Ken K. Nischal, MD, FAAP, FRCOphth

  • Professor of Ophthalmology
  • Vice Chair, Quality
  • Director, Pediatric Ophthalmology, Strabismus & Adult Motility
  • Director, Pediatric Program Development
  • University of Pittsburgh School of Medicine

"Research is the Mother of Clinical Practice; all children ask their mother’s difficult questions. Together they inevitably find an answer” 
Ken K Nischal

A Conversation With Dr. Nischal

 

Dr. Nischal is Chief of the Division of Pediatric Opthalmology and Strabismus at Children's Hospital of Pittsburgh of UPMC, Director of Pediatric Program Development at the UPMC Eye Center, and  Professor of Ophthalmology at the University of Pittsburgh School of Medicine.

Dr. Nischal attended King's College Hospital Medical School of the University of London and completed ophthalmology residencies at both Birmingham and Midlands and the Oxford Eye Hospital in the United Kingdom. He completed his pediatric ophthalmology fellowship at The Hospital for Sick Children in Toronto. Prior to joining Children's Hospital of Pittsburgh in 2011, Ken was at Great Ormond Street Hospital for Children in London, UK. 

Dr. Nischal is one of the pioneers of pediatric corneal transplants. Children from all over the world come to see Dr. Nischal because of his expertise in helping children with genetic corneal diseases. His research focus is on evidence based protocol led clinical care with clinical outcome measures to drive clinical care. His main areas of clinical research are anterior segment developmental anomalies affecting the cornea, lens and trabecular meshwork. He has published widely on the topics of pediatric cataract, glaucoma and cornea as well as craniofacial anomalies.

He is a member of the Scientific Advisory Board of the Pediatric Glaucoma and Cataract Family Association (PGCFA) and has contributed articles and responses to our Ask the Doctor feature. He is the founder and co-director of the World Society of Pediatric Ophthalmology and Strabismus, an outstanding organization with members from around the globe.

Education & Training

  • 1991-1997 King’s College Hospital, London, UK (Residency Equivalent)
  • 1991-1997 Prince Charles’ Eye Unit, Windsor,UK
  • 1991-1997 Birmingham and Midlands Eye Hospital, UK
  • 1991-1997 Oxford Eye Hospital, Oxford UK
  • 1998 The Hospital for Sick Children, Toronto, Canada (Fellowship In Pediatric Ophthalmology)
  • Specialty Certification - PEDIATRIC OPHTHALMOLOGY
  • Medical Professional Licensure - 1988 UNITED KINGDOM: GENERAL MEDICAL COUNCIL
  • Board Certification Equivalent Qualification - 1991 to Present - FELLOW OF THE ROYAL COLLEGE OF OPHTHALMOLOGISTS (FRCOphth) (UK)

Representative Publications

AREAS OF CLINICAL EXPERTISE

Pediatric Cataract

Pediatric Cornea

Pediatric Glaucoma

Craniosynostosis

Syndromes and Ocular Genetics

 

