An eye for the future of ophthalmology

Dr. Jay Pepose says it’s always interesting to look at surveys of people’s worst fears — especially since it’s his job to help prevent one of them.

“Blindness is always in the top three answers,” he said. “In Judaism, they say restoring someone’s sight is equivalent to restoring their life. It is given the same emphasis.”


Pepose, medical director of the Pepose Vision Institute, has long since given emphasis to the eyes as his field of expertise. Recognized annually in “Best Doctors in America,” Pepose earned his M.D. and Ph.D. from UCLA. He later completed his residency at Johns Hopkins and his cornea training at Georgetown University. Recently, he was honored with the Association for Research in Vision and Ophthalmology Fellows Award while his institute was the first in the country to receive Bausch & Lomb’s “Excellence in Vision Care” Award.

In addition to his work with patients, Pepose also serves as a professor of clinical ophthalmology at Washington University and Barnes Jewish Hospital.

At present, Pepose Vision Institute is proud of its work on clinical trials for a number of new technologies.

‘We’re doing a trial on something call AcuFocus, which is an inlay that goes in the cornea for people who have good distance vision but don’t want to wear reading glasses so it helps with both near and far simultaneously,” Pepose said.

Another project is a new light-adjustible lens. The intraocular lens implant, developed by Calhoun Vision, responds to ultraviolet light and allows the surgeon to fine-tune the devise after cataract surgery. Previously, adjustments had to be made before the lens was put into operation.

“Once we implant it in the eye, we can change the power of the lens with a laser,” Pepose said. “When we get it where the patient likes it we can lock it in.”

Pepose said other advances are on the horizon as well for chronic problems.

“One thing that occurs more commonly in women than in men is dry eyes,” he said. “Particularly, as women become menopausal and go through hormone changes, dry eyes become very prevalent.”

The OcuSense tear testing device uses “lab on a chip” technology to identify the problem using only microliters of tears, making diagnosis quicker and easier.

What attracted you to this field?

When I went to medical school I was very open-minded. Like most medical students, as you go through the rotations you get excited about different areas. Ophthalmology was just very appealing to me because I realized that I already had a background in visual sciences and here was an area where I was helping people to see, which I thought was tremendous.

How does your faith impact what you do?

From the time I was a young child I was taught that you want to give back to the people, to the community. The older you get, the more life experience that you get and with the things you see as a doctor, you start to appreciate how life can change on a dime.

Unless you suffer from a lot of hubris, after a while you start to realize as a doctor that we are limited as people in what we can do. Faith helps me because I realize that I’m not doing it alone. I’m getting some help.

As a resident at Hopkins I remember talking to one of the neurosurgery guys and said, ‘How do you do this? You go in and you are dealing with children with tumors and all these things. I’m in a field where 99 percent of patients come out happy. You are in a field where 50 percent of these children die. How do you deal with it?’ He said, ‘First, I promise myself before I do any surgery that I’ve done everything possible to prepare. If I can say to myself that I’ve done that, then I can sleep at night because I feel the rest is in God’s hands. I can’t control everything. The second thing I do is I pray.’

Those two things are very important to me. I was able to incorporate both into my daily life. In getting ready for surgery, I can prepare to the point where I’ve done everything that I can. Then I pray before every case.

What areas do you specialize in at your office?

We do a lot of things. We’re into vision correction. That’s our main thrust. Laser vision correction and Lasik. We do cataract surgery. We’re involved in the development of a lot of these new lens implants that do both near and far. They are sort of like bifocals. We do glaucoma treatments, both laser and others. We also do comprehensive ophthalmology, people with infections, allergies, trauma or more generalized problems. We’re involved in a lot of clinical trials. We’re always trying to push the technology forward. We feel that’s an important service that we provide.

You’ve talked a lot about some of the emerging technology. What other areas of vision treatment are seeing advancements?

The future is also bright for the treatment of macular degeneration. We’re seeing more and more drugs become available, not only for the wet form, which we’ve had recently but there are also new drugs coming down the pike for the dry form. As people live longer we start to see age-related diseases. For our field that means cataracts, glaucoma, macular degeneration and dry eyes.

We’ve also seen better treatments for diabetic retinopathy. We have better diagnostics. We have tests now that are almost like CAT scans of the retina that can be done in the office. Ophthalmology has always been at the forefront. We’re a small group. We only represent two percent of physicians but I think we’ve been very quick to adopt new technologies and apply them. We were the first to apply lasers. We were one of the first to understand the impact of genetic diseases on the eye.

Is that one of the things you like most about the field — its cutting edge nature?

It is a cutting edge field but the thing that I like about it the most is that we actually enhance people’s lives. We cure people. There are very few aspects of medicine where you cure someone. If you go to the doctor because your back hurts, he’ll give you something so your back will hurt less but the problem never goes away. With ophthalmology, with so many things we are curative. A patient comes in with a cataract. They can’t see. We do surgery and the next day they’ve got a giant smile on their face.

What do you do for a hobby to unwind?

I spend a lot of time with my family. I’ve got triplets. I’ve got four kids including three 14-year olds. That takes up a lot of my time. Each one is involved in something different. One loves to sing and is in the St. Louis Children’s Choirs and takes voice lessons. I have another son who is into wrestling. I have another son who is part of the St. Louis Arches. So I spend most of my free time with the kids. My wife and I just had our 30th wedding anniversary. We like to travel, too. For our anniversary we went to the Arctic. We joined National Geographic for an expedition of the Svalbard Archipelago, which is 12 degrees further north than Alaska.

Dr. Jay Pepose

AGE: 54

PROFESSION: Medical director of the Pepose Vision Institute and professor of clinical ophthalmology at Washington University and Barnes Jewish Hospital

OFFICE: Chesterfield

HOME: Town and Country

FAMILY: Married to Susan Feigenbaum; the couple has four children