History of Berkeley Optometry—Part IV

1979-2005
Modernizing Clinical Training and Vision Science

"Those of us who as students … were inspired by Berkeley's excellence and innovations—and who now as practitioners rely on the School to update our skills—are all privileged to be a part of this prestigious university. The Campaign for the School of Optometry will renovate and expand facilities for teaching, research, and clinical training that will ensure the School's optometric leadership…." —Edward Elliott (Class of '65), 1990 President-elect, American Optometric Association Honorary Chair, Minor Hall Expansion Committee

 A complete history of Berkeley Optometry is available --- see History Book.

Residency Training

Establishing Berkeley Optometry's first optometric residency

The growth in optometry residency programs was largely due to Veterans Administration (VA) support of clinical education for optometry students and residents. Henry Peters (Class of '38), who left Berkeley Optometry in 1969 to become founding dean of the University of Alabama, Birmingham, School of Optometry, established the first VA residency in 1973 at Birmingham.

The Council on Optometric Education, recognizing the need for validation mechanisms by which to ensure standards in advanced optometric education and clinical training, accredited its inaugural optometry residency program in June 1976 at the Kansas City Veterans Administration (KCVA) Medical Center. Berkeley Optometry became the KCVA's first affiliate in 1978, largely through the initiatives of Robert Carty, OD, KCVA Chief of Optometry, and Kenneth Polse (Class of '65, OD '68, MS '69), who was then an associate professor and director of clinics at Berkeley Optometry. The KCVA residency concentrated on ocular disease, low vision, and team healthcare. The innovative program was modeled after VA medical and dental residencies. It was the first clinically based, one-year, accredited optometry program in the U.S., establishing a model followed by many VA and school programs thereafter.

Berkeley Optometry added two more affiliated VA programs in the 1980s. Edwin Mehr (Class of '41) and Curtis Keswick (Class of '75) directed a new residency program in the Palo Alto Veterans Administration Medical Center (Western Blind Rehabilitation Center) beginning in 1983. Bernard Dolan (Class of '80) established a program at the San Francisco VA Medical Center in 1985.

Berkeley Optometry's on-campus optometric residencies

Berkeley Optometry established its first on-campus residency in 1983; from 1983 through 1989 residents were offered programs in binocular vision, low vision, contact lenses, and visual functions. On-campus residents in the late 1980s-early 1990s treated patients and instructed or supervised in general or specialty clinics nearly half their time. They also attended seminars and graduate colloquia, taught in optometric laboratories, conducted research, engaged in independent or group study on topics assigned by faculty, and attended didactic courses. Current on-campus residency training follows a similar path. The present-day program's goal is to provide each resident with mentored postgraduate education and clinical training in one or two specialty areas of optometric practice — primary care, ocular disease, contact lenses, low vision, pediatrics, and binocular vision.

Dean Jay M. Enoch, OD, PhD

Jay Enoch, Berkeley Optometry's fifth dean (1980-1992), graduated in 1950 from Columbia College at Columbia University with a BSc in optics and optometry. He did his graduate work (PhD, 1956) at Ohio State University in the laboratory of Glenn Fry, where he studied the integration at the retinal plane of contributions of radiant energy from the entire eye pupil and the resultant visual response.

In 1958, Enoch joined the Department of Ophthalmology at Washington University, St. Louis, where he conducted studies on receptor fiber optics properties and ran experiments observing and photographing waveguide modal patterns in vertebrate receptors. In later psychophysical measurements, he explored the relationship between photoreceptors and measurements of the Stiles-Crawford Effect. Enoch developed an improved test apparatus and investigated the origin, purpose, and role of certain mechanisms (directional sensitivity, waveguide and fiber optics properties, color effects), investigating the properties of photoreceptor alignment and how receptor orientations are maintained.

