The Journal Register (Medina, NY)

Local News

January 30, 2008

MEDINA: Ophthalmologists look back on history with eyes for the future

Ophthalmology. It isn’t the easiest word to say, and spelling it can be a task.

But two men have turned the study of the eye from a branch of medicine to a passion for your optical care.

Drs. Arthur Mruczek and William Cosman have been working together for about a year and a half. Mruczek is slowly adjusting his hours so he has more time to travel and be with his family, while Cosman has become a full partner at the practice and will someday take over when Mruczek goes into full retirement. Cosman, 31 and a father of five, also recently became a board certified ophthalmologist, following a lengthy written exam and then an oral exam in Boston.

Lake Plains Eye Center

Mruczek and his wife, Donna, made West Center Street, Medina, their home in 1975.

“I’m originally from Corfu and my wife’s from Oakfield and coming to Medina was like coming to the big city, because we’re both from such small towns,” Mruczek said.

In 1976, Lake Plains Eye Center opened on the lot at 500 Erie St., directly behind the Mruczek home, and Orleans County had its first eye clinic.

When the eye center opened it was a chance to offer quality eye care to people without the burden of going to Buffalo or Rochester, which used to be the case. Back then, Mruczek’s colleagues at Medina Memorial Hospital wondered if he would do much business, he said. Before the Erie Street office was built, if a Fisher-Price employee, for example, got something in their eye, they’d be sent out of the area to have it checked; if a child had an eye infection, they would be sent out of the area for treatment; the same scenario occurred for each person locally who needed care for an eye problem.

When Mruczek opened his doors, the emergency room sent patients his way, and the business that some had questioned became the place for eye care in Orleans County.

“Aside from Bill, the next closest colleagues we have are in Lockport and Batavia, and we work very closely with them,” Mruczek said.

Throughout the past 30 years, changes in medical procedures and technology have shaped the future of ophthalmology. What occurs today in the operating room is like night and day from the way it was done in 1976.

Technology in ophthalmology

“When I started, patients were hospitalized for 10 days after cataract surgery,” Mruczek said. They used sandbags in the hospital beds to keep patients from rolling over and the sutures were 6-0 silk sutures, or three times the diameter of a human hair, he added.

“Recovery took six months and required thick George Burns glasses,” Mruczek said.

Intraocular lens implants for cataract patients hadn’t even been thought of at that point. Now, there are “no suture” surgeries, patients go home about an hour after operation, and if the doctors do use sutures, they are 10-0 — meaning they are about half the diameter of a strand of hair. Surgeries now are also done under microscopes.

“In 1976, we had no lasers,” Mruczek said. “Many hospital procedures are now performed in the office, such as glaucoma.”

In his 30-plus years in practice in Medina, Mruczek has done more than 30,000 cataract surgeries and laser procedures.

“I am surprised there are that many cataracts in Orleans County, but everyone has two eyes,” he said.

According to Cosman, probably the biggest changes over the past few years are in cataract surgery. Instead of patients needing thick glasses after the procedure to remove the cataract, some need glasses, while others need none at all.

“We’ve gotten really good. Our techniques have gotten better,” Cosman said. “A lot of them are able to go through surgery and not have to have glasses. It’s not anymore just a medical surgery.”

With what are called “multi-focal lenses,” cataract patients are able to see up close and far away after surgery. The surgery is no different than the one performed for an Intraocular lens, which is slipped into the eye after the cataract is removed. The difference between the multi-focal lens and the intraocular lens is that there usually isn’t a need for reading glasses afterward.

While cataracts can be corrected with surgery, Cosman said along with them the other big problem in eye care is glaucoma, which is hereditary and causes a loss of vision. There has been nothing to date that will help reverse the effects of the disease — no vitamin to take or change in diet to ward it off, he said.

“Glaucoma and cataracts are probably the two biggest (problems). Glaucoma is probably the worst because its symptoms can go undetected,” Cosman said. “It’s really only something that can be detected by regular eye exams, checking (eye) pressure and the optic nerve.”

Although cataracts and glaucoma often affect adults, Cosman said one problem that causes visual impairment in children is amblyopia. The latter is a condition in which one eye does not see as well as the other. Often, it goes undetected, and unless diagnosed by the time a child is 7 or 8 years old, it cannot be corrected, he said.

The doctors’ futures

Cosman said a move from the family home in Monroe County to Orleans County is in consideration, but for the time being, uprooting the younger members of the family is not in the near future. Cosman and his wife, Victoria, have five children — ages 9, 7, 6, 4 and 5 months — and felt the schools closer to Rochester were better suited for addressing their oldest child’s autism needs at this time. However, once the kids get bigger, the option to move closer to Medina will be more feasible.

“I think that they’re (his family) very supportive of me, obviously, to make it through medical school and residency,” Cosman said of his career choice.

Mruczek and his wife also have children, three of them, and two grandchildren, all of whom the doctor would like to be able to spend more time with, he said.

“Recalibrating my office hours was a decision based on the decision of my daughter to move to Oklahoma,” Mruczek said. “That has given me, by taking a day or two off a week, a chance to visit my kids and be more spontaneous with my wife.”

According to Mruczek, he believes his wife is enjoying his reduced time in the office.

“I’m very excited to be able to spend more time together and to travel,” Donna Mruczek said.

Dr. Mruczek said they try to get away every month. The couple’s travel log includes visits to 47 states and 21 countries.

“The world has so much to offer,” he said. “Our cities are second to none. My goal is to go everywhere.”

When Mruczek isn’t in, Cosman is the doctor in the house.

“Dr. Cosman is a great surgeon and a great clinician,” Mruczek said. “He’s offered to cover my time out of the office. I still work three days a week on an abbreviated schedule.”

“I’m very excited for him. He’s amazingly gifted,” Mruczek said. “We’re very fortunate to have someone of his caliber in Orleans County.”

Mruczek added he never doubted Cosman’s ability to pass the boards.

“They send you a nice little certificate,” Cosman said. “It means I’d be recognized by the main certifying body, as being a member of their community. ... It’s an honor.”

Cosman plans to continue his education, keeping up on new developments in the field. He is excited about the opportunity to have his own practice, once Mruczek fully retires.

“I love it, I definitely made the right choice for me,” he said. “You get to work with people on a personal level. ... You get to know families, but then you get to do surgery and you can help them. With ophthalmology you can do a laser or a surgery and fix the problem. It’s really rewarding.”

Contact reporter Miranda Vagg at 798-1400, ext. 2225.

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