Five Questions With: Dr. Wendy Chen

Dr. Wendy Chen is the new chief of pediatric ophthalmology at Hasbro Children’s Hospital. She oversees the delivery of comprehensive emergency, outpatient, and surgical eye care for children ranging in age from infancy to adolescence. She received her bachelor’s degree from Washington University in St. Louis and her M.D. and Ph.D. degrees from the Warren Alpert Medical School of Brown University.

PBN: The eye is very vulnerable, and children are very vulnerable. What are the various unique challenges that being a pediatric ophthalmologist presents?
CHEN:
Eye problems in children are very different than those in adults. Adults are typically screened for age-related disease such as cataracts, glaucoma, and macular degeneration. In contrast, children are screened for developmental diseases of the visual pathway. The most common eye problems in children are amblyopia and strabismus, both of which are reversible causes of vision loss if detected and treated early. The greatest challenge in pediatric ophthalmology, as in the field of pediatrics in general, is gaining the trust of a young child that you are seeing for the very first time. The true challenge in pediatric ophthalmology is making a technically difficult exam fun for both the patient and the doctor, while at the same time gathering reliable information that can help direct your treatment strategy.

PBN: Are children especially grateful when their eye and vision problems are solved?
CHEN:
I’d like to think that children and parents alike are always very grateful when their eye and vision problems are solved. Though children may not always fully understand that they are having trouble with the eye(s) and aren’t always able to express their gratitude verbally, their visual behavior can often be a clue to whether your treatment strategy is effective. For example, when a parent says to me, “my daughter reaches for her glasses as soon as she wakes up,” this says to me that her vision is better with the glasses that I’ve prescribed. This in itself is its own reward!

PBN: Hasbro is increasing its ophthalmology services in conjunction with your appointment. What kinds of opportunities do the new facilities present you as a doctor?
CHEN:
Hasbro Children’s Hospital has been incredibly supportive in the development of the pediatric ophthalmology services. Our ophthalmology faculty have always provided basic eye care to the pediatric population. However, with the opening of a dedicated pediatric ophthalmology clinic with child-friendly exam equipment, we have been able to make our evaluations more complete and to improve access to care for our patient population. Our staff has been trained to work with children, and this helps to facilitate a good experience for the children and their families. In addition, we are now equipped with portable exam equipment that is housed in the Hasbro Children’s Hospital operating room.

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PBN: What have been the biggest developments in the field of pediatric ophthalmology in the last 20 or 30 years?
CHEN:
There are so many! Where to start? Ophthalmic technology has come so far in the last few decades. One, there are a number of new vision screening devices that can be used in infants and pre-verbal children that assists in early detection of strabismus and risk factors for amblyopia. Two, advances in intraocular lens implants and vitrectomy have revolutionized the way that congenital and childhood cataracts are managed. Three, there is an explosion of new information daily that helps us to understand developmental and genetic disease, both where eye disease is the main feature, or where eye disease is included in the manifestation of a more global, systemic disease process. And four, technology ranging from a simple fundus photograph to detailed optical coherence tomography has been adapted for use in the pediatric population and continues to develop and improve constantly.

PBN: What were some of the things that drew you to the field?
CHEN:
The kids, of course! The ophthalmology exam is so different in children compared to adults – it’s extremely challenging, at times frustrating, but oh-so-rewarding! I can pinpoint two exact moments in my training when I realized without a doubt that I wanted to dedicate my career to pediatric ophthalmology. The first was when I was an ophthalmology resident in Pittsburgh, while I was on my pediatric ophthalmology rotation. There was a very sick child that our service had been following in the ICU, whose previously mysterious illness was diagnosed based on eye findings. This is when I realized that the eye exam could be so crucial in diagnosing systemic disease. But what drew me in was the fact that this little girl’s face would just light up every time I came to check on her, greeted by “Dr. Chen! My eyes are better today!” The second instance was during my pediatric ophthalmology fellowship in Philadelphia – I was seeing a post-op strabismus patient. He was an 8 month old infant with congenital esotropia who underwent eye muscle surgery to place his eyes into better alignment. His parents brought him in for his first post-operative exam and could not stop gushing at how he “took off” right after his surgery – literally. Up until then, he had been slightly delayed with his motor skills. Soon after his surgery, he began to crawl, then “cruise” along with the help of the couch. Vision is so critical in the overall developmental course in children. To see the joy in these children’s’ and parents’ faces is what makes pediatric ophthalmology one of the best jobs in the world!

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