Pediatric Cataract Papers

  1. Byles DB, Nischal KK, Cheng H. Ectopia lentis et pupillae. A hypothesis revisited. Ophthalmology. 1998 Jul; 105(7):1331-6.
  2. Cassidy L, Rahi J, Nischal KK, Russell-Eggitt I, Taylor D. Outcome of lens aspiration and intraocular lens implantation in children aged 5 years and under. Br J Ophthalmology. 2001 May; 85(5):540-2.
  3. Nischal KK. Two-incision push-pull capsulorhexis for pediatric cataract surgery. J Cataract Refract Surg. 2002 Apr; 28(4):593-5.
  4. Amaya L, Taylor D, Russell-Eggitt I, Nischal KK, Lengyel D. The morphology and naural history of childhood cataracts. Survey of Ophthalmology. 2003 Mar; 48(2):125-144. PMID: 12686301
  5. DeSilva DJ, Nischal KK, Packard RB. Preoperative assessment of secondary intraocular lens implantation for aphakia: A comparison of 2 techniques. J Cat Refr Surg. 2005 Jul;31(7):1351-6.
  6. Hamada S, Low S, Walters BC, Nischal KK. Five-year experience of the 2-incision push- pull technique for anterior and posterior capsulorrhexis in pediatric cataract surgery. Ophthalmology. 2006 Aug; 113(8):1309-14.
  7. Jones SM, Weinstein JM, Cumberland P Taylor D, Wright KW, Amaya L, Cassidy L, Nischal KK, Russell-Eggitt I, Lightman S, McCluskey P. Should we aggressively treat unilateral congenital cataracts? View 1. Br J Ophthalmology. 2007 Sep; 85(9):1120-1125.
  8. Wong IB, Sukthankar VD, Cortina-Borja M, Nischal KK. Incidence of early-onset glaucoma after infant cataract extraction with and without intraocular lens implantation. Br J Ophthalmology. 2009 Sep; 93(9):1200-3. Epub 2009 May 7.
  9. Solebo AL, Russell-Eggitt I, Nischal KK, Moore AT, Cumberland P, Rahi JS; British Isles Congenital Cataract Interest Group. Cataract surgery and primary intraocular lens implantation in children < or = 2 years old in the UK and Ireland: finding of national surveys. Br J Ophthalmol. 2009 Nov; 93(11):1495-8.
  10. Aragon-Martin JA, Ahnood D, Charteris DG, Saggar A, Nischal KK, Comeglio P, Chandra A, Child AH, Arno G. Role of ADAMTSL4 mutations in FBN1 mutation-negative ectopia lentis patients. Hum Mutat. 2010 Aug; 31(8): E1622-31.
  11. Mataftsi A, Dabbagh A, Moore W, Nischal KK. Evaluation of whether intracameral de80xamethasone predisposes to glaucoma after pediatric cataract surgery. J Cataract Refract Surg. 2012 Jul 26.
  12. Matafisi A, Haidich AB, Kokkali S, Rabiah PK, Birch E, Stager DR Jr, Cheong-Leen R, Singh V, Egbert JE, Astle WF, Labert SR, Amitabh P, Khan AO, Grigg J, Arvanitidou M. Dimitrakos SA, Nischal KK. Postoperative Glaucoma Following Infantile Cataract Surgery: An Individual Patient Data Meta-analysis. JAMA Ophthalmol.2014 Jun 12 2014. 1042.
  13. Medsinge A, Nischal KK. Capsular blockage syndrome in child: a case report. Eye (Lond.). 2013 Aug 9.
  14. Medsinge A, Nischal KK. Pediatric cataract: challenges and future directions Clin Ophthalmol. 2015 Jan 7; 9:77-90 eCollection 2014. Review.
  15. Serafino M, Trivedi RH, Levin AV, Wilson ME, Nucci P, Lambert SR, Nischal KK, Plager DA, Bremond-Gignac D, Kekunnaya R, Nishina S, Tehrani NN, Ventura MC. Use of the Delphi process in paediatric cataract management Br J Ophthalmol. 2016 May; 100(5):611-5.
  16. Solebo AL, Russell-Eggitt I, Cumberland PM, Rahi JS; British Isles Congenital Cataract Interest Group. Risks and outcomes associated with primary intraocular lens implantation in children under 2 years of age: the IoLunder2 cohort study. Br J Ophthalmol. 2015 Nov; 99(11):1471-6
  17. Nischal KK. State of the Art in Pediatric Cataract Surgery. Dev Ophthalmol. 2016; 57:15-     28.
  18. Patil-Chhablani P, Kekunnaya R, Nischal KK. Complex Cases in Pediatric Cataract. Dev Ophthalmol. 2016; 57:85-106.
  19. Samant M, Medsinge A, Nischal KK. Pediatric Glaucoma: Pharmacotherapeutic Options. Paediatr Drugs. 2016 Jun; 18(3):209-19.
  20. : Nischal KK. Practice patterns in pediatric cataract management: Time for real world data. Indian J Ophthalmol. 2017 Sep;65(9):779-781
  21. Chowdhary S, Nischal KK. Banded technique for pediatric traumatic cataract surgery. J Cataract Refract Surg. 2019 Jan;45(1):8-10

