Unparalleled Vision Papale & Bouvier Eye Center Sets Its Sights on Continued Growth

A few weeks ago, a 98-year-old woman came to Dr. John Papale’s office requesting cataract surgery. He thought it was unfortunate that she had missed out on years of enhanced vision by waiting so long to have the procedure.

“We encounter people with cataracts who have been told to wait for surgery when they could benefit significantly from having it sooner rather than later,” said the founder of Papale and Bouvier Eye Surgery in Springfield. “Technological advances have made it the most successful operation done today. The results are dramatic, the surgery is easy to go through, and recovery is very rapid.”

The nonagenarian in question is one of countless people who have turned to Papale and Bouvier for their expertise. Papale prides himself on keeping pace with innovation, and he and Dr. Peter Bouvier are known for their ability to handle complex cases as well as provide state-of-the-art care. They get referrals on a daily basis from other physicians and the public.

Papale has seemingly always been at the head of his class. In 1984, he was the first resident at the Massachusetts Eye and Ear Infirmary in Boston to do outpatient cataract surgery. Initially, many surgeons did not want to perform the procedure outside of a hospital. “They used to keep people in the hospital for several days because there could be problems with wound healing, because surgeons used bigger incisions,” he said, adding that, in time, it became customary to perform the operation on an outpatient basis.

Papale continued to perform outpatient cataract surgery when he came to Springfield in 1985. He was the first in Western Mass. to use drops for anesthesia during cataract surgery and the first to do it without stitches — two big innovations in the early ’90s.

Papale was also one of the first local eye surgeons to open a freestanding outpatient surgery center, which saved patients money and also offered enormous appeal to those who didn’t want to go the hospital.

In addition, his was the first practice in Springfield to offer Lasik surgery with a permanent, office-based laser, and the only Springfield physicians who use the state-of-the-art excimer laser in the office, which operates via ultraviolet light.

“This is our third excimer laser,” Papale explained. “When I began doing Lasik surgery in this area, people were going to Boston or Canada to get it.”

He cites experience as a reason for the large number of surgeries performed at Papale & Bouvier.

“Cases can become complex if you don’t do surgery on a regular basis; other surgeons refer cases here because of the specialized care we provide,” said Papale, adding that this includes operating on people who have vision in only one eye. “In the last three years, I have done cataract surgery on more than 100 patients with usable vision in only one eye.”

Indeed, he has always been on the forefront of innovative procedures. “I was the first in Western Mass. to do Botox injections,” Papale said, explaining that, prior to being approved for cosmetic use, the drug was used to treat blepharospasm, which is a neurological movement disorder that causes contractions of the muscles around the eyes.

Bouvier, who joined the practice in 2005, has continued the history of ’firsts’ with DSAEK transplants, which are an innovative partial-corneal-transplant procedure performed on an outpatient basis. The surgery was pioneered in 2003, and “it’s a procedure that was never thought possible,” Bouvier said, adding that it’s done using tiny incisions. “A lot of people only need the inner layer replaced and can keep 99{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of their natural cornea. But it relieves the hazy, blurry vision that typically occurs in older individuals.”

Storied History

Papale began his career in Springfield after completing his residency and fellowship in Harvard University’s Ophthalmology program at the Massachusetts Eye and Ear Infirmary in Boston.

He worked initially with Dr. Terry Ryan, but when the physician approached retirement, Papale opened his own practice in Springfield in 1997.

“My goal was to provide the same level of care here that someone could get in Boston or New York City,” said Papale. “I wanted people to be able to get the best eye care possible as well as use the expertise and skills I had gained in Boston. There were a lot of challenging local cases, and in the past, people had to go to Boston to get the help they needed.”

He is the chief ophthalmologist at Baystate Medical Center, and has been instrumental in bringing eye specialists to the hospital who have the skills to handle complex cases.

Bouvier’s career began when he became an Air Force flight surgeon after graduating from Columbia Medical School. He spent six years in that role, working in Korea, Germany, and Saudia Arabia before he made the decision to return to school at Cornell Medical Center.

