remind me how lucky I am to do what I do.

What is the focus of some of your research?

I am most fascinated by and interested in the microinvasive glaucoma surgery (MIGS) space. My research has primarily focused on my results of combined cataract surgery and MIGS, including the iStent inject (Glaukos) and 180° viscocanaloplasty/goniotomy (Omni, Sight Sciences), with long-term follow-up.

Tell us about a new technique or technological advance that you have found particularly exciting.

It is an amazing time to be a glaucoma specialist. Our field has been the epicenter of ophthalmic advances and development. As mentioned above, I am constantly excited by the MIGS space. The safety profile of these procedures and the ability to combine them with cataract surgery has enabled me to provide IOP-lowering therapy while improving vision at the same time! The challenge of MIGS is determining which device or angle-based procedure is best for which patient, while also realizing that it is not a replacement for more traditional glaucoma surgery. Nevertheless, these advances have given more power to the glaucoma patient than ever before.

What is a typical day in your life? What keeps you busy, fulfilled, and passionate?

I start my day bright and early with a workout, either at home or in the gym. I then go to the office to see patients. Once a week, I am in the OR performing a variety of procedures, including cataract surgery, MIGS, laser-based procedures, trabeculectomy, tube shunt implantation, or revision surgery. I am blessed to have a stellar group of nurses and technicians who make it a joy to walk into work each morning. One of the best parts of my job is that I get to spend time with our residents precepting their surgical glaucoma clinic. They certainly keep me on my toes, and for that I am grateful. When I am not seeing patients, I can be found cooking, traveling, and spending time with my husband and daughter.

What advice can you offer to individuals who are now choosing their career paths after finishing residency or fellowship?

My advice is to be open, inquisitive, and generous. Residency and fellowship training are just the beginning of a long and fulfilling career. Continue to read and learn, attend conferences, and give talks of your own. Introduce yourself to leaders in the field. Accept challenging cases and ask for advice on how to manage them from those who have been there before you. This will help you build your surgical repertoire and be better prepared for the next challenge you encounter. Seek out mentors in your community who are willing to teach you from their experience. In return, give back and teach residents, fellows, technicians, and nurses. Learn from your mistakes. Never stop asking questions. And do everything with a smile.

author
Neda Shamie, MD | Section Editor

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