Dr. Hoffer, who developed the Hoffer Q formula, now spends most of his time on his website, where he details his travels to 30 countries in Europe over 20 years.
Dr. Hoffer, who developed one of the main formulas used to calculate intraocular lenses, namely, the Hoffer Q formula, is well known and well respected in the field of ophthalmology with his books and articles. He can be dubbed a modern traveler who loves to visit and discover new places. He was the founder and the first president of the American Society of Cataract Refractive Surgery (ASCRS). Dr. Hoffer, who lives in America, travels everywhere by car. He published his trips through his website https://khoffer.com/. In our interview, he shared his travels and memories.
How was your childhood?
A little rough. At the age of 3 or 4, my parents had a quite traumatic separation and divorce, such that my younger brother and I had to live with my maternal grandmother (Mildred) who raised me until the age of 11 in fifth grade (Berlin Central School). After living with foster parents for 6 months, I moved in with my Mom in Troy, NY, and finished my 5th–6th grades at Public School #10. Then, I attended St. Mary’s School in 7th–8th grades and graduated. I then attended Catholic Central High School in Troy and graduated in 1961 (with the class prize in Science and German). I was given a four-year Principal’s Appointee Scholarship to the local Siena College in Loudonville, NY. After applying to medical schools in my third year in college, I started medicine at the SUNY Upstate Medical University in Syracuse, NY. Moreover, I was awarded with the $2000/year grant for 2 years, for obtaining the highest mark in Anatomy in a class of 100.
My early interest in getting superior results led me to perform the first ultrasound axial length measurement in the U.S. and write a formula to calculate IOL power. This formula ultimately became the Hoffer Q formula used around the world for short eyes (<22 mm) for the past 25 years.
How did you meet your wife?
In 1969, during my first year of residency at Wayne State University, Kresge Eye Institute in Detroit MI, Marcia Wasgatt from Rockland, ME, was a social worker and brought in a patient for an eye exam. After the patient’s eye exam, I gave her a prescription for his glasses and then handed a pad to her and asked her to write a prescription for me – her telephone number. We were married 4 months later, on May 30, 1970, by Rev. Montieth in Rockland, ME and again in 1974 at St. Monica’s Church by Msgr. Raymond O’Flaherty. We celebrated our 50th anniversary this May!
How many children do you have? How is your relationship with your children?
I have three children. My first child is Kevin Joseph Hoffer, who was born on August 22, 1972. Then, Jeffrey Kenneth, my second child, was born on January 5, 1975, while Marcia was attending Law School. And Kristin Lenore was born on January 2, 1978. They all live a half-hour drive from us: Kevin and Gisele (with Wesley (11) and Madeliene (6) in Glendale; Jeffrey and Rebecca (with Kaylin (20), Anabella (16), and Erik (11) in Woodland Hills, and Kristin in Burbank. Every summer we took them on 1 month van trips throughout the USA and national parks.
How has your career progressed?
Much more interesting than I ever could have imagined. Out of my residency for 4 months, I concentrated on cataract surgery and started phacoemulsification in 1972 and implanting IOLs in 1974. Due to government interference, and having established the ASCRS in April 1974, I was at the center of the legal battles with the California FDA and later the federal device legislation in Washington, DC, winning both. When I established the first ASCRS Scientific Sessions in 1975 (and chaired the first 8 meetings), I made sure that we allowed anyone to make a presentation and let the audience decide its validity. I am proud that ASCRS has continued that policy.
My early interest in getting superior results led me to perform the first ultrasound axial length measurement in the U.S. and write a formula to calculate IOL power, which ultimately became the Hoffer Q formula that is used around the world for short eyes (<22 mm) for the past 25 years. I delved into refractive surgery in November 1979 and performed one of the first radial keratotomies in the U.S. Moreover, I was the first American surgeon to use Hyaluronic acid (Healon) in a cataract operation and developed several instrument and surgical procedures. My interest in research has led to over 215 peer-reviewed journal publication, 60 textbook chapters, and one text book (“IOL Power”). I never could have imagined all this. What a ride it has been.
Can you talk about your research, the papers that you presented?
Most of my publications have been about biometry and IOL power calculation along with some surgical procedures and recommendation. I’m proud of our UCLA study of RK, which was the first study presented at the AAO and the first one published (in Ophthalmology). This helped begin the revolution of refractive surgery, with ensuing PRK, LASIK, and LASEK.
What are you most proud of in your career?
Simple, the establishment of the Journal of Cataract and Refractive Surgery, which I founded in 1975. I worked night and day to have papers submitted and acquire information from the members on IOL surgery, even cutting and pasting the typeset articles prior
to printing in the early days. It has become the premier journal in the field of anterior segment eye surgery, thanks to its many subsequent Editors and the support of clinicians and scientists around the world.
What can the industry do to help support clinicians?
Financially support scientific organizations that provide education.
Can you tell us your ideas about Ophthalmology Future? Where do you see the focus of innovation heading in the next 5 years?
If I knew that, I would get a patent on it. I have never been a predictor of the future.
What advice would you offer to junior ophthalmologists?
Regardless of what mode of practice they get into, they should always find time for clinical research even without grants and funding. Think of something that needs improvement and work on it.
How many countries have you visited around the globe?
Outside of Mexico and Canada, Marcia and I have toured 30 countries in Europe, except Romania and Malta.
Which city impressed you most during your travels?
