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Nichols excels in academia, dry eye research
Kelly K. Nichols, OD, MPH, PhD, FAAO, said she welcomes change as she continues her mission to improve academic growth for optometry.
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As part of Primary Care Optometry News’ 20th anniversary celebration, in each issue throughout 2015 we profiled a “Pioneer in Optometry” as chosen by the PCON Editorial Board.
In this last issue for this feature we profile Kelly K. Nichols, OD, MPH, PhD, FAAO, dean of the University of Alabama (UAB) at Birmingham and a leading vision scientist for dry eye disease, as our final “pioneer” for our anniversary celebration.
“Optometry reached a new milestone of respect within medical science because of Kelly Nichols. Leading the MGD Workshop [Meibomian Gland Dysfunction Workshop] essentially placed optometry on the map in terms of the ocular surface,” PCON Editorial Board member Milton M. Hom, OD, FAAO, told Primary Care Optometry News.
“Prior to Kelly, we had such optometric giants as Don Korb, OD, making significant discoveries,” he continued. “But Kelly put it all together in a massive consensus work that encompassed both ophthalmology and optometry. Her work is both simple and complex, taking known things and making them scientific. It is elegantly simple in concept, but incredibly difficult to execute.”
Nichols said she both embraces change and thrives from it. Her career and education brought her to Colorado, California, Ohio, Texas and Alabama. Throughout all these changes, her work has not side-stepped, and her family values have remained paramount, she said.
“Kelly has accomplished so much in a relatively short period of time. UAB is so fortunate to have such a talented dean,” board member Joseph P. Shovlin, OD, FAAO, said. “Her research has helped move all of us from the ‘bench to chairside’ with novel ways to recognize and treat dry eye disease. Her passion remains improving the quality of life for those who suffer from dry eye.”
Images: Nichols KN
“Kelly has been a singular voice for the profession in regard to her outstanding scientific contributions to the field of ocular surface disease and its affiliated areas,” PCON Editorial Board member J. James Thimons, OD, said. “Her research stands its ground against the best in ophthalmology and represents our profession at the highest level.
“Additionally she has broken barriers in academia with regard to women in leadership roles and the important transition that will be ushered in over the next decade,” he added.
In an interview with PCON, Nichols shared her beginnings in optometry and what she considers to be her most significant contributions to the profession.
PCON: Why did you choose optometry as a career path?
Nichols: I was actually recruited by our family optometrist who had a successful, thriving practice that I always enjoyed. I was looking for a medical profession in college, and I always thought optometry was a nice, clean profession. I had a fear of a lot of blood. It also appealed to me because optometry at the time didn’t involve needles or operating rooms. I liked the idea of private practice. The atmosphere was always calm, nice, friendly and yet busy. I thought it seemed like a happy medical profession.
PCON: How has your career unfolded?
Nichols: Well, for all of those reasons, I kind of went in an entirely different direction at some point. Even though I don’t believe it’s true now, I was under the impression that what an optometrist does was routine. The same concept drove me to consider a more varied optometric profession in academic optometry where things change all the time. Now, I know there are many ways in which private practitioners can enhance their practice, but at the time I was kind of a rolling stone, and I think it would have been hard to commit to a private practice then to sit down and stay somewhere for my whole life.
My family always joked that I would get another degree. At my residency in Denver, I loved the elements of comanagement and seeing a lot of ocular disease. I had the opportunity to work with many different specialists – glaucoma, retina and cornea – and participate in pre- and postop. I learned so much in that experience. That provided the backdrop for my interest in dry eye, because we saw dry eye patients every day. At the time, I was more interested in the retina, so I say the retina was my first true love. However, there weren’t a lot of things optometrists could do for the retina back then.
I wanted to continue working at a referral center with optometry and ophthalmology together. At the same time, I was looking at graduate schools at Berkeley, which is where I went to optometry school; then I was recruited to Ohio State. I was told I could stick around and do the same thing I had been doing or I could come to Ohio State to build something new. I decided to build new. At Ohio State, I finished a PhD and Master’s in public health. While trying to decide on my research topic, the National Eye Institute/Industry Report on Clinical Trials in Dry Eye was published (in 1995). It provided the first professional definition of dry eye. It’s the seminal paper in dry eye – like a road map – which laid out the unmet need in terms of research. There was a lot of dogma that existed on the topic at the time. So, I picked dry eye and stuck with it ever since.
I have worked with organizations that have promoted dry eye, and now people say optometry should “own” this topic. Since then, I’ve done a variety of things in academia, but dry eye research and being involved in organizations that promote dry eye has been very rewarding to me and hopefully the profession.
PCON: What are you doing now?
