Strong Kids

Ophthalmologist Leader Aims to Expand Genetic Horizons for GCH

Dec. 21, 2022
Multidisciplinary division will scale-up testing and treatment capacity

Talk to Alex Levin, M.D, MHSc., for more than a few minutes and a theme becomes clear: he has a passion for helping kids however he can.

Levin holds two leadership posts. He is the Chief of Pediatric Ophthalmology and Ocular Genetics at the Flaum Eye Institute and Chief of Clinical Genetics at GCH. Levin’s dual appointment represents his myriad interests as well as his winding career path.

Levin received his medical degree from Jefferson Medical College in Philadelphia. At first, he wanted to be a pediatric general surgeon, but quickly concluded surgical culture wasn’t a fit, so he pivoted to general pediatrics while completing his residency in pediatrics at Children’s Hospital of Philadelphia. It was here that he became focused on identifying and helping child abuse victims. Later, missing surgery, he found his way back to the operating room through ophthalmology, which was also a path to unite his interests in several ways.

“Retinal hemorrhages are an unfortunately common result of abusive head trauma,” said Levin.

Levin also found great fulfillment in this work as a child abuse pediatrician. “You’re helping families and protecting children, you’re intervening in ways that are very impactful,” he said.

Levin did his ophthalmology residency at Wills Eye Hospital in Philadelphia, and then his pediatric ophthalmology fellowship at the Hospital for Sick Children in Toronto, where he also began his career as an ocular geneticist, another way to combine his interest in pediatric systemic disease with the surgical specialty.

“What the general community needs to know is that the eye is the second most common organ, after the brain, that is involved in genetic disorders: the eye is so important for understanding the origin of many diseases, both rare and common” said Levin. “A typical example is Down syndrome, in which patients may have many ocular complications and we should always be looking at them.”

Levin is double board-certified in both pediatrics and ophthalmology, which is a rare combination: there are only approximately 10 active physicians in the world who can claim this. “Genetics marries those two specialties very nicely,” he said.

Throughout his career, Levin has been able to serve both of these interests in the efforts to improve the lives of children. On a typical day, he and his team will be consulted on cases of child abuse while handling a clinical and surgical load of treating children with genetic eye diseases. Levin also has experience treating children for conditions such as glaucoma and cataracts, which are largely genetic, as well as adults with ocular genetic disorders.

Levin served as Chief of Pediatric Ophthalmology and Ocular Genetics at Wills Eye Hospital in Philadelphia for 12 years before coming to URMC to help establish a similar division here as well to develop the new Division of Clinical Genetics, which will bring together into a single administrative entity four services: pediatric genetics, metabolic genetics, adult/medical genetics, and cancer genetics (including the Wilmot Institute Hereditary Cancer Screening and Risk Program).

“URMC is a wonderful place to work: great people, a collaborative spirit: it’s all about doing the right thing, and genetics is the right thing, it’s our future,” said Levin.

In his role as Chief, Levin has been taking exploratory steps talking to departments and divisions to determine their needs and how Clinical Genetics can support them. With his leadership, Levin is already providing genetic counseling and support to several divisions in Pediatrics, and he hopes to expand this to the entire institution. “I want to hear from everyone out there,” Levin said. “What are your needs? How can we do it better? What resources are needed? I also want to hear from the research community: how can we best support your work?”

This type of multi-disciplinary communication is critical for Levin. As an ocular geneticist, he frequently sees patients with unknown rare diseases that his team would be able to diagnose: many in healthcare aren’t always aware how critical the eye is for identifying conditions.

“I would say that 30 percent of the patients that come to me have the wrong diagnosis, not because we’re particularly smart or other doctors are failing. It’s just that we have experience seeing so many types of disorders that manifest through the eye,” said Levin, “If a patient comes to me with a rare disease, chances are I’ve heard of it and seen it before.”

For the new division, Levin hopes to improve availability and precision of institution-wide genetic testing. Genetic testing and counseling can provide a specific diagnosis, which leads to better care management, the ability to find niche support/resources, and can open doors to clinical trials, gene therapy, and new treatment pathways. The long-term goals of the division is to increase availability of in-house testing, provide shorter times to genetics consultation, and increase availability of counseling services to UR patients across all specialties.

Under the leadership of director Audrey Schroeder, M.S., the University will start its Master’s Degree Program in Genetic Counseling, welcoming the first class in 2023. There are currently 5 genetic counselors in pediatric genetics and 1 in adult genetics with one position open for hire. There are two genetic counseling assistants, with the hope to hire more in the near future. And there are additional genetics counselors in cancer genetics as well as the other divisions that provide genetic services.

Another geneticist in the new division is Chin-To Fong, M.D., who previously served as Division Chief of Metabolic, Adult/Medical, and Pediatric Genetics at various times over the last 18 years, and has been with UR for a total of 31 years. During his tenure as division chief, he expanded the spectrum of genetic services offered, including cardiogenetics and craniofacial genetics. He is well known for his superior teaching and clinical services.

Danielle Marino, M.D. will serve as medical director of the Wilmot Hereditary Cancer Screening and Risk Program. URMC also recently welcomed new cancer geneticist, Eran Tallis, M.D., who is also a clinical geneticist and metabolics specialist, in October. Further recruitment, improvement, and growth are ongoing. Meanwhile, Levin leads his team of two ocular geneticists, 2 genetic counsellors, and a genetic counselling assistant, with two fellows, in ocular genetics at Flaum Eye Institute as well.

“Combining this level of expertise will be a huge benefit for families in the region,” said Levin, “our goal is for everyone to get the highest quality genetic-based assessment and treatment here at home.”