Baxter's Blog

I wanted to write again on glaucoma as we all see many patients with glaucoma everywhere --- many unfortunately with severe, advanced, end-stage glaucoma when we first see them. As you know, glaucoma is the second leading cause of blindness in the world after unoperated cataracts. Most of what I Read more:

Recently an ophthalmologist in a developing country asked me when I would start a patient with ocular hypertension ( mid-20’s IOP and a normal cup / disc ratio ) on therapy. I wanted to follow up about that. Perhaps this would be a good conversation to have with eye care providers in emerging Read more:

Recently I was able to show a health care provider two separate patients with an eyelash caught / embedded under a pterygium on the bulbar conjunctiva. I have seen this previously simply an incidental finding. At first our optometrist thought this black linear lesion was a suture but after gently Read more:

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:

#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:

#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:

#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:

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:

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:

In regards to our talking about optical coherence tomography ( OCT ) last week, I would encourage you to read the entire OCT manual which is available online. I know it can be rather daunting but if you would read 3 pages each day and try to make sense of what the book is describing then over Read more:

I wanted to write everyone and go over diagnosis / management / treatment of glaucoma. Glaucoma is the second leading cause of blindness in Belize, USA, the industrialized world and the emerging world. As we all know, once vision is lost with glaucoma ( optic atrophy ) there is no drops, surgery, Read more:

Check out this one page quick reference for how to evaluate mature cataract. Please click on the image below to view in higher resolution. Read more: