Andy/ July 16, 2021/ blindness, low vision

I’m Mohamed, Accessible Pharmacy’s student intern. Last week I had the pleasure of speaking with Dr. Delaram Shirazian, an Assistant Clinical Professor with the State University of New York (SUNY) College of Optometry. Dr. Shirazian does a lot of work at SUNY where she educates students and gives quality care to patients in the primary care and low vision clinics. We discussed SUNY’s Low-Vision Rehabilitation Center (referred to as “Low Vision”) and Dr. Shirazian herself. As a student at SUNY myself (I am an undergraduate student at SUNY Binghamton), I was very excited to speak with Dr. Shirazian!

dr delaram shirazian headshot photo from the SUNY low-vision clinic

Mohamed: What’s your name and title?

Dr. Shirazian: Well, my full name is Delaram Shirazian, and I am an Assistant Clinical Professor at SUNY and I work with our patients in both the Primary Care and Low Vision Rehabilitation Clinics. 

Mohamed: Can you tell me a bit about yourself and your background?

Dr. Shirazian: Yeah so, I went to my undergrad at the University of Missouri in Columbia, Missouri. I am from St. Louis, so I am originally from the Midwest and not the Northeast. I always knew I wanted to go into healthcare, but it wasn’t until I shadowed an optometrist for the first time that I got to see the one-on-one nature and the relationship that the optometrist was able to build with their patients that I realized this was a profession that really appealed to me. So, after my undergrad I went to optometry school at the University of Missouri in St. Louis and after that, I pursued a residency in ocular disease and low vision rehabilitation at the Kansas City VA Medical Center. So, I really liked combining those two things because I feel like in a lot of ocular diseases there’s not many medical cures for them so low vision rehabilitation provides us a way to give the patient some form of treatment or some hope for continuing their independence in their daily life. 

Mohamed: What led you to working with SUNY?

Dr. Shirazian: After residency I knew I wanted to teach so I just applied to the various optometry schools and SUNY was one that stuck out to me because when I interviewed with them, I presented on patient-doctor communication. I think that’s really important all across-the-board no matter what kind of optometry that you’re practicing, and SUNY was really open to that and wanted to incorporate that into the curriculum, so it seemed like a really good fit. So, after residency I’ve been in New York ever since.

Mohamed: What do you do at SUNY? What’s a normal workday like for you?

Dr. Shirazian: No workday is the same between the week! Which is something I really like about working in academia is that I don’t do the same thing every single day. For example, one day I might be working in the primary care clinic seeing patients with our third-year students. The next day I’ll be in the Low Vision Clinic, and I may also be helping to teach a clinical optometry lab. So, teaching students how to do their technical skills. Some days I work with our low vision ocular disease micro-credential students, which are three- or four-year students choosing to emphasize one of their fourth-year externships in this topic. Sometimes we’ll do article reviews and discuss clinical cases. I used to sit in on the admissions committee prior to COVID as well. Basically, it’s a lot of different things which is something I like.

Mohamed: What is SUNY doing to be more accessible to the blind community and what does it offer through its services to the community?

Dr. Shirazian: Yeah, that’s a great question. So, I think as far as services go, the easiest answer for that is, you know, our Low Vision Clinic. So, being in the center of Midtown Manhattan, where all the trains kind of converge here anyways, I think we’re in a central location to be able to take care of a lot of different people. So, not only do we see patients that are referred from our clinic, but we also have every clinic that you can think of for eyecare here. So, if another doctor thinks they have a patient that really needs low vision services, they can make a referral in-house to us. And we also take referrals from outside of SUNY. So, a lot of different, you know, retinal specialists, glaucoma specialists, etc. will send patients to us to do their low vision rehabilitation. So, I think being where we are as far as location goes and making sure that the doctors around us know that we’re here is really important. We also work with state services, like the Commission for the Blind and other organizations like VISIONS to ensure that our patients are getting adequate services from the state level as well. So yeah, I think those are the main things that we’re doing. We’re also trying to make sure that we’re educating our students on the importance of either referring to low vision or being a low vision practitioner. So that’s one of the things that I had mentioned, the Low Vision Ocular Diseases Micro-Credential Program. We introduced that to make sure that we are educating our future optometrists to make sure that they’re aware of this, because there’s so many times in our clinic where somebody comes in and they’re like, “oh my gosh, my doctor never told me about ‘Low Vision’ I should have been here ages ago.” And so we’re making sure to bridge that gap and teaching the future generation of eyecare providers, that this is a very important area that we need to make sure that we’re referring patients appropriately when needed.

Mohamed: Is there something specific that makes you say you’re proud you’re doing your job there?

