Bio


Caroline Fisher, MD, is a Clinical Associate Professor of Ophthalmology at Stanford University Hospital and Clinics. She specializes in cataract and glaucoma surgery, including minimally invasive glaucoma surgery.

She completed her undergraduate education at Stanford University, obtaining both a Bachelor of Science degree in Biology and a Bachelor of Arts degree in Spanish, with Departmental Honors. She earned her medical degree from Stanford University School of Medicine and then went on to her internship at the University of Pennsylvania Presbyterian Hospital. She completed her ophthalmology residency at NYU/ Manhattan Eye, Ear, Throat Hospital. She then returned to Stanford for her Glaucoma Fellowship.

Dr. Fisher is Director of the Stanford Belize Vision Clinic, dedicated to promoting eye health and care in Belize, and providing an international rotation for Stanford Ophthalmology Residents. She is also an Office of Faculty Development and Diversity Liaison and is currently one of the Stanford Network for Advancement and Promotion (SNAP) Cohort Leaders. Dr. Fisher is the Director of Diversity, Equity, and Inclusion for the Department of Ophthalmology.

Clinical Focus


  • Ophthalmology
  • Glaucoma
  • Cataract

Academic Appointments


Administrative Appointments


  • Director of Diversity, Equity, Inclusion, Byers Eye Institute Department of Ophthalmology (2020 - Present)
  • Associate Clinic Chief, Byers Eye Institute Department of Ophthalmology (2018 - 2021)
  • Director, Stanford Belize Vision Clinic (2017 - Present)
  • Liaison, Office of Faculty Development and Diversity (2014 - Present)

Honors & Awards


  • Office of Faculty Development & Diversity Community Support Initiative Grant, Stanford University School of Medicine (2019)
  • Plager Faculty Teaching Award Department of Ophthalmology, Stanford Ophthalmology (2017)
  • Alpha Omega Alpha Medical Honor Society, Alpha Omega Alpha, AOA (2015)
  • Gerbode Medical Scholar, Stanford University School of Medicine (1998-1999)
  • Excellence in Teaching Award, Department of Biology Stanford University (1998)
  • Excellence in Teaching Award, Department of Biology Stanford University (1997)
  • Excellence in Teaching Award, Department of Biology Stanford University (1996)
  • Major Golden Grant for Humanities Scholarship and Creative Arts, Stanford University (1996)
  • Sigma Delta Pi National Literary Honor Society, Sigma Delta Pi, Stanford University (1996)

Boards, Advisory Committees, Professional Organizations


  • Co-Chair, Clinical Educator Diversity Recruitment Taskforce (2021 - 2021)
  • Member, Clinical Educator Task Force Committee (2015 - 2015)
  • Member, American Glaucoma Society Diversity, Equity, Inclusion Taskforce (2021 - Present)
  • Faculty Fellow, CIGH Center for Innovation in Global Health (2017 - Present)
  • Member, American Academy of Ophthalmology (2003 - Present)
  • Member, American Glaucoma Society (2014 - Present)

Professional Education


  • Medical Education: Stanford University School of Medicine (2002) CA
  • Internship: Presbyterian Medical Center of Philadelphia (2003) PA
  • Residency: New York University School of Medicine (2006) NY
  • Fellowship, Stanford University Hospital and Clinics, Glaucoma (2007)
  • Board Certification: American Board of Ophthalmology, Ophthalmology (2009)
  • BS, Stanford University, Biology (1997)
  • BA, Stanford University, Spanish (1997)

Community and International Work


  • MSICS Surgery, El Faro Mission Camp, Guatemala

    Topic

    Manual Small incision Cataract Surgery

    Partnering Organization(s)

    Vision Outreach International and SEE International

    Populations Served

    Central America

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • Stanford Belize Vision Clinic, San Pedro, Belize

    Partnering Organization(s)

    Belizekids

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

Clinical Trials


  • Efficacy and Safety of Bimatoprost Sustained-Release (SR) in Patients With Open-Angle Glaucoma or Ocular Hypertension Recruiting

    This study will evaluate the efficacy and safety of bimatoprost sustained-release (SR) in patients with open-angle glaucoma or ocular hypertension. The study includes a 12-month treatment period with an 8-month extended follow-up.

