This edition of Eyeconic section, which showcases the contributions of great ophthalmologists and vision scientists, focuses on the life and work of the giant in Ocular Immunology, Dr. Charles Stephen Foster. Dr. Charles Stephen Foster was born and raised in West Virginia. He received his Bachelor of Science Degree in Chemistry at Duke University, with distinction and Phi Beta Kappa recognition in 1965. In 1969, he received his Doctor of Medicine Degree at Duke University Medical Center and was elected to the Alpha Omega Alpha society. He was trained in Internal Medicine at Duke University Hospital (1969–1970), and at the National Heart and Lung Institute of the National Institutes of Health in Bethesda, Maryland (1970–1972). During which period, he also taught Internal Medicine at the George Washington University Hospital in Washington, DC. Dr. Foster started his Ophthalmology Residency training program at Barnes Hospital, Washington University, St. Louis, Missouri in 1972. After completing the Residency in 1975, he went on to do Fellowship trainings in Cornea and External Diseases and in Ocular Immunology at Boston. After completing his training in 1977, he joined as the full-time faculty of the Department of Ophthalmology of Harvard Medical School, where he was a member of the Cornea Service and Director of the Residency Training Program at the Massachusetts Eye and Ear Infirmary. He began his independent research in 1977.1 Dr. Foster has received the American Academy of Ophthalmology Award in 1983, the Research to Prevent Blindness Senior Scientific Investigator Award in1995 and Mildred Weisenfeld Award for Excellence in Ophthalmology in 2005. He received a lifetime achievement award from the Academy of Ophthalmology in 2007. In 2016, Foster was named as one of America's top doctors in ophthalmology for 15th consecutive year. He has authored more than 1,000 published papers and 14 textbooks and his work had been cited over 42,000 times.2 After 30 years on the full-time faculty of Massachusetts Eye and Ear Infirmary, he established his own private practice at The Massachusetts Eye Research and Surgery Institution. Dr. Foster continues to direct a research laboratory at the Massachusetts Eye Research and Surgery Institution (MERSI), through the Ocular Immunology and Uveitis Foundation. He continued his teaching activities and training fellows as a part time Professor of Ophthalmology at Harvard Medical School. Dr. Foster retired from practicing medicine in 2023. Having had the privilege of associating with Dr. Foster as a Research Fellow, during 2011-12 at the Massachusetts Eye Research and Surgery Institute (MERSI), I had the fortune of watching his work at close quarters. I regard that period as one of the most defining phases of my career and the most enriching professional experiences I have had to date. The interview below throws some light to his academic life and the philosophy that underpins it: discipline, integrity, and an unwavering commitment to patient-centred care. Presented below is the interview with Dr. Foster Dr. Reena Abdul Rasheed: Could you please share us how your interest in Ocular Immunology and Uveitis developed in your career, and what initially drew you toward this subspecialty? Dr. Stephen Foster: I had no interest in Ocular Immunology initially and was focused on cornea problems. However, I had some background education from Duke in chemotherapy for autoimmune disease and began applying it in patients with ocular pemphigoid. Slowly I had an increasing number of referrals of patients with stubborn ocular inflammatory diseases from the doctors in the community. Eventually I started the Uveitis service because of the large number of referrals and it became my love over cornea. Dr. Reena Abdul Rasheed: You were among the pioneers in introducing systemic immunosuppressive and chemotherapeutic agents for chronic, recurrent ocular inflammatory diseases nearly two decades ago; long before their disease-modifying benefits were widely recognized. How would you describe this journey, from those early days to the present, in your own words? Dr. Stephen Foster: I have already mentioned how my interest in Uveitis shaped and how the Uveitis Services were set up. My experience with patients with ocular inflammatory diseases supported me in pioneering the step-ladder approach to ocular inflammatory disease management by translating research from other autoimmune conditions and validating it through targeted efficacy studies. I also led research identifying autoimmune markers to guide immunomodulatory therapy selection and applied these therapies confidently in clinical practice, leveraged on my training at Duke. Dr. Reena Abdul Rasheed: You are uniquely recognized as an ophthalmologist, immunologist, pathologist, and basic science researcher combined in one professional identity. In an era when increasing subspecialization is the norm, how has this multidisciplinary approach shaped your thinking and helped you evolve as a leader in your field? Dr. Stephen Foster: The long and short of it is that for me, cornea was so limiting and treating diseases like Pemphigoid and Uveitis were so expansive and it made an incredibly thrilling career for me. Dr. Reena Abdul Rasheed: Over the years, you have mentored and trained numerous ophthalmologists from across the world in Ocular Immunology and Uveitis. Could you share your experiences as an educator and mentor? Dr. Stephen Foster: Educating and mentoring were among the most fulfilling aspects of my career. I took great pride in watching my fellows grow and thrive, much like they were my own children, as they went on to have successful careers in Ophthalmology. Dr. Reena Abdul Rasheed: When selecting trainees, what qualities do you value most beyond academic credentials?Dr. Stephen Foster: Tenacity, good problem-solving skills, and curiosity. Dr. Reena Abdul Rasheed: You have successfully balanced multiple roles—clinician, researcher, scientist, educator, administrator, and author. Looking back, which of these roles has given you the greatest personal satisfaction? Dr. Stephen Foster: My most loved role was that of a clinician scientist. Dr. Reena Abdul Rasheed: What words of wisdom would you offer to young ophthalmologists who aspire to excel in their chosen subspecialty? Dr. Stephen Foster: My advice to young ophthalmologist is to do what you love and that which makes you get out of bed excited each morning for a new day. Dr. Reena Abdul Rasheed: I recall seeing a granite plaque in your office with the words “Never, never give up; whatever it takes!” This seems to reflect a philosophy you have consistently lived by. Could you share what this principle means to you and how it has influenced your professional life? Dr. Stephen Foster: Ocular Inflammatory disease is a stubborn disease, there is no one recipe for treating it, and the occasional patient reaches the end of the step ladder and still has active disease, but I never gave up. I promised patients I would provide the same care I would want for myself, therefore I always kept in the hunt for more therapies that would work to care for these patients and not just give up when we got to the top of the step ladder.
Reena A. Rasheed (Thu,) studied this question.