The Department of Ophthalmology Leading in Clinical and Academic Excellence
"Jewish" ophthalmology in the Eretz Israel began with the visit of Henrietta Szold at the beginning of the last century. Miss Szold was overwhelmed by the scope of eye disease she found, especially trachoma, and decided to bring medical personnel, doctors and nurses, from her native America to Israel to treat these diseases. These medical missions led eventually to the establishment of the Hadassah Medical Organization in Israel and to the building of Hadassah hospitals, the most prominent of them being opened on Mt. Scopus in Jerusalem in 1939.
The Hadassah Medical Organization recruited to its ranks Dr. Aryeh Feigenbaum, who established the eye clinics of HMO and in 1922 was named "chief ophthalmologist of the HMO in Eretz Israel and chairman of the eye department of Rothschild [later to become Hadassah] Hospital in Jerusalem".
Dr. Feigenbaum, who consequently was appointed to the rank of Professor in Ophthalmology at the Hebrew University of Jerusalem, was among the pioneers of academic medicine in Israel, the first editor of the journal "Harefuah", and the first dean (pro-dean) of the Medical School of the Hebrew University and Hadassah, which for years was the only Medical School in Israel.
Dr. Feigenbaum served as chairman of the department of ophthalmology for 32 years, until 1954, when he was succeeded by Professor Isaac Caesar Michaelson,
Professor Michaelson, who was one of the "giants" of ophthalmology in his generation, nurtured academic ophthalmology in Israel in general and at Hadassah University Hospital in particular, established the first generation of specialists in ophthalmology in Israel, many of whom became over the years heads of eye departments in various hospitals throughout Israel, and in 1959 began the tradition of our department's assistance to African countries and other developing nations, a tradition which continues to this very day.
In 1973 Professor Michaelson was succeeded by Professor Hanan Zauberman, one of his pupils, as chairman of the department. Professor Zauberman carried on the traditions of academic ophthalmology and help to developing countries. He was the first in Israel to set up specialized clinics in the various sub-specialties of ophthalmology, and our department was the first in Israel in which the residents were required to study the various sub-specialties.
Professor Zauberman has retired in 1998, and was succeeded by Prof. Jacob Pe'er, who currently serves as the Chairman of the Department of Opthalmology .
The department of ophthalmology of Hadassah University Hospital in Jerusalem has been, from its inception, a leader in both clinical and academic ophthalmology. It was the first ophthalmology department to include research laboratories, and in which the physicians were required to participate in clinical and basic research.
The components of our department which deal with various fields of ophthalmology include:
The outpatient clinic , which serves patients referred to our various sub-clinics; the in-patient ward and operating theatres outfitted specifically for ophthalmic surgery; the ophthalmology unit at Hadassah University Hospital on Mt. Scopus, which is community-based; the Michaelson Institute for the Rehabilitation of Vision, located in downtown Jerusalem, which is the only institution in Israel which treats children with low vision in a comprehensive manner; and the laser institute for refractive surgery located in Malcha, which is commercially-based; and the leading research laboratories and imaging services in the country.
The Department of Ophthalmology at the Hadassah University Hospital provides medical and surgical services at the highest level in all subspecialties in ophthalmology.
The Department of Ophthalmology operates the following clinical services: Comprehensive ophthalmology, cornea and external eye diseases, glaucoma, medical retina, vitreo-retinal surgery, pediatric ophthalmology, ocular oncology, uveitis, neuro-ophthalmology, and oculoplastics. Each of these sub-specialties is served by senior physicians ranked amongst the leaders in the country, working together with Israeli and foreign residents. In addition, the department provides services in ocular pathology, vision functions and electrophysiology, ocular immunology, ocular ultrasonography, and ophthalmic photography and imaging.
Approximately 40,000 patients are served and about 3500 patients are operated every year in the Department of Ophthalmology of the Hadassah University Hospital, in its Ein Karem center and its branches at Mt. Scopus, and the Michaelson Institute for the Prevention of Blindness. In addition, thousands of patients undergo refractive surgery in our new laser center in Malcha.
In the cornea and anterior segment field, our department leads in refractive surgery, using the LASIK technique. Our cornea service is the only one in Israel that performs transplantation of limbal stem cells and transplantation of amniotic membranes in treating severe ocular surface conditions. Together with our ocular oncology service, we treat patients with ocular surface malignancies by Mitomycin-C drops, a method that was developed by us and is now in use in many centers worldwide.
The ocular oncology service continues its unique role in treating patients with intraocular tumors, mainly uveal melanomas and retinoblastomas. We are one of only two centers in the world using intraocular chemotherapy in treating intraocular lymphoma. We are pioneering the use of epi-ocular and intraocular chemotherapy in other malignant conditions.
