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  • Doheny Eye Institute: Beginnings, Milestones, and Legacy

    In 1944, Los Angeles philanthropist Carrie Estelle Doheny suffered sudden vision loss in her left eye. It severely compromised her total vision, since her right eye was affected by long-standing glaucoma.

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    Carrie Estelle Doheny

    Her ophthalmologist at the time, A. Ray Irvine Sr., MD (and my grandfather), offered support to help her make sense of her vision loss. At the same time, Doheny held extensive conversations with Irvine family members about the idea of an eye research laboratory at a local hospital that would also offer expanded ophthalmic services to the community and foster vision research activities. Those discussions launched the birth of what would later be called the Doheny Eye Institute.

    Many respected ophthalmologists, including Alan Woods, MD, director of the Wilmer Eye Institute, and Phillips Thygeson, MD, of the Proctor Foundation, were consulted to research the resources and organization of the best U.S. eye institutions. In 1947, with Doheny’s $227,000 donation, the Carrie Estelle Doheny Eye Foundation was founded.

    Its mission was to provide diagnostic services, an eye bank, community medical services, and “to further the conservation, improvement and restoration of human eyesight,” Doheny said.

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    A. Ray Irvine Sr., MD

    The West Coast lacked a central ophthalmic pathology service at the time, so specimens were often sent cross-country to the Armed Forces Institute of Pathology (AFIP) in Washington, D.C., for review and diagnosis. The resulting reports could be slow to arrive.

    Once the Doheny Eye Foundation was established, a robust ophthalmic pathology diagnostic service grew and thrived, filling a significant void in the area. Doheny became a tremendous resource for the community and region. Voluntary ophthalmic pathologists would teach and mentor University of Southern California (USC) eye residents in ophthalmic pathology since there were no full-time ophthalmic pathologists at the university. Additionally, assistance with identification and characterization of clinical microbiologic specimens was offered.

    Experimental pathology projects were also initiated using a small vivarium and cell culture lab enabling experiments with adjunct time lapse photography. This was initially done with the help of Walt Disney engineers. With the development of fluorescein angiography, Doheny expanded its offerings to the community to include diagnostic testing.

    The gradual increase in research activities required outsourcing to labs with existing expertise in specialized areas not yet developed at Doheny. Accordingly, the Doheny Board of Trustees began to consider an affiliation with a university partner. The goal was to maintain its independence while still taking advantage of the research and academic resources of a larger institution. In 1962, Doheny and USC entered into a formal affiliation agreement which benefited both parties.

    Four years later, the foundation offered financial support to the young eye research foundation to create a vision institute, and in 1969 USC sold property to the foundation on its health science campus to create a physical location close to the new resources.

    With this acquisition, the board recognized the need for a full-time medical director. Dr. Irvine, who had been serving as the part-time medical director, helped recruit William Spencer, MD, who served as the first full-time medical director for three years. Under Dr. Spencer and the board, the Doheny building design with clinic and laboratory facilities was completed, and the project broke ground in 1973.

    In 1974, Stephen J. Ryan, MD, was recruited to become the first full-time chairman of USC’s Department of Ophthalmology. Dr. Ryan’s first hire was a familiar ally from Johns Hopkins, Ronald E. Smith, MD, who had just completed his postgraduate fellowship and his commitment to the Public Health Service in Alaska. They were joined by Mike Allen, MD, and together they began a consultation service for community ophthalmologists. At one critical juncture, the three clinician scientists leveraged their homes to secure a loan for the clinical enterprise to move forward.

    Doheny evolved with the addition of new facilities and the establishment of the Estelle Doheny Eye Medical Clinic. The clinic allowed the faculty to offer their expertise in complex ophthalmological dilemmas and surgery to the community. However, surgeries had to be performed at local community hospitals. As the practice grew, Dr. Ryan recognized the need for a dedicated surgery facility on site in order to attract faculty and provide the specialized and necessary ophthalmic care.

    In 1985, the Doheny Eye Hospital, a 32-bed inpatient hospital facility with four operating suites, opened and began providing care to the community through a tertiary care practice, and the faculty grew. The hospital also grew to include several entities: a clinical practice, an eye hospital, a vision research institute, and an affiliation with the local eye bank, and so the Estelle Doheny Eye Foundation formally changed its name to the Doheny Eye Institute.

    As the USC ophthalmology faculty found their home in the Doheny facilities, interdepartmental and interdisciplinary research activities became possible, department faculty grew in number, scope, and expertise. This enhanced the education of the USC residents who previously were supervised by community ophthalmologists. Fellowships in all subspecialties were offered and became competitive.

    Research blossomed with core grants and funding, attracting international students, physicians, and researchers from Europe, Asia, the Middle East, Latin America, and Australia. It spawned educational, cultural, and research collaborations. Many Doheny alumni have gone on to become ophthalmology department chairs, medical school leaders, and major figures in organized medicine as well as national/international clinical and research organizations.

    One of Dr. Ryan’s goals was to transform the USC ophthalmology residency into a world-class program to attract the best and the brightest young doctors and nurture their education scientifically, clinically, and politically to become the future leaders in the field. Dr. Smith and Alfredo Sadun, MD, PhD, visited and successfully recruited from top-tier medical schools. The renewed commitment to the resident and fellow education gradually transformed the Doheny/USC program into one of the nation’s top 10 ophthalmology programs. This was aided by support from Doheny/USC alumni who supported residency training needs that were beyond the department’s budget.

    A major strength of this affiliation was patient-related philanthropy. Doheny Eye Institute’s fundraising from grateful patients provided USC ophthalmology additional resources and allowed its vision research programs and initiatives to flourish. This was instrumental in creating endowed chairs for many faculty and a vital pillar to successful physical expansion, and also enabled the purchase of additional land and buildings. Doheny resources were critical for the creation of the eye hospital as well as the gradual expansion of separate research and clinical facilities dedicated to Doheny/USC ophthalmology faculty and research activities. 

    Through the years, Drs. Ryan and Smith forged a partnership that valued innovation, energy, and success, allowing them to recruit well-qualified faculty and create a model for the future that supported independent thinking. Their leadership saw the development of a widely used glaucoma implant, the experiment of an intramural “retina institute,” development of a retinal chip, creation of an image reading center, and many other groundbreaking collaborations which have advanced and enhanced Doheny’s charter mission.

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    Drs. Steve Ryan and Ron Smith

    Dr. Ryan frequently stated his vision to transform Doheny and USC into a world-class eye institute with strong international ties to enhance the depth and breadth of potential collaboration. Doheny was positioned for unbridled success, since its founder and board members were resolute on institutional independence from a university partner while tapping into the resources available through such affiliation and collaboration.

    The internationally renowned Ryan Initiative for Macular Degeneration (RIMR) annual conference continues to bring together participants from different backgrounds and disciplines to generate ideas and discuss research challenges to facilitate new treatments and cures for age-related macular degeneration.

    After the end of the USC-Doheny affiliation, the deaths of Dr. Ryan in 2013, and Dr. Smith in 2014, there was a challenging period of reorganization. However, the Doheny board continued to look into partnerships. With the support of UCLA’S Stein Eye Institute Medical Director Bartly Mondino, MD, and the University of California Board of Regents, it entered into a 99-year affiliation with Stein. Shortly before his passing, Dr. Smith called this the “merger of the millennium.”

    Central to the evolution and future of Doheny Eye Institute lies in leadership’s foresight and strategic approach to extend collaborations beyond its institutional boundaries, reaping the associated benefits while preserving its fundamental core identity.

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    Doheny Eye Institute today