Rising Star: Introducing Adam Jacobson, MD

Adam Jacobson, MD, never set out to be a doctor. However, despite his plans to follow a different path, he didn’t shrink from the opportunity when it presented itself. He is now a board-certified ophthalmologist at the Kellogg Eye Institute of the University of Michigan, Ann Arbor.

In the beginning…

Initially, Jacobson was exclusively engaged in forwarding his plans to become an educator. As an undergraduate at Brandeis University in Waltham, MA, he was a teaching assistant in a number of classes and designed curricula. “This was the first step down the path of teaching,” he commented.

In 2026, he revisited the university and found, satisfyingly, in fact, that the classes that he had helped design have stood the test of time, because 15 years later they are still being taught.

He is especially proud of a course on evolution that initially kicked off with about 10 to 15 students and now commands attention as a 200-student seminar.

Another high point was his help in the redesign of a biology lab course and the lab itself that is still in operation today.

He credits this activity with his teaching aspirations.

Journey interrupted

A bit of whimsy is that during a 2-year gap after graduation, he decided to study for the MCATs over a summer just for fun because of his ambiguity about attending grad school or medical school, both of which would provide exposure to science, teaching, and research.

The core sciences of his triple major during undergraduate study (neuroscience, biology, and psychology) served him well, and he was accepted to medical school at the New York Medical College.

Another important factor in his journey was his desire to work with children that were with him from his earliest work experience that resulted in stints of babysitting and working at a nursery school. “I never knew how to talk to adults,” he quipped, “but was successful with children.”

He ultimately found ophthalmology and wanted to carve a niche in pediatric ophthalmology. Of all the ophthalmic areas, glaucoma was his personal focus during residency, but he refused to abandon his passion of working with children. Through this, he has developed a niche in childhood glaucoma and anterior segment surgery.

Research arm

Most of his research has been on the clinical side. The theme of his work, he described, is how to treat childhood anterior segment diseases more appropriately by investigating primary and secondary childhood glaucomas to determine which treatments are most effective and help prognostication.

“This is difficult when dealing with a disease that is rare for which conducting randomized controlled trials is nearly impossible. The availability of data is not the same as that in adults. Conducting high-quality research is difficult,” he commented.

A project of which he is particularly proud was finding a way to modify Ahmed valve implants in children—the first such study of its kind for children.¹

Jacobson and Brenda L. Bohnsack, MD, PhD, from the Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, and the Department of Ophthalmology, Northwestern University Feinberg School of Medicine, conducted this retrospective interventional case series in which they investigated the 2- to 6-year outcomes of Ologen augmentation of Ahmed glaucoma devices (New World Medical Inc.) in children with glaucoma for whom surgery was necessary.

He pointed out that glaucoma drainage devices fail very quickly in children, from 3 to 5 years after implantation, depending on the age of the child and the glaucoma type.

Ologen (Aeon Astron BV) is a biodegradable type I collagen matrix disc that is implanted with the Ahmed device as an adjuvant for glaucoma surgeries. During trabeculectomy, Ologen has demonstrated similar success to that of antimetabolites1 and also has been used with Ahmed glaucoma drainage devices in adults and children.¹

In this patient population of 28 patients (40 eyes), the intraocular pressure (IOP) and the number of glaucoma medications decreased significantly (P < 0.0001). At the final visit, complete success was achieved in 55% of eyes with 3- and 5-year survival rates of 75% and 57%. The qualified success rate was 75%, with 3- and 5-year survival rates of 87% and 67%, respectively.

In a previous study,² he and Bohnsack reported that in children, Ologen augmentation of Ahmed glaucoma device mitigated the hypertensive phase and achieved a 100% qualified (±glaucoma medications) success rate after 6 months to 3 years of postoperative follow-up. “Ologen dramatically increased the lifespan of the tubes. Over time the disc melts and is incorporated into the bleb and capsule that form around the device,” he stated.

He hypothesized that the collagen disc binds the fibroblasts in the connective tissue and the conjunctiva and Tenon’s capsule and reorganizes them in a way that prevents the scarring response that occurs in children, thus allowing the device to work for a longer time.

