Look into my eyes…
May 2017Tobias Pauli looks deeply into people’s eyes every day. It’s his job. He is a practicing ophthalmologist and even after so many years, their beauty does not cease to fascinate him. Already during his days at the Biozentrum, the alumnus dealt with the many facets of the eye – more precisely flies’ eyes. And the fine motor skills needed for his profession were already carefully groomed here.
You studied medicine in Basel. What brought you to ophthalmology?
This resulted from my time at the Biozentrum. My PhD project in Walter Gehring’s lab was on eye development. At the time, he had the idea to study a human eye disease, macular degeneration, using the fly model. There were also ophthalmologists involved in this project and this attracted my interest in this profession. After completing my dissertation, I soon found a position at the Eye Clinic of the University Hospital in Basel.
Why did you decide to do a PhD?
After finishing my studies, I didn’t want to immediately start working in the hospital. Through the practical courses, I realized that I was interested in research and so I looked around for interesting projects. I had already read many things about Walter Gehring’s work and ectopic eyes. And so one thing led to the other and after a meeting with Walter Gehring the matter was settled.
How did you experience Walter Gehring and his research at that time?
I can still vividly remember my first meeting with him. Walter Gehring stood before me with chalk in his hand, describing the eye project and explaining this with drawings of interactions and some diagrams on the blackboard. His enthusiasm for research and how he inspired others fascinated me totally. And he seemed to just bubble over with ideas.
And which idea finally developed into your PhD project?
In the first project, I wanted to examine the human gene which was responsible for the hereditary form of macular degeneration, using the fly as a model. Unfortunately, the fly was unsuitable for this. And so I carried out my dissertation on a classical eye development project. At the beginning, it was totally exciting for me, when my colleagues introduced me to crossing flies and then how to select them. As a medical doctor, I had no idea about this. How to identify the males and the females and how to pick out the virgins among the female flies… I remember thinking, wow, they are amazing being able to do that. But after two or three years, I could also almost tell which were males or females while in flight.
Do you still profit from your research today in your work as an eye specialist?
I think that the fine motor skills of the fingers, that were trained through my work in the lab, for example, when removing the imaginal disc from fly larvae, helped me at the beginning to perform eye surgery.
How difficult was it to start working as a doctor at the Eye Clinic after four years at the bench?
That was a big transition. I was pretty stressed for the first three months. We did not have much contact with patients during our medical studies and after four years in the lab I had forgotten a number of things. Especially at the beginning I sometimes wished to go back to the lab and my work with the flies. I still enjoy thinking about those days. And even though at the practice I don’t always do something as exciting as in my lab time, it is good to see that my patients do need me. Today, the small things I do are very important, in contrast to earlier, where in the global research arena, what I achieved was extremely tiny.
Wasn’t it strange at first to look so deeply into the eyes of so many people?
There is always the examination device between me and the patient. Every day, I see so many eyes, you might think this is boring. But that’s not the case. I find every eye unique and beautiful to look at. It is also the interpersonal contact when speaking with the patient that I greatly value in my profession and that with many simple means, such as glasses, drops and ointments, we can enormously improve the eyesight and consequently the quality of life of people.
How can we look after our eyes?
What applies to the rest of the body, also applies to the eye. So by doing some sport, eating healthy food, not smoking and not looking with unprotected eyes in the sun, you are already doing much for eye health. In any case, from about the age of 40, you should have your eye pressure checked regularly.
Did you learn your skills directly on the patient?
Yes, all non-surgical procedures, such as laser treatments or removing foreign bodies from the cornea, are learned one by one on the patient. Surgery requires more fine motor skills. These I learned step-by-step from my boss, an accomplished surgeon. Initially, one operates in twos. Should something not be so optimal, the more experienced surgeon can take over. So that the final result is still perfect in the end.
Do you remember your first surgery?
Oh, that was pretty nerve wracking. But you keep on practicing until you no longer shake. In order to achieve the recognition as an eye surgeon, one has to have carried out a surgical procedure, such as replacing the clouded lens in cataract surgery, at least 200 times. By now, I must have performed operations on around a thousand eyes.
What do you do in a regular day at the practice?
In most cases, I do routine work such as controls of eyesight, eye pressure or the retina, or deal with complaints such as conjunctivitis. Among the most common diseases are age-related macular degeneration. It is diagnosed more frequently, as we are getting older and older. And this takes us back to Walter Gehring.
When I started working with him, his mother was suffering from macular degeneration and that was his motivation to investigate what actually happens at the molecular level in the disease, using flies. When he told his mother that he was now doing research in this area, she said, “Now you are finally doing something sensible”.
Tobias Pauli has been working as a specialist in ophthalmology and eye surgery at the Eye Center (Augenzentrum) at Basel SBB station since 2009. After studying medicine, he undertook his PhD as part of the MD-PhD Program at the Biozentrum in Walter Gehring’s research group. Pauli then commenced his four-year clinical training as an ophthalmologist and, in 2008, completed the specialist exams.