    View full details

  • Efficacy and Safety Study of Bimatoprost Sustained-Release (SR) in Participants With Open-angle Glaucoma or Ocular Hypertension Recruiting

    This study will evaluate the efficacy and safety of bimatoprost SR in participants with open-angle glaucoma or ocular hypertension. The study includes a 12-month treatment period with an 8-month extended follow-up.

    View full details

  • A Study Evaluating the 24-Hour Intraocular Pressure Lowering Effect of Bimatoprost SR in Patients With Open-Angle Glaucoma or Ocular Hypertension Not Recruiting

    This study will evaluate the 24-hour intraocular pressure lowering effect and safety after a single administration of Bimatoprost SR in patients with Open-Angle Glaucoma or Ocular Hypertension

    Stanford is currently not accepting patients for this trial.

    View full details

All Publications


  • Evaluation of Website Accessibility and Content for all Glaucoma Fellowship Programs in the United States. Ophthalmology. Glaucoma Cohen, S. A., Fisher, A. C., Pershing, S. 2021

    Abstract

    Fellowship program websites are a critical information source for applicants. Our results demonstrate that information on glaucoma fellowship websites is inconsistent and incomplete. Our study provides a basis for improving glaucoma fellowship website content.

    View details for DOI 10.1016/j.ogla.2021.11.004

    View details for PubMedID 34838811

  • Implicit Bias and the Association of Redaction of Identifiers With Residency Application Screening Scores. JAMA ophthalmology Pershing, S., Stell, L., Fisher, A. C., Goldberg, J. L. 2021

    Abstract

    Importance: Diversity in the ophthalmology profession is important when providing care for an increasingly diverse patient population. However, implicit bias may inadvertently disadvantage underrepresented applicants during resident recruitment and selection.Objective: To evaluate the association of the redaction of applicant identifiers with the review scores on ophthalmology residency applications as an intervention to address implicit bias.Design, Setting, and Participants: In this quality improvement study, 46 faculty members reviewed randomized sets of 462 redacted and unredacted applications from a single academic institution during the 2019-2020 ophthalmology residency application cycle.Interventions: Applications electronically redacted for applicant identifiers, including name, sex or gender, race and ethnicity, and related terms.Main Outcomes and Measures: The main outcome was the distribution of scores on redacted and unredacted applications, stratified by applicant's sex, underrepresentation in medicine (URiM; traditionally comprising American Indian or Alaskan Native, Black, and Hispanic individuals) status, and international medical graduate (IMG) status; the application score beta coefficients for redaction and the applicant and reviewer characteristics were calculated. Applications were scored on a scale of 1 to 9, where 1 was the best score and 9 was the worst score. Scores were evaluated for a significant difference based on redaction among female, URiM, and IMG applicants. Linear regression was used to evaluate the adjusted association of redaction, self-reported applicant characteristics, and reviewer characteristics with scores on ophthalmology residency applications.Results: In this study, 277 applicants (60.0%) were male and 71 (15.4%) had URiM status; 32 faculty reviewers (69.6%) were male and 2 (0.4%) had URiM status. The distribution of scores was similar for redacted vs unredacted applications, with no difference based on sex, URiM status, or IMG status. Applicant's sex, URiM status, and IMG status had no association with scores in multivariable analysis (sex, beta=-0.08; 95% CI, -0.32 to 0.15; P=.26; URiM status, beta=-0.03; (95% CI, -0.36 to 0.30; P=.94; and IMG status, beta=0.39; 95% CI, -0.24 to 1.02; P=.35). In adjusted regression, redaction was not associated with differences in scores (beta=-0.06 points on a 1-9 scale; 95% CI, -0.22 to 0.10 points; P=.48). Factors most associated with better scores were attending a top 20 medical school (beta=-1.06; 95% CI, -1.37 to -0.76; P<.001), holding an additional advanced degree (beta=-0.86; 95% CI, -1.22 to -0.50; P<.001), and having a higher United States Medical Licensing Examination Step 1 score (beta=-0.35 per 10-point increase; 95% CI, -0.45 to -0.26; P<.001).Conclusions and Relevance: This quality improvement study did not detect an association between the redaction of applicant characteristics on ophthalmology residency applications and the application review scores among underrepresented candidates at this institution. Although the study may not have been powered adequately to find a difference, these findings suggest that the association of redaction with application review scores may be preempted by additional approaches to enhance diversity, including pipeline programs, implicit bias training, diversity-centered culture and priorities, and targeted applicant outreach. Programs may adapt this study design to probe their own application screening biases and track over time before-and-after bias-related interventions.