 

Pediatric Cornea

  1. Nischal KK, Naor J, Jay V, MacKeen LD, Rootman DS. Clinicopathologic correlation of congenital corneal opacification using ultrasound biomicroscopy. Br J Ophthalmology. 2002 Jan; 86(1):62-69
  2. Goyal R, Jones S, Espinosa M, Green V, Nischal KK. Amniotic membrane transplantation in children with symblepharon and massive pannus. Arch Ophthalmology. 2006 Oct; 124(10):1435- 40.
  3. Nischal KK. Pediatric Keratoplasty. Techniques in Ophthalmology. 2003; 1(2):119-126
  4. Ioannidis A, Speedwell L, Nischal KK. Unilateral keratoconus in a child with chronic rubbing. Am J Ophthalmology. 2005 Feb; 139(2):356-357.
  5. Jones SM, Klein N, Nischal KK. Visual outcome and corneal changes in children with chronic blepharokeratoconjunctivitis. Ophthalmology. 2007 Dec; 114(12):2271-80.
  6. Harding SA, Nischal KK, Upponi-Patil A, Fowler DJ. Indications and outcomes of deep anterior lamellar keratoplasty in children. Ophthalmology. 2010 Nov; 117(11):2191-5.
  7. Wong IB, Nischal KK. Managing a child with an external ocular disease. J AAPOS. 2010 Feb; 14(1):68-77.
  8. Mataftsi A, Islam L, Kelberman D, Sowden JC, Nischal KK. Chromosome abnormalities and the genetics of congenital corneal opacification. Mol Vis. 2011; 17:1624-40.
  9. Nischal KK. A new approach to the classification of neonatal corneal opacities. Curr Opin Ophthalmol. 2012 Sept; 130(3): 452e – 4e.
  10. Narang A, Reddy JC, Idrees Z, Injarie AM, Nischal KK. Long –term outcome of bilateral penetrating karatoplasty in child with xeroderma pigmentosa: case report and literature review. Eye (Lond). 2013 June; (6): 775-6.
  11. Medsinge, A., Nischal, K.K. Managing blepharokeratoconjunctivitis in children: A review: Expert review in Ophthalmology 2013; 8(5):485–499
  12. Medsinge A., Speedwell L, Nischal KK. Defining Success in Infant Penetrating Keratoplasty for Developmental Corneal Opacities. American Orthoptic Journal 2014
  13. Jones SM, Nischal KK. The non-invasive tear film break-up time in normal children. Br J Ophthalmol.2013 Sep; 97(9):1129-33.
  14. Medsinge A, Nischal KK. Paediatric keratoplasty: choices and conundrums. Br J Ophthalmol. 2013 Oct; 97(10):1225-7. doi: 10.1136/bjophthalmol-2013-303469. No abstract available
  15. Weiss JS, Moller HU, Aldave AJ, Seitz B, Bredrup C, Kivela T, Munier FL, Rapuano CJ, Nischal KK, Kim EK, Sutphin J, Busin M. Labbe A, Kenyon KR, Kinoshita S, Lisch W. C3D Classification of corneal dystrophies – Edition 2 Cornea. 2015 Feb; 34(2):117-59
  16. Nischal KK. Genetics of Congenital Corneal Opacification--Impact on Diagnosis and Treatment. Cornea. 2015 Oct; 34 Suppl 10:S24-34.
  17. Nischal KK, Lathrop KL. The Palisades of Vogt in Congenital Corneal Opacification (An American Ophthalmological Society Thesis). Trans Am Opthalmol Soc. 2016 Aug; 113:T8
  18. Medsinge A, Nischal KK. Cataract Surgery in Children with congenital keratolenticular adhesion (Peters anomaly type 2) J AAPOS 2015;19:24-28
  19. Medsinge A, Gajdosova E, Moore W, Nischal KK. Management of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature. Eye (Lond). 2016 Apr; 30(4):593-601.
  20. Kim J, Medsinge A, Chauhan B, Wiest C, Scanga H, Monaghan R, Moore WH, Nischal KK. Coenzyme Q10 in the Treatment of Corneal Edema in Kearns-Sayre: Is There an Application in Fuchs Endothelial Corneal Dystrophy? Cornea. 2016 Sep; 35(9):1250-4.