In the medical retina service, we have developed the Macular Degeneration Center, which deals with macular diseases in adults and children. In the past three years, we have been using Photodynamic Therapy (PDT) for the treatment of Age-Related Macular Degeneration (ARMD). This center is very active in basic and clinical research. Our retinal specialists are using different types of laser, such as the argon-krypton, diode-laser and the Visulas laser for PDT.
Our vitreoretinal surgeons perform the most complicated operations of the retina and vitreous, including removal of subretinal membranes, retinectomies and transposition of retina, peeling of membranes, and others, and are the only ones in the country who use intricate retinal surgery to treat severe cases of ROP, where hope for vision has been lost.
In the glaucoma service, we treat patients with severe glaucoma by advanced medical therapy, surgery, and various laser treatments.
The staff of the pediatric ophthalmology unit treat all varieties of ocular diseases in children, and are leading the treatment of congenital cataract and other types of cataracts in childhood.
In our uveitis service, patients with uveitis of various etiologies and other ocular inflammatory diseases are treated. This service also cares for patients with difficult eye conditions that accompany their systemic illnesses.
The neuro-ophthalmology clinic handles ambulatory patients who are referred to us with difficult optic nerve and visual system problems, and provides consultation services to the departments of neurology and neurosurgery.
The oculoplastic clinic deals with diseases of the orbit, eyelids and lacrimal system, and collaborates with the departments of plastic surgery, ENT, and maxillofacial surgery in treating complicated problems.
Cataract surgery is performed in both the main department at Hadassah Ein Karem and in our branch at Hadassah Mt. Scopus, using delicate instrumentation for the suture-less phacoemulsification procedure, with insertion of state-of-the-art foldable lenses. YAG laser is used for capsulotomy in cases of secondary cataract.
The ultrasound service provides imaging of the anterior and posterior segments of the eye, with the help of A- and B-scan ultrasound equipment and high-frequency ultrasound. This service has the most experience in the country in the diagnosis and follow-up of patients with intraocular tumors.
Our ophthalmic photography unit uses the confocal laser camera system for fluorescein and indocyanine green angiography, which are valuable tools in diagnosing retinal diseases. A slit lamp camera is used for recording the anterior segment, while corneal topography and the specular microscope are employed to measure facets of the cornea. We have just purchased the new-generation ocular coherent tomogram for analysis of the retina and the optic nerve, which together with the GDX nerve-fiber analyzer will give us an unprecedented "view" into the posterior part of the eye. We have a new Humphrey Visual Field analyzer in addition to the old one. We have two types of wide-angle fundus camera: The RetCam which is used for children and the Israeli-made Panoret-1000 which is used for both adults and children, even through a small pupil.
The members of the Department of Ophthalmology conduct both basic and clinical research. The research is conducted mainly in the laboratories of the Department of Ophthalmology as well as in collaboration with other laboratories of the Faculty of Medicine, Hadassah University Hospital, and with departments abroad.
The laboratories in our department are:
The Visual Functions Laboratory, which provides diagnostic services (ERG, VEP, EOG, and psychophysical testing) as well as facilities for basic research.
The Ophthalmic Pathology Laboratory, which provides, in addition to diagnostic services, also services for all the morphological studies that have been done in our department, including immunohistochemical studies.
The Molecular Ophthalmology Laboratory has been established as a core for all studies involving molecular techniques, including molecular genetics, that are carried out by the researchers of our department.
The Laboratory of Immuno-Ophthalmology provides research and diagnostic services in inflammatory eye disease.
The Laboratory for Laser Research has been restructured and will provide services in basic and applied research with femtosecond lasers.
With the establishment of the retinal degeneration center, both basic and clinical research is being conducted in this field on the molecular, electrophysiology, and clinical levels such as studies on experimental drugs. Retinal as well as ocular tumor angiogenesis have been explored on the morphological and molecular levels. Cell proliferation in normal tissue and in ocular tumor tissue, with and without treatment, has been studied.
In the field of cornea and ocular surface diseases, inflammatory and repair have been explored, as well as methods of drug delivery, the use of amniotic membranes and their preparation, and others. In glaucoma, investigation of visual fields methods and new instrumentation are the main fields of interest.
Other areas of research carried out in the Department of Ophthalmology are in pediatric ophthalmology, neuro-ophthalmology, ocular inflammation, ocular microbiology, genetics of eye diseases, lasers in ophthalmology, and refractive surgery.
The department has developed, in cooperation with the Division of International Cooperation of the Foreign Ministry of Israel, a program which provides developing countries with eye services both by training foreign doctors and nurses at Hadassah University Hospital in Jerusalem, and by establishing clinics in their countries of origin.