    View details for DOI 10.1001/jamaophthalmol.2021.4323

    View details for PubMedID 34673889

  • Phase 1b randomized controlled study of short course topical recombinant human nerve growth factor (rhNGF) for neuroenhancement in glaucoma: safety, tolerability and efficacy measure outcomes. American journal of ophthalmology Gala, B., Laurel, S., Sohail, H. M., Mariana, N., Lilia, P., Bac T, N., Sylvia L, G., Amy, D., Zhongqiu, L., Melissa, A., Tom, K., Sophia Y, W., Robert, C., Ann C, F., Yasir J, S., Jeffrey L, G. 2021

    Abstract

    No approved therapies directly target retinal ganglion cells (RGCs) for neuroprotection or neuroenhancement in glaucoma. Recombinant human nerve growth factor (rhNGF) has been shown to promote RGC survival and function in animal models of optic neuropathy. Here we evaluate safety, tolerability, and efficacy of short-term, high-dose rhNGF eye drops versus placebo in a cohort of glaucoma patients.This study is a single-center, randomized, double-masked, vehicle-controlled, parallel group study designed to assess safety and tolerability as well as short-term neuroenhancement of structure and function (Clinicaltrials.gov NCT02855450). Sixty open-angle glaucoma patients were randomized 40:20 to receive either 180 μg/ml rhNGF or vehicle control eye drops in both eyes, three times daily for 8 weeks, with a 24-week post-treatment follow-up. One eye was officially selected as the study eye, although both eyes were studied and dosed. Primary endpoints were safety, as assessed through adverse events, and tolerability, as assessed through patient reported outcomes. Secondary outcome measures included best corrected visual acuity (BCVA), Humphrey visual field (HVF), electroretinogram (ERG), and optical coherence tomography (OCT) of retinal nerve fiber layer (RNFL) thickness at baseline, after 8 weeks of treatment, and at 4 and 24 weeks after treatment (12- and 32-weeks total).Of the 60 randomized subjects, 23 were female (38%) and the average age was 66.1 years. Through week 32, there were no treatment-related serious adverse events, including no unexpectedly severe progression of optic neuropathy, no adverse events affecting ocular function or pressure, and no drug-related systemic toxicity. Topical high-dose rhNGF was tolerated well, with low level of symptom burden mainly eliciting periocular ache (in 52% of treated, 5% of placebo) and only 3 patients (7.5%) discontinuing treatment due to discomfort, out of whom 1 patient (2.5%) prematurely withdrawing from the study. There were no statistically significant differences in global indices of HVF, and no meaningful differences in total, quadrant, or clock-hour mean RNFL thickness between the groups, although both of these function and structure measures showed non-significant trends towards significance in favor of rhNGF. Real-world participant data was used to generate an estimate of cohort size needed to power subsequent studies.rhNGF is safe and tolerable in a topical 180 μg/ml formulation. Although no statistically significant short-term neuroenhancement was detected in this trial, given the strong effects of NGF in preclinical models and trends detected in this study, analysis for efficacy in a neuroprotection trial is warranted.

