Specialist in rare eye cancers joins UCI Health

Kapil Mishra, MD, is like a missing puzzle piece. The new UCI Health ophthalmologist’s expertise in certain cancers of the eye was the last ophthalmic subspecialty needed at the Gavin Herbert Eye Institute. Until now.

Eye cancer may be quite rare — about five cases per million people annually — but Mishra is currently the only ocular oncologist practicing in Orange and Riverside Counties, which means hundreds of patients in the region may need his services each year.

Returning to UCI Health as a physician is a homecoming for Mishra, who completed a residency in internal medicine at the UCI School of Medicine. Growing up in the Inland Empire, he’d always viewed UCI as a beacon of healthcare excellence.

“Anytime anyone needed complex or higher level coordination of a multidisciplinary disease, they’d be referred to UCI Health,” he remembers. “My impression was that UCI was a cutting-edge place offering high-acuity care, and that was welcomed by the community, not only in Orange County but beyond.”

After earning his medical degree from Icahn School of Medicine at Mount Sinai in New York City, Mishra was excited to complete his residency at UCI Health. He went on to complete a second residency, in ophthalmology, at Johns Hopkins University in Baltimore, Md.  followed by a fellowship in vitreoretinal surgery — surgery on the retina and the fluid-filled spaces inside the eye at Stanford University in Palo Alto.

This training makes Mishra uniquely equipped to help patients dealing with a variety of retina diseases, including uveal melanoma, or skin cancer in the eye. He also is the first UCI Health physician who can treat the condition surgically by implanting a small radioactive plaque in the retina, which targets the tumor for several days before it is removed. He also works with patients whose cancer has spread to their eyes from other parts of the body. Such metastatic cancers can cause a variety of vision problems, with treatment options ranging from radioactive plaques to lasers.

Eye sight can also be affected by radiation and chemotherapy used to combat other types of cancers. Mishra collaborates with a patient’s cancer care team to determine whether the vision changes are a result of toxicity of the treatment or an inflammatory reaction and help manage those side effects.

Not all eye tumors are cancerous. Mishra also treats benign hemangiomas and other non-malignant growths in the back of the eye that can cause vision problems. Ultimately, ruling out a potentially life-threatening eye cancer, and providing a patient with an accurate diagnosis and proper treatment, is a top priority for both Mishra and his patients.

Mishra expects to stay busy working with the institute’s ocular oncology team, which includes cornea specialist Olivia Lee, MD, who operates on tumors on the eye surface, as well as oculoplastics specialist Jeremiah Tao, MD, and Lilangi Ediriwickrema, MD, who deal with tumors on the bony outer structure of the eye called the orbit. He is excited to be working with a multidisciplinary UCI Health team to serve patients with complicated cases.

“Patients are often scared and may have been referred multiple times before I see them,” Mishra says. “I have the opportunity to develop a significant relationship with ocular oncology patients as we address what can be a very complex disease pathology, involving all parts of the eye.

In addition to seeing patients at the eye institute, Mishra is dedicated to improving vision health globally, particularly in underfunded regions of the world. Through partnership with India’s Aravind Eye Hospital in Tamil Nadu, he is developing a device that would manually break apart cataracts because traditional cataract procedures involve ultrasound, a technology not widely available. He is also collaborating with researchers from other institutions to develop a telehealth option to screen patients in Ghana for sickle cell retinopathy.

Mishra’s research projects are focused on leveraging big data tom improve outcomes in vitreoretinal surgery and ocular oncology. Right now, he says, retinal research and innovations are flourishing, which benefits patients at UCI Health and around the world.

“There have been so many recent discoveries for retina diseases, where before there were few options,” Mishra says. “It’s exciting to be able to offer novel treatments for diseases that millions of people have.”