In this Q&A we welcome touchOPHTHALMOLOGY Future Leader honouree Dr Marina Roizenblatt from the Universidade Federal de São Paulo, one of the up-and-coming retina specialists who is already making a mark in the world of ophthalmology.
Following her medical degree, ophthalmology residency and professional masters degree at Federal University of São Paulo, Dr Roizenblatt became the first participant in a program funded by the Lemann Foundation and Vision Institute-IPEPO to train at Johns Hopkins University, a testament to her dedication to advancing ophthalmology on a both a national and global scale.
Join us as Dr Roizenblatt discusses the motivations that shaped her career, her early contributions to making a meaningful impact, and her vision for the future of her groundbreaking research in retinal surgery.
1. What inspired you to pursue a career in ophthalmology?
I believe vision is one of the most important aspects of life, yet many people don’t fully realize how important it is until they face issues with their eyes. Losing vision or dealing with eye diseases can be incredibly debilitating and significantly impact a person’s quality of life. For me, ophthalmology offers a unique opportunity to make a significant difference in people’s lives.
As a retinal specialist, I find it incredible how we can restore sight in cases like retinal detachments. When a patient comes in unable to see, and through surgery, you can give them back their vision—it’s truly amazing. That feeling goes beyond money or recognition; it’s about the direct impact on someone’s life, which is incredibly fulfilling.
I’m also drawn to the precision and challenge of the field. Retinal surgery, in particular, demands excellent dexterity and a pursuit of perfection, which I find both motivating and rewarding. Of course, there are always potential improvements and lessons to learn, but the dynamic nature of ophthalmology keeps me engaged. There’s always something new—whether it’s advancements in technology or the discovery of new diseases—which makes the field exciting and ensures you’re always learning.
Another aspect I love is the blend of clinical and surgical work. During medical school, I realized I wanted a specialty that allowed me to address problems from both perspectives. Unlike fields where you might only diagnose and manage without a surgical solution, ophthalmology lets you take a problem from diagnosis through to resolution. It’s satisfying to work in a field that’s logical and precise, where the outcomes are clear.
Ultimately, my decision to pursue ophthalmology came late in my training, but I’m grateful for that. I explored many fields before choosing this one, which gave me confidence in my decision. Now, as a retinal specialist, I can’t imagine doing anything else. The opportunity to blend surgery, clinical care, and the constant evolution of the field makes ophthalmology a perfect fit for me.
2. How can aspiring ophthalmologists make a meaningful impact early on in their careers?
In Brazil, the healthcare and education systems create a unique environment for aspiring ophthalmologists to make a significant impact early in their careers. Unlike in North America, where private universities dominate, the best universities in Brazil are public and tuition-free. Admission is highly competitive, with hundreds of applicants vying for limited spots. Once admitted, students are immersed in public healthcare, gaining hands-on experience while serving a population with limited access to medical services.
Brazil’s public healthcare system, SUS (Sistema Único de Saúde), provides universal care at no cost to patients. This means patients don’t choose their doctors and often rely on long wait times for services. While this system has its challenges, it also allows medical trainees to make a meaningful difference and allows students to perform their first surgeries and manage clinics, of course always under the supervision of more experienced doctors.
One impactful initiative was a day dedicated to providing free glasses to children. Hundreds of children were brought in by bus to receive prescriptions, an act that could dramatically change their lives by improving their ability to learn and succeed in school. Such seemingly small actions can have a life-changing impact.
Additionally, early career ophthalmologists in Brazil encounter a range of complex cases due to delayed access to care, which deepens their learning experience. This exposure equips them with skills and insights that may not be as readily available in private practice settings.
The gratitude of the patients and the opportunity to learn through high-quality service create a mutually rewarding experience. Aspiring ophthalmologists in Brazil find themselves making meaningful contributions from the outset, whether through community outreach, patient education, or surgical interventions, even in resource-limited settings.
3. Are there specific areas of research or clinical practice you aim to specialize in or help to advance?
My research focuses on identifying and studying modifiable variables that impact surgical dexterity, particularly among retinal surgeons. During my PhD and postdoc, we used a virtual reality simulator to expose surgeons—both novices and experts—to various conditions such as weight-adjusted doses of caffeine, propranolol (a beta-blocker), sleep deprivation, alcohol, and physical exercise. This allowed us to observe and measure their effects on surgical performance.
The research has yielded significant insights. For example, we demonstrated numerically that factors like sleep deprivation—getting only three hours of sleep—can negatively affect surgical dexterity the following day. These findings have been published in high-impact journals and have provided practical guidelines for improving performance in surgical practice. Our work was recognized with an award in 2022 for the best thesis in the medical field in Brazil, a proud milestone for our team.
We’re now expanding the research and applying for a new grant to investigate additional variables that can potentially impact the patient’s surgical anatomical and functional outcomes, such as fatigue. This exploration is especially relevant in the surgical field, where practitioners are often expected to perform at their peak regardless of circumstances. For instance, while surgeons are trained to maintain precision throughout the day, working all day in the operating room with a busy surgical schedule might lead to a decline in quality by the last surgery due to cumulative fatigue.
Our goal is to identify thresholds where performance begins to decline and to personalize recommendations. For example, caffeine may improve focus for individuals accustomed to it, but for someone unaccustomed, it can induce tremors, particularly in novice surgeons.
One area of interest has been studying real-world scenarios, such as the effects of a hangover on surgical performance. Surgeons may not plan for urgent cases the morning after a social event, but understanding the potential impacts of alcohol consumption on dexterity is crucial for patient safety. Another focus has been the effects of sleep disorders like apnoea and fragmented sleep, measured through polysomnography, which can significantly impact surgical performance the next day.
I believe this line of research can improve both surgeon performance and patient outcomes, and I remain committed to advancing it further through publications, presentations, and ongoing studies.
Disclosures: This short article was prepared by touchOPHTHALMOLOGY in collaboration with Dr Roizenblatt. No fees or funding were associated with its publication.
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