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One To Watch | Mar/Apr '21

One to Watch: Alison Early, MD

Dr. Early is a cataract surgeon and comprehensive ophthalmologist at the Cincinnati Eye Institute.



PLEASE SHARE WITH US YOUR BACKGROUND.

I grew up in the suburbs of Cleveland as the second of four children. My parents instilled a love of learning in us at a young age and had high expectations for us in all of our endeavors, both academic and extracurricular. Athletics were a huge part of my life, and I played three varsity sports in high school. Being a team athlete taught me important lessons that have helped me succeed throughout my life, such as the importance of consistency, daily practice, showing up on time, maintaining a healthy mind and body, and working successfully with other team members.

From a young age, I expressed interest in being a doctor. My grandfather was a general surgeon, but the draw to medicine skipped a generation, and I was the next one in the family to pursue this path. With a lot of guidance and research from my parents, I applied to and was accepted into an 8-year combined BA/BS-MD program at the University of Cincinnati. With a full scholarship awarded for being a National Merit Finalist, it was an easy decision to attend UC.

When I entered medical school, I did not have a clear idea of what type of medicine I was interested in. Early on, I considered preventive or lifestyle medicine, as I felt these fields would relate well to my interest in overall health and wellness. I clearly remember the day as a first-year student when Robert H. Osher, MD came to present a lecture on ophthalmology and showed a video of one of his cataract surgeries. I had never seen anything like it before and was amazed at how quickly the surgeon could restore a patient’s eyesight. This led me to pursue more exposure to ophthalmology, including shadowing and research. Once I saw the incredible opportunities and breadth of the field, I knew it was the right one for me. I have always loved to work with my hands, and the fine attention to detail was a perfect match.

I completed my residency training at The Ohio State University Havener Eye Institute, after which I felt well equipped to begin a career as a cataract surgeon and comprehensive ophthalmologist. It was truly a full-circle moment when I was hired back at my dream institution, the Cincinnati Eye Institute, and began my career in the company of some of the most brilliant minds in our field.

WHAT DREW YOU TO OPHTHALMOLOGY AND, SPECIFICALLY, TO YOUR FIELD OF INTEREST?

Once I had exposure to the OR in my general surgery rotation, I knew I wouldn’t be happy unless my career included surgery. Throughout residency, I loved every opportunity to watch and observe my attendings performing cataract surgery, and I quickly learned that, the more I operated, the more valuable it was to watch others’ techniques.

I love that ophthalmology is a fast-paced, quickly developing technical field with tangible results and amazing patient outcomes. There is nothing like taking someone from light perception vision with a white cataract to 20/20 the next day. Since starting in practice, I have been drawn to advanced-technology IOLs and other new frontiers such as MIGS, as well as the effective management of ocular surface disease (OSD).

PLEASE DESCRIBE YOUR CURRENT POSITION.

I am in my third year of practice as a cataract surgeon and comprehensive ophthalmologist at Cincinnati Eye Institute, which is part of the larger Cincinnati Vision Partners group. My clinical practice is broadly comprehensive, and I have quickly become a busy cataract surgeon. My primary clinical locations are in our northern satellite locations, where the patient population brings a wide variety of pathology to a comprehensive practice.

WHO ARE YOUR MENTORS?

Asking for help was always uncomfortable to me, and I did not fully understand the value of mentorship until I was in residency. My mentor in residency was Mary Lou McGregor, MD, a pediatric ophthalmologist at Nationwide Children’s Hospital in Columbus, Ohio. Dr. McGregor was exactly who I wanted to be when I grew up. I was immediately drawn to her personality and admired how well she balanced a successful career with being a very involved mother to her four children. She provided valuable advice to me on everything from job and career to family planning decisions. Her home is always open to residents for a warm meal when you’re on call.

Since becoming part of CEI, I have had the pleasure of counting Michael E. Snyder, MD, as a mentor. Everyone in the ophthalmology world knows who Dr. Snyder is, and for good reason. A few weeks before my first day on the job, I was able to spend a day observing him in the OR. I came home with pages of notes and a completely new way of thinking about many aspects of cataract surgery. I am grateful I had that opportunity. Any time I have reached out to ask his advice, he is extremely open and available to share his wealth of knowledge.

Another partner who has been an incredible mentor as a young physican and mom is Kavitha Sivaraman, MD. Dr. Sivaraman was one of the only female anterior segment surgeons in the practice when I joined, and she has since become a close friend and clinical advisor. She is an intelligent, talented physician, and I admire her leadership and dedication to her work. She welcomed me into the group, and we communicate nearly daily for consults on everything from patient care to parenting and navigating a professional career as a young woman.

WHAT HAS BEEN THE MOST MEMORABLE EXPERIENCE OF YOUR CAREER THUS FAR?

