Episode 1: Why Eyesights?

Why was Eyesights created? What is the North Texas Eye Research Institute? We sat down with Dimitrios Karamichos, Ph.D., FARVO, Vice President, Research and Graduate Studies, UNT Health Fort Worth, and Executive Director, North Texas Eye Research Institute, for the answers to these questions and more.

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Speaker 0:03

Welcome to Eyesights, a podcast from the North Texas Eye Research Institute at UNT Health Fort Worth. Vision shapes almost every part of how we experience the world, how we read, work, learn, and connect with the people around us. And yet, millions of people are living with vision loss from diseases that we still don't fully understand. But behind every discovery in eye care, every new treatment, every clinical breakthrough, there are researchers, clinicians, and trainees working to push the science forward. This podcast explores that work. We'll talk with scientists, physicians, and innovators about the discoveries shaping the future of vision. And we'll ask a simple question: How does eye health impact health outcomes? Welcome to the very first episode of Eyesights, a podcast from the North Texas Eye Research Institute (NTERI) at UNT Health Fort Worth. I'm your host, Krystle Gabele, and in this podcast, we'll be exploring the science, the people, and the ideas that are shaping the future of vision research and eye care. In each episode, we'll talk with leaders in the field, from experts, clinicians, and even trainees. Our goal is to make the research happening in our institute more accessible, more understandable, and hopefully more inspiring. For this first episode, we wanted to start at the beginning by talking about why this work matters and what makes our institute unique. So to help us do that, I'm joined today by Dr. Dimitrios Karamichos, Vice President of Research and Graduate Studies at UNT Health Fort Worth, and the Executive Director of NTERI. Dr. Karamichos is a scientist, teacher, mentor, and innovator whose work focuses on interdisciplinary and collaborative corneal research that can give rise to deep understanding of diseases and the development of novel therapies. As Executive Director, Dr. Karamichos leads the Institute's mission to advance research, train the next generation of scientists and clinicians, and ultimately improve the lives of people living with eye diseases. Dr. Karamichos, welcome to the podcast.

Dr. Karamichos 2:23

Thank you for having me. It's really, truly an honor to be here.

Krystle Gabele 2:27

Before we begin, I just want to ask: I know we're going to be releasing this episode in May. So what are your favorite summer activities?

Dr. Karamichos 2:36

So I guess two things. One, myself and the rest of the family, my two kids, Ethan and Emma. I should mention the name in case they're going to listen to this one. And my and my wife are practicing Taekwondo. So that's going to keep us busy. Well, it keeps us busy throughout the year and therefore this summer as well. And then the second part will be cruising sometime in July, right before they start school in August. That's something we got into a couple of years ago, and we've been doing it at least once a year.

Krystle Gabele 3:05

Oh, that sounds like fun. So before we talk about NTERI, I'd love to start with your story. What first drew you to the field of vision research?

Dr. Karamichos 3:14

So my interest in vision research really came from realizing how much we rely on sight, how we interact with the world, and how devastating vision loss can be when it's taken for granted. Early in my career, I had the pleasure to work with clinicians and saw them treating patients whose quality of life changed dramatically because of an eye disease. And that stayed with me. Vision sits at the intersection of neuroscience, biology, and behavior. And that combination, along with the real-world impact, pull me in. It's a field where even small advances can have life-changing consequences. And that sense of purpose has always motivated my work.

Krystle Gabele 3:53

This podcast is called Eyesights. And one thing that many people don't realize is how closely eye health is connected to overall health. When you talk with colleagues, how do you explain that connection?

Dr. Karamichos 4:06

People often say the eye is window into the body because it's one of the few places where we can be non-invasive. We know now from numerous studies that the eye gives us early clues about systemic conditions. Eye health doesn't exist in isolation. It truly reflects cardiovascular health, metabolic health, neurological health, and even immune function. That makes the eye and the eye research an important contributor to understanding disease well beyond vision itself.

Krystle Gabele 4:34

When someone says, I'm going to see my eye doctor, they often think it's about vision or glasses. But what are they missing about the bigger picture of eye health?

