Eye to eye . . .
"Emory's doctors were different."
College softball recruiters have already started watching Lori Smith. At 16, she pitches 65 mph, excels in math, loves to draw, and ranks #2 in her South Carolina high school class. She also has uveitis: specifically, pars planitis, a disease of the eye characterized by inflammation behind the lens, not far from the retina.
For years Lori assumed that the floating spots and black specks occasionally dotting her vision were commonplace. After she mentioned them to her mother, Kim Smith, the family’s search for a diagnosis began, spanning a series of doctors and tests before someone recommended the Emory Eye Center. Since 2010, Lori’s vision has been under the care of Steven Yeh, a specialist in retina as well as adult and pediatric uveitis, and the director of Emory Eye’s new subspecialty, the Uveitis and Vasculitis Service.
“Because of the longstanding nature of Lori’s condition,” Yeh says, “her case developed complications. It took us some time to figure out what combination of therapies would work best for her.” Her treatment has included systemic immunosuppressive medications, laser surgery, cryotherapy, and steroid injections to the eye.
Lori, who briefly saw Emory Eye’s Baker Hubbard before beginning treatment with Yeh, says that Emory Eye’s doctors were different: “I felt comfortable with them. When they were telling me about the uveitis, I could understand it better. And they were friendlier.”
Kim agrees: “At Emory, the doctors ask Lori about her activities, how she’s doing in school. They reassure her that they will treat her the best way they know.” Over time, a closeness has grown between Yeh and the Smiths. “They’re such engaging people,” Yeh says. “It’s easy to think of them as sort of a second family.” To Lori, “Dr. Yeh is awesome.”
Yeh takes for granted the expectation that Emory Eye physicians will show interest in their patients, invite questions, and make sure the family understands options and risks: “I don’t think what I do is unusual. I believe all of us at Emory strive to give our patients the most outstanding care possible.”
A key colleague for Yeh in the Uveitis and Vasculitis Service is Emory rheumatologist Sheila Angeles-Han. The two physicians collaborate to create a strong team: Yeh studies clinical outcomes of pediatric uveitis, and Han studies quality of life issues for pediatric uveitis patients – including Lori Smith.
Lori, looking toward college softball and possibly a major in physical therapy, rarely thinks about the blunt, terrifying prediction she heard at age 12 from a physician who suspected she had uveitis: “You might go blind.” Thanks to Yeh, a much more optimistic prognosis has taken its place – one that Yeh first shared with her parents while Lori was sleeping after surgery. He told the Smiths, “She may even outgrow this problem.”
Yeh sees the next few years as an exciting time for uveitis treatment: “A lot of work has been done in biologic medications; we now have options that didn’t exist 10 or 15 years ago.” A major development, he says, is the work of Emory Eye’s Hank Edelhauser and Georgia Tech researchers in suprachoroidal delivery of drugs to the eye.
Even though her vision still contains some clutter, Lori reports that the specks don’t interfere with her activities. “Having uveitis doesn’t bother me,” she says. “At first I would think, ‘I’m not normal anymore.’”
Through years of dealing with surgeries, medications, and side effects, however, Lori has learned what a strong individual she is. “Now,” she laughs, “I don’t even care about being ‘normal’!”
While continuing to treat Lori, Yeh keeps up his own normal activities: gaining insight from each patient; sharing new knowledge with patients and colleagues; and building the Uveitis and Vasculitis Service along with Purnima Patel and Bhairavi Dholakia, who also specialize in ocular inflammatory diseases.
Dr. Yeh also definitely intends – much like one of the family – to cheer from the stands at Lori’s next in-town softball game. “I have two sons,” he says, “who would love to see her play.”