William Tsiaras

Chief of Ophthalmology, Rhode Island Hospital

What is it that we see? Do we see things as they truly are or as we truly are? How far does our outer eye reach into our inner world?

As Surgeon-in-Chief of Ophthalmology at the Rhode Island Hospital and the Veterans Administration Hospital in Providence, Dr. William Tsiaras has spent a lifetime dedicated to the advancement of understanding of the human eye.

"Even our most sophisticated visual enhancing apparatus falls short when compared to of the design of the human eye," he says.

Although many have said that eyes are the gateway or windows to our soul, for most of the 20th century, behaviorists believed seeing was merely a mindless process of stimulus and response. "Only recently," Tsiaras says, "researchers have begun to understand the many complexities involved in the physiology of sight."

Tsiaras is more than just an eye doctor. Board certified in both ophthalmology and internal medicine, he's one of the few physicians in the country who is able to take an advanced, holistic approach to medicine.

"Vision is our primary sensory input and can ignite a cascade of electrochemical and biochemical events that effect our most vital body systems," he says. "The moment we open our eyes it has an effect on our entire being."

Take cataracts for instance. Tsiaras tells a fascinating story about French impressionist painter Claude Monet. If you take a look Monet's early works, like The Japanese Bridge painting of 1900, you'll see a masterwork of color intensity. A harmony of vibrant greens and blues and golden hues, it's an amazing naturalistic painting.

Now jump ahead 20 years and look at Monet's later works, for example, The House Seen from the Rose Garden. This painting is on the verge of abstract, with colors bleeding into each other with a lack of rational shape and perspective. The painting is an explosion of orange, yellow and red hues, and it leaves us barely able to discern the vague shape of a house in the background.

The explanation for this radical change in style might surprise you. Monet, as it happens, had cataracts. "Over time, the lenses of his eyes grew cloudy, making the world appear dim and colors muted. Essentially, he was blind as a bat," explains Tsiaras. Yet Monet's story is far from unique.

According to the World Health Organization, between 41 and 50 million people live with blindness or impairment. And cataracts are the leading cause of blindness. "Everyone on the planet, if they live long enough, will develop cataracts," says Tsiaras. "It's inevitable."

Throughout history, physicians have adopted many—and some unorthodox— practices to counteract cataracts. Today, the only form of therapy is surgery. "That's the bad news," says Tsiaras. The good news is that the success rate of the surgery is 95%.

"So we're not going to make any increasingly new strides or innovations in surgical techniques, because we're already there," says Tsiaras. Instead, he explains, we need to figure out ways to delay or prevent cataracts all together. "Ultimately, we're shooting to make this operation unnecessary. How can we delay this metabolic process? That's the ultimate goal."

According to Tsiaras, the next important ophthalmologic innovations will occur through further study of the lens of the eye. Because it turns out that the structure of the lens is physiologically unique.

In the human body, nearly all cells die at some point in time and are replaced by new cells. This programmed death is called apoptosis. It's a deliberate life relinquishment by a cell and is typically carried out in a genetically controlled fashion. For example, the differentiation of human fingers in a developing embryo requires the cells between the fingers to initiate apoptosis so that the fingers can separate.

"The lens is unique," says Tsiaras, "because typically, apoptosis takes place at birth. The cells in the lens however, remain in suspended animation for a lifetime." And according to Tsiaras, this has huge scientific implications. "If we can begin to understand this process, and dare I say control it, it will represent an amazing breakthrough in medicine."

Hearing from Tsiaras, you get the immediate sense that his mind never stops—a classic overachiever who continually challenges himself to master the unknown. Yet he's not one to leave the past behind. "In the 1960s, medicine was downright medieval, yet overall patient satisfaction was quite high. Today, advancements in modern medicine have made a huge impact on our overall quality of life. We're healthier. We're living longer. But people are extremely dissatisfied with the healthcare system. That disconnect is only getting bigger. Solve that problem, and innovation will occur."