ASRS 2023: Crystal Apple Award Distinguished Lecture

Jonathan D. Tijerina, MD, MA
Bascom Palmer Eye Institute

The Early Career Section Luncheon of this years ASRS meeting was moderated by Dr. Basil Williams who kicked of things by announcing Dr. Patrick Staropoli of the Bascom Palmer Eye Institute as the 2022-2023 ASRS Grand Rounds Champion for his case of tattoo-associated uveitis. Acknowledgments were also given tot he current ASRS Fellows In Training (FIT), Dr. Alexis Warren and Dr. Asad Durrani, as well as incoming FIT, Dr. Tianyu (Tom) Liu.

After a warm introduction by Dr. Leyla Isik, the session then transitioned into the distinguished lecture from Dr. Prithvi Mruthyunjaya of the Stanford University Byers Eye Institute, the recipient of this year’s Crystal Apple Award. The Crystal Apple Award is given annually to “an ASRS member who has gone to great lengths to advance the education and professional development of young retina specialists.”

Dr. Mruthyunjaya detailed his early influences by Dr. Gullapalli Rao, founder of the L.V. Prasad Eye Institute, and later by Drs. Cynthia Toth, Brooks McCuen II, Eric Postel, and Glen Jaffe at the Duke Eye Center where he attended residency, served as chief resident, and completed fellowship in vitreoretinal surgery. He also credited Dr. John Hungerford for teaching him and subsequently giving him space to grow on his own during his time at Moorfields Eye Hospital in London, UK completing an additional fellowship in and ocular oncology, before returning to work at Duke.

Throughout his time Dr. Mruthyunjaya reflected on the strides made in vitreoretinal surgical techniques since his residency and fellowship training. He credits his mentors at Duke for inspiring his interest in ocular oncology and identifying this as a niche he could fill and contribute to in a meaningful way both at the Duke Eye Center and in the field of ophthalmology at large. After returning from his training at Moorfield’s, he remained at Duke for the subsequent 15 years and built up the ocular oncology department with a specific interest in vitreoretinal approaches to treatment and established clinics evaluating conjunctival lesions, iris nevi and tumors, and ocular melanomas.

During this time he refined techniques in intraocular biopsy approaches, liquid vitreous and anterior chamber biopsies, 27g microvitreoretinal cutter assisted biopsy, and became involved in the leadership of the Collaborative Ocular Oncology Group (COOG) with Drs. J William Harbor and Zelia Correa.

Subsequently,  Dr. Mruthyunjaya transitioned to his position at the Stanford University Byers Eye Institute where he currently serves as director of the vitreoretinal surgery and ocular oncology fellowship programs as well as a professor of radiation oncology.  He has conducted extensive research into multiomic/proteomic profiling of aqueous and vitreous samples taken during choroidal tumor sampling to create a biorepository and refine techniques for sample analysis.

Dr. Mruthyunjaya credits the spike in telecommunications-based learning during the COVID-19 pandemic for inspiring several of his most recent educational endeavors including co-directing the inaugural Duke Fellows Advanced Vitreous Surgery Course, the Cole Eye Institute and Byers Eye Institute Retina Fellow Surgical Rounds (COBRA) Conference, and many others.

Dr. Mruthyunjaya’s finished the lecture with a few take-away pearls:

  • Every patient is an n of 1
  • Bad things happen to those who are not prepared
  • Approach todays case anticipating the next surgery
  • Allow yourself time (“The 2 Year Rule”) to adjust to new roles and locations
  • Be a physician not just a “vitrectomist”
  • Strive for growth
  • Embrace your complications
  • Discuss cases with trusted colleagues and mentors (swallow your ego to do so)
  • Always put the patient first