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Focus on Gregory Van Stavern, MD

Gregory Van Stavern, MD is an associate professor of ophthalmology & visual sciences, and neurology. His areas of specialty include optic neuritis, pseudotumor cerebri, visual field loss, pituitary tumors and eye movement abnormalities.

Dr. Van Stavern sees patients at the Eye Center, Center for Advanced Medicine, 4921 Parkview Place, 12th floor, suite C, St. Louis, MO 63110.

FOR AN APPOINTMENT, PLEASE CALL 314 362-EYES.

What happened in the course of schooling to make you choose your specialty?

I have an unusual background. While in college I worked part time as an ophthalmic technician and I fell in love with the field of ophthalmology. During medical school, I did my research project in ophthalmology and was chosen to present it at a national meeting. I started my residency in ophthalmology at University of North Carolina. However, during the course of my first two years I realized that although I liked many aspects of specialty, I didn’t really enjoy the surgery as much as I thought I would. So after my second year, I switched residencies and completed a neurology residency, followed with a neuro-ophthalmology fellowship.

For me, neuro-ophthalmology combined the elements of the two specialties that appealed to me the most. Ophthalmology has a technical side that uses the most advanced equipment to diagnose and treat patients. Neurology involves an element of mystery, like solving a puzzle, in order to figure out which part of a patient’s nervous system is affected, then making a diagnosis and treating the specific condition. It was a merging of both fields that I enjoyed the most.

What brought you to Washington University?

After my fellowship, I went to Wayne State University in Detroit. I was there for about eight years when Washington University’s chairman of ophthalmology called saying their neuro-ophthalmologist was retiring and they were interested in recruiting someone to take over the position. He had gotten my name from some of my colleagues in the field. So, my wife, who is also a neurologist, and I came for a visit. We fell in love with the city and Washington University. It’s just such an amazing institution; it was a no-brainer – no pun intended. As much as we enjoyed the people we were working with at the time, we felt that this was the right move for both of us.

Drs Van Stavern and Van Stavern with their daughter

Which aspect of your practice is most interesting?

It’s really gratifying to wake up every morning and do something I love, while being able to help other people. Not everybody gets to say they love what they do.

A patient is usually referred to me by an ophthalmologist or neurologist when his or her doctor can’t figure out what’s causing the patient’s visual symptoms. It is like solving a mystery. There are times when it is a complicated disease and we have to figure out how to treat it. But sometimes I get to say it’s nothing serious and we don’t need to do a whole series of tests because it’s going to get better. That’s just as gratifying.

What are some of the new developments in your field that you are excited about?

It’s interesting, when you talk about our field, you’re talking about aspects of both neurology and ophthalmology. With neuro-ophthalmology there is no simple way to answer this question—because it touches on many different aspects of neurology and ophthalmology. For example, multiple sclerosis (MS) is a condition that frequently affects the visual system; and early symptoms can first occur as vision loss, also called optic neuritis.

Neuro-imaging is a real strength of Washington University, and this institution is at the forefront of new brain imaging techniques that help predict the patients who are more likely to develop MS. This knowledge can determine which patients would benefit from early treatment and which patients would not. The neuro-ophthalmologist plays a role in helping to make any early diagnosis of patients who are at risk for developing MS.

There’s another condition called pseudotumor cerebri – which is high pressure in the head for no obvious reason. It usually affects young women of childbearing age and can cause significant visual disability. We’re fortunate to be part of a large multi-centered treatment trial that is funded by the National Eye Institute. We hope once this study is completed, we’ll have a lot more insight into what causes the condition and how to best manage it.

Are there treatments for optic neuritis?

There are treatments, but they don’t make any difference as far as visual recovery because the natural history for optic neuritis is spontaneous recovery -- with or without treatment. The vast majority of patients do recover, and that’s important for patients who come to us with severe vision loss to know.
This is also another role for imaging. We hope to soon start a study of a newer MRI imaging technique to help understand more about what happens in the visual system with optic neuritis.

Where are you from?

I’m from Philadelphia. I’m a hardwired Phillies fan -- I will root for the Cardinals as long as they are not playing the Phillies.

My wife is from Corpus Christi, Texas, and we like the fact that St. Louis incorporates aspects of both our hometowns that we enjoyed. It’s a big enough city, so it has all the cultural attractions that I’m used to from growing up in Philadelphia. It also has the sports teams and passionate fans -- plus the river. But it also has a more southern feel, it’s not quite as intense as some of the East coast cities can be. My wife really appreciates that.

Is there a particular award or achievement that is most gratifying?

The teaching awards I’ve won are the most gratifying. The idea that I can impact young physicians, even in some small way, and they carry what I taught them throughout the rest of their careers is immensely satisfying.

What is the best advice that you’ve received?

Since most of my time is spent seeing patients, teaching and doing research, one of my colleagues told me to make myself indispensible – it is important to be an integral part of the University.

If you weren’t a doctor, what would you like to be doing?

I’ve always wanted to be a writer. I wrote stories and poetry when I was in college; and I still do that occasionally. It’s hard to make a career out of writing and being a doctor on the side -- it’s easier to do it the other way around.

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Gregory Van Stavern, MD

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