 

Pediatric Glaucoma

  1. Mungan NK, Wilson TW, Nischal KK, Koren G, Levin AV. Hypotension and bradycardia in infants after the use of topical brimonidine and beta-blockers. J AAPOS. 2003 Feb; 7(1):69-70.
  2. Morris S, Geh V, Nischal KK, Sahi S, Ahmed MA. Topical dorzolamide and metabolic acidosis in a neonate. Br J Ophthalmology. 2003 Aug; 87(8):1052-3.
  3. Ong T, Chia A, Nischal KK. Latanoprost in port wine stain related pediatric glaucoma. Br J Ophthalmology. 2003 Sep; 87(9):1091-3.
  4. Bowman RJ, Cope J, Nischal KK. Ocular and systemic side effects of brimonidine 0.2% eye drops (Alphagan) in children. Eye. 2004 Jan; 18(1):24-6.
  5. Moore W, Nischal KK. Pharmacologic management of glaucoma in childhood. Pediatric Drugs. 2007; 9(2):71-9.
  6. Low S, Hamada S, Nischal KK. Antimetabolite and releasable suture augmented filtration surgery in refractory paediatric glaucomas. J AAPOS. 2008 Apr; 12(2):166-72. Dec 21.
  7. Khaier A, Nischal KK, Espinosa M, Manoj, B. Periocular port wine stain: the Great Ormond Street Hospital Experience. Ophthalmology. 2012 Jan; 96(1):90-2
  8. Way AL, Nischal KK. High-frequency ultrasound-guided transscleral diode laser cyclophotocoagulation. Br J Ophthalmol. 2014 Jul;98 (7):992-4
  9. Medsinge A., Nischal KK. Technique for identifying Schlemm’s canal in paediatric glaucoma surgery Br J Ophthalmol published online March 17, 2015. Br J Ophthalmol. 2015 May; 99(5):715-6.

 

