A Visionary Gift
Cover Story

If you stop to think about it, the human eye is a phenomenal creation. The steps involved for our brain to translate what our eyes see is nothing short of amazing. The speed at which it happens – incredible.

According to the American Optometric Association (aoa.org), vision begins when light rays are reflected off an object and enter the eyes through the cornea. The cornea then bends, or refracts, the rays that pass through the pupil, a round hole. The iris (the colored portion of the eye surrounding the pupil) opens and closes, making the pupil bigger or smaller to regulate the amount of light passing through. The light rays then pass through the lens, which actually changes shape so it can further bend the rays and focus them on the retina, a thin layer of tissue in the back of the eye which contains millions of tiny light-sensing nerve cells called rods and cones. These cells convert the light into electrical impulses, which the optic nerve sends to the brain and an image is produced.

This is a constant process that is happening every second of every minute of every day that allows us to read road signs and books, to see the beautiful colors and scenery that surrounds us. But vision isn’t just a luxury, it’s critical. This is the very reason that Dr. Robert P. Lehmann, M.D., F.A.C.S., cites for choosing to practice ophthalmology. “Because of all the professions in medicine, this deals with the sense most critical for patients – vision. As an ophthalmologist … [you can] restore vision to patients who are otherwise going to lose their ability to function. And you can diagnose diseases like diabetes and blood pressure problems and other circulatory problems by looking into the eye – the only part of the body where you can actually see the blood vessels at work!”

Born in Ohio, Dr. Lehmann made his way to East Texas after completing his specialty training in Ophthalmology at Baylor College of Medicine in Houston from 1973-1977. In '77, Dr. Lehmann founded Lehmann Eye Center in Nacogdoches. “East Texas is home now. The little expression, ‘I wasn’t born in Texas but I got here as soon as I could,’ [really fits] – I have no desire to move anywhere else,” he said.

Now 63, Lehmann is still plugged in to the higher learning facility as Associate Clinical Professor of Ophthalmology at Baylor. He treasures this staff appointment at Baylor because, "I enjoy maintaining a role at the forefront of what’s going on in my profession and because I also enjoy teaching and sharing knowledge with other eye surgeons.”

Through his position with Baylor College of Medicine, Dr. Lehmann visits every few weeks to help residents in surgery and has authored a number of published works appearing in professional journals, periodicals and even one chapter in a textbook. Lehmann Eye Center has also become an observation hot spot for surgeons across the U.S. and even abroad. “Surgeons can come to Lehmann Eye Center and observe surgery – not touch, not perform – but observe, and we can discuss. They learn and go back to their practices and typically can become more efficient,” Lehmann explained.

Dr. Lehmann has worked diligently to build his practice into one of the most prestigious in the United States, but he’s not in it alone. He has a skilled team behind him, including his wife, Kathy Lehmann, R.N.; Jacqueline Hilton, O.D.; And Timothy Young, M.D., D.A.B.O., Ph.D. Dr. Hilton joined the LEC team in 2002. “I had known Dr. Lehmann growing up and Dr. Dixon Golden in Center (where I’m from) and admired them both. That’s just what made me decide [to go into eye care],” she explained.

As for Dr. Young, Lehmann recruited him from North Carolina, where he was in private practice for nine years. “I actually grew up as the son of an ophthalmologist. So, I was aware of it from an early age. I decided after I went to medical school … to follow in dad’s footsteps,” Young said. The Duke University graduate said Dr. Lehmann offered him a great opportunity, so he packed up his family of six and moved to East Texas. “[Dr. Lehmann] has a phenomenal practice – it’s one of the top in the United States. It was a great opportunity to join him in practice here,” Young said.

When any one part of the eye required to process what we see becomes anything less than perfect, so does our vision. One such condition that impedes vision is called a cataract. Lehmann explains, “A cataract is a clouding of the God-given crystal clear lens.” Cataracts are most commonly caused by aging, but are sometimes congenital or associated with diabetes, glaucoma, injury or use of certain medications. No matter the cause of a cataract, they can cause great vision impairment, causing people to lose their ability to perform what used to be normal, everyday activities. Colors become less distinct, vision is clouded and many have difficulty driving at night from the glare of headlights and street lights.

Although cataracts can significantly interfere with life, not everyone can afford to have the surgery to correct this impairment. But if left untreated, cataracts can cause total blindness. In 1991, Dr. Lehmann had the idea to give the gift of cataract surgery (removing the “God-given lens” and replacing it with an acrylic lens) to those in need. “The inspiration was the simple fact that, there are needy people who are genuine; who, if they had the ability to pay for this surgery which is desperately needed, they would have done so. … They are people that my heart went out to,” Lehmann explained. “The bottom line is, cataract surgery changes people’s lives.”

And so 19 years ago, Dr. Lehmann started “Gift of Sight.” In honor of the season, Gift of Sight now takes place the Monday before Thanksgiving (this year on Nov. 22, 2010) Lehmann Eye Center performs cataract surgery on 20 to 30 patients (referred by eye care providers throughout East Texas), 100 percent free of charge. Lehmann and Young donate their time and expertise, but there are still costs involved. “We’ve partnered with industry, with the manufacturers that make the lens implants and so forth to help cut down the actual cost of the process,” Lehmann said.

“Gift of Sight is a phenomenal thing to be involved with. … The community is so good to us, we’re able to give back some eye care to patients that really don’t have the opportunity to afford [it]. It’s a very happy day – we can take somebody who’s blind and give them their sight back,” Young shared.

