Spotlight on Dr. Borchert
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My Biography
I chose to work at Children's Hospital Los Angeles because...
I was impressed by Children's Hospital Los Angeles during my second year of residency when I did a rotation through the hospital’s Division of Ophthalmology. Although I later went to Harvard to do training and considered many other opportunities, I couldn’t find any other place with people who had the same level of: personal warmth, excitement about setting up programs for children with vision disorders, interest in research collaboration, and a welcoming attitude towards budding new faculty who want to pursue their dreams. These intangible benefits were so great here compared to any of the other places I was considering.
I chose to work in Ophthalmology because...
 I initially began my career by studying the brain. But it turns out that vision research is a key way to study the brain. It wasn’t until my second year in medical school, when I did my rotation in Ophthalmology, that my insights into the brain’s function and vision really connected. In Ophthalmology, my previous experience in studying vision and its connections to brain development made this specialty a clear niche for me. At the same time, I found myself becoming invested in the lives of the children I treated and realized that I really enjoyed solving their vision problems. It was a perfect fit.
I come to work everyday because...
I love my patients . . . the challenges they bring to me, the laughter they add to my life, and the serious nature of their conditions that grounds me. I also love the staff of the Vision Center – they are amazing in their dedication, drive, and genuine desire to help kids with health problems.
My favorite part of my job is...
My favorite parts of my job are 1) seeing the happiness we bring parents when their little ones have some remarkable improvement in their eye problems as a result of our work, and 2) seeing the “aha” in the eyes of a student, resident, or fellow-in-training when I have helped them make an important discovery or step forward in their development as a physician.
My greatest accomplishment is...
I am the most proud of raising two fantastic, smart, charming children. In terms of my contribution to the world of medicine, I’d have to say that my greatest accomplishment has been expanding our understanding of the syndrome of optic nerve hypoplasia. Before I started my research, there was limited information and a lot of erroneous thought on the nature of this disorder. I’ve been able to shed light on an epidemic problem and demonstrate that it is a multi-system disease affecting much more than just the eyes. This has resulted in families being able to come out of isolation and be united with other families who have a child with this diagnosis. Plus, they’ve been able to procure appropriate resources for their child and procure better care.
My Role at Children's
What my day is like...
 Typically, I begin my days by meeting with our residents, fellows, and junior faculty members and reviewing patient cases. Next, I see patients with students and trainees at my side. We work together to make the patients feel comfortable and recognize that, in this care setting, they are special. Toward the end of the day, I attend to children who are admitted to the hospital and have eye problems. I sit on various committees at the hospital that are responsible for strategizing better ways to provide care for children. I sandwich the work for these committees into blocks of time in the early morning, lunch hours, or after patient visits in the evening. I set aside a few days each month to see the patients who are part of our research efforts. I also spend large amounts of time with my research staff working on my clinical research projects - reviewing data, setting up protocols, writing papers to update the medical world on our findings, and submitting requests to grantmaking agencies for support of our efforts.
Each day I interface with...
My patients, of course, the young healthcare professionals that I am training, nurses, clinical care coordinators, plus all of the staff who are helping me with my research.
What my job means...
For me, being Division Head means that I have been given the opportunity to mold something really great out of the generous resources – the amazing people – who have all come here to care for childrenI hope that my staff and colleagues see me as an example of how to deliver personal, family-centered, yet technologically and medically sophisticated, care for children with extremely complicated and emotionally-distressing diseases.
Staff come to me for...
I have an open door policy with my staff. They come to me with their clinical questions, but they come to me to share jokes or when they need to borrow money for lunch, and even when they are having personal or professional problems. I think they also come to me seeking leadership and advice.
Strategic Initatives
Optic Nerve Hypoplasia
 Prior to my research into optic nerve hypoplasia (ONH), the disease was poorly understood, and there appeared to be few answers for parents as to how to care for their child. There were no answers for parents' most basic questions like: “Will my child be able to read? What plans should I make for my child’s education? Will my child need medication? Will the medication help? What will my child’s development be like?”
You can’t answer these questions until you follow many hundreds of children closely, conducting x-rays, laboratory testing, surveys, and eye measurements from the time of infancy onward for many years. Ultimately, our efforts helped us identify correlations between a child’s symptoms in infancy and their care requirements as well as their probably developmental paths. We can now predict, from symptoms presented at infancy: 1) which children with ONH will have learning disabilities, and 2) which hormones, when deficient, will impact a child's development.
Currently, there are two more things we are attempting to tease out of the data. We’ve learned that approximately 50% of children with ONH develop some form of autism. Identifying what features these children share in infancy can help us get these children early intervention therapy to alleviate or minimize the severity of autism.
Second, some children with ONH have severe sleep disorders. We hope that additional analysis of our data will help us identify children with these disorders earlier and aid in determining what the best course of treatment might be for them.
Minimally-Invasive Testing Techniques
The eye is a window into the rest of the body. You can look into a person’s eyes and usually get a fairly clear picture of what might be wrong in other parts of the body. Using this principle, I am using imaging and spectroscopic techniques such as Raman spectroscopy that focus light onto the aqueous humor - the water in the eye that is between the cornea and the lens. From the information gathered through the reflected light, we can calculate levels of glucose or drugs in the eyes. We’ve already begun testing the use of this methodology to see if we can accurately measure glucose levels in diabetic patients without ever pricking them with needles. From extrapolating how well drugs are penetrating the eyes, we may, with further research, be able to tell if a chemotherapy agent is effective in penetrating the brain of a child who is being treated for a brain tumor at the level necessary to treat the disease.
Committee on Clinical Investigations
I’ve been involved in the hospital’s Committee on Clinical Investigations for nearly 20 years. This is a federally-mandated committee that approves and oversees all research on humans in the hospital.It is a rewarding position for me because I believe so strongly that it is extremely important that human subjects’ rights are protected and that the research we conduct with our patients is being done with a purpose and with the highest likelihood of useful results. We were determined to lower the rates of bleeding. The staff involved in this project reviewed the literature and wrote a new cardiac ECMO anti-coagulation protocol (formula for providing care).
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BACKGROUND AND TRAINING
Medical School
Baylor College of Medicine
Residency
LAC-USC Medical Center; Ophthalmology
Boston City Hospital; Internal Medicine
Massachusetts Eye and Ear Infirmary: Neuro-Ophthalmology
Certifications
Ophthalmology, American Board of Ophthalmology
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