'Hoping to cure blindness': From roots in Cuba, Austin doctor finds his calling
Retina surgeon and diabetic eye specialist Jose Agustin Martinez, MD mission to prevent blindness caused by diabetic eye disease was recently featured in an article by Nicole Villalpando in the Austin American Statesman. You can read the entire article below or find it on the Austin American Statesman website here.
Dr. Jose Agustin Martinez moves swiftly from patient to patient at his Austin Retina Associates' practice on West 38th Street. Before he enters each room, he reviews the patient's files with his staff.
They call out numbers to one another in a code that describes their patient's eyes and the improvement or areas of concern.
On this morning, he'll see about 50 different patients, but he's personable with each one, his staff said.
"The only one that matters is you," Martinez said of his patients.
His goal is to practice humility, he said. He wants to be the guy who works with his patients to develop the best answer for them, "as opposed to being the guy with the right answers."
Many of the patients he sees have diabetes and the eye complications that come with that disease. They begin to lose their vision as the disease affects the retina at the back of the eye.
"This is preventable, treatable blindness," Martinez said.
From Cuba to Texas
Martinez, 60, has been treating eyes in Austin since 1993.
The University of Texas alum and UT Southwestern Medical School graduate knew he wanted to return to Texas after completing his residency at Emory University in Georgia and then a surgical retina fellowship at Bascom Palmer Eye Institute in Florida.
Martinez's roots are deep in Texas, but also reach into Cuba. His family immigrated to Houston after leaving Cuba when the Castro regime took over in the 1960s, just before Martinez was born. His father had previously been in the United States as an exchange student in 1947 and knew the culture and understood the language, Martinez said.
His family was part of the Cuban melting pot. His father's family was from the Canary Islands. His mother's family had multiple European roots but had been in Cuba for a few generations.
When it came time to leave Cuba, his family could have gone to Miami, where many Cuban immigrants settled, but Martinez said his parents wanted their four children to grow up in a free society as well as assimilate into that society. The Martinez family settled in Houston, in a middle-class neighborhood west of the city.
Where we grew up, there weren't many Cubans," Martinez said. "We were probably the only Cubans in the neighborhood, us and our cousins.
When his family talked about being a minority, he said, it wasn't about being Cuban. "It was always about being a member of a minority of excellence," he said. "The only minority you belong to is excellence."
His parents taught the children about being hard-working and educated and "trying to be a good force to society," Martinez said.
Everyone's a doctor, but what kind
Being a doctor wasn't unusual in his family. "Most of my male mentors growing up were either doctors or dentists. It was a default. ... It's just who I saw; it's what men did."
His father, Waldo, was a pediatrician, and treated many of Martinez's classmates, until he later began specializing in allergies.
Martinez's brother, also Waldo, was older by four years, and recently retired as a radiologist in Lubbock. His brother was the one who encouraged Martinez to look at becoming an ophthalmologist, after Waldo did his own rotation in ophthalmology.
There were other earlier influences on Martinez's future career. One of his sisters has diabetes. Martinez as a kid actually had an eye injury caused by a piece of a bike inner tube flying into his eye. "It caused tremendous pain," Martinez said, but the ophthalmologist he saw, "flicked the foreign body out of the cornea. It was relieved so rapidly. I was amazed."
Martinez also thought about becoming an orthopedic surgeon. "I walked in on the first day of that rotation and passed out. Someone had a rod sticking out," he said. "Eyes never bothered me."
Part of an evolving science
Since becoming an ophthalmologist in Austin, Martinez has seen the medical community here grow and the treatments for eye diseases change rapidly.
"We have much more effective treatments, especially for diabetic treatments," Martinez said. Diabetic retinopathy — eye disease of the retina caused by diabetes — when he first started was only treated by surgical interventions using lasers, which were not as effective as the injections into the eye Martinez now can do in his office.
They have really been a game-changer," he said of the injections. "They reduced preventative blindness for most diabetics if they get timely treatments.
Martinez urges people with diabetes to have an annual eye exam and not to wait until they have symptoms such as vision loss or seeing floaters in their vision. Many primary care physicians also have a screening system to take pictures of the back of retina to identify retina changes. They would then refer a person to an ophthalmologist if some issue is identified.
Martinez urges people with diabetes to keep their blood sugar and A1C under control, as well as their blood pressure. Some patients will come to him with A1C levels — that's the average blood sugar level in the hemoglobin during the course of three months — of 8 to 12, but "If they can get to 6 and 7, that will dramatically reduce their eye disease."
Without doing anything, most people who have been diabetic for more than 10 years will have some form of diabetic eye disease, Martinez said. Diabetic retinopathy is the leading cause of blindness in working adults, according to the federal Centers for Disease Control and Prevention.
Diabetes affects the blood vessels throughout the body. The back of the eye is lined by the retina and abnormal blood vessels can leak fluid into the retina and cause vision loss, Martinez said. It can also cause the retina to pull away from the eye wall and cause permanent blindness.
By getting rid of the abnormal blood vessels either using injections or laser surgery, Martinez can prevent blindness. The injections might sound terrifying, but Martinez said, "In reality, it is painless."
Patients are given eye drops to numb the eye before the injection. Martinez also explains the condition with pictures of their eye and what is happening.
They trust their doctor and allow us to do what we recommend," he said. Many, especially those who are hesitant about needles, "they are amazed we can do it.
Martinez still does eye surgeries one day a week in the hospital. His favorite surgeries are diabetic vitrectomy, those that fix diabetic retinopathy.
Every case is different," he said. "We can really save someone from losing their sight to having very functional vision.
Because of the work he and other doctors have done to spread awareness about diabetes and eye disease, and because of advancements, Martinez has not been seeing as many advanced cases that required surgery instead of injections or in-clinic treatments.
He did see a spike again in cases of advanced disease during COVID-19, when people skipped annual eye exams or ignored symptoms.
Looking for new solutions
Austin Retina Associates does clinical trials and clinical research. Some of what doctors are testing, or will be testing in the next five to 10 years, include gene therapies to treat what are thought to be untreatable, blinding eye diseases. "We're hoping to cure blindness," he said.
They are also starting to do earlier phases of clinical trials, not just the final phases.
Austin has a phenomenal ophthalmology community," Martinez said. There are still some highly specialized cases in which he might make a referral to an ophthalmologist in another city, but in most cases, he said, "In Austin, Texas, the ophthalmologists are as good.
For Martinez, on what he calls "a philosophical birthday" of turning 60, "I've been very grateful for the life I'm getting to lead professionally and personally."
Will there be another doctor in the family? Not likely.
He and his wife, Catherine, have one son in law school and another is working in business, while his daughter will probably go into nursing. "I've always encouraged them to do whatever they wanted to do," he said.