Nichols: Currently I’m the dean of the UAB School of Optometry. I oversee this wonderful school that has a strong research portfolio, which was essential to me in choosing this opportunity. I’ve been funded by the National Institutes of Health, I continue to do dry eye research and submit grants, and I have an active research portfolio. I’m a tenured professor, with a lot of research overtime – both clinical basic and translational research. It was important to maintain a research profile and have an administration role as well as teaching the first-year Intro to Optometry course. We are also developing a dry eye clinic. I do not have as much clinical care in this role yet, and I enjoy keeping my hand in the pot of all the different elements that make academic optometry: research, teaching and service.
PCON: What have you learned?
Nichols: Along the way, I have always had a partner in crime. At Ohio State, I found my husband (or he found me?), Jason Nichols, (associate vice president for research and industry relations at UAB), and he has the same degree set that I do: OD, MPH, PhD. Unfortunately, we talk about eyes a lot in our house. We’ve completed research as a team for all these years. Currently, we still have a research team with a lab and six graduate PhD students. When we go somewhere, it has to be for both of us. We don’t know any other way. Family is important and comes first.
We both have access to the administration on campus and are a part of the overall administration team that runs the university, which is really unique and has been a huge learning experience. We’ve had the pleasure of serving at a number of schools of optometry associated with different universities. We’ve had many different interactions with central campuses throughout the years. This has added to the toolbox, and you learn something everywhere you go.
PCON: What is your most significant accomplishment?
Nichols: In general, I would say my children are: Brady who is 13 years old and Cullin who is 11 years old. Hopefully they feel the same as they grow up – that family must come first. It is hard to balance everything; they know we are very busy and hopefully they won’t hold that against us as we get older. From a professional standpoint, working on the Tear Film and Ocular Surface Society, (TFOS), which involves many countries, is something I’m proud of.
I worked on the steering committee for the TFOS DEWS Report [Dry Eye Workshop Report], and I helped write the new version, the new definition. I felt very proud of being an OD on the steering committee. I was relatively young. Where I looked up to the author of the first one, Michael Lemp, MD, I was now working with him. I looked up to these mentors who then turned into friends and colleagues, and, in turn, we advanced the field together.
I completed another TFOS workshop on MGD, which I was asked to chair, and it was published in 2011. The goal was to make MGD accepted across the world so people have a common understanding of what it is and how it relates to dry eye. As it turns out, MGD may be the leading cause of dry eye in the world. This, in turn, led to another report on contact lens discomfort, the TFOS Contact Lens Discomfort Workshop.
We were trying to make dry eye accepted across the world, so people have a common understanding of what it is. I have been on the governing board with the TFOS since almost the beginning of my work in dry eye.
Now, DEWS II is in the works with a 10-year revision from the last DEWS workshop, and it should be published in early 2017. Subcommittees have been formed. NIH is becoming more interested in clinical, translational and basic dry eye research, and everything improves. I am very proud of that because I feel like dry eye has really grown. I have enjoyed being part of the TFOS workshop process and organization.
When I see lifelong learning I appreciate it, and the young students who are going to march forward give me a sense of satisfaction and motivation as well. It’s a great profession, and I enjoy seeing that. It’s good to know I stumbled into it.
PCON: What have you contributed to optometry?
Nichols: I’ve been inspired by those who studied dry eye before me. I hope I can be inspiring to those after me, as well. I’ve always looked up to others and tried to lead by example. I try to encourage others to go into a career of academic optometry.
PCON: What do you enjoy most about optometry?
Nichols: Personally, I enjoy the variety of the type of optometrists I’m involved with. The camaraderie, friendship and the caring that I find in ODs is vast.
PCON: What do you wish for the future of optometry?
Nichols: From enhancing the learning of optometry as we know it in the U.S. across the globe, as evidenced through the Brien Holden Vision Institute, growing optometry worldwide is a worthy initiative.
Linda Casser, OD, FAAO, summed up Nichols’ accomplishments: “The diagnosis of dry eye/ocular surface disease is widely prevalent among various patient groups. The condition is one that can be challenging to assess, treat and manage, yet one that has immense potential to negatively impact the patient’s quality of life from the standpoints of comfort, clarity of vision and ability to maintain meaningful daily living, vocational and avocational activities. Dr. Nichols’ scholarly work is significant in the field of dry eye in that it enhances the scientific bases and methods upon which the condition is assessed, both objectively and subjectively. Her research has substantially enhanced the understanding of this important and highly prevalent condition.
“In addition,” Casser continued, “Dr. Nichols’ work has introduced new and widely respected methods of assessing and monitoring dry eye that add immensely to the approaches used in studying this condition, allowing for further elucidation and advancement through continued study and meaningful research.” – by Abigail Sutton