Charles Flowers Jr., MD, is a renowned eye surgeon and physician at the USC Roski Eye Institute, who has made significant contributions to eye care in Guam.

By: Eric Weintraub

Flag of Guam waving in the wind on a clear day. (Photo/iStock)

Charles W. Flowers, MD, Ophthalmology (Photo/Ricardo Carrasco)

Charles W. Flowers, Jr., MD, Associate Professor of Clinical Ophthalmology, is recognized as one of the United States’ top eye surgeons for his expertise in cornea and refractive surgery. He specializes in laser vision correction, in particular laser-assisted in situ keratomileusis (LASIK) procedures, along with cataract surgery and corneal transplantation. In addition to the work he performs at the USC Roski Eye Institute, Dr. Flowers has spent more than a decade of his life performing vision-saving eye care procedures in the U.S. Island Territory of Guam.

“Before I began to offer laser vision correction procedures in Guam, anyone who wanted laser vision correction either had to travel to the Philippines or the United States – a thirteen-hour flight. You couldn’t get care if you didn’t have the means to get off the island,” Dr. Flowers said.

His work in Guam began in 2010 when a former resident of his, Dr. Anthony Smith, requested Dr. Flowers’ assistance in establishing a LASIK center at his Guam based practice, Island Eye Institute. Intrigued by the opportunity, Dr. Flowers flew to Guam to conduct an initial site visit. From 2010 to 2013, Dr. Flowers dedicated his efforts to designing and establishing a LASIK center for Island Eye Institute.

“In 2013, we became the first group to perform LASIK on Guam,” Dr. Flowers said. “Since then, I’ve performed LASIK for 600 patients in Guam.”

Dr. Flowers recalls one patient who he was able to help using laser vision correction.

“A young woman, who was a contact lens wearer, developed a corneal ulcer that resulted in a significant scar obstructing her visual axis. For a couple of years, she endured visual impairment as she was unable to seek treatment off the island due to the scar. However, once our laser center was established, I had the opportunity to evaluate her condition. Using the same laser we use for LASIK procedures, I removed the scar via a procedure called phototherapeutic keratectomy.”

Addressing Diabetic Retinopathy

As Dr. Flowers’ time on the island continued, his focus expanded beyond LASIK procedures to help the citizens of Guam with a myriad of eye diseases, including diabetic retinopathy, an eye condition that can cause vision loss and blindness in people who have diabetes.

“Guam is a high-risk population in terms of diabetes, and there is a notable genetic predisposition to the disease. We became interested in wanting to do a population-based study looking at the prevalence of diabetic retinopathy on the island and establish protocols for early intervention to prevent visual loss.”

Currently, Dr. Flowers strives to visit Guam four times a year. Whenever he does, he sets aside time to perform a handful of corneal transplant procedures for patients who do not have the means to get off the island.

Expanding Telemedicine

Dr. Flowers is working to expand telehealth services on Guam while operating remotely from Los Angeles. To support this goal, he successfully secured funding for a telemedicine grant. Presently, Dr. Flowers is involved in implementing a teleretinopathy pilot project on Guam in collaboration with USC.

“We’re going to install retina cameras in primary care clinics in Guam, capture retinal images and upload those images to the cloud, which will be read by the specialists at Island Eye Institute and have backup consultations with the retinal specialists at USC.”

This process enables the identification of patients at risk of developing sight-threatening diabetic retinopathy. The advancements in camera technology, coupled with improved internet robustness, have made these telemedicine practices possible.

Volunteering in the U.S. Territories and Abroad

Dr. Flowers encourages more physicians to consider practicing away from home and breaks down how simple it is to volunteer.

“If you’re interested, call a local provider, and express your interest in volunteering. There aren’t a huge number of providers looking to volunteer, so they’ll be happy to have someone come in and provide additional service. Delivering help is always welcome in these communities.”

In addition to providing healthcare to patients, Dr. Flowers is also working to mentor the two general ophthalmologists who work year-round at Island Eye Institute.

“Oftentimes when I’m in Guam, I don’t do any formal teaching, but I am there to assist if a patient has complex issues. Lately, the doctors are wanting to perform LASIK procedures themselves, so I’m in the process of training them on how to do LASIK.”