Christy became passionate about oculoplastics and began looking for a fellowship. She learned which ones would not take a woman (e.g. Dick Tenzel); and along the way, she met with Joel Glaser who offered her a neuroophthalmology fellowship at Bascom Palmer which she took 1983-84, immediately following residency.  The following year, she ended up at UCSF as one of the 1^st women (Bernice Brown was the first) with Crowell Beard, Earl Rathbun, and John Sullivan in what they called the “freeway fellowship” for 12 months in 1984-85.    

After her graduation from the oculoplastics fellowship, Christy joined the faculty at the University of Michigan, Ann Arbor.  She felt like she had a lot to prove, as very few women had gone before her.  Perhaps because the only previous woman faculty quit after one year, her chairman, Paul Lichter, offered an extension to achieve tenure – it’s unclear if he thought she was not ready, or it was male prejudice, but she didn’t need the extension.  She found it harder to get asked to be on committees, to be invited to collaborative meetings, or to be invited to speak.

Christy got involved in Women in Ophthalmology early in her career.  She started in the 1980s and got great advice from other women about tactics to enhance her trajectory.  They told her that if you wanted to be on an AAO committee, she should write to several of the chairs.  She tried it and remembers that “One never answered, and another replied, ‘why would I want you?’”  Ultimately, the third took her.  Later, she became vice chair of that committee.  Now, she enjoys mentoring and would be happy to chat about ideas and guidance with interested young oculofacial plastic surgeons.  Among her pearls of wisdom: Be open to opportunities that come along.  Some are unplanned but many can be pursued.

Christy’s work as an educator and researcher has been prodigious.  In 2010, she was the first woman to be invited to give the prestigious Wendell Hughes lecture (a combined AAO-ASOPRS honor).  She chose the topic: “From Bench to Bedside: Genetics of Congenital Anopthalmia,” reflecting her work with a gene associated with retinol binding protein transporter that led to a novel treatment for children with MAC (microphthalmos, anophthalmos, coloboma) spectrum of congenital disease.  Her research interests have ranged from periocular malignancies to thyroid eye disease, but most recently, she has become very active in organizing and writing about global ophthalmology.

About 15 years ago, Christy began to be very active in the international community, initially with the International Council of Ophthalmology and later the World Association of Eye Hospitals (she is the Chair-elect at present) and the ASOPRS Global Opportunities Committee.  Since 2015, she has been the co-director of the Kellogg Eye Center for International Ophthalmology and has worked assiduously in Ethiopia at St Paul’s Millennium Medical College in Addis Ababa. Her goal has been to help them establish an academic department and research program.  She describes this as “Very exciting!  It has been wonderful to share the fun and awe.  To use the old adage, we’ve tried to “teach them to fish instead of giving them fish.”  The western allopathic ideas around medical ethics, fair compensation, and peer-reviewed scientific publications were mostly new to them. She recalls that there were just over 70 ophthalmologists in the entire country when she started, and now they have opened more residencies, and the total is around 140 ophthalmologists.  In addition, fewer are leaving the country as the community has become stronger.  Dr. Nelson was given the Humanitarian Award by Women in Ophthalmology in 2022 in recognition of this work.  Half of the Michigan ophthalmology residents are involved in this outreach program so Christy’s work is likely to continue when she retires. (In fact, one of them did a survey showing that residents are more likely to stay involved in global humanitarian work if they participate in residency.)  She has recently been invited to try to get something similar going in Nepal.

Dr. Christine Nelson’s evolution from a ground-breaking female resident at Duke to a ground-breaking Hughes' lecturer to a ground-breaking global educator has been remarkable.  Her academic work, together with her teaching, mentoring, and leadership, has inspired and propelled many young women (and men – including me) to pursue similar interests over the past 30 years. 

SASOPRS:  Jonathan, we understand that your professional trajectory has been somewhat unusual, in that you had an illustrious career prior to pursuing medicine and oculofacial surgery, serving as an internationally renowned paleontologist and evolutionary biologist and a named Professor in the former field at Princeton University. How did you become interested in evolutionary biology?
J. Dutton:  In college, I became close to the chair of biology and a herpetologist, and I spent many evenings on Long Island observing, catching, and raising frogs, salamanders, and various snakes with him and his family. I volunteered as a research assistant at the American Museum of Natural History and spent several summers at the Museum’s research station on LI.  Because of my published research on fish behavior, I was awarded a fellowship at Harvard for PhD studies.  After a year with the icons of evolutionary biology and paleontology at Harvard, I decided to major in vertebrate paleontology and evolutionary biology and spent years collecting and studying fossils in East Africa. Princeton offered me a position as Sinclair Professor of Paleontology and Director of the Princeton Natural History Museum, which I accepted in 1970.