Craniosynostosis

  1. Nischal KK. Ocular aspects of craniofacial disorders. The John Pratt Johnson Lecture 2001. American Orthoptic Journal. 2002; 52:58-68.
  2. Liasis A, Thompson D, Hayward R, Nischal KK. Sustained raised intracranial pressure implicated only by pattern reversal visual evoked potentials after cranial vault expansion surgery. Pediatr Neurosurg. 2003 Jul; 39(2):75-80.
  3. Khan SH, Nischal KK, Dean F, Hayward R, Walker J. Visual outcomes and amblyogenic risk factors in craniosynostotic syndromes: a review of 141 cases. Br J Ophthalmology. 2003 Aug; 87(8):999-1003.
  4. Rattigan S, Nischal KK. Foster-type modification of the Knapp procedure for anomalous superior rectus muscles in syndromic craniosynostoses. J AAPOS. 2003 Aug; 7(4):279-82.
  5. Dansingani KK, Al-Khaier A, Russell-Eggitt IM, Nischal KK. Intrastromal corneal bleb: An unusual complication following trabeculectomy for congenital glaucoma. Management of intracorneal bleb after trabeculectomy for congenital glaucoma. Cornea. 2005 May; 24(4):486-8.
  6. Liasis A., Nischal K.K., Leighton S., Yap S., Hayward R., Dunaway D. Adenoid- tonsillectomy to treat visual dysfunction in a child with craniosynostosis. Pediatric Neurosurgery. 2005 Jul-Aug; 41(4):197-200.
  7. Khan SH, Britto JA, Evans RD, Nischal KK. Expression of FGFR-2 and FGFR-3 in the no7rmal human fetal orbit. Br J Ophthalmology. 2005 Dec; 89(12):1643-5.
  8. Thompson DA, Liasis A, Hardy S, Hagan R, Hayward RD, Evans RD, Nischal KK. Prevalence of abnormal pattern reversal visual evoked potentials in craniosynostosis. Plast Reconstr Surg. 2006 Jul; 118(1):184-92.
  9. Liasis A, Nischal KK, Walters B, Thompson D, Hardy S, Towell A, Dunaway D, Jones B, Evans R, Hayward R. Monitoring visual function in children with syndromic craniosynostosis: A comparison of 3 methods. Arch Ophthalmology. 2006 Aug; 124(8):1119- 26.
  10. Liasis A, Walters B, Thompson D, Smith K, Hayward R, Nischal KK. Visual field loss in children with craniosynostosis. Childs Nerv Syst. 2011 Aug; 27(8):1289-96.
  11. Nischal KK, Smith DM, Losee JE. Discussion: nocturnal ultrasound measurements of optic nerve sheath diameter correlate with intracranial pressure in children with craniosynostosis.Plast Reconstr Surg. 2012 Sep; 130(3):452e-4e.
  12. Nischal, KK Visual. Surveillance in craniosynostoses. American Orthoptic Journal 2014;64 (1): 24-31
  13. Ruane EJ, Garland CB, Camison L, Fenton RA, Nischal KK, Pollack IF, Tamber MS, Grunwaldt LJ, Losee JE, Goldstein JA. A Treatment Algorithm for Patients Presenting with Sagittal Craniosynostosis after the Age of 1 Year. Plast Reconstr Surg. 2017 Sep;140(3):582-590.

 