Marcia fell in love with Venice, but for me, it was always too crowded. I love a little town on an island at the tip of a peninsula that juts way into Lake Garda called Sirmione. We have stopped there for a day or two on every single EU trip we have made. I fell completely in love with the Basque city of San Sebastian on the north coast of Spain; it is the most beautiful place to live in the EU. Athens was much nicer to me than I had imagined. If I have to move to Europe, it would be to Munich, Germany.
Of course, the capitals of all the countries offer the best in the country, but I do not have a favorite anymore (maybe Rome). I also liked the little town of Kesik in the Cotswolds in the UK, Killarney in southwest Ireland, Pecs in southwest Hungary, Zagreb in Croatia, Sophia in Bulgaria, Bled in Slovenia, especially Krakow and Gdansk in Poland, Bournemouth on the south coast of UK, Stavanger in Norway, Vilnius in Lithuania, Savonlinna in Finland, Oviedo in the north and Sevilla in the south of Spain, Stockholm in Sweden, Zurich, Lugano and Lausanne in Switzerland, Positano, Sorrento, Santa Margherita Ligure and Punta Est in Italy, Biarritz, Honfleur, Dijon, Lyon, St. Tropez in France, Ioannina and Monemvasia in Greece, and Lindau and Binz both in islands in Germany.
Did you come across a surprising incident during your travels?
In 2005, at a restaurant in Frejus, during the early part of our France trip, we met a man who gave us a beautiful itinerary for cities and towns to visit for the rest of our trip. Most of these places we had never heard of. We visited most of them and when writing the events in my EU Travel website (www.KHoffer.com), I wanted to email him, but since it was daytime in France, I called him to tell him about the website and thank him for his wonderful recommendations. He told me he knew about it already because a colleague in China found him on the internet through my website. Quite incredible.
Is there any country/city that you want to visit but never had the chance to travel?
Probably Tokyo, Saigon, Singapore and places like that, but the language and signage are so foreign. It would be impossible to travel the way we like to do it. With my minimal German and Italian, I can get by in any language in Europe. I might be interested in touring Australia someday.
What is on your daily to-do list?
Part of my daily to-do list is, first and foremost, my half-hour run with my little dog Barkley. I have not missed one day of running in 26.5 years. Next, is my daily cappuccino at Peet’s Coffee, 1/2 mile from my home where I do all my computer work for several hours (on hold now). Each day (especially now), I get to watch 2–3 old movies on Turner Classic Movies to catch up on all I missed during my education. I keep track of them so
as not to rewatch movies I have seen already. I have now reached seeing 5,300 movies. Since we moved to our present house in 2009, I have been cooking all the dinner meals. I have only eaten one meal a day for over 40 years, making dinner important to me. When my first granddaughter (Kaylin) was 3–4 years old, I would watch something appropriate for her age like a cooking show called “Molto Mario.” Through this, Mario Batali taught me a lot about cooking Italian food and made me interested in doing it. I have gotten to be pretty good at it. About 3 years ago, I started ordering from menu delivery programs that ship three meals a week complete with all the needed recipe. Then, I cooked them. I’ve tried them all, and Home Chef is, beyond doubt, the best.
What do you like and not like about yourself?
I like that my mind can be very inventive at times (not often enough, though) and I can come up with ideas that no one had thought of before… sometimes, ahead of my time, which doesn’t always lead to a successful conclusion. I dislike that my obsessiveness for details can sometimes rub people the wrong way.
What inspires you?
New ideas that make sense to me (maybe not to others).
Do you have any motto?
Persistence, persistence, persistence.
What is the best lesson you learned in life?
Persistence in everything you do will get your aims accomplished. Keep your promises and vows.
If you could go back to 10 years, what advice would you give to your younger self?
Nothing different than I already know at that time.
What is something you would like to do that you haven’t yet accomplished?
Finish the entire 20 years of trips on my EU Travel website (www.KHoffer.com).
DR. HOFFER’S OPINION ABOUT COVID-19
“In late December or early January, I learned that there was an outbreak of a new virus in Wuhan, China. I was in Peets Coffee shop as usual and told several friends there that this was going to spread throughout the world and to get ready for it. I told everyone then to buy some special face masks and gloves and be prepared. Well, I got busy and never followed my own advice, but my friend Diana purchased 15 N95 masks while I had none. Later, I tried buying some, but of course, they were all sold out everywhere by then. I finally asked her if she would give me two for me and my wife, and she did.
I run daily in the street wearing the mask she gave me.
I gave up shaking hands with anyone about 4–5 years ago since that is the easiest way to catch pneumonia, which is the leading cause of death for those over 70. I am turning 77.
About 11 years ago, I began cooking dinner every night for me and my wife, and 3 years ago, I started ordering these pre-selected meals from various purveyors, including Home Chef, Chef’d, Hello Fresh, Plated, Blue Apron, Imperfect Foods, etc. After more than a year, I determined that the best by far was Home Chef (with Plated and Hello Fresh ranking 2nd and 3rd). Plated went out of business, and when the pandemic started causing us to stay home, I slightly panicked and started ordering from new ones such as Dinnerly, Freshly, and Sun Basket. Now I am inundated and have 14 meals (for two) sitting in my fridge (and freezer) and 18 more (Freshly, totally prepared microwave dinners) in my freezer. This turned out to be ideal for staying out of the grocery store completely. We are eating pretty well.
I have used the time over the past 4 weeks, sitting at home, to work on the complete historical record of the IOL Power Club (finished 6 out 15 years), work on my EU Travel Website, piling through old family photographs, and watching three old Turner Classic movies/day (now lifetime 5,300 movies). I can’t wait to escape!”