From the Fall of the Iron Curtain to Helping Children

Profile of biomedical engineer and medical device developer Boris Gramatikov

It’s tough to get young children to sit still, much less to get them to look in the same spot for any length of time.  This is likely not news to you.  And no, you haven’t stumbled upon a parenting advice column.  It’s about helping children whose eyesight is at risk.

Amblyopia, otherwise known as lazy eye, is a disorder of the visual system that is characterized by indistinct vision in an eye that is otherwise physically normal. Amblyopia can be caused by poor or no transmission of the visual image to the brain, due to either strabismus (misalignment of the eyes) – when the brain may suppress the input from one eye to avoid double vision or visual confusion, or defocus – a discrepancy in the focus between the two eyes can lead to amblyopia in the defocused eye.

Amblyopia is a major public health problem. Approximately 380,000 children in the US alone are affected by it.  If it goes undetected, the brain may irreversibly turn off the amblyopic eye, to avoid double or blurred vision. The disorder, if detected early on, can be effectively treated with glasses, patches, or surgery. Pediatricians prefer that all children be screened for vision and amblyopia between the ages of 2 and 4. The earlier these conditions are detected, and the underlying cause corrected, the more successful the treatment in equalizing the vision between the two eyes – and preventing blindness.

Boris, Aneta and Ivan Gramatikov, soon after their arrival to the United States in 1996.

Enter Boris Gramatikov, a biomedical engineer originally from Sofia, Bulgaria and a truly Outstanding Immigrant. He and his colleagues at the Wilmer Eye Institute at The Johns Hopkins University School of Medicine are developing a novel medical device that is able to send a low-power laser beam through a child’s pupil and scan the retina to determine whether each eye is able to fix on a central target.  The device captures data at a high speed and this is important because the child is looking in all possible directions and not sitting still.  Even brief episodes of attention are precious.  A computer then analyzes this data, to detect central fixation and refractive errors. If not both present, the patient is referred to doctors who then develop a course of treatment – whether corrective lenses, eyepatch, or surgery – before it’s too late.  Before blindness is the irreversible result.

For his work on this device, in 2009/2010 Boris was awarded the prestigious 3-year Individual Biomedical Research Award by The Hartwell Foundation. He also filed a U.S. patent application in the same area recently, endorsed by Johns Hopkins.

Boris’ story is one of exceptional contributions to the field of biomedical engineering and to the U.S.  By the time he first came to the United States in 1993, Eastern Europe had experienced significant decline in its research capabilities.  “The Iron Curtain had fallen, the economy was down, and there was no room for serious research,” commented Boris.  “The labs were emptying.  I wanted to go where I would be able to exercise my profession effectively, and would be valued.”  In 1993, while still in Bulgaria, he won a 3-month research award from the Fogarty International Center, a division of the NIH dealing with international projects. He spent three very successful months at the Biomedical Engineering Department of Johns Hopkins, but then went back to Bulgaria, because he was on a J visa, and had also won another award from the European Commission for Research – this time in at the Medical School of Hannover, Germany.  “After spending some time in Germany and Bulgaria, I came on an H visa back to Johns Hopkins in Baltimore, where my collaborators had in the meantime managed to provide funding for an exciting project aimed at developing a medical device that would detect heart perfusion problems Bal(myocardial ischemia) and help avoid myocardial infarction or dangerous tachycardias.”

Biomedical engineer Boris Gramatikov and his son, Ivan, visiting the Statue of Liberty.

“The true centers for research are in America – Duke, Harvard, Hopkins – and it was a no-brainer to want to be here where the innovation was happening.”  Of course, in order to ‘be here’ for more than a brief basis, Boris needed assistance with immigration, and that’s when he found me.

It was clear to me from the start that Boris had a strong case for a National Interest Waiver as his work clearly had a significant impact on his field.  Working with Boris was a pleasure.  As an engineer, as you might imagine, he is very thorough and detail oriented.  In preparing his case, I had a plethora of evidence from which to choose with perhaps the hardest part determining what to leave out.  In the end, I was able to make an extremely effective NIW case and the Immigration and Naturalization Service (now the USCIS) agreed with me.  Since obtaining permanent residence, Boris has just continued to prove over and over again, that he is of exceptional ability and that his presence in the U.S is truly in our national interest.

Boris has contributed not only breakthrough medical devices and instrumentation to the United States and the world at large, but he has established himself as a leader in the largest professional organization in the world – the IEEE, or the Institute of Electrical and Electronics Engineers.  Through this strong network, he has met others in his field and it has given him the opportunity to share stories and meet his “equivalents in society, his peers.  To get encouragement, advice, and help whenever necessary.”  Now, as the director of the IEEE’s continuing education program for the Baltimore region, he recommends that other immigrants find networks that they can tap into.  “It’s a great way to stay in touch with the most recent developments in the field, to meet other like-minded people, to not feel isolated. It’s one of the most efficient ways to get integrated and at the same time learn the specific communication style in your area.”

Boris also has remained active in sustaining the Bulgarian community here in Baltimore, and in encouraging his son to stay in touch with his culture and roots.  “While he goes to a very good school and is a normal American boy, it’s important that he understand Bulgarian traditions, folk dancing, holidays, culture and religion.  We’ve stayed active in the Bulgarian embassy in Washington, D.C., attended Bulgarian churches in DC and Harrisburg, PA, and we have traveled to Bulgaria and throughout Europe so that he knows first-hand the history, the geography, and is connected with our heritage.”

Boris Gramatikov has been a member of the Hopkins faculty since 1996, and is currently Assistant Professor in the Division of Pediatric Ophthalmology and Adult Strabismus at The Wilmer Eye Institute. He is a biomedical engineer with expertise in medical instrumentation, electronic hardware, computer software and signal processing.

For more information on his research, visit: http://www.hopkinsmedicine.org/wilmer/employees/cvs/gramatikov.html

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