Dr. Karamichos 4:44

They're missing the fact that eye exams can detect serious diseases early, sometimes before symptoms appear elsewhere. An eye visit isn't just about seeing better, it's about staying healthier. Vision care is preventative medicine, and that's something we need to emphasize much more. In many cases, the eyes are the first place silent diseases show up.

Krystle Gabele 5:04

From your perspective, why is vision research such an important part of improving overall health?

Dr. Karamichos 5:10

Vision research advances far beyond the eye itself. By studying retinal neurons, blood flow, inflammation, cornea dystrophies, and degeneration, we gain insights into diseases like diabetes, Alzheimer's, and stroke. Protecting vision also protects independence, safety, and mental health, which are all fundamental to whole person care. In many ways, vision research serves as a bridge between basic science and everyday quality of life.

Krystle Gabele 5:36

Can you share a moment in your research career when you really saw how vision affects someone's overall quality of life?

Dr. Karamichos 5:43

I remember serving on a scientific panel where members with partial blindness share the stories and how through treatment and intervention they were able to regain partial functional vision. They talked about things many of us take for granted, being able to drive, read to a grandchild, or return to work. Those moments made it very clear to me that vision isn't a luxury. It's central to dignity and independence. You really see how vision affects our identity and confidence.

Krystle Gabele 6:11

We know the eye can reveal a lot about the rest of the body. Things like diabetes, hypertension, and even neurological disease. But what are some of the most fascinating examples of that connection?

Dr. Karamichos 6:25

One of the most fascinating and often overlooked examples of the eye-body connection is the cornea, which is really the focus of my own research. The cornea is not just a clear window for vision, it's one of the most densely innervated and immunologically active tissues in the body. That means it reflects systemic conditions like autoimmune disease, diabetes, inflammation, and even nerve damage elsewhere in the body. Changes in corneal nerves, wound healing, or immune responses can tell us a great deal about overall neurologic and metabolic health. That's why we focus so much on the cornea. It is uniquely positioned to help us understand not only vision loss, but broader processes like tissue regeneration, pain, and inflammation across the body. It is also very accessible.

Krystle Gabele 7:08

If people understood one thing about how eye health relates to whole health, what would you want it to be?

Dr. Karamichos 7:15

The taking care of your eyes is taking care of your body. Regular eye exams should never be optional. They should be an essential part of preventative health care. Eye health should be viewed the same way as we view blood pressure checks or even cholesterol screenings.

Krystle Gabele 7:30

Since you joined NTERI in 2020, there has been a lot that has changed. Could you perhaps share what excites you the most about the future for Interi?

Dr. Karamichos 7:39

Since joining NTERI in 2020, I've been energized by how the Institute has evolved into a more integrated, collaborative, and truly translational research enterprise. What excites me the most is our growing ability to move discoveries from lab closer to patients through strong partnerships, innovation, and interdisciplinary science. There is a real momentum now that positions entered to make national and even global impact. Since becoming the executive director in 2022, we've seen tremendous success in federal funding, with 100% of our investigators supported by major grants. We've also experienced significant growth in the number of students and postdoctoral fellows we train, which is critical for building the next generation of vision scientists. More recently, we strengthened and expanded our network with other academic institutions, private sector partners, and philanthropic organizations. And I'll say we have some very exciting initiatives on the horizon, but I'll save a few surprises for your audience.

Krystle Gabele 8:35

And I'm excited about these new initiatives that we're developing. One thing that seems unique about modern vision science is how interdisciplinary it is. How do fields like neuroscience, genetics, engineering, or data science come together in iResearch?

Dr. Karamichos 8:52

Modern vision science is truly a team effort. Neuroscience helps us understand how visual information is processed, genetics reveals risks and resilience to diseases. Engineering drives advances in imaging and medical devices, and data science allows us to identify patterns we simply could not see before. iResearch is really where the disciplines converge to solve complex problems. And now with the arrival of artificial intelligence, vision science is poised to become one of the most exciting and impactful areas in biomedical research.

Krystle Gabele 9:23

What discoveries or technologies in vision science are you the most excited about right now?

Dr. Karamichos 9:29

Well, advanced inocular imaging, gene, and cell-based therapies, AI-driven diagnostics, and neuroprotective strategies are all transforming the field. These aren't incremental changes. They really have the potential to redefine how we detect and treat eye diseases. What's exciting is how rapidly these innovations are moving toward clinical applications.