    View details for DOI 10.1016/j.ajo.2021.11.002

    View details for PubMedID 34780798

  • An Open-Label Phase Ib Study to Evaluate Retinal Imaging After Short-term Use of the Balance Goggles System (BGS) in Patients with Glaucoma Li, Z., Knasel, C., Nunez, M., Beykin, G., Goldstein, A., Fisher, A. C., Singh, K., Sun, Y., Chang, R. T., Lee, W., Goldberg, J. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2020
  • Comparison of 1-Year Effectiveness of Trabecular Microbypass Stent implantation (iStent) in Conjunction With Phacoemulsification Among Mild, Moderate, and Severe Primary Open-angle Glaucoma Patients. Journal of glaucoma Chansangpetch, S. n., Ittarat, M. n., Yang, S. n., Fisher, A. C., Singh, K. n., Lin, S. C., Chang, R. T. 2020

    Abstract

    The study compared 1-year effectiveness of single trabecular microbypass stent (iStent) implantation with phacoemulsification among glaucoma severities in primary open-angle glaucoma. The study found that mild glaucoma had greater success rate and lower number of medications compared with moderate and severe glaucoma.To evaluate the effectiveness of iStent implantation in combination with cataract surgery in moderate to severe glaucoma compared with mild glaucoma.Medical charts of primary open-angle glaucoma subjects undergoing 1 iStent implantation were retrospectively reviewed. Glaucoma was classified on the basis of mean deviation (MD) of the preoperative standard automated perimetry into mild (MD>-6 dB), moderate (MD -6 to -12 dB), and severe (MD<-12 dB). Mixed effect regression models were performed to determine the effect of iStent at 1 year. The outcomes included as follows: (1) intraocular pressure (IOP) and the number of medications, (2) eyes with IOP ≤ severity-based target (18 mm Hg for mild, 15 mm Hg for moderate, 12 mm Hg for severe) (2A) without medication, and (2B) with medication reduction.In total, 104 eyes from 89 subjects were analyzed. Cataract combined with iStent surgery significantly lowered the number of medications in all groups and significantly decreased IOP in moderate and severe glaucoma (P<0.05). There was significantly higher number of medications in moderate (β: 0.58, P=0.002) and severe (β: 1.20, P<0.001) compared with mild glaucoma. Eyes with moderate glaucoma had significantly lower rate of success (criterion 2A) compared with mild glaucoma [odds ratio (OR): 0.008, P=0.047]. Eyes with moderate and severe glaucoma had significantly lower rates of success (criterion 2B) (moderate vs. mild OR: 0.002, P=0.028; severe vs. mild OR: 0.026, P=0.026).Combined phacoemulsification with iStent seems to have a better IOP-lowering and medication-lowering effect in mild glaucoma cases versus those with moderate and severe glaucoma. This difference was found in real-world data over one-year follow-up period. Long-term studies with defined IOP goals and medication removal protocols are warranted.

    View details for DOI 10.1097/IJG.0000000000001542

    View details for PubMedID 32433095

  • Comparison of Using One Trabecular Microbypass Stent versus Two during Cataract Surgery at Two Sites: One-Year Follow-Up. BioMed research international Yang, S., Ittarat, M., Tran, E., Ferrell, P., Wang, G., Fisher, A. C., Li, Z., Chang, R. T. 2020; 2020: 1920352

    Abstract

    Purpose: To compare IOP and ocular hypotensive medication reduction of using one trabecular microbypass stent versus two in patients with open-angle glaucoma. Setting. Palo Alto Veterans Affairs (VA) Hospital and the Byers Eye Institute at Stanford University, Palo Alto, California, USA.Design: Retrospective case series.Methods: A chart review included patients who underwent trabecular microbypass implantation with cataract surgery in 2015-2017, with at least one-year follow-up. Subjects were divided into two groups by location (always one stent at Stanford versus two stents at the VA). Primary outcome measures included IOP and medication reduction at baseline and 12-month follow-up.Results: 132 subjects (166 eyes) were included. The preoperative IOP was 16.3 ± 3.4mmHg on 2.6 ± 1.1 medications in the one-stent group (N = 85) and 17.5 ± 3.1mmHg on 2.7 ± 0.6 medications in the two-stent group (N = 81). There was no significant difference between the two groups (p = 0.06). At the 12-month visit, there was a 13.37% ± 2.93 reduction in IOP in the 1-stent group (p ≤ 0.001) and 13.49% ± 2.69 in the 2-stent group (p ≤ 0.001); both were not significantly different from each other (p = 0.074). At 12 months, there was also a 14.5% reduction in medication use for the 1-stent group and 15.3% reduction in the 2-stent group, both statistically significant from baseline, (p = 0.022 and p = 0.037, respectively).Conclusions: Implantation with either one or two stents during cataract surgery in patients with glaucoma demonstrated similar IOP and med reduction in both groups between the two sites.

