Dr. Tonk is a cornea, cataract, and refractive surgeon at the Bascom Palmer Eye Institute in Miami.
Please share with us your background.
I was born and raised in New Jersey in a household that valued hard work, looking after one another, and finding joy in the simple things. For my undergraduate degree, I attended Cornell University, where I met the incredible woman who would ultimately become my wife and mother to my two beautiful children.
I always aspired to have a career in medicine, but I realized that the doctors I admired most were working to solve broader challenges in our health care system with respect to equity, quality, and cost. This led me to pursue an undergraduate degree in economics and then to return to New Jersey to pursue a 5-year combined MD/MBA program at Rutgers University.
I completed ophthalmology residency at Albany Medical College in New York, where I received terrific (and intense!) clinical training in a supportive, familial environment. Finally, I moved to Miami for a cornea and refractive surgery fellowship at the Bascom Palmer Eye Institute, after which I accepted an incredible opportunity to join the institution’s faculty.
What drew you to ophthalmology and, specifically, to your field of interest?
Like many others, my interest in ophthalmology was sparked by work in global health. As a sophomore in college, I spent a summer in rural Nicaragua to screen for and fund cataract surgeries for needlessly blind patients. I was incredibly moved by the joyful reactions of the patients whose sight was restored. What’s more, I fell in love with the Spanish language and Latin culture, which shares many similarities with my Indian heritage.
My interest in cornea, cataract, and refractive surgery branches from that same desire to improve patients’ quality of life in a visceral, perceptible way—whether that means helping a healthy young person achieve 20/15 vision with LASIK or helping a patient with corneal blindness see again after keratoplasty.
Please describe your current position.
I am currently an Assistant Professor, Associate Medical Director, and Fellowship Codirector at the Bascom Palmer Eye Institute. It’s about as close as it gets to a dream job.
Miami has been a great place for my wife and I to raise our children, who learn Spanish in school and enjoy the warm waters of Biscayne Bay year-round. The city is a global hub that connects the Americas and the Caribbean; this bestows upon our center the duty to manage complex eye disease, which keeps me both stimulated and humble.
I have the extraordinary privilege of working closely with some of the best and brightest residents and fellows in the country, whether in clinic, in the OR, or in research. They constantly push me to innovate, evolve, and think differently. The cliché is true—I learn more from them than they do from me!
Finally, as an Associate Medical Director, I work with our administrators to innovate and optimize our group practice in a way that puts patients first and allows physicians to do what we do best.
Who are your mentors?
I am fortunate to have incredible personal and professional mentors in my life, each of whom asks only that I pay it forward to those who follow. This list is woefully inadequate, but here goes.
I thank my residency mentors, including Robert Schultze, MD, FACS; Martha Farber, MD; John Simon, MD; and Ted Wladis, MD, for pushing me to my full potential while always looking after my spirit. I thank my fellowship mentors, including Kendall Donaldson, MD, MS; Anat Galor, MD, MSPH; Carol Karp, MD; Sonia Yoo, MD; Guillermo Amescua, MD; William Culbertson, MD; Eduardo Alfonso, MD, and Victor Perez, MD, for teaching me how to think and for the ongoing advice on tough patient cases, career development, and work-life balance. Finally, I thank Bill Trattler, MD, for helping me to develop my professional network as well as the peers I’ve met in my first several years of practice who both inspire and elevate me.
What has been the most memorable experience of your career thus far?
My most memorable case was a keratoprosthesis surgery for a kind, monocular woman with multiple failed corneal transplants in her only seeing eye. She moved to Miami with hope that I could help her. After months of preparation, including immunomodulation for her rheumatoid arthritis, we proceeded with surgery: a Boston Type I keratoprosthesis procedure, glaucoma drainage device implantation, vitrectomy, and lateral tarsorrhaphy.
The day after surgery, I removed the patient’s patch and began to examine her eye. She pulled back from the slit lamp. “What’s the matter?” I asked. A moment passed, and then a big smile came to her face. “Dr. Tonk, it’s the first time I’ve seen your face!” She now enjoys 20/40 vision with a stable, well-integrated keratoprosthesis device. This experience gives me the faith to continue taking on tough cases—they can often be the most rewarding!
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 am excited about the IC-8 Apthera small-aperture IOL (AcuFocus) becoming available in the United States. I frequently perform cataract surgery on patients with irregular corneas from prior refractive surgery (including radial keratotomy), keratoconus, corneal scars, etc. To have an IOL option that can block peripheral, aberrant light rays and provide a focused image to the retina is very compelling.
I am also thrilled to see companies developing cloud-based digital health platforms (eg, Veracity Surgical [Carl Zeiss Meditec] and Smart Solutions [Alcon]) that hold the potential to integrate electronic health records, diagnostic devices, and surgical equipment. As these platforms mature, and as they ultimately integrate AI, I hope that surgical planning becomes more precise, safe, efficient, and flexible.
What is the focus of some of your research?
My research is inspired by real-world patients who aren’t well served by current medical knowledge and by trainees whose questions I can’t answer! On the ocular surface front, I am conducting prospective and retrospective research on patients with ocular graft-versus-host-disease, and I am engaged in clinical trials in infectious keratitis, neurotrophic keratitis, and Sjögren syndrome. For corneal surgery, I am working to understand and modify risk factors for corneal transplant failure, particularly in grafts that develop retrocorneal membranes. Finally, for cataract surgery, I am studying IOL power calculations in eyes with aberrated corneas and real-world performance of presbyopia-correcting IOLs.
What is a typical day in your life? What keeps you busy, fulfilled, and passionate?
I typically wake up around 5:30 AM and take the first hour of the day to sneak in a quick workout, catch up on email, or simply cook and savor a nutritious breakfast. Shortly after, my two lovely (but very energetic!) kids wake up, and controlled chaos ensues while getting everyone changed, fed, packed, and out the door.
My typical workweek involves 2 days in clinic, 1 or 2 days in the OR, and a half day in the refractive surgery suite. I am blessed to work with a resident or fellow nearly every day. Operating days are my favorite—a certain zen comes with applying one’s mental and physical capacities to a single task and allowing the distractions to fade away.
After work and on the weekends, it is all about family. We love to play music and sports together and to spend time enjoying sunny South Florida.
What advice can you offer to individuals who are just now choosing their career paths after finishing residency or fellowship?
Not everything has to happen right away. Focus your early years on building your practice and taking great care of patients. If you love what you do, your enthusiasm will lead to opportunities for research, education, speaking, and so on.
Stay in touch with your mentors! I love hearing from former trainees, whether to discuss a difficult case, review career advice, or simply say hello. Also, take extra time for your family and friends. They have invested years in your training and education and want to see you thrive both personally and professionally.
Tell us about an innovative procedure you are performing or a new imaging/diagnostic tool that has improved your practice.
About a year ago, I began implanting the CustomFlex Artificial Iris (HumanOptics), a foldable iris prosthesis for medical and aesthetic reconstruction of eyes with aniridia. This device has been a game changer for my patients whose irides could not be reconstructed with conventional pupilloplasty or iris cerclage techniques.