Harry W. Flynn Jr.

Professor of Ophthalmology, The J. Donald M. Gass, Distinguished Chair in Ophthalmology, Bascom Palmer Eye Institute, UHealth – University of Miami Health System, Florida, USA

What was the reason that you decided to pursue ophthalmology / your subspecialty in the first place?

As a first year medical student, we were required to go through a physical exam which included screening by ophthalmology. At that time, I was wearing glasses for myopic correction. The attendant asked, “Have you ever tried contact lenses?” My answer was “no but, I want to give it a try.” Within about one week I was wearing contact lenses full-time and was delighted with my wide field of vision and improved sharpness for distance and near vision. As a result of this positive encounter, I began to hang around the ophthalmology clinic, observing patient care and surgery. Ophthalmology is a unique specialty in which medical therapy and surgery combine to achieve visual improvement and improve the quality of life for our patients.

Who is someone in ophthalmology / your subspecialty that you feel has been particularly influential?

A number of individuals were influential in guiding my career in ophthalmology. It is difficult to include everyone but, I will list the major influencers. During residency, Marion Humphries was the chairman and program director at the University of Virginia. As a medical student, I had the opportunity to watch his surgery and to interact with him in the clinic. He provided essential guidance to me as a medical student and later as a resident. Jon Day and Gordon Buzzard were my chief residents and great teachers. As a surgery intern at California Pacific Medical Center in San Francisco, I had the opportunity to have a two-month elective in the Ophthalmology Department. During this elective, I worked in Medical Retina with John Cavender and in Surgical Retina with Wayne Fung. I especially enjoyed the Surgical Retina, including scleral buckling procedures as well as pars plana vitrectomy. After ophthalmology residency at UVA, I returned to San Francisco to be a Retina fellow with Wayne Fung and Gilbert Cleasby. 

After retina fellowship training, I was obligated to a two year tour of duty in the United States Army. My assignment was Brooke Army Medical Center in San Antonio, Texas under the supervision of John Shock. Although I dreaded going into the military, the assignment turned out to be excellent as I was involved in resident teaching and surgery supervision for two years at this large Medical Center. I was also allowed to serve as an attendant for the University of Texas Health Science Center in San Antonio as well as at the Wilford Hall Air Force Medical Center and the VA Hospital. The benefits of this diverse experience was the opportunity to work with a large group of residents and to enjoy participating in and giving lectures. As a result of the exposure to these academic programs, I was convinced that I wanted to pursue an academic career. I interviewed at a number of academic jobs from East Coast to West Coast and places in between. At an academic meeting in San Antonio, I had the opportunity to meet John Clarkson who was on the faculty at Bascom Palmer Eye Institute. I asked John if Bascom Palmer needed another retinal surgeon, and he connected me with Edward Norton, Founder and Chairman of BPEI. By chance, two retinal surgeons were leaving Bascom Palmer for other positions and there was a need for another person. My focus for the new position at Bascom Palmer was to work in clinical trials in diabetic retinopathy (mentor Dr. George Blankenship) and to manage endophthalmitis cases. This was absolutely perfect for me. I am now completing 45 years on the faculty at Bascom Palmer Eye Institute, University of Miami.

What’s been the biggest breakthrough in ophthalmology / your specific field over the last 20 years, and what are the reasons behind your choice?

There are 2 significant breakthroughs which arrived together around 2003 to 2005. The first is optical coherence tomography (OCT) which allows imaging of the posterior pole in order to identify vitreoretinal traction and macular edema. By establishing the baseline clinical features, the impacts of therapies could then be understood. As we gained a better understanding of the response on OCT, effectiveness of treatment on visual acuity was clear. The second breakthrough was the use of anti-VEGF agents for diabetic macular edema (DME), age related macular degeneration (AMD), and venous occlusive diseases. These two breakthroughs changed the retinal field and allowed us to restore and stabilize visual acuity for many patients worldwide.

What is your prediction for where ophthalmology / your subspecialty will be 10 years from now?

I believe that artificial intelligence will play a major role in screening and accurately diagnosing most retinal conditions and allow selection of better treatments for various common retinal diseases. As new pharmacotherapies are developed, artificial intelligence will allow more rapid selection of appropriate treatments in order to improve efficiency and outcomes for our patients with retinal conditions.