Krystle Gabele 9:49

When a discovery happens in a research lab, how does it eventually make its way to helping patients?

Dr. Karamichos 10:00

It starts with basic discovery, understanding mechanisms of disease at the molecular, cellular, or system level, and then moves into validation, where we ask whether those findings are robust and reproducible. From there, promising ideas are developed into potential therapies or diagnostics and tested through carefully designed preclinical studies or clinical trials. What matters most is building strong translational pathways, so innovation doesn't stop at publication but continues all the way to patient care. That truly requires close collaboration between scientists who make discoveries, clinicians who understand real patient needs, industry partners who can scale, and so on and so forth. When those groups work together early and intentionally, discoveries move faster and more efficiently, ultimately making a real difference in people's lives.

Krystle Gabele 10:46

I know you mentioned AI, and I wanted to ask a few questions pertaining to AI, since it is starting to play a bigger role in clinical ophthalmology and healthcare, from screening diseases to helping interpret imaging. How do you see AI changing the way we diagnose not just eye conditions, but potentially broader health issues that show up in the eye?

Dr. Karamichos 11:08

AI is already changing how we practice ophthalmology, specifically in screening and interpreting imaging. AI can detect subtle changes in retinal, cornea, or optic nerve images, often earlier and more consistently than a human eye can, which allows us to diagnose early and intervene. What's especially powerful is that these same tools can help identify broader health issues that show up in the eye, such as diabetes, cardiovascular disease, and neurologic conditions. Looking ahead, AI has the potential to shift eye care and healthcare more broadly, from reactive to proactive. If you use it thoughtfully, I believe, AI won't replace clinicians, but will enhance decision making and help us deliver more personalized and preventive care.

Krystle Gabele 11:51

Looking ahead, where do you think AI has the greatest potential in vision science? Whether that's accelerating research, improving patient care, or even helping us understand how the eye reflects overall health.

Dr. Karamichos 12:04

I think AI has the greatest potential where it directly improves people's lives by helping us move faster in research, make better clinical decisions, and understand health more holistically. In research, AI can analyze complex data sets in ways humans simply cannot, helping researchers spot patterns, generate new hypotheses, and accelerate discovery. That means promising ideas don't just sit on the shelf for long periods of time. In the clinic, AI can support early detection and more personalized care, flagging risks before symptoms appear and helping clinicians focus their time where it truly matters. And because the eye reflects so much about the rest of the body, AI gives us a powerful way to use eye data to better understand broader health issues. At Enteri, we're actively developing initiatives around AI that build on these ideas with a strong focus on transnational impact. While I can't share all the details just yet, we are preparing to launch new AI-driven efforts in the near future that we believe will meaningfully advance both vision research and patient care. It's an exciting time and we are just getting started.

Krystle Gabele 13:08

When we think about health, prevention becomes really important. What are some things people can do today that can actually protect their vision long term?

Dr. Karamichos 13:18

This question comes up so often in so many different forums. Regular eye exams managing chronic conditions like diabetes and hypertension, wearing eye protection, staying physically active, and non-smoking all make a real difference. Vision health is cumulative. It reflects daily choices over time. What you do today can significantly affect how well you will see decades from now.

Krystle Gabele 13:39

As people age, vision becomes incredibly important for maintaining independence and overall well-being. How do you see vision health playing into healthy aging?

Dr. Karamichos 13:50

Vision plays a central role in healthy aging because it touches nearly every aspect of daily life. Good vision supports independence, mobility, and social engagement. It allows us to drive, navigate our homes safely, remain physically active, and stay connected with our families and communities. When vision declines, the impact often goes far beyond eyesight alone. Protecting vision as we age means reducing for risk, preventing injuries, and preserving autonomy for as long as possible. Vision loss is also closely linked to social isolation, depression, and cognitive decline, which means maintaining eye health can have ripple effects across both physical and mental well-being. Healthy aging isn't just about living longer, it's about maintaining quality of life, confidence, and independence. From that perspective, vision health is not optional. It's foundational to aging well.