“The bottom line is: it is better to give than to receive. We are always just so pleased to see the smiles on people’s faces, and sometimes the tears in their eyes, when they leave – in many cases already seeing better right after their cataract procedure,” Lehmann said. The procedure itself is quite brief – being in practice so many years, Lehmann has his technique down to an art. Patients are in and out of LEC typically within two hours, according to Kathy McGough, patient care coordinator for Gift of Sight. The procedure is done with topical anesthesia to the eye and a small IV of medicine “that will cause you to be in a moonlight state. You can still respond, but you don’t remember what happens. … It’s a phenomenal procedure,” McGough said.

“In the old days, people had to go into the hospital and stay for 10 days. They couldn’t move their head after the surgery. We hear people talk about having sandbags put on either side of the head so they wouldn’t move. Look how far we’ve come! Now they come in, they’re here for a couple hours, take a little nap maybe when they get home, and then are back to their normal routine in a few hours,” she explained.

“We offer the best technology to patients,” Lehmann said, “There is no ‘second-class’ surgery. We were one of the first [facilities] in the country to convert to the small incision, the
no-stitch and also one of the very early converters to topical (no-shot) anesthesia. … The [cataract] procedure is safer, with faster recovery than in the past.

PINEYWOODS MAKEOVER
The Piney Woods “Change Your Life” Makeover was birthed from a roundtable discussion at Lehmann Eye Center. “We were sitting around the office after a big, full day … we had a patient that really struck all of us – struck our heart strings. Someone who was beautiful inside and yet because of problems that were primarily cosmetic, couldn’t show that beauty to a world that wasn’t willing to stop and discover it. You know, if somebody was just looking at the surface, they would have looked at this person and not noticed them, not cared. And we talked about it and thought, ‘Couldn’t we do something?’” Lehmann shared.

During the course of the year, Lehmann explained doctors from all over provide a good amount of free care. “When we see a patient in need, we take care of the patient,” he said. In the case of LEC, free care includes eye exams, eye glasses or cataract surgery on Gift of Sight day. “But beyond that, there is the patient that really needs a lot more,” he continued – not just eye care, but varied cosmetic fixes such as a poor complexion, droopy eyelids, bad teeth, being out of shape and/or overweight … “[We thought,] ‘We have people here in this community that have a heart for caring for others just like we do. Why don’t we see if we can’t put together a team that can change a person’s life?’ And so that’s what we did,” he said.

Beyond providing just glasses or laser vision correction, Lehmann put together the “Dream Team” (now a group of 12 professionals) to address every aspect of the recipient’s needs. “It wasn’t hard to get them to sign on, and that’s what excites me. If we can do it in Nacogdoches, then why can’t every community in this country … do the same thing, just as well?” Lehmann challenged. “If other people get involved and start doing it – even just once – they won’t be able to stop because it truly is a wonderful experience for all of us to be involved in changing a life like that.”

Candidates must apply for a chance to win the Piney Woods Makeover, either for themselves or if they have a loved one they feel deserves the chance. The process of choosing the winner can be difficult, said Kathy McGough, LASIK Coordinator for Piney Woods Makeover – “sometimes we have three or four that could be winners,” she said. In answering the same question, Dr. Lehmann shared the story of the children attempting to save even just a handful of the thousands of stranded sand dollars by tossing them, one by one, back into the ocean. “We can’t do this for everybody and our resources are limited in that respect, but it’s a blessing to the one winner each year,” he said.

LASIK
In 1995, the Food and Drug Administration (FDA) approved LASIK, a brief laser procedure that is now the safest, most successful and most common vision correction procedure ever developed. With the goal of always staying at the forefront of ophthalmology, LEC began offering LASIK in 1996. The technology has evolved so greatly, even within the last five years – a reason Lehmann sites for his love of the field: there is always more to learn with new procedures and new technologies. “The technology has evolved to where … all of my LASIK is blade-free. We use a Femtosecond laser to create the LASIK flap, extremely safely. … And then we use an Excimer laser to reshape the cornea and correct the patient’s prescription in a very customized, individualized way,” he said.

“While no operation is without risk, there have been an estimated 750,000 in the U.S. to have laser vision correction this year. And the total number is over 7,000,000 – it’s unbelievable. And of all those people, yes probably a couple hundred are unhappy. … But you’ve got to wonder what each individual story is, how long ago the procedure was done,” Lehmann said. “Overall, it changes people’s lives in an incredible way. And as far as safety goes, it’s now permitted by NASA and all branches of the military.”

Is any end in sight for this visionary? “It’s still such a growing profession as far as technology goes. Things keep on getting better every year. … I love what I do,” he answered. “And I love my family. With Dr. Young and Dr. Hilton in the practice, it does give me more time to spend with family.” While Dr. Lehmann may be letting Dr. Young and Dr. Hilton take the reins more frequently at LEC, he is still heavily involved in ophthalmology through his affiliation at Baylor and is also an involved member of both the European and American Societies of Cataract and Refractive Surgery as well as the American Academy of Ophthalmology. Lehmann and his wife, Kathy, recently traveled to Paris and will soon travel to Chicago, where Dr. Lehmann will “have some form of presentation and we go and we learn and we impart knowledge to others and we gain knowledge from others.”

At Lehmann Eye Center, there is a commitment to eyecare excellence, and that will continue to be the top priority. “Patients deserve our very best effort and the very best technology that is available today,” Lehmann said. To learn more about Lehmann Eye Center and its team of doctors, visit lehmanneyecenter.com.

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