His interest in infectious diseases led him to become a corneal refractive specialist; the cornea is the clear, outer lens of the eye.

“Its integrity and clarity are critical for clear vision,” Bouvier said. “A lot of blindness around the world is due to corneal issues, but it is often reversible with surgery. Corneal problems affect people of all ages, but vision correction for the problem is usually done in people age 20 to 50.”

Surgeon Sarah Hanson joined the practice in August. She handles general comprehensive ophthalmology as well as cataract and laser surgery.

The work performed at the practice ranges from laser, Lasik, and photorefractive keratectomy surgery to cataract surgery, treating glaucoma, performing corneal transplants, implanting contact and collagen lenses for nearsightedness, and a variety of general services.

The team has treated people from all over the world, including patients from China, Greece, Barbados, Italy, South America, and Jamaica.

Many have macular degeneration and glaucoma, but cataract surgery is a mainstay of their business.

“It’s almost inevitable that people will develop cataracts, and as soon as it becomes visually significant, it is safe to remove the cataract,” Bouvier explained, adding that putting off surgery can cause the cataract to become denser, which makes it more difficult to remove.

Today, the surgery is performed frequently and is extremely successful. “The word ’cataract’ is not something to be feared, because advances in technology and techniques have made it one of the safest surgeries there is,” said Bouvier. “And surgery can change a person’s outlook on life.”

Many people seek out the team at Papale & Bouvier for a second opinion when they are told cataract surgery cannot be performed or will not improve their vision. Papale cited the case of a patient with macular degeneration and cataracts who became frustrated because he could no longer drive at night, couldn’t read, and suffered from a loss of depth perception. His doctor had told him surgery wasn’t possible because of his macular degeneration.

“But we have a device to see how severe it is,” Papale told HCN, adding that the team was able to perform the surgery. “And he literally had 20/20 vision afterwards.”

At the other extreme are patients who fail to get treated, which can have adverse effects on their overall health. Bouvier said an Australian study shows cataracts can cause people to break their hips because they cause a loss of depth perception, which can lead to falls.

Unfortunately, since cataracts are painless and many people fail to get regular eye exams, they are often unaware of the problem, so the problem can progress to the point where it is difficult to treat.

Vision Quest

Dry eye is another condition the doctors see frequently. “It’s a big problem,” said Bouvier. “A recent study indicates that up to 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of people over age 50 have symptoms.”

These can include fluctuations in vision; a stinging, burning, or scratchy sensation; redness; sensitivity to light; periods of excessive tearing, which happens as the body tries to keep the eye moist; blurry vision that gets worse at the end of a day or after reading for a long time; and difficulty wearing contact lenses. “When people read, they don’t blink as often, and the already-low volume of tears evaporates even faster,” Bouvier explained.

In most cases, dry eye results from chronic low-grade inflammation, but it can also be caused by chronic allergies or medications, and Bouvier said antihistamines and antidepressants often exacerbate the condition. “Other causes include menopause or wearing contact lenses. And, often, a woman’s perceived intolerance to certain eye makeup may actually be due to dry-eye syndrome.”

Many clients tell the doctors they have never gotten much relief from their symptoms and use artificial tears to try to cope with discomfort. “In the past, there wasn’t a good treatment for dry eye,” Bouvier said.

But that has changed, and once the specific type of dry eye has been identified, effective measures can be taken.

“We have a variety of ways to diagnose and treat it,” he continued, adding that these can include anti-inflammatory medication or putting a plug in the tear duct to provide relief, which causes an increase in the volume of tears within the eye. “Severe cases can take a long time to resolve, and it can take months to get the full effect of medication. But I have seen people who have told me other treatments have failed, whom I have gotten back to normal.”

The practice educates patients about the condition, as well as what they need to do to resolve the problem and prevent it from happening again.

Eyes on the Mission

Bouvier says there are many excellent eye doctors in the area trained in modern methods of treatment.

“But our mission continues to be to provide people with the best possible eye care in both routine and challenging cases,” he told HCN. “You can do people a real service by improving their vision, no matter what age they are.”