Syndromes and Ocular Genetics

  1. Nischal KK, Hingorani M, Vivian A, Baker A, Mieli-Vergani G, Bird AC, Bentley CR, Aclimandos W. Ocular ultrasound in Alagille syndrome: a new sign. Ophthalmology. 1997 Jan;
  2. Hingorani M, Nischal KK, Davies A, Bentley C, Vivian A, Baker A, Mieli-Vergani G, Bird AC, Aclimandos W. Ocular abnormalities in Alagille syndrome. Ophthalmology. 1999 Feb; 106(2):330-7.
  3. Kelberman D, Islam L, Jacques TS, Russell-Eggitt I, Bitner-Glindzicz M, Khaw PT, Nischal KK, Sowden JC. CYP1B1-related anterior segment developmental anomalies novel mutations for infantile glaucoma and von Hippel’s ulcer revisited. Ophthalmology. 2011 Sep; 118(9):1865-
  4. Kelberman D, Islam L, Holder SE, Jacques TS, Calvas P, Hennekam RC, Nischal KK, Sowden JC. Digenic inheritance of mutations in FOXC1 and PITX2: Correlating transcription factor function and Axenfeld-Rieger disease severity. Hum Mutat. 2011 Oct; 32(10):1144-52. Epub 2011 Sep 8.
  5. Kelberman D, Islam L, Lakowski J, Bacchelli C, Chanudet E, Lescai F, Patel A, Stupka E, Buck A, Wolf S, Beales PL, Jacques TS, Bitner-Blidzicz M, Liasis A, Lehmann OJ, Kohlhase J, Nischal KK, Sowden JC. Mutation of SALL2 causes recessive ocular coloboma in humans and mice. Hum Mol Genet. 2014 Jan 12.
  6. Scanga HL, Nischal KK. Genetics and ocular disorders: a focused review. Pediatr Clin North Am. 2014 June: 61(3):555-65.
  7. Weiss JS, Moller HU, Aldave AJ, Seitz B., Bredrup C, Kivela T, Munier FL, Rapano CJ, Nischal KK, Kim EK, Sutphin J, Busin M. Labbe A, Keyon KR, Kinoshita S, Lisch W. IC3D Classification of Corneal dystrophies-Edition 2. Cornea. 2014 Feb; 34(2); 117-59
  8. Scanga HL, Nischal KK. Genetics and ocular disorders: a focused review. Pediatr Clin North Am. 2014 Jun; 61(3):555-65. doi: 10.1016/j.pcl.2014.03.005
  9. Islam L, Kelberman D, Williamson L, Lewis N, Glindzicz MD, Nischal KK, Sowden JC. Functional Analysis of FOXE3 Mutations Causing Dominate and Recessive Ocular Anterior Segment Disease. Hum Mutat. 2015 Mar; 36(3):296-300.
  10. Chauhan BK, Hoover JM, Scanga H, Medsinge A, Arnold GL, Nischal KK. Isolated Sagittal Synostosis in a boy with Craniofrantonasal Dysplasis and Novel EFNB1 Mutation. Plast Reconstr Surg Glob Open. 2015 Jul 8; 3 (6):e427.
  11. Ansari M, Rainger J, Hanson IM, Williamson KA, Sharkey F, Harewood L, Sandilands A, Clayton-Smith J, Dollfus H, Bitoun P, Meire F, Fantes J, Franco B, Lorenz B, Taylor DS, Stewart F, Willoughby CE, McEntagart M, Khaw PT, Clericuzio C, Van Maldergem L, Williams D, Newbury-Ecob R, Traboulsi EI, Silva ED, Madlom MM, Goudie DR, Fleck BW, Wieczorek D, Kohlhase J, McTrusty AD, Gardiner C, Yale C, Moore AT, Russell-Eggitt I, Islam L, Lees M, Beales PL, Tuft SJ, Solano JB, Splitt M, Hertz JM, Prescott TE, Shears DJ, Nischal KK, Doco- Fenzy M, Prieur F, Temple IK, Lachlan KL, Damante G, Morrison DA, van Heyningen V, FitzPatrick DR. Genetic Analysis of 'PAX6-Negative' Individuals with Aniridia or Gillespie Syndrome. PLoS One. 2016 Apr 28; 11(4):e0153757.
  12. Partha R, Chauhan BK, Ferreira Z, Robinson JD, Lathrop K, Nischal KK, Chikina M, Clark NL. Subterranean mammals show convergent regression in ocular genes and enhancers, along with adaptation to tunneling. Elife. 2017 Oct 16;6. pii: e25884.
  13. Chauhan BK, Medsinge A, Baumgartner MP, Scanga HL, Kamakari S, Gajdosova E,
  14. Camacho CJ, Nischal KK. Case series: Pyramidal cataracts, intact irides and nystagmus from three novel PAX6 mutations. Am J Ophthalmol Case Rep. 2018 Feb 28;10:172-179.
  15. Taubenslag KJ, Scanga HL, Huey J, Lee J, Medsinge A, Sylvester CL, Cheng KP, Nischal KK. Iris anomalies and the incidence of ACTA2 mutation. Br J Ophthalmol. 2018 Jun 6. pii: bjophthalmol-2018-312306.

Research Interest Summary

Translational Clinical Research; Visual Surveillance for Intervention Techniques; Ocular Genetics

Research Interests

TRANSLATIONAL CLINICAL RESEARCH
Congenital Corneal Opacities ( Peters’ anomaly, Sclerocornea etc)
Other Anterior Segment Developmental anomalies ( Axenfeld Rieger Anomaly, Aniridia, Brittle Cornea Syndrome, Congenital Aphakia)
Pediatric Acquired Corneal Diseases ( Keratoconus, Blepharokeratoconjunctivitis, Epidermolysis Bullosa, Metabolic disorders)

SURGICAL TECHNIQUE DEVELOPMENT
Pediatric Cataract
Pediatric Cornea
Pediatric Glaucoma

VISUAL SURVEILLANCE FOR INTERVENTION TECHNIQUES
Visual Evoked Potential
Electroretinogram

OCULAR GENETICS
Structure Function anlaysis for Retinal Dytsrophies
Systemic disease with ocular involvement