2025 Myers Lecture

Picture yourself caring for a patient with glaucoma or suspected of having glaucoma. You measure intraocular pressure, image the retina with OCT, and perform visual field testing. The visual field took less time to do than in the past, the amount of information it provided was more extensive, and the probabilities about progression helped guide your management of the patient. You enjoy practicing with state-of-the-art instrumentation, but did you ever stop and wonder exactly how visual field testing became so sophisticated? 

A large part of the “how” was provided through the career of V. Michael Patella, OD, the 2025 Jeffrey and Joyce Myers Lecturer. “Lessons learned from 50 years wandering in the jungle of ophthalmic diagnostics” took us from Dr. Patella’s undergraduate degree in physics, to meteorology in the Air Force, to aerospace engineering on Skylab for NASA, to an OD degree from the University of California, Berkeley School of Optometry, and finally to Humphrey Instruments when it was just a tiny Berkeley startup company. Rubbing shoulders with Nobel laureate Luis Alvarez (he of dinosaur extinction fame) at Humphrey might make anyone smarter but probably also more driven. Professor Alvarez could deliver a lethal dose of disapproval, so according to Dr. Patella, only a “milli-Luis” was needed to keep a project on track. Humphrey was eventually acquired by Zeiss, a global player in ophthalmic diagnostic equipment.

Computerized automated perimetry was an idea whose time had come in the 1980s. Dr. Patella the engineer could see how to deliver the stimuli, but the real value was in making a better diagnosis: what was normal so you can tell what was abnormal? The answer was to put together a team that could make sense of huge sets of data, one that is recognized today as a veritable who’s who in the world of glaucoma. It takes a village, and in this case it was a Swedish one: Anders Heilj, MD, PhD, Boel Bengtsson, PhD, and Jonny Olsson, PhD. Johns Hopkins University’s Wilmer Eye Institute supplied normative data and the result was SITA (Swedish Interactive Thresholding Algorithm), constantly evolving into what became SITA Fast and SITA Faster.

Equally comfortable in the worlds of optometry and ophthalmology, Dr. Patella has traveled the world to educate clinicians on the interpretation of visual fields. His text, “The Field Analyzer Primer”, may be the most widely distributed guide in the world for both professions. Not only is he a member of medical glaucoma societies, he was one of the founders with Tom Lewis, OD, PhD, and Murray Fingeret, OD of the Optometric Glaucoma Society (OGS).

So how did something like visual field testing get so sophisticated? The answer in Dr. Patella’s case is chance (favoring his prepared mind), finding talented people, teamwork, darned hard teamwork, and decades of effort. Think of the vision you save through modern, evidence-based care in glaucoma and then multiply it by millions and you have the impact of the career of our 2025 Jeffrey and Joyce Myers Lecturer, Dr. Mike Patella.

LIFE LESSONS

Fifty years is a long road. Dr. Patella offered 16 life lessons as guides for the journey. 

1. Pick good guides (like Luis Alvarez and Douglas Anderson, MD).
2. You don’t have to bat 1000.
3. It takes a village (go find yourself a good one).
4. Learn what people do well and don’t do well. Assign tasks accordingly.
5. Go outside your neighborhood. Expertise is out there.
6. Success is earned over and over. No resting on laurels.
7. Figure out what the world needs (and not on what you want to make).
8. Stand on giant shoulders.
9. It is more fun to lead than to follow.
10. Your data may humble you.
11. If you mess up, admit it.
12. There is always more to be done.
13. Professional organizations are important (like OGS).
14. Be nice (especially if somebody’s mother is watching).
15. Change the world (wonders and wonderful people are out there waiting for you).
16. Retired people can still contribute!