Notes on Glaucoma

Notes on Glaucoma
Visual Field testing ( perimetry ) is useful but often the first test is unreliable. Someone should stay in room with patient and have them look straight ahead. The test is worthless if patient is looking all around. The patient needs to be instructed on how to take the test. Give patient a Read more:

Eye Examination of a Small Child

Eye Examination of a Small Child
#1. Get a history from the mother. What is the eye problem? Was the child born pre-mature. ? Does the mother think the child can see? Has any other eye doctor seen the patient. What was their opinion? Ask the child some easy questions. Establish eye contact with the child. #2. Let the child sit Read more:

General Cataract Advice

General Cataract Advice
#1. If the V.A. is 20/60 or 20/70 with both eyes open without glasses then that may be sufficient vision. Everyone does not need to see 20/30 at distance. Many patients know their numbers but not their letters. May need to have patient read numbers rather than letters. #2. If the Read more:

Evaluation of Pre-op Patient with Dense Cataract

Evaluation of Pre-op Patient with Dense Cataract
#A. Get a good history. Did the patient use to see well in that eye or always poor vision ( lazy eye). Any hx of old trauma? #B. Check IOP. Look at that eye with slit lamp.Is the cornea OK? Is the cataract displaced ( subluxated )? Below is three step evaluation for a mature cataract Read more:

Suggestions concerning MSICS - Part 2

Suggestions concerning MSICS - Part 2
This is the second part ( continuation ) of MSICS suggestions after the SEE course. After hydrodissection / hydrodelineation and a capsulotomy, if possible spin the nucleus  before you rotate  it up through pupil into A.C.  If unable to spin then just rock nucleus east / west and north/ Read more:

Post-Ebola Survival Eye Clinic In Liberia Part 1

Post-Ebola Survival Eye Clinic In Liberia Part 1
Well here I am. I finally made it.
All my ophthalmic life I have wanted to work for / with Medecins Sans Frontieres ( MSF ) / Doctors Without Borders. Recently MSF, NYC told me I was the first ophthalmologist they have ever recruited. Currently I’m here in Monrovia, Liberia seeing post-Ebola Read more:

Life in the Slow Lane

Life in the Slow Lane
I would like to do something a little different with this blog and to make some observations / comments about medicine and beyond. First I would like to give you some of my favorite quotes / expressions of 2016: #1. Don’t quit your day dream. #2. Gracious plenty. ( Southern expression ). #3. Read more:

Post-Ebola Survival Eye Clinic In Liberia Part 2

Medecins Sans Frontieres / Doctors Without Borders is usually an emergency / crisis health organization rather than a developmental health NGO. As they frequently state, they go where others don’t. They are happy enough eventually to hand over their operations / programs to other NGO’s ( Read more:

Blog From West Africa

Blog From West Africa
In February I was with my ophthalmic friend Dr. Edgar Ogaldez in San Benito / Flores, Peten, Guatemala. Dr. Ogaldez visited my wife and I last year as part of the Rotary / AAO Host An Ophthalmology program ( Chair, Ken Tuck MD ). After visiting us in S.C. and talking to two of the local Rotary Read more:

Academy Meeting Las Vegas November 2015, Part 2

I would like to continue my summary of our 2015 AAO annual meeting 2015 in Las Vegas. As always, most of my observations / discussion / comments lean toward working / teaching in the developing world. Cornea Symposium:
Dr. Elisabeth Cohen spoke about Varicella Zoster Virus ( VZV ): Epidemiology, Read more:

SEE MSICS Course and Eye Exam

SEE MSICS Course and Eye Exam
Recently I participated in the Surgical Eye Expedition ( SEE ) MSICS course in Santa Barbara, Ca. Would recommend this one day course with didactic lectures in the AM and then a well planned / prepared wet lab in the afternoon. Special thanks to Dr. John Crowley, Luis Perez and the entire Read more:

Ten Commandments of Working in Low Resource Settings

I recently attended the Widows and Orphans annual banquet which is a 165 year old medical society in Charleston, SC. The guest speaker was Rudolph Rustin, MD who recently completed 1 1/2 years working in a hospital in Rwanda. Although Dr. Rustin is not an ophthalmologist, I would like to share Read more:

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