In 1964, Enoch participated in the creation of the National Eye Institute, serving as executive secretary of a newly formed subcommittee on vision and its disorders within National Advisory Neurological Diseases and Blindness Council of the National Institutes of Health. In 1973, he was appointed to an endowed research chair by the State of Florida and the University of Florida at Gainesville, becoming a graduate research professor of ophthalmology and psychology in 1974, and later also a graduate research professor of physics, as well as director of a newly formed Center for Sensory Studies. At Berkeley, Enoch's primary research focus was on psychophysical testing of vision in four areas: hyperacuity and vernier acuity (alignment), studies on the Stiles-Crawford effect, experiments with perimetric and layer-by-layer assessments of neuropsychiatric patients, and aniseikonia experiments.

Enoch promoted postgraduate optometric education by expanding the scope of continuing education programs offered by Berkeley while serving as the first director of the on-campus residency program from 1983 until early 1991. Enoch also had a longstanding concern regarding eye care in the developing world. As one of the founders of the Elite School of Optometry in Madras, India (dedicated in 1985), he worked on improvements in diagnostic instruments for use with underserved populations in that country.

Berkeley's Clinical Program in the 1980s–early 1990s

Fiscal Crises

The clinic faced difficult financial challenges during the 1980s and early 1990s. The main causes were the need for improvements in clinic operations, especially in cost containment and revenue generation, and a lack of clinical teaching support (CTS) from the California State legislature, funds that at the time were distributed to all but two health science units within the multi-campus system. In addition, prepaid vision plans, which had become more prevalent in the corporate world, pushed increasing numbers of potential patients toward private practitioners. Unfortunately, the fiscal crisis also affected operations in clinical instruction.

To bring in more revenue, Dean Jay Enoch worked with clinic director Roy Brandreth (Class of '53) to reorganized the schedules of the general and specialty clinics from a nine-month academic calendar to a twelve-month annual calendar (1983). The year-round schedule remains in effect to this day. It not only ensures greater revenue for clinic operations, but also provides extended opportunities and a broader scope of training for student interns and residents while more closely following the private practice model.

For more than a decade, periodic University subsidies helped to partly offset growing revenue deficits. Finally, a debt-forgiveness agreement, initiated by Enoch and negotiated in final form by a new dean, Anthony Adams (see below), ultimately wiped the slate clean, with the understanding that no further bailouts would be possible. Since 1992-93, the clinic has operated profitably without the need of supplemental funding.

Controversy over the teaching of therapeutics

As if the fiscal crisis were not enough of a challenge to clinic operations, a controversy erupted in the early 1980s over the teaching of therapeutics at Berkeley Optometry. Spurred on by medical interests at the University and state levels, pressures were brought to bear on Berkeley Optometry to block the teaching of therapeutic drugs in didactic and clinical instruction. Most clinical faculty, students, and alumni were frustrated by this, as more and more states passed therapeutic privileges for licensed optometrists (California's law, however, was not passed until 1996). To compensate, faculty and administrators made changes to the curriculum as Berkeley Optometry began inching closer toward teaching therapeutics. Courses were added, such as "Ocular Implications and Manifestations of Systemic Disease," "Instrumentation of Ocular Disease Detection," "Basis, Recognition, and Management of Ocular Disease,"; and "Pharmacology." By the late 1980s, Enoch voiced more open support for therapeutics at Berkeley arguing for the University to recognize the inevitable changes taking place in the optometric profession. If Berkeley Optometry was to remain a leader in optometric education and fulfill its mandate to prepare its students for licensing and practice, TPA instruction had to be included in the curriculum. This was done in the 1990s.

Dean Anthony J. Adams, OD, PhD

Tony Adams graduated from the University of Melbourne in December 1962, where he received a bachelor of applied science (BAppSc) degree with honors, along with his Licentiate in Optometry from the affiliated Victorian College of Optometry. After a brief stint in private practice, including occasional travel throughout Victoria as an itinerant optometrist, Adams went to Indiana University where he worked on neurophysiological studies of color vision using open-eye preparations in goldfish. He received his PhD from Indiana in 1970 after joining the faculty at UC Berkeley in 1968, where he completed his dissertation on chromatic opponent responses in ganglion cells in goldfish retina.

