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TRADITION OF EXCELLENCE

The doctors at the Glaucoma Center of San Francisco are teachers at the University of California, San Francisco, Stanford University, California Pacific Medical Center, the American Academy of Ophthalmology, and invited lectures at many universities around the world. They are pioneers in the development of automated perimetry, ultrasound biomicroscopy (UBM), laser treatment, surgical techniques, and new drugs for glaucoma, as well as experts at diagnosing and treating the myriad forms of glaucoma in both the young and the aged. But more than anything, they are doctors whose focus is serving people, not just patients.

At the heart of the Glaucoma Center of San Francisco is the memory of Dr. Robert N. Shaffer. Dr. Shaffer was hand-picked by the head of the department of ophthalmology at UC San Francisco (UCSF) to study glaucoma when both he and glaucoma were new to ophthalmology. Dr. Shaffer learned about congenital (childhood) glaucoma from the expert at the time, Dr. Otto Barkan. He then started a clinic at UCSF for this specialty in 1942. That year, Dr. Shaffer also broadened his teaching emphasis by serving as a Diplomat (and later as Consultant and Secretary-Treasurer) of the American Board of Ophthalmology. In 1961, he co-authored the quintessential text on glaucoma, Becker-Shaffer's Diagnosis and Therapy of the Glaucomas, now in its 8th edition.

In 1941 Dr. Warren Horner asked Dr. Shaffer to join him in practice at 490 Post Street, anticipating that he would be called to war and would need someone to keep his practice going while he was away. Dr. Horner served in WWII from 1942-1945 and died in 1949, leaving Dr. Shaffer with the 490 Post Street clinic. By that time, Dr. Shaffer had distinguished himself as among the great early leaders in glaucoma, along with Dr. Bernard Becker (St. Louis) and Dr. W. Morton Grant (Boston). Dr. Shaffer was highly respected as a great diagnostician and known to 'lead by example'. He had a strong belief that research should be useful and significant to patient care. Dr. Shaffer was patient-oriented, a doctor known to be extremely ethical and credible in every aspect of his practice and his life. These are the building blocks on which the Glaucoma Center of San Francisco still stands and that have upheld it as the leading glaucoma practice in California for 70 years.

As the clinic grew, Dr. Shaffer asked other respected ophthalmologists to join him. Drs. William Ridgway and William van Herick began seeing patients at the 490 Post Street clinic in the 1950s. Dr. Shaffer then decided to formalize the specialty training he was providing (with the help of his wife Virginia) by establishing a glaucoma fellowship. The Shaffer Glaucoma Fellowship, a 1-year advanced training program for select ophthalmologists wishing to specialize in glaucoma, began with Dr. John Hetherington in 1961 and has produced a long list of luminaries in the field. By 1966 Dr. Shaffer was so impressed by Dr. Hetherington's research and clinical skills that he asked Dr. Hetherington to join him. Dr. Hetherington later became a Clinical Professor at UCSF as well as holding a host of titles nationally and internationally in ophthalmology.

In 1972, Shaffer and Hetherington asked their then Fellow, Dr. H. Dunbar Hoskins, Jr., to join the practice. Dr. Hoskins raised the level of excellence yet again. He held National Institutes of Health research grants from 1976-1981; at the urging of patients, Shaffer, Hoskins, and Hetherington created the Foundation for Glaucoma Research in 1978 (now known as the Glaucoma Research Foundation) with Dr. Hoskins spearheading the effort; and from 1993-2009 Dr. Hoskins served as Executive Vice President of the American Academy of Ophthalmology, the world's largest organization for ophthalmologists. In 2009 the Academy opened the H. Dunbar Hoskins, Jr., M.D. Center for Quality Eye Care as a quality of care and health policy research center that promotes accessibility to and appropriateness of eye care services.

In 1987 Hetherington and Hoskins asked Dr. Christopher Dickens, another Shaffer Fellow alumnus, to join them. In 1989 Drs. Hoskins and Hetherington invited Dr. Andrew Iwach, upon completion of his Shaffer Fellowship, to join the practice.

After 49 years, Dr. Shaffer retired, but he and Virginia continued to mentor the unique and accomplished group of physicians he had assembled until his passing in 2007.

Dr. Shaffer's influence is extensive even today. The Glaucoma Research Foundation, with its mission to find a cure for glaucoma through research and education, has grown to encompass a multidisciplinary team of basic and clinical scientists at several universities in the United States, working together to solve the underlying mysteries of this blinding disease. With a small group of ophthalmologists from other institutions, Drs. Hetherington and Hoskins founded the American Glaucoma Society, which is a professional organization for glaucoma specialists to share their latest research findings and techniques. Recognizing an unmet need in the general ophthalmology community, Dr. Iwach established the annual Glaucoma Symposia, bringing together the most influential clinicians of the day for one comprehensive seminar geared toward educating the general ophthalmologist about the latest in glaucoma; within a few years he started a similar one for optometrists. The ophthalmology seminar debuted the Shaffer-Hetherington-Hoskins named lecture and is attended by ophthalmologists from across the U.S. and the world. In 2012 Dr. Iwach cofounded the Glaucoma 360 New Horizons Forum in conjunction with Glaucoma Research Foundation Gala and the Symposia, bringing together key clinical, industry, financial, and FDA leaders in a unique exchange on research innovation and advances in glaucoma treatment that has since served as a template for other medical specialty collaborations. The Glaucoma 360 tagline is to “Celebrate, Innovate and Educate”. This catalyst meeting brings together physician, industry, and government experts to accelerate the process of turning new ideas into clinical practice that will directly benefit patients.

Since its humble beginnings at 490 Post Street, the group of physicians at the Glaucoma Center of San Francisco not only trained today's leaders in the practice and study of glaucoma but also have themselves given well over 1000 lectures throughout the world and produced over 350 scientific publications and textbooks on glaucoma.

In 2005 the 490 Post Street clinic that Drs. Horner and Shaffer once occupied closed and reopened at 55 Stevenson Street as the Glaucoma Center of San Francisco. With Dr. Iwach as Executive Director, this institute, dedicated to serving those with glaucoma, is one of the largest free-standing glaucoma clinics on the West Coast. Although Dr. Hoskins retired in 2016 and Dr. Hetherington retired in 2018 and passed in 2020, Drs. Terri-Diann Pickering, Sunita Radhakrishnan, and Shan Lin have brought in their own breadth of education, experience, and research interests as the next generation of glaucoma specialists. Among our doctors and staff, approximately 10 different languages are spoken, reflecting the diversity of the San Francisco Bay Area. What has not changed is our philosophy of treating the person and not just the disease.

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