Ophthalmologist finds another way to be a rock star

From a series on researchers and innovators at Boston Children’s Hospital.David Hunter, MD, PhD

David G. Hunter, MD, PhD, dreamed of a career as a rock star. Instead, he became Boston Children’s Hospital’s ophthalmologist-in-chief and invented the Pediatric Vision Scanner. The device, designed for use by pediatricians, detects amblyopia or “lazy eye,” the leading cause of vision loss in children, as early as preschool age when the condition is highly correctable. Because of its high degree of accuracy, the scanner was awarded the Sheikh El Zayed Pediatric Medical Device Innovation Award after it was presented at Children’s National Medical Center (October 24, 2014). The innovation is being developed by RebiScan, a company Hunter founded. 

What is the potential impact of your innovation?

One in 20 children is silently losing sight from an eye condition that cannot be seen by parents and is not easily diagnosed by pediatricians. Amblyopia is easy to treat if diagnosed early. But because the condition isn’t noticed in half of children until it is too late, amblyopia is now the number one cause of vision loss in children. We have discovered how to use a laser scan of the retinas to detect amblyopia automatically and with such high accuracy that it has the potential to eradicate amblyopia, by helping pediatricians make the diagnosis at the annual well visit.

How was the idea that sparked this innovation born?

It started more than 20 years ago, rooted in my unlikely combination of training in electrical engineering, cell biology and pediatric ophthalmology. At an engineering meeting, my mentor, David Guyton, MD, from Johns Hopkins School of Medicine in Baltimore, saw a presentation on the properties of light passing through the nerve fibers in the eye. He came back from the meeting and said, “Wouldn’t it be neat if we could scan the eye with polarized light to figure out where the eye is looking?” That question launched my career in this field. There followed a series of discoveries and innovations, including the discovery that this method was so accurate that if you scanned both eyes at the same time, you could detect whether the two eyes were working together, followed by the incredible surprise that it was so accurate that we could use it to detect not just eye misalignment but vision loss essentially 100 percent of the time.

What did you want to be when you were a kid?

Hunter's early inspiration
Hunter’s early inspiration

The first recollection I have of career aspirations was that I wanted to be an astronomer. In art class in second grade, I made a picture of Saturn by gluing different colored beans onto a piece of wood. I can still see that picture in my mind’s eye. I would stare at that picture or other pictures of Saturn in different books and imagine spending all night in a lab on a mountain top studying the rings of Saturn though the most powerful telescope on earth. Then I wanted to be a rock star, until I realized I couldn’t sing or play an instrument, nor did I have any charisma or stage presence. Now, when I walk through the waiting room at Boston Children’s and overhear my 4-year-old patients gasp, “I just saw Dr. Hunter!” it makes me feel like I might be a rock star after all!

What sparks your imagination?

I like to understand how things work. When I was growing up, my favorite book was called “The Answer Book,” and it explained how refrigerators work, why the sky is blue, how cats purr and hundreds of other gems. I was always so excited to understand and then to explain to others about whatever new thing I had learned, to the point where I remember being teased that the first words out of my mouth were always, “Did you know that…?” But understanding how things work is the first step toward fixing them when they don’t work, and I love to fix things, be it broken pencil sharpeners, broken computers or broken preventive health care systems. So, I guess my imagination is sparked when I encounter something that is not working right and where there is no obvious solution.

How do you find inspiration?

For the Pediatric Vision Scanner project, it is more desperation than inspiration. I am desperate to find a solution because I share parents’ pain when I have to tell them that their child has lost vision in one eye permanently because the amblyopia was not discovered early enough to be able to treat it. This still happens on a regular basis, and it makes me redouble my efforts to get our solution out into the world.