Dr. Shirazian: One of the things that does make me proud of being at SUNY is the fact that since we’re an academic institution, there’s comradery. Working as a team oftentimes to take care of a patient. So, it’s not just me, I’m often in clinic with other doctors. So, one of my other low vision colleagues will be seeing patients at the same time with their students as me. So I think one thing that is really special about, you know, where I work is that if I have a question or if I feel like there’s a patient with a need that I’m not able to really figure out what to do with, or I’m not quite sure what the best course of action would be, I can always consult one of my colleagues and we can kind of work together to make sure that the patient is best taken care of. Versus, if I was on my own, of course you can call a friend, but it’s not the same as just turning around and being like, “hey, what do you think I should do with this patient?” Or “this is what I think the best course of action should be,” or, “I think this device would be really beneficial. Do you agree with me?” And so, it’s really nice to have that teamwork approach. And I think at the end of the day, it just leads to better patient care because two heads are oftentimes better than one when you’re brainstorming creative strategies for management for some of these patients. I think that’s the best thing about SUNY.

Mohamed: What’s your favorite part or moment of your job?

Dr. Shirazian: I think there’s a couple of favorite parts. One of my favorite parts is really teaching the students. So, I think there’s something really rewarding about having a student leave after having gone through your clinic or teaching them in a course and seeing how much of a better clinician they are afterwards. And seeing that growth in them is really cool and makes it much more exciting than just if I were seeing patients on my own but getting to share that experience with a student and helping them in their growth has been really, really awesome. And then I mean, my absolute favorite part of the job, I think, which is why we all do it, is, you know, patient care. Having a patient, leave your exam feeling better than when they came in that day, I think is the best thing. And I think, in low vision, oftentimes unfortunately we see patients that have mentioned this, that haven’t known about low vision services and didn’t know that there was some device out there to help them, you know, read their paper or something very simple. And when those patients leave and they’re just like, “wow, I’m just so happy that I came here and I’m so excited that I’m getting this device to, to help me with my day-to-day tasks.” I mean, there’s really no better feeling than the knowing that you helped someone in that way. So, I think those are the moments that, you know, you think about and make you feel really happy to work here and to do what you’re doing.

Mohamed: Is there a significant event or person who inspired you?

Dr. Shirazian: Yeah, I would say in optometry in general is probably my residency supervisor, Dr. Tim Harkins. So, when I first started residency, just the wisdom that he instilled, he also pushed me in a direction of really thinking about the human side of what we do too. And an area called the medical humanities. So, under his residency program, I read a lot of books on like the art of doctoring and like, you know, how do we actually take care of people and not just their conditions and so on and so forth. And just his drive to continue what he does is every day and reading evidence-based medicine, always keeping up to date on everything, you know, treating his patients with compassion and respect. Those are all qualities that I feel like I still strive to emulate, and kind of think motivated me to want to be the best doctor that I could be. So, if I could pick one person, it probably would be him.

Mohamed: What do you think of the pandemics effect on you and your work?

Dr. Shirazian: Yeah, although I’m a healthcare provider, I obviously wasn’t on front lines taking care of patients with COVID, but I still had a responsibility of, you know, coming into work certain days and taking care of urgent care patients and whatnot. And I think any healthcare provider would probably tell you that was quite stressful. You know, being the only person taking the subway one day and like being the only one in the car and walking around Midtown when there’s no one else here was a little bit jarring, but I think professionally and at SUNY, how it kind of changed things is we really started implementing virtual telehealth, at least for like our primary care clinic. But it did kind of leave this big gap with low vision care because a lot of our patients, they’re usually coming to us because they can’t see their computer or their tablet. So, to tell them to use that device, to virtually meet with us was really not something that worked with our clinic unfortunately. You know, we wanted to do some simple things, like let’s say they had a device, and they needed some troubleshooting… We wanted to be able to do simple things like that virtually, but unfortunately it didn’t work very well. So oftentimes we did some telephone consultations with them and just the low vision exam at the office. I can’t really measure your acuity and show you a device and see if it works for you remotely. So, I think, unfortunately it left a big gap in terms of the patients that needed care in terms of low vision rehab. But thankfully we were only kind of closed for that service for a few months. So, we slowly got back into things at the end of last summer, and now we’re back into the full swing of things. So hopefully we’re caught up on those patients that we unfortunately missed out on. 

Mohamed: Talk to me about something you like to do for fun.

Dr. Shirazian: I really enjoy reading, so I’m always reading some type of book. I started a medical humanities book club at SUNY with some faculty. So, I’m constantly looking for the next best medical humanities book and reading a lot about that. I enjoy yoga and exercise, so I used to like going to the gym, but now I really like doing that in my living room where I know I’m safe!

I want to thank Delaram for speaking with me this week and for her work with SUNY College of Optometry, the Low Vision Clinic, her patients, and students. 

To learn more about SUNY College of Optometry, please visit: https://sunyopt.edu/

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