On the eighth floor of the UPMC Eye Center can be found every ophthalmic imaging tool that money can buy -- and some that aren't yet commercially available.

"They have and do every test," said Mary Damp, 58, of Robinson, a glaucoma patient who can run off a long list of sophisticated tests and procedures she has undergone at the Eye Center. In fact, the reason she went to UPMC on the referral of her longtime ophthalmologist was that it offered SLT, or selective laser trabeculoplasy, a relatively new treatment used to treat certain types of glaucoma by reducing the pressure in the eye.

Controlled for years, Mrs. Damp's pressure went up and her old doctor "had no means to lower it." Her husband read about SLT on the Internet and she decided she wanted to try the treatment if she qualified. She did and she has undergone it once on her right eye and twice on her left as her doctor is seeking to control the pressure without medicines, which she has problems tolerating.

Such cutting-edge technology is a benefit not just for patients but for the students who come through the ophthalmology department of the University of Pittsburgh School of Medicine, which is in the Eye and Ear Institute in Oakland.

Thanks to a big financial commitment by UPMC and the hiring five years ago of highly regarded clinician/researcher Dr. Joel Schuman as Eye Center director and ophthalmology department chairman, both center and department have become nationally recognized for clinical treatment.

An established reputation for research and development has been further enhanced as measured by the number and value of grants the center and department receive from the National Institutes of Health.

"Our purest need was to improve clinically and to provide state-of-the-art medical care and surgical care for patients with disorders and diseases of the eye," said Dr. Arthur S. Levine, senior vice chancellor for the health sciences and dean of the School of Medicine at the University of Pittsburgh.

"Our department had been strong in research. It was already probably one of several top departments nationally as measured by NIH grants, but we were not one of the highly recognized departments clinically. I think Joel has turned that around."

Since his arrival from Tufts University and New England Eye Center, the volume of patients seen at the Eye Center has increased annually by "double digits," according to Dr. Schuman. "Just roughly, we saw about 40,000 patients in fiscal year 2004 and are on track for about 50,000 patients in fiscal year 2008," he said.

"That's meant a remarkable increase in revenues that we can reinvest in research and education and improvement of patient care," Dr. Levine said. That in turn has led to a "substantial number" of top people applying for and taking positions within the department.

Arguably, the most important clinical improvement instituted by Dr. Schuman is a policy that enables a patient to get an appointment with his or her doctor of choice within 48 hours. "We removed all the barriers to patients being able to access our doctors," he said. "It's typical for them to exist. It's easy to fall into the trap of making it hard to see a doctor in the department because it makes life easier for our doctors and staff."

Despite his administrative duties, Dr. Schuman continues to see patients one day a week himself. They include Mrs. Damp, who raves about how he answers any and all questions. "It's like he has all the time in the world," she said.

Good bedside manner like that brings patients back, but Dr. Schuman is more proud that his 48-hour appointment policy eventually was adopted UPMC-wide, though the window for getting such dates is 72 hours. "It was interesting that my goals for the department came to be aligned with system goals for all departments," he said.

A big bear of a man full of infectious enthusiasm, Dr. Schuman also waxes proudly when he biographies the faculty he recruited to the department and Eye Center. They include Dr. Robert Noecker, formerly vice chairman of ophthalmology at the University of Arizona, who is now vice chairman at Pitt.

Since Dr. Schuman's arrival -- officially on July 1, 2003 though he put in a couple days each month starting the previous December -- the faculty has nearly doubled, from around 23-25 to about 40, including basic scientists and clinicians. They were recruited from the likes of Notre Dame and Dartmouth universities, and the NIH.

"We started with an outstanding group of clinicians and scientists, and we've built on that by hiring the best from around the country," he said.

All the clinicians teach, and they're expected to produce on both fronts.

Meanwhile within ophthalmology's five floors of the Eye and Ear Institute are research projects dealing with such disparate subjects as tracing the development of the retina in the zebra fish, looking for the means to eradicate bacterial biofilms of the eye, upgrading a high-speed, three-dimensional retinal imaging machine known as OCT and developing a Google-like search engine for ophthalmic diagnostic images. The last is the subject of an interdisciplinary, collaborative research program called the Diamond Project.

Partners in various collaborations include Pitt's Swanson School of Engineering (at which Dr. Schuman and other ophthalmic faculty have joint professorships), Carnegie Mellon University and the Intel laboratory on the CMU campus.

"Pitt made a significant commitment to the development of the ophthalmology department," Dr. Schuman said. "It was Pitt but even more so it was UPMC. ...

"Because UPMC is well-managed, funds exist for the revitalization of and development of the ophthalmology department. Otherwise, we wouldn't be able to have built what we've built, plus we're continuing to grow."

Interested in glaucoma and retinal disease, Dr. Schuman, 48, proved himself in research early in his career as one of the six scientists who collaborated on the development of OCT, ranked the top development in ophthalmology over the last 25 years by the journal Ocular Surgery News. OCT stands for optical coherence tomography,

"It's a way of creating a map of nerve tissue in the eye, the retina and optic nerve," he said. "It does very specific measures of that tissue, so it's not just a picture, but a measurement of the thickness of tissue. ... It allows you to compare the eye to the healthy population."

The first retinal imaging was done in 1989, when Dr. Schuman was a fellow at Massachusetts Eye and Ear. He continued to work on the project when he moved to Tufts University in 1991.

"At the [beginning] a single scan took over 20 minutes," he said. "Now a single scan takes less than 1/50,000th of a second."

The first commercial OCT, which measured only the back of the retina and made 100 scans per second, came out in 1996. A second generation with improved ergonomics came out in 2000, and in 2002 a third generation that could make 400 scans per second hit the market. The 2002 model also was equipped to compare the scans to images of normal tissue.

The new fourth generation, which can provide images of the retina as well as the front of the eye, is called "spectral OCT. It's different because ... instead of measuring the reflection at each point of a scan, it can measure all of the wavelengths coming back at the same time. It can scan very quickly -- up to 50,000 scans per second," he said. The image also is in 3D.

Now Pitt scientists are working on even higher resolution and faster OCT. "The other kind of 'blue sky' [goal] is being able to measure the function of the retina using OCT," Dr. Schuman said.

Academia also has benefited during Dr. Schuman's tenure thanks to donations used to endow three chairs. When he arrived at UPMC there was just one, partially funded chair.

"Joel has been very successful in recruiting philanthropic support," said Dr. Levine.

"No matter what metric one uses, the department is enjoying great success and is on a very substantial trajectory under Joel's leadership."