The Horsley Doctors - They're All in the Family

Dr. Ernest Horsley of Melrose is a retired ear, nose and throat doctor. His wife, Margaret, is a retired ophthalmologist. Between the two, they have six brothers who are physicians. Six of their seven children are also doctors: two radiologists, a psychiatrist, two family doctors and an ophthalmologist. That makes 14 doctors in the immediate family. So, when medical attention is needed, the Horsley family doesn't have to look far for help. The senior Dr. Horsley was in just such a position recently when he called on his oldest son to help with an eye problem that was hindering his active lifestyle. Dr. Will Horsley practices ophthalmolgy in Stoneham.

"Dr. Ernie," who is 82 years old, had developed cataracts, just as may people over the age of 60 eventually do. His problem was further complicated by a condition called corneal dystrophy, a disease that causes a cloudiness of the cornea, the front covering of the eye. And, to make matters worse, he was born with a condition called strabismus (crossed eyes) that causes alternating vision between the eyes. In addition, he is very farsighted.

Despite an active lifestyle, including lots of travel to visit family scattered around the country, the elder Dr. Horsley's eye problems reached a point about two years ago where he was considering giving up driving. Then, just before Christmas of 2001, his wife had a minor stroke and he decided to see if son, Will, could fix the problems that were impairing his vision. Dr. Will was concerrrned about doing cataract surgery on his father becaause of the corneal dystrophy problem but, after consulting with corneal speacilaist Dr. Jeffrey Gilbard, he decided his father was a good candidate for surgery on his right eye, the one with the worst vision.

The surgery took place in January 2002 and, as with all of his patients, Dr. Will used the latest in surgical techniques on his father, a procedure called topical small incistion cataract surgery. The day following surgery, Dr. Ernie was seeing 100 percent better at 20/30, and his thick reading glasses were no longer a necessity. He was also surprised at how bright and vivid colors were, especially blues and greens, and whites that were very white instead of creamy or tan. The other thing that amazed Dr. Ernie was that his activities were unrestricted following surgery. He could bend over, sleep on both sides and didn't need to wear a patch. He was able to see out of the eye the same day as the surgery.

Recently, the senior Dr. Horsley decided it was time to have the cataract removed from his left eye when vision declined to 20/80 and he couldn't even recognize people in photographs, including one of himself! Once again, surgery by son, Will, was successful, and with a surprise benefit; Dr. Ernie can now see for reading and at a distance, all without wearing glasses for the first time in 60 years!

Dr. Will explains that cataracts can be a "blessing in disguise" for some patients because lifelong vision problems such as nearsightedness or farsightedness may be fixed when modern intraocular lenses are inserted during cataract surgery. By visiting with patients prior to surgery, Dr. Will often finds out about special needs that can be addressed with modern intraocular lenses. For instance, one of his patients is a roofer and wanted the lens in one eye focused so he could pound nails at two feet. More typically, patients are interested in correcting their driving or reading vision.

Dr. Will explains that modern cataract surgery is quite comfortable for the patient. A mild sedative is administered and topical drops are placed on the surface of the eye prior to surgery. No injections are used and the entire cataract (the cloudy lens) is removed through an incision in the side of the cornea that is less than 1/8 inch in diameter. Before being removed, the cataract is broken into tiny peices using an ultrasound device, after which the new intraocular lens is inserted in the same position the cataract had occupied. The incision in this modern surgical technique is so small that it is self-sealing and no sutures are used.

The senior Horsleys are back to their sojourns around the country, including a month-long trip to see their son Joshua in Loma Linda, California and to attend their mdical school alumni meeting. Both are graduates of Loma Linda University and met while in training there. In addition to their private pratices, the Horsleys spent several years as missionary doctors in Puerto Rico. Both of the doctors are well-respected in their fields of medicine and Dr. Margaret was featured in a TIME magazine article more than 45 years ago for a discovery that has since saved thousands of persons from blindness due to glaucoma.

In explaining the benefits of modern cataract surgery, Dr. Will says failing eyesight due to cataracts severly limits activities and causes otherwise healthy seniors to rely on their extended families for assistance. With today's families scattered across the country (like his own), that kind of help is not always available. With modern cataract surgery, he says, many seniors now stay active and independent - able to keep their own finances, drive, do their own corresponding, baby-sit their grandchildren and handle a multitude of other tasks until they are well into their eighties or nineties.

Dr. Will Horsley is founder and medical director of Clear Vision Laser Center in Medford, and a founding member of the North Shore Cataract and Laser Center where Dr. Earnie was treated. Dr. Will Horsley is also the former Chief of Ophthalmology at the Boston Regional Medical Center. He has also been on the laser staff of the Massachusetts Eye and Ear Infirmary since 1996.