Making it through my first day in the OR on my own was a proud moment for me. One of my other partners shared with me that he broke the capsule on his first surgery in practice. In retrospect, he said, it was good that he got it out of the way so that he didn’t have to dread it every time he was in the OR. I had somuch anticipation and anxiety around that first day in the OR, as the captain of the ship for the first time. My first case went great, and I breathed a huge sigh of relief. I made it through all of my cases for the day, and that “I can do it” feeling grew with each one.

As it happens, I have since had a few “first days back” to the OR,after maternity leave and then again after the COVID-19 shutdowns in 2020. Although there is undoubtedly some anxiety any time you return to surgery after a hiatus, it really is like riding a bike. I know now that I absolutely can do it.

WHAT NEW TECHNOLOGICAL ADVANCES HAVE YOU FOUND PARTICULARLY EXCITING? WHICH ADVANCES IN THE PIPELINE ARE YOU MOST ENTHUSIASTIC OR CURIOUS ABOUT?

I am very excited about new advanced-technology IOLs including the nondiffractive extended depth of focus AcrySof IQ Vivity (Alcon). I have been impressed with the outcomes with the PanOptix Trifocal (Alcon) this past year, and I can’t wait to offer even more patients the possibility of an expanded range of vision.

I have also recently begun offering the bimatoprost implant 10 mcg (Durysta, Allergan) to my patients with open-angle glaucoma. A significant proportion of my patients deals with chronic OSD, and those taking topical glaucoma medications are increasingly burdened with OSD. The Durysta implant and other long-acting agents in development comprise an exciting frontier for medical management of glaucoma with the benefit of decreasing the drop burden on the ocular surface. As the population ages, chronic disease rates rise, and as we spend more time looking at screens, dry eye and OSD will increasingly affect our patients.

WHAT IS THE FOCUS OF SOME OF YOUR RESEARCH?

I am not currently enrolled in any clinical research studies but am working on some mentorship and educational projects geared toward an online audience.

WHAT IS A TYPICAL DAY IN YOUR LIFE? WHAT KEEPS YOU BUSY, FULFILLED, AND PASSIONATE?

My days begin between 5:30 and 5:45 am, when I roll out of bed and head to the basement for a workout. The past few months I have really turned over a new leaf (or an old one) and gotten back into regularly exercising. Before having children, I worked out almost every morning before going to work. I do not love waking up early, but I love having it done, getting my energy going, and not having that task hanging over my head all day.

Most days I am out the door for work before my children are awake. I am the mother of two incredible smart, active children; a 2-year-old boy and 15-month-old girl. I work full time as a cataract surgeon and comprehensive ophthalmologist. Depending on the week, I have OR time 1 to 3 half days and the remainder is clinical time. At this point in my life it is very important to me to have quality time with my children, so I like to be home by about 5 in the evening. That gives us time to play, interact, and get dinner ready. Nights that I get home late leave me feeling off-balance and disconnected from the kids.

My husband is an orthopedic surgeon, so while we both have busy schedules, we place a high value on sharing dinner as a family every night, without disruptions from electronics. The kids go to bed around 7:30, and the next few hours are time for to-do list items, tidying, and unwinding. I try to go to bed by about 10:30 pm. to get good rest for the next day. I have never been a night owl, so if I don’t have the energy to accomplish something at night I will get up extra early in the morning to get the job done.

WHAT ADVICE CAN YOU OFFER TO INDIVIDUALS WHO ARE JUST NOW CHOOSING THEIR CAREER PATHS AFTER FINISHING RESIDENCY OR FELLOWSHIP?

I recently heard this excellent advice: Create your dream job in your mind, and find a practice where you can bring it to life. Of course, many of us have external considerations such as family location, spouses’ careers, etc., but having a clear idea of what you are looking for will go a long way in evaluating whether a certain opportunity is the right one for you.

TELL US ABOUT AN INNOVATIVE PROCEDURE YOU ARE PERFORMING OR A NEW IMAGING OR DIAGNOSTIC TOOL THAT HAS IMPROVED YOUR PRACTICE.

For more than a year, I have been delighted with the outcomes my cataract surgery patients are having with the PanOptix Trifocal IOL. The quality and range of vision provided by this IOL far surpass those of previous-generation multifocal IOLs. One limiting factor is that, for this diffractive multifocal IOL, many interested patients can be disqualified by mild disease such as early macular degeneration, glaucoma, etc. Recently, the nondiffractive extended depth of focus Vivity IOL has become available, and this is a fantastic option for patients who are not perfect candidates for the PanOptix diffractive IOL technology. I am excited to be able to offer more of my patients a new lease on life without glasses using these excellent new IOLs.

author
Neda Shamie, MD | Section Editor

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