The lenses of the McKeesport woman's eyes were solid white from advanced cataracts. But low income and lack of health insurance had forced her to go without surgery or even a visit to the eye doctor.
Other low-income patients without eye care were found to have advanced-stage glaucoma, diabetes retinopathy, detached retinas or retinal vascular occlusions -- all of them potentially blinding.
"I can't tell you how many people are walking around Pittsburgh who are blind or disabled from cataracts and other simply fixed problems," said Evan L. "Jake" Waxman, 50, an ophthalmologist from Aspinwall who practices at UPMC Eye Center Mercy.
Remarkably, eye problems among the underserved in Pittsburgh are on par with what UPMC Eye Center medical residents see during care missions to Central America, he said. While UPMC Eye Center residents continue to go on care missions to Central America, Dr. Waxman rallied University of Pittsburgh School of Medicine students and residents to provide free eye care here.
The resulting Guerilla Eye Service has emerged as a mobile force against eye disease regionwide, treating hundreds of patients each year for free while providing medical students and residents a chance to hone their skills. "A lot of people need eye care in other countries, but a lot of people in our own backyard need it and don't get it, and it's cheaper and easier to take care of people here," he said.
The founder and director of the Guerilla Eye Service is one of six finalists for Most Outstanding Volunteer from among 50 local Jefferson Award winners. His work will be honored at an award ceremony next Tuesday at Heinz Field, where the winning volunteer will be announced. That person will represent Western Pennsylvania at the national Jefferson Awards ceremony in Washington, D.C., this summer.
"I'm just the kind of guy who just wants to go and make it happen," Dr. Waxman said, adding that it's fun to help others.
The Snavely Family Fund of The Pittsburgh Foundation will donate $1,000 on Dr. Waxman's behalf to The Eye and Ear Foundation of Pittsburgh.
The Guerilla Eye Service brings treatment directly to those in need, said Lauren Wally, a co-worker who nominated Dr. Waxman for the award. The free service targets underserved populations in Allegheny and surrounding counties who face the risk of vision loss without free care. He spends 40 hours a month on the project while working full time as a clinician teacher based at Mercy.
In 2006, Dr. Waxman organized students and residents to participate in community eye-care missions several weeknights or weekends a month. Corporate and foundation grants were used to buy portable ophthalmic equipment, while students came up with the logo and name. In the early years, he'd pack equipment inside his own sedan, stacking the trunk and the interior floor to ceiling to drive to community centers. In time, UPMC donated a van.
"I drove the van to the mission site and unpacked it, and it was a miracle to see the students turn an empty space [inside a community center] into an eye-examination room in a half-hour," he said.
During each session, 15 to 20 people undergo eye examinations and treatments. The service also provides free prescription eyeglasses or reading glasses. With equipment costs covered by the grants, he said, his only cost is the price of pizza to feed volunteers.
Patients who need additional care are invited to a follow-up appointment at the Mercy eye center. "We help patients that need operating-room care apply for UPMC financial assistance," Dr. Waxman said, adding that they usually receive it.
Dr. Waxman, UPMC's vice chairman of education for ophthalmology, now encourages other academic health centers to start free eye-care programs while he continues seeking grants and donations to fund his own program.
Service sites include the Birmingham Free Clinic on the South Side, Squirrel Hill Health Center, 9th Street Clinic in McKeesport, East End Community Health Center, Hazelwood Family Health Center, Greene County Cornerstone Care and the Verland Foundation residential care center in Sewickley, along with occasional setups at public events.
Younger UPMC ophthalmologists now have begun volunteering with the Guerilla Eye Service, Dr. Waxman said. Robotic eye-imaging technology also is being installed in community centers that automatically takes images inside patient's eyes that are emailed to Dr. Waxman. If he spots problems in the retina or optic nerve, he invites the person to the eye center for a full examination and possible treatment.
"The earlier the treatment the less likely you are to lose your vision," he said.
People often enter the medical field to help others, but "along the line cynicism kicks in."
"A service like this is an antidote to cynicism," Dr. Waxman said. "Everyone there needs you and are grateful for care. We feel we really are doing something good."
Proof is found during each care mission, including the school girl with declining grades whose prescription for free eyeglasses allowed her once again to see the classroom whiteboard.
"A poor woman in McKeesport was suffering from depression with white-eye cataracts that you see in Third World countries right here, where we have all this stuff to treat it," Dr. Waxman said.
Led by a family member into the 9th Street Center for free care, she was uncommunicative due to depression. But cataract surgery on the first eye changed all of that.
"It was fantastic. She was a different person. She talked and smiled. Her face came alive, and she gets around by herself now," Dr. Waxman said. "When we made her able to see again, it was so rewarding."
David Templeton: firstname.lastname@example.org or 412-263-1578.