Adams next became involved in studies on human color vision and glare recovery and the effects of alcohol, marijuana, and other drugs on visual, ocular, and oculomotor functions. He then turned his attention to the effects of eye disease on visual processes. He studied rod-cone interaction, flicker, ERG, color discrimination, blue cone sensitivity, adaptation, glare recovery, and contrast sensitivity in normal, color defective, and diseased eyes, emphasizing early changes in vision associated with diabetes and glaucoma. Adams' research during the 1980s-90s included the Orinda Longitudinal Study of Myopia (begun in 1992; funded by the National Eye Institute, NIH), for which he was the principal investigator.

Adams became assistant dean of Berkeley Optometry in 1985, and accepted the position of dean in 1992, remaining in that role until 2001. One of his first accomplishments was to institute a change in philosophy in the management of the optometry clinic and in the training of optometry students. The training developments included significant expansion in off-campus externships during the fourth year. He also established a new clinical faculty series, Professor of Clinical Optometry (PCO), increasing the number of full-time clinic faculty who had governance authority. In anticipation of California adopting TPA legislation (mentioned above), Adams worked with a group of faculty to organize Berkeley's first TPA course for licensed optometrists in 1992.

The Expansion of Continuing Education

The 1980s and 1990s were years of significant expansion of continuing education (CE) programs hosted or sponsored by Berkeley Optometry. Jay Enoch and Karen Walker-Brandreth (Class of '68; director of CE) introduced a modified grand-rounds modality of instruction to Berkeley in the early 1980s, first as lectures with clinical workshops starting in 1981, and later with live patients beginning in 1991. Important CE lecture series were added beginning in 1985 by Enoch and Kenneth Polse (Class of '65, OD '68, MS '69; director of CE, 1985-87). The first was the Berkeley Lecture Series, which quickly morphed into the annual Meredith Morgan Lectureship and Symposium in 1986 (later called the Meredith Morgan Symposium). The year 1987 saw the start of the annual Morton D. Sarver Lecture Series, which ultimately merged in 2005 with the Morgan program; the combined program today is titled the Morgan Symposium and Sarver Lecture Series. In 1989 the annual Berkeley Practicum was established, a classroom-style program covering practical clinical work, and highlighted since 2005 by the Karen-Walker Brandreth Lecture.

The Minor Hall Expansion

By the 1970s, roughly one-quarter of Berkeley Optometry's space allocations were in Cowell Memorial Hospital just across a service road from Minor Hall. The hospital allocated spaces for research and teaching laboratories occupying roughly 12,300 square feet. By the late 1980s, however, the hospital could no longer meet the demands of a modern healthcare facility, and the building was demolished in 1993. Berkeley Optometry was thus forced to find new facilities for some of its research labs and offices.

Fortunately, relatively modest alterations of the existing building met the specifications for earthquake safety and other building codes, and so Minor Hall was retrofitted with two additional floors. The renovation replaced the attic, added a new level (sixth floor), and provided modern, state-of-the-art facilities for research laboratories and animal quarters. The expansion of Minor Hall, along with a new optometry clinic in UC Berkeley's Tang Center (University Health Services), increased Berkeley Optometry's overall allocated space in campus facilities.

Other Facilities and Renovations

Tang Center Optometry Clinic

The two-floor expansion of Minor Hall was planned in tandem with the placement of a clinic providing primary optometric outpatient, specialty, and urgent-care services for the student body, as well as a variety of services for faculty and staff, in a new University Health Services building, the Tang Center. As it was situated in a hospital setting, the new clinic integrated optometry within overall health care operations on the Berkeley campus, while its design and clinical procedures gave the students an unaccustomed taste of what it was like to provide eye care in private practice.

