Bird’s Eye View
Dr. Elaine Holt and her colleagues in Penn Vet’s Ophthalmology Service improve animals’ quality of life, one eye at a time
by Debra Wallace

The front lines of cutting-edge veterinary medicine are being drawn in Philadelphia’s University City neighborhood, courtesy of Elaine Holt, D.V.M., and her colleagues at Penn Vet. These modern-day Dr. Doolittles treat a wide range of domestic and exotic animals in need of expert care for everything from cardiology and internal medicine to neurology and critical care.

For her part, Dr. Holt specializes in veterinary ophthalmology. In the same way that human ophthalmologists treat patients with cataracts, glaucoma, retina problems and blindness, among other eye-specific conditions, Dr. Holt and her colleagues at Penn Vet (formally known as the University of Pennsylvania School of Veterinary Medicine) treat domestic animals such as dogs and cats, as well as all kinds of exotic animals, suffering from a variety of eye problems.

“You can never believe how beautiful the eyes of animals are,” says Dr. Holt, who also serves as clinical associate professor of ophthalmology. “In this line of work I am never bored; I always have to be ready to acknowledge what I don’t know, as there will be things that I’ve never seen before.”

Veterinary medicine is a second career of sorts for Dr. Holt, who started her working life as a teacher in her native England. Once she began studying veterinary medicine, there was no looking back. She completed her specialty training in ophthalmology at the University of California, Davis, and subsequently earned a position with Penn Vet. She worked at the School’s hospital from November 2000 to May 2005, before returning to the United Kingdom for family reasons. She then worked as a veterinary ophthalmologist at the Royal Veterinary College at the University of London before moving into private practice.

After 10 years, Dr. Holt returned to the United States and, this August, she restarted her career at Penn Vet. It was a happy reunion for everyone involved.

“I have discovered that Penn is still one big family,” says Dr. Holt, referring to the camaraderie among her Penn Vet colleagues. “I was at the beginning of my ophthalmology career when I started here, and after being far away and working in other places, returning to Penn is truly like coming home.”

A. Brady Beale, V.M.D., one of Dr. Holt’s colleagues in Penn Vet’s Ophthalmology Service, had a similar experience. Dr. Beale has been interested in animals since the age of 3, and she surrounded herself with dogs, hamsters, gerbils, fish—basically any animal her parents would tolerate. She earned her veterinary degree from Penn and stayed on as an intern. She completed her residency in comparative ophthalmology in 2006 at North Carolina State University, and then went on to private practice. She returned to Penn Vet in September.

“There is nothing more rewarding than removing cataracts from a blind dog’s eyes and watching the joyous family reunion,” says Dr. Beale. “It still brings tears to our eyes every time we see that; it is such an amazing opportunity. We get to bring comfort or restored vision back into their everyday lives.”

Dr. Beale praises the entire Penn Vet team, including the ER, nursing staff, anesthesiologists and other doctors, for giving such a high level of care to their animal patients, whether it pertains to matters of crisis or chronic disease. She has a particular affinity for Dr. Holt, whom she considers “a gifted mentor” from when they first started working together 15 years ago.

“It’s amazing the ways that the stars aligned,” Dr. Beale says. “For all of these years I have told people that my mentor, Dr. Holt, is the reason I became an animal eye doctor. It is wonderful to be sharing an office and working on the same team with her.”

Penn Vet had the first formal veterinary ophthalmology program in the nation. Gustavo D. Aguirre, V.M.D., Ph.D., a medical geneticist/ophthalmologist, was the third resident to be accepted into the program. His recent work involves genetic studies to identify the genetic defects causing inherited blindness, and developing DNA tests that can be used by breeders to prevent disease. He is working with William A. Beltran, D.V.M., Ph.D., to develop advanced gene-therapy approaches to cure blindness in dogs that has led to progress in treating blindness in humans.

“We have a large group of people here actively involved in clinical work and research,” Dr. Aguirre says. “I have a small boutique clinic for cats and dogs with genetic eye diseases. We work on research on inherited diseases of the retina that cause vision impairment or blindness. What we develop in a dog is carried over to humans. We treated the first case and reversed blindness in dogs 15 years ago.”

When prominent Bucks County physician Glenn A. DeBias, D.O., took his dog, Maggie, to Penn Vet for specialized ophthalmology care, he was impressed with the practice’s level of care and attention. “We had been underwhelmed by the care Maggie had received in suburban specialty veterinary hospitals,” Dr. DeBias says. “Dr. Holt and Penn Vet were exceptional, and I would recommend them to any pet owner.”

Challenging, Gratifying
On a typical day at Penn Vet’s Ryan Hospital, the close-knit group of nine veterinary ophthalmologists treats domestic pets, as well as show dogs, members of K-9 units and therapy and service animals, as well as the occasional exotic animal. At first glance, Ryan Hospital appears to resemble a human hospital, with wards for emergency medicine, oncology, neurology, cardiology and orthopedics, as well as multiple surgical suites. A second look reveals the telltale signs of an animal hospital, including 17-pound bags of pet food and signs reading “Doggy Ward” and “Kitty Ward.”

Large animal specialists at Penn Vet tend to horses and other farm animals at the New Bolton Center hospital in Kennett Square. In addition, Penn Vet experts consult with zoos and other specialists around the nation. They also conduct continuing education programs for local veterinarians and reach out to local K-9 units for annual screenings.

There’s simply no telling what kind of animal Penn Vet doctors might treat from one day to the next. Past patients have included everything from parrots, ducks and guinea pigs, to rabbits, snakes and farm animals. Penn Vet doctors have even treated zoo animals such as owls, kangaroos and jaguars. There was one celebrated case from August 2011, when three Penn Vet doctors performed surgery on two snow leopard cubs from the Philadelphia Zoo to correct congenital eyelid defects, known as coloboma. The zoo continues to contact Penn Vet when unique eye-related conditions arise.

Dr. Holt recalls a case from early in her career, in which she successfully treated the corneal laceration of a bird of prey that had been trained as a demonstration animal. Dr. Holt has also worked on the eyes of a camel, a walrus and an elephant, and removed cataracts from the eyes of a snowy owl at a zoo in the United Kingdom.

“For the eyes of exotic species, you sometimes need to use information gained from treating domestic animals,” Dr. Holt explains. “It is helpful to communicate with other veterinary ophthalmologists since little may be published about a particular animal.

“Our work can be challenging,” she continues, “but it is also extremely gratifying.”

University of Pennsylvania School of Veterinary Medicine
Ryan Hospital
3900 Spruce Street
Philadelphia, PA 19104

Photograph by Alison Dunlap