John S. Penn, PhD, has been named the inaugural holder of the Knights Templar Eye Foundation (KTEF) Directorship in Pediatric Vision Research at the Vanderbilt Eye Institute in honor of his contributions to the foundation and the field of vision research.
Penn’s connection with the KTEF, which is committed to supporting discovery science on eye conditions that are potentially preventable in infants and children, began in 1986 as a research fellow at Baylor College of Medicine. He was awarded a two-year grant from the foundation to investigate retinopathy of prematurity (ROP), an eye disorder that is caused by abnormal blood vessel growth in the retina. It occurs most often in babies who weigh less than 3 pounds or who are born before 31 weeks of pregnancy and is one of the most common causes of vision loss in children.
Penn, also associate dean for Faculty Affairs at Vanderbilt University School of Medicine, developed an animal model of ROP to investigate its pathogenesis. “Research had been going on since the late 1940s, and the ROP models used in the 1980s were still following age-old standards of care, so they were largely irrelevant for the preemie population of the time,” Penn said. “Backed by the foundation’s funding, I worked to develop what I thought was a more clinically relevant model, and that proved to be true,” he said.
Prior to Penn’s groundbreaking research, it was believed that the more therapeutic oxygen was provided to premature infants, the more ROP was likely to result. “Of course, we couldn’t stop treating infants with oxygen. They wouldn’t survive without oxygen supplementation,” Penn said. “So, it was a Catch-22. Neonatologists had to give the premature babies oxygen to keep them alive, but oxygen can be toxic, and it contributed to the pathology in the retina. At this stage, everyone believed that more oxygen meant more ROP. Our early work with the model demonstrated that the culprit was not simply more oxygen, it was the variability of oxygen in the bloodstream,” he said. “Oxygen variability is a side-effect of oxygen treatment in preemies.”
This early work and funding from the KTEF set Penn on a path to continuous large-scale funding to investigate ROP and related diseases from the National Institutes of Health. For more than 30 years his research has influenced advances in the treatment of ROP around the world.
“ROP is still a problem today,” Penn said. “Despite neonatologists’ best efforts, they can’t completely control bloodstream oxygen variability. There are too many conditions in premature infants that affect the blood oxygen levels, and neonatologists can only do so much to control variability. But our work, and the work of others, did change practice standards for Neonatal Intensive Care Units, and as oxygen treatment standards were revised, the prevalence of blinding ROP dropped. There’s been a measurable impact, at least in developed countries,” he said.
In addition to ROP, Penn’s work has expanded over the years to other blinding conditions that exhibit the abnormal growth of blood vessels as the central pathologic feature. His research includes neovascular age-related macular degeneration and proliferative diabetic retinopathy, the more advanced stage of diabetic eye disease. “Those three conditions are the leading cause of blindness in the elderly, working-age and childhood populations in the U.S.,” he said.
He has also served as a member of the KTEF’s Scientific Advisory Committee since 2000 and became the committee’s chair in 2012, helping to guide its grant distribution to, and mentoring of, new investigators. He completed his service on the committee in March 2020.
“That initial grant from the Knights Templar Eye Foundation had a lot to do with my professional development and my early career success,” Penn said. “Working with the organization has been an honor and labor of love, and it has allowed me an opportunity to repay, in some small measure, the KTEF for a variety of things they’ve done for me. I’ve developed many personal relationships with members of the Knights Templar organization that will remain important to me for the rest of my life,” he said.
“This remarkable gift from the Knights Templar Eye Foundation is the result of decades of service to this organization by Dr. Penn,” said Paul Sternberg Jr., MD, George Weeks Hale Professor of Ophthalmology and Visual Sciences and chair of the department. “John is an extraordinary scientist and leader who has had a profound influence on Knights Templar’s exceptional impact on pediatric vision research. I am very proud to see his contributions recognized in such a deserving and meaningful way,” he said.
Penn said the directorship will allow him to step back a little from the day-to-day operations of his 25-person lab, “to reflect on the science of our efforts and not spend all of my time enmeshed in the details of the work. I need to think more and act less. It’s so easy for us to get caught up in the day-to-day, hour-to-hour, minute-to-minute minutiae that there’s not enough time left for reflection on the science.”
The KTEF, incorporated in 1956 and located in Flower Mound, Texas, is a charity sponsored by the Grand Encampment of Knights Templar, a national Masonic fraternal organization.
“The Knights Templar Organization has been honored to have Dr. Penn on our Scientific Advisory Committee. He was recognized by the Grand Encampment Knights Templar, College of Honors, with the ‘Companion of the Temple’ medal for his many years of faithful service to our foundation,” said Jeffrey N. Nelson, president of the Knights Templar Eye Foundation, Inc., and Grand Master of the Grand Encampment Knights Templar.
“The Officers, Trustees and staff of the Knights Templar Eye Foundation are very proud of the accomplishments of Dr. Penn and are excited to support this endowment project. His research has influenced advances in the treatment of this disease (ROP) around the world.”