SASOPRS: We've heard that visiting your home is a little like visiting the Smithsonian, with a collection of fascinating artifacts from your paleontology-related travels around the world. What were some of your most unique destinations and most memorable academic paleontology projects?
J. Dutton: During my expeditions to Africa, I became fascinated with primitive art, which was used by the local peoples for social functions, religious symbolism, functionalism, and utilitarianism rather than purely creative purposes. I acquired many pieces from the local villages and from the doctors at a small one-room hospital near Lake Turkana in Northern Kenya who often collected artifacts in exchange for medical treatment. My most memorable project was working with Richard Leakey as co-investigator of several National Geographic-sponsored expeditions to Lake Turkana.  For my PhD thesis, I spent 14 months outside the US, traveling around the world studying fossils in 18 countries.

SASOPRS: Can we ask what motivated you to pursue a career in medicine, given your tremendous accomplishments in paleontology and evolutionary biology? And how did you come to choose ophthalmology and oculofacial surgery? 
J. Dutton: Fieldwork in East Africa was in the deserts where midday temperatures reached 120° F.  We always returned to camp for a few afternoon hours where most of my colleagues and staff took a nap.  Harvard had an intensive 2-week medical course for faculty and fellows who would be working away from medical help.  So, I was the medical officer for the expeditions.  While everyone else napped, I treated local tribespeople who came into camp with infections, spear wounds, cobra bites, and occasionally crocodile injuries. After doing this for five years, I decided that this was what I wanted to do. 

SASOPRS: You are known as an innovator in the discipline of oculofacial surgery. You developed an ocular oncology clinic, for example, and served as one of the principal investigators in the COMS (Collaborative Ocular Melanoma Study) study, the largest NIH-funded ocular oncology study to date, when this was not a common practice focus area for oculofacial surgeons. What prompted your interest in ocular oncology?
J. Dutton: I was on the faculty at Duke University in 1985 when the COMS study was created. Duke was asked to participate, and my chairman asked me to be involved since I took care of other ophthalmic malignancies.  I became the Duke COMS PI until 2000 and then moved to the University of North Carolina where I continued COMS participation.

SASOPRS: You've also made major contributions in thyroid eye disease, serving as board member and President of the International Thyroid Eye Disease Society (ITEDS) and founder of the ITEDS Tissue Bank. Can you tell us a little about the background and goals of this initiative?

J. Dutton: The International Thyroid Eye Disease Society (ITEDS) was originally founded in 2006. Since then, it has expanded to include members from nearly every continent. The goal of ITEDS is to promote and facilitate collaborative interactions among authorities to define clinical disease parameters, understand pathogenesis, and develop tools for the assessment and treatment of thyroid eye disease. Members of the society are interested in studying TED from basic science and clinical perspectives to evaluate patient-centered outcomes and foster therapeutic advances. The ITEDS Tissue Bank was created in North Carolina in 2013. The bank collects, characterizes, annotates, stores, and distributes biospecimens for research purposes to help support better understanding, education, and research for TED. 

SASOPRS:  On behalf of ASOPRS/SASOPRS members and oculofacial surgeons worldwide, we’re pleased to celebrate the 15^th year of your service as Editor-in-Chief of our flagship journal, OPRS. What have been some of the most notable challenges, rewards, and changes that you've experienced during your tenure as Editor?
J. Dutton: I was exceptionally fortunate to stand on the shoulders of five extremely talented previous Editors of OPRS who set the stage for OPRS being an outstanding international journal for oculofacial ophthalmology. During my tenure, the number of annual manuscript submissions more than doubled to more than 900 today. As with all medical journals, a major challenge is getting peer reviews from experts in the many subfields in our discipline.  Editors need to try to envision the future of their discipline and help direct it to some extent by the selection of key papers to publish. Readers need to be assured that the editor makes well-grounded and unbiased decisions. The rewards for me have been a contribution to the education of our colleagues around the world and in turn to help improve patient care, and help authors improve their publications.

SASOPRS: To close with an easy question, there has been a lot of excitement regarding the potential impact of AI on biomedical science and medical practice (topics that have been the subject of recent publications in OPRS). Can you share a couple of ways in which you feel AI may be particularly impactful in the field of oculofacial surgery?