By Donald H. Harrison

Dor l’ dor, from generation to generation, Jewish tradition teaches. Anne Ratner of San Diego remembers that her father-in-law, Isaac, always helped anyone who approached him on the street with a hard-luck story.  He was concerned lest he fail to respond to the one person who might really need his assistance the most, "so he didn't turn anyone down," she recalled.

Now in her 90's, Ratner said she also remembers how her late husband, the clothing manufacturer Abraham Ratner "always was interested in helping children"—thus, Anne's decision to underwrite Tifereth Israel Synagogue’s Abraham Ratner Torah School.

Both Anne and Abraham had eye problems and while being treated at UCSD's Shiley Eye Clinic, Anne also became interested in Dr. Stuart  Brown's dream of creating a center that would deal exclusively with children's eye problems.  She quoted Brown, chairman of UCSD's ophthalmology department, as telling her that for some children "if you don't get to them before they are five, they can have a problem that can never be repaired."

So, she provided the financing to build the Abraham Ratner Children's Eye Center, but her interest did not end when the center named in her husband’s memory opened nine years ago.  She also donated the funds for the Anne F. Ratner Endowed Chair of Pediatric Ophthalmology, which has been occupied from the outset by Dr. David Granet.  Additionally she has helped finance an eye mobile that is a critical part of UCSD's outreach to children in the underserved communities of San Diego County. 

"They go in and give exams and glasses to kids who can't afford it," she said, "and some kids come home and see their mothers for the first time. This helps to make their lives what they should be."

And yet, neither Ratner nor other members of her extended family, believe they have done enough.  Modestly declining to tell the extent of their donations, they are involved in a campaign to double the size of the children's eye clinic, which UCSD has decided to rename as the Anne and Abraham Ratner Children's Eye Center.

The Ratner Children’s Eye Center’s program for children is wide in scope. Among those playing an important role is Barbara Brody, a PhD whose responsibilities include overseeing the ophthalmology department's community outreach program. Digital photographs are taken of thousands of children's eyes at preschools and Head Start programs at approximately 170 locations throughout San Diego County.  A computer reads these images, flagging those that indicate possible eye problems. In such cases, parents are invited to bring their children to the eye mobile for a follow-up examination.

Recently, at the Brooklyn Child Development Center at 3303 A Street,  San Diego, Sharie Ford in response to one of those invitations accompanied her four-year-old son. As Patrick was given a series of eye tests, his mother expressed appreciation to Brody and to Marcia Hazan, the granddaughter of Anne Ratner, not only for Patrick’s examination but also for the fact that the eye mobile comes right to the school grounds. For working parents, she pointed out, "this is very convenient.” If the examination had to be conducted somewhere else, "I would have to pick him up, take him somewhere else, and then bring him back."

It is a trailblazing program. Hazan, at the eye mobile for a tour, commented that her daughter, Shana, wishes there could be a similar outreach effort in Chicago where she teaches fourth grade.  In that city, she reported, many students “have problems and can’t see and there is nobody to really address those issues.”

Bill Orvis, a UCSD graduate in history who manages the eye mobile, administered a series of vision tests to Patrick, a bright and energetic child. Patrick particularly enjoyed one requiring him to put on the type of 3-D glasses that moviegoers used to wear and to look at a picture of a fly.  Orvis asked young Patrick to try to grab the fly in his hand, and Patrick swiped at the image above the paper on which it was printed—a good result because it meant that Patrick was seeing in three dimensions.  If he had reached all the way down to the paper, it might have meant he could only see flat images.

Meanwhile, inside a compact examining room in the back of the eye mobile, Dr. Lara Hustana, an optometrist who also did her undergraduate work at UCSD, tested Fabian Caballero, 4, for visual acuity, eye posture and diverse eye diseases. In one examination, in which grandmother Maria Elena Enriquez was asked to click a button to project simple images on a wall, Fabian was asked in Spanish to identify what he was seeing. In essence, the exercise was a diversion—a way to hold the engaging young Fabian’s interest while Dr. Hustana searched his eyes with her machines.