Different glaucoma behavior

Another noteworthy project concerned recognition of a possible new glaucoma type.³

The background to this is that children of shorter and shorter gestational ages are being born and survive; the so-called micro-preemies can be as young as 22.5 to 23 weeks, according to Jacobson. These babies were referred as a result of screening for retinopathy of prematurity or for the presence of cloudy corneas or increased cupping in the optic nerve. They appeared to have signs of primary congenital glaucoma.

Jacobson pointed out that these babies fell into 1 of 2 categories. The first is comprised of children who do not “outgrow” the glaucoma; the IOP continues to climb, the corneal opacity increases with minimal to no response to topical glaucoma medication, and the need for surgery is often unavoidable. In the second group, the children responded well to the topical medications, and the IOP decreased, unlike what is usually seen in children with primary congenital glaucoma who are treated with drops; ultimately, these children outgrew the glaucoma, the corneas cleared, the cup-to-disc ratio normalized, they were tapered off of all IOP-lowering medications, and they did not require surgery, Jacobson reported.

With this recognition, he retrospectively investigated a population of micro-preemies. “We identified 2 main differences,” he stated.

The first was a successful response to the eyedrops in contrast to the patients who developed primary congenital glaucoma with no IOP decrease.

The second difference was the description of the anterior segment. In the children who developed primary congenital glaucoma, the anterior chambers were described as deep, formed, or normal. In the children in whom the glaucoma resolved, the anterior chambers were described as shallow or very shallow.

Jacobson and his collborators refer to this as transient glaucoma of prematurity.³ “In utero, the crystalline lens grows before the axial length of the eye. When these children are born prematurely, we believe, the large crystalline lens crowds the anterior segment structures, closes the trabecular meshwork and the drainage system, and causes an increase in IOP. However, these children are still growing, and as the axial length catches up, everything opens up, the shallow anterior chamber deepens, the IOP decreases, and the glaucoma resolves. This was a transient glaucoma that resulted from being a micro-preemie,” he explained.

Teaching experience

In his current position, he also functions as the associate program director for the residents and medical students at the University of Michigan. In this capacity, he delivers lectures, mentors research, and teaches surgery.

Gaps in knowledge base

Congenital glaucoma is incredibly rare and develops in 1 in 50,000 infants, the patients also are highly vulnerable and research is particularly difficult. No database is available to facilitate comparisons of various treatment approaches as in adults. “This is the nature of rare diseases in a vulnerable population,” he commented.

He is currently involved in a consortium that collects genetic data on new glaucoma patients from saliva samples, doing deep phenotyping, and looking at whole exome sequencing to identify different subgroups of childhood glaucoma with factors that can explain, for example, the number of surgeries needed to control glaucoma that can vary substantially among patients.

Regarding the work that is being done, Jacobson pointed out the biggest high point, ie, the dedication of the physicians involved in childhood glaucoma.

Research endowment

Jacobson and Lev Prasov, MD, PhD, an ophthalmic geneticist from the University of Michigan, have received a $5 million endowment to establish the Wadhams Family Center for Children’s Vision, described as a multidisciplinary clinic at the Kellogg Eye Center designed to treat children with complex needs and function as a pipeline for high-quality research.

Jacobson’s role is seamless coordination of the care and surgical needs of children who must undergo treatment by any number of ophthalmic subspecialists on a given day. The setup dramatically improves family access to care for families that in many cases have traveled from 8 to 10 hours to gain access to this level of care.

Ultimately, the goal is to provide the services of a social worker and housing for families who travel to the Kellogg Eye Center.

References

1. Jacobson A, Bohnsack BL. Ologen-augmentation of Ahmed valves in pediatric glaucomas: 2- to 6-year follow-up. Ophthalmol Glaucoma. 2025;8:609-15. https://www.ophthalmologyglaucoma.org/article/S2589-4196(25)00120-6/fulltext

2. Jacobson A, Bohnsack BL. Ologen augmentation of Ahmed valves in pediatric glaucomas. J AAPOS. 2022;26:122.e1-122.e6. doi:10.1016/j.jaapos.2022.02.009

3. Jacobson A, Skanchy D, Samaha JRE, Bohnsack B. Temporary angle closure glaucoma of prematurity. A novel glaucomatous process in neonates. 2023; presented at the American Association for Pediatric Ophthalmology and Strabismus, New York, March 29-April 2.