    View details for DOI 10.1155/2020/1920352

    View details for PubMedID 32337227

  • Comparison of 1 year effectiveness of trabecular microbypass stent implantation (iStent) among mild, moderate, and severe primary open angle glaucoma Chansangpetch, S., Ittarat, M., Yang, S., Fisher, A. C., Singh, K., Lin, S. C., Chang, R. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2019
  • Recombinant human nerve growth factor (rhNGF) eye drops for glaucoma: Results from a prospective double - masked randomized controlled trial Nunez, M., Popova, L., Nguyen, B. T., Groth, S. L., Dennis, A., Li, Z., Khavari, T., Wang, S. Y., Chang, R., Fisher, A. C., Goldberg, J. L. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2019
  • Characteristics of cataract surgery patients influencing patient satisfaction scores. Journal of cataract and refractive surgery Lee, M. D., Chen, S. P., Chen, T. A., Leibold, C., Li, Z., Fisher, A. C., Lin, C. C., Singh, K., Chang, R. T. 2019

    Abstract

    PURPOSE: To determine factors that influence patient satisfaction scores in individuals who have recently had cataract surgery.SETTING: Byers Eye Institute, Palo Alto, California, USA.DESIGN: Prospective case series.METHODS: Selected questions from the Press Ganey survey and the National Eye Institute Visual Function Questionnaire-25 were administered to each patient immediately after completion of a clinic visit. The correlation between patient-specific variables and the answer to the survey question "likelihood of recommending our practice to others," a surrogate for overall patient satisfaction, was assessed using the Student t test. A logistical regression model was used to adjust for potentially confounding variables.RESULTS: One hundred forty-three patients were recruited from 4 providers; 57 (39.8%) were men, and the mean age was 70.0years±11.6 (SD). The main outcome was the proportion of scores less than 5, or "very good," for the likelihood of recommending the practice to others. There was a statistically significant association between a non-5 patient satisfaction score and self-reported ethnicity of Asian or Pacific Islandercompared with other ethnicities (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.0-5.1; P=.049); other possible correlates were not statistically significant. The relationship persisted after adjustment for potential confounding variables (OR, 2.6; 95% CI, 1.1-6.3; P=.027).CONCLUSION: In postoperative cataract patients, Asian or Pacific Islander ethnicity, a factor out of the control of the provider and clinic staff, was associated with a lower overall Press Ganey patient satisfaction score compared with patients of all other ethnicities.

    View details for PubMedID 30824352

  • Recombinant human nerve growth factor (rhNGF) eye drops for glaucoma: Interim results Popova, L., Nunez, M., Bac Tien Nguyen, Groth, S., Dennis, A., Li, Z., Khavari, T., Wang, S., Chang, R., Fisher, A., Goldberg, J. L. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2018
  • Characteristics of cataract surgery patients influencing Press Ganey patient satisfaction scores Lee, M., Chen, S., Chen, T., Fisher, A., Lin, C. C., Singh, K., Chang, R. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2018
  • Impact of Race on Press Ganey Measures of Ophthalmology Clinic Visits Chen, T., Chen, S., Lee, M., Fisher, A., Lin, C. C., Singh, K., Chang, R. ASSOC RESEARCH VISION OPHTHALMOLOGY INC. 2018
  • Chapter 107: Modulation of Wound Healing Techniques Glaucoma, 1st Edition Fisher, A., Doshi A, Singh K 2009
  • Crystalline Retinopathy associated with retinal dialysis and chronic retinal detachment Retina Ciardella AP, Yannuzzi LA, Borodoker N, Mendoza C 2002; 22 (3): 360-2
  • Chapter 109: Automated Perimetry Diagnostic Modalities in Ophthalmology Duane's Ophthalmology Fisher, A., Prince A