January 24, 2020

Alan L. Wagner, MD

Wagner Macula & Retina Center

As a youngster growing up in Omaha, Nebraska, it was instilled into Alan Wagner that as a member of a community, he had a responsibility to it.  “It’s called tikkun olam,” he says.  “It’s one of the guiding principles of Judaism: that we have a responsibility to repair the world, to pursue justice through social action.”  Both of his parents were actively involved in their community, secular and non-, his mother serving as the voice of the League of Women Voters and ultimately being elected Vice Mayor of Omaha.

Community service wasn’t the only lesson he learned from his parents:  accompanying his mother to her frequent guest spots on KFAB-AM, he absorbed the skill of radio broadcasting; and from his father, a World War II pilot who also photographed the war, he discovered the art of the camera and the darkroom.  By the time he was in high school, he was hosting a program on the local public radio station, and taking photographs and providing prints to local churches and synagogues.

As a student, he also enjoyed music, jewelry making and a number of creative arts.

So when it came time to choose a career path, Alan Wagner had a lot of options.  It was a friendly neighbor in Omaha who led him to medicine.  “His name was Dr. Abe Feldman, and he was very well respected in Omaha,” Dr. Wagner says.  “He embodied caring for others with honesty, intellect, and humor.”

After attending Northwestern, Dr. Wagner went to Vanderbilt for his medical degree, and stayed to complete a general surgery internship.  Despite an early interest in cardiothoracic surgery, he was drawn to the intricacies of the human eye, intrigued by the burgeoning technology becoming available.  “It was the golden age with the use of microscopes,” he says, “and the huge impact that was having.  It was the combination of the delicacy of the eye, the nuance – and having to really understand the physics and engineering of the growing microsurgery.  It was irresistible.”

He took the Lancaster Course in Ophthalmology, the oldest and largest educational course in the world, and completed a residency in ophthalmology at EVMS.  He later completed an AFIP course in ocular pathology.  He did a stint as Chief Resident in Ophthalmology at EVMS, and in 1986, began a year as a Dyson Fellow in Retinal and Vitreous Disease and Ophthalmic Trauma at Cornell University in New York.

In 1987, Dr. Wagner returned to Virginia to establish the practice he maintains today: Wagner Macula & Retina Center, which has now expanded to nine offices throughout Hampton Roads.  From these offices, Dr. Wagner and his partner, Dr. Kapil Kapoor, treat a variety of complex eye conditions – including diabetic eye disease, macular degeneration, ocular tumors, uveitis, macular pucker and holes, retinal detachment, and retinal vascular disease. Since the earliest years of his practice, Dr. Wagner has been committed to research.  The practice is currently involved in at least a dozen randomized clinical trials; in fact, so committed is he to the research component that the practice’s new Norfolk location is designed around a research center.  Research is critical, he says, “because we’re learning how to halt the conditions that make people go blind.  We’re involved with research on diabetes and auto immune disorders – the number one and number two causes of blindness; a close third is macular degeneration.  We have active projects in all three areas.”

Dr. Wagner is adamant that blindness can be prevented; it takes education and access to services – and this is a large part of why he has chosen to open offices in two of the poorest counties in the Commonwealth.  “It’s part of the tikkun olam mode of caring for the whole community,” he says.  “We kept seeing people coming to us from these areas, nearly or completely blind.  It was horrible.  On the Eastern Shore alone, there is about a 22 percent underinsured – and underserved – population rate.  It’s just about getting care to people, how they want to get it, and personalizing it, while doing it inexpensively, so there’s enough money to go around for everybody.”

Dr. Wagner is excited about the role prevention is starting to play in eye care.  “And we’re learning so much more about genetics, so we’re able to do true, personalized health care, allowing patients to better own their condition, while understanding their options and their odds.  And with research, we’re understanding more about the molecular and metabolic pathways.” The results of such knowledge, he says, are evident in care: “We used to essentially take a bulldozer to transplant a blade of grass.  I’m doing less than a hundredth of the lasers I did five years ago, because we have medicines to do the same thing.  We’re doing less of the invasive, ablative tissue-altering procedures because of medicines that are being developed.”

What he sees in the not too distant future is the increasing importance of remote imaging, along with fewer surgeries being performed.   And he thinks, “We’re going to have greater access to gene therapy, combined with personalized medicine, that will allow us to offer long term therapies that will prevent or even reverse some problems.”

He calls this new golden era ‘the age of injections.’   “We have many people coming in every month for an injection to save their sight, kind of like dialysis for the eye.  It works, and it’s very safe. I’m excited that soon we’ll have better and more durable ways to treat specialized eye problems.  Through our research, we’re already starting to see that.”