Krystle Gabele 14:40

There's also growing evidence that vision loss affects mental health, cognitive health, and even social connection. How does that influence how we think about eye care?

Dr. Karamichos 14:50

Here are some facts. Vision loss increases the risk of social isolation, depression, and cognitive decline. That reality forces us to rethink eye care not as a standalone specialty, but as an essential part of holistic health care. Vision health is directly connected to mental well-being, brain health, and social engagement. If you speak with your physician, I'm almost certain they emphasize the importance of regular eye exams and taking care of your vision. Yet, whether people follow through often comes down to perception and motivation. There is still an education gap in many communities, and too often the mindset is, it won't happen to me. Changing that perception, helping people understand that vision loss is common, impactful, and often preventable is just as important as the treatment themselves.

Krystle Gabele 15:37

If we were to fast forward 10 years from now, what advances in vision research could have the biggest impact on overall health?

Dr. Karamichos 15:55

AI-enabled screening tools, precision medicine approaches could allow us to identify disease earlier, intervene more effectively, and tailor treatments to each individual patient. And if I may add, AI is real. It's no longer a future concept. It's already part of our daily conversations and workflows. We absolutely must harness its powers. If we do that well, AI can help us move towards a future where many eye diseases are detected earlier, managed better, and in some cases potentially eradicated.

Speaker 16:24

What role do you hope NTERI will play in shaping that future?

Speaker 1 16:28

I envision NTERI as a national leader in translational and collaborative vision research, one that connects discovery, clinical care, industry, and community to improve outcomes at scale. Our goal is not just to generate knowledge, but to ensure that knowledge translates into real impact for real people. Right now, the NTERI leadership team is working hard to reshape and redefine how community outreach and service should look for a world-class research institute like ours. In the past, NTERI conducted community eye screenings that eventually faded. But what's coming next is a new model, more comprehensive, more sustainable, and more impactful. We are working closely with our partners to launch this next phase soon, and I genuinely believe it represents the next level of how research institutions can serve and engage their communities.

Krystle Gabele 17:13

What discovery in vision science do you find the most inspiring?

Dr. Karamichos 17:17

One of the most inspiring discoveries in vision science is the realization that vision loss is not always irreversible. For a long time, many eye diseases were considered progressive and untreatable, but advancing understanding tissue regeneration and molecular repair mechanisms have fundamentally changed the mindset. The emergence of gene therapies and cell-based approaches have shown us that restoring, or at least preserving, vision is possible. What inspires me most is not just the science itself, but what it represents for patients, hope. Hope that vision loss doesn't have to define the rest of people's life, and that research can meaningfully restore independence, confidence, and quality of life.

Krystle Gabele 17:56

What's one simple thing you wish everyone did to take better care of their eyes?

Dr. Karamichos 18:02

That would be for everyone to get regular comprehensive eye exams, even when they think their vision is fine. So many serious eye conditions develop silently, without any pain or obvious symptoms. And by the time vision changes are noticeable, the aims may already be significant. Eye exams aren't just about glass or contact lenses. They are a critical form of preventive healthcare.

Krystle Gabele 18:23

What gives you the most optimism about the future of vision science?

Dr. Karamichos 18:28

The convergence of innovation, collaboration, and urgency in the field of vision science. We now have unprecedented tools, advanced imaging, artificial intelligence, precision medicine, and regenerative technologies that allow us to ask better questions and move discoveries faster than ever before. Equally important, researchers, clinicians, engineers, industry partners, and communities are increasingly aligned around a shared goal, and that is preserving sight and improving lives. That combination of scientific capability and collective purpose makes me deeply optimistic about what lies ahead for patients and for the future of vision science.

Krystle Gabele 19:06

Dr. Karamichos, thank you so much for joining us and for helping to launch the podcast.

Dr. Karamichos 19:11

Thank you for having me.

Krystle Gabele 19:12

If you enjoyed this episode of Eyesights, be sure to subscribe so you don't miss future conversations with the scientists, clinicians, and trainees working to advance vision research. You can also learn more about the North Texas Eye Research Institute by visiting our website www.unthealth.edu slash interi, where we'll also post show notes and additional resources related to each episode. Thanks for listening.