Eye in the Sky

The logo for Dr, James Oestreicher’s flourishing practice has a stylized eye over the words Cosmetic Laser Eyelid Surgery, bringing to mind the latest medical technology and the polished clients who can afford to seek it out. In his academic life, Oestreicher teaches ophthalmic surgery at the University of Toronto and is an award-winning researcher in oculoplastics, a specialty that applies the techniques of plastic surgery to ophthalmology. But as he sits in his downtown office discussing the rewards of his work, none of these achievements enters the conversation.

Instead, he points to his wall. There hangs a framed photo of an airplane – a memento of his “other life.” He has done some of his most fulfilling work aboard this plane as a member of Orbis International, a New York-based non-profit organization that flies ophthalmologists throughout the developing world. Their mission is to teach local eye doctors, nurses and other health-care personnel methods that prevent and reverse curable blindness. In a renovated DC-10 containing an operating room linked by video camera to a 50-seat onboard theatre and external classrooms, large groups benefit from the volunteers’ expertise. In the fall of 1998 Oestreicher made his fourth Orbis trip, journeying to Chongqing, China. Previous one-week missions took him to Burma, Latvia and Guiyang, China.

The 43-year-old, who completed his residency at U of T in 1989, first learned about Orbis in the late 1980s. “What drew me was the idea of teaching and going someplace and making an impact,” he says. A professor of ophthalmology at U of T, he says his overseas experiences are unlike any teaching he has done – or ever will do. Orbis doctors focus on introducing procedures that local ophthalmologists can use to help the most people. “We want fairly typical cases rather than extremely rare birds, but we have to go with the flow and see what comes.”

Sometimes what comes is anything but typical. “One woman [in China] came to us with blindness that was caused by an industrial accident and never properly treated,” he says. “Her eyelids had fused to her brow, but it wasn’t too late to repair the damage.” When he describes patients suffering from medical neglect, such as the monk with a disfigured eye who trekked through the Burmese jungles to get to the Orbis site, Oestreicher shows compassion as well as hope: he knows he can’t fix systemic health-care problems, but his work does leave behind a framework for a better future.

Another thing that keeps him going back is the interaction with local health-care teams. “They are very grateful, appreciative and always interested in learning.” He still corresponds with doctors overseas; a Chinese colleague, for one, consulted him about a child with a rare eye tumour. The standard treatment there was to remove the whole eye, and Oestreicher says the child would likely have died. So he sent medical literature on an alternative treatment. He has no idea what the outcome was, but takes comfort in knowing that he tried to make it a positive one.

“Part of the reason I’m in this field is that it’s very creative and every case is different,” he says. “Orbis extends the range of work I do from cosmetic, to functional, to going to the Third World and really making a difference. It gives my work some balance.”