Meredith W. Morgan University Eye Center

In 1995, the former binocular vision unit on the second floor of Minor Addition was remodeled to house the Eye Wear Center, an upscale display and service area on a par with many well-appointed dispensaries in the private sector. Later, as Berkeley Optometry was deep into preparations for its gala celebration of the school's seventy-fifth anniversary year in 1998, Chancellor Robert Berdahl approved a request from Dean Anthony Adams to rename the optometry clinic in honor of Dean Emeritus Meredith Morgan. It is now called the Meredith W. Morgan University Eye Center.

Refractive Surgery Center

In March 2000, Berkeley Optometry expanded clinic services with the installation of its first refractive surgery center. From its inception, the center has served a large number of patients, including referrals from private optometrists and patient self-referrals.

Pamela & Kenneth Fong Optometry & Health Sciences Library

On April 3, 2000, Kenneth Fong and Pamela Fong (Class of '77) pledged a substantial donation to establish the Kenneth and Pamela Fong Optometry and Health Sciences Library. (Additional funds were also provided for the remodeling of the lecture hall in Minor Hall.) With its modernized approaches to information access and retrieval, the Fong optometry library, which was dedicated on February 27, 2002, is a very different resource from the original optometry library of 1949 or its modifed successors in 1953 and 1977. The new library has seen more use as a collective space. Students are able to access library and web-based resources from their laptops, or from the Library's public PCs. Having materials online provides 24/7 access to journals that previously required interlibrary borrowing or a walk to another campus library. Yet despite the shifting patterns of patronage, the Library's collection of printed materials continues to receive heavy use. The collection includes more than 15,000 volumes of books and journals in the fields of optometry, ophthalmology, and vision science. These include all aspects of the eye, eye care, and vision. The health-sciences collection includes textbooks in health and medicine, health and medical education and research, and selected resources in medical informatics.

Dean Dennis M. Levi

Dennis Levi, OD, PhD, became the seventh dean of Berkeley Optometry in 2001. Raised in South Africa, Levi received his diploma from the Witwatersrand School of Optometry in 1967. He had treated strabismic and amblyopic patients in private practice. These were challenging cases that inspired him to learn more and seek better opportunities, but he could not see a future for himself in South Africa. So he entered the graduate program at the University of Houston.

At Houston, Levi received his OD (1971), MS (1973, "Brightness Contrast in Amblyopia"), and PhD (1977, "The Performance Properties of the Amblyopic Visual System"), while also working as an instructor and then assistant professor. He spent thirty years at Houston, with appointments as professor (1982), associate dean for research (1990–2001), and Cullen Distinguished Professor in 1996 (a lifetime honor). During his career, Levi's research focus has shifted from investigations into the etiologies of amblyopia to the recovery of function. Most of his efforts have been in behavioral studies or psychophysics. He has found that a surprising amount can be learned by individuals to correct some amblyopia with the right kind of training, even after six years of age.

On August 15, 2001, Levi ended his long career at Houston to become the seventh dean of Berkeley Optometry. To give the clinical faculty a greater voice within the administrative structure, Levi appointed an associate dean for clinical sciences (along with an associate dean for basic sciences). He also directed a faculty recruitment plan to begin the long process of replacing retiring faculty and extending the range of expertise in teaching and research. He negotiated with the University to increase temporary academic support funds and equipment replacement funds, and he worked to develop substantial student financial aid to offset some of the State-mandated fee increases.

Additional organizational improvements also followed upon Levi's appointments of an assistant dean for external relations and development (Lawrence Thal, Class of '75) to raise private funding, some of which would be allocated toward student financial support, and an associate dean for student affairs (Richard C. Van Sluyters, OD, PhD, vision science faculty). Levi has also worked to develop a improved academic profile on the campus for the School of Optometry by establishing stronger connections with other units and thereby increasing the School's visibility as an important academic unit. Such efforts have included shared faculty hiring with the Helen Wills Neuroscience Institute at UC Berkeley.

References