As in the cases of Patrick and Fabian, examinations often indicate no serious problems. Many students simply need eyeglasses, which UCSD makes and delivers to them at their pre-schools. 

However, if an eye examination indicates more serious problems, then an appointment will be made at the Anne & Abraham Ratner Children's Eye Center. From the way it is furnished, to the clothing worn by the doctors, the Ratner Center is designed to make children feel comfortable in what otherwise might be intimidating surroundings.

The reception area boasts a large fish tank—with a puffer fish inside never failing to draw the interest of children-- that was donated to the center by Anne Ratner's daughter, Pauline Foster and her late husband, Stan Foster—both of them well known leaders of the United Jewish Federation of San Diego County. 

The lobby is bright and sunlit, and there is a television that continuously runs animated movies.  Jo Adamcik, office manager at this happy place, notes that "we have games on the other side of the partition for the older kids; we have a movable art piece out on the patio; books all over the place, tons of little toys and things--we want to make it fun and relaxed and exciting for the children."

The examination rooms, painted in separate colors of the rainbow— red, yellow, green and blue — also have cartoons playing to keep the children amused while they are waiting for the doctor.  After eye examination are completed, Adamcik confesses, “the parents often are ready to leave but the kids aren't."

The 5,000 children who visit the facility yearly may be treated by Granet—who shuns white coats as too forbidding, and likes to wears ties and even socks decorated with children's favorite cartoon characters —or by Dr. Shira Robbins, who, like Granet is a member of the Jewish community and knows how a bespectacled teddy bear can help a child relax during an examination.

Explaining why a special center was needed just for children's eye problems, Granet said that as a child grows, and especially in the first 18 months of a child's life, dramatic changes are occurring in his or her visual system.  "If you don't have a system that works properly at the right time, that child will never see--it is not something you can fix later in life." 

But how do you find out that a child has problems?  The children are too young to talk about it, "they don't have the verbs, the nouns; they don't have language" and even if they can talk, "they don't know that there is anything wrong because this is the only world that they have ever known,” Granet pointed out.  “So you have to have special tests, special skills and special approaches to first interact with that child."

Granet said he just had spent 25 minutes on the floor with an 18-month old child "trying to get him to play with me" so he could do an examination.  In the case of a child’s vision, unfortunately, "if you don't use it, you lose it," Granet said.  "So, for example, if a child needs significant glasses in one eye and we find them at age 9, I can put the prescription on him but he will not see because the connection between the eye and the brain was never made.  That is a completely treatable blindness if it is caught early, but irreversible if it is caught late.  That is why catching kids early is so important."

One of the programs of the Ratner Children's Eye Center attempts to measure the impact on a child's life of having vision problems successfully treated.  Granet said that a fellowship named after Stan Foster goes to a PhD who "looks at the consequences of all these visual things on the children that we have been working on — to demonstrate the effect and value of catching these kids early."

The center also trains foreign doctors, with one from the Philippines and another from Brazil currently in residence.

Dr. Stuart Brown, who had initial “vision” of the children's eye center, says San Diego School Superintendent Alan Bersin—who is married to Anne Ratner's granddaughter, Superior Court Judge Lisa Foster—helped the eye center reach out to pre-school children served by the San Diego Unified School District.  "It is still inexplicable to me that the previous superintendent had said no," Brown said.  Bersin comprehended how much difference it could make to a child if a vision problem were corrected early, "and became a champion" for the program.

"We realize that children's brains start working early, and that the earlier they start learning, they better they perform,” Brown said. “ The earlier you read to your child, the earlier that they are challenged, the better they perform in life.  But how do they do it, if it is uncomfortable for them to see, or if they can't see well--if a good part of their brain isn't getting what it needs?”

Anne Ratner's father in law, Isaac Ratner, worried about missing the one who might really need his assistance the most. As it doubles its size, and continues to spread its net, the Ratner Children's Eye Center is doing everything it can to find the children who are similarly in need.