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:

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:

Instructions for techs on the OCT


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:

Review of glaucoma management for Belize

Review of glaucoma management for Belize
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:

Evaluation of Mature Cataract

Evaluation of Mature Cataract
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:

Suggestions From MSICS Course ( SEE ) September 2016

Don’t believe everything you think.
Did you see the September 2016 National Geographic magazine? Cover story on -- The End of Blindness Winning The Fight To See? The article talked about blindness in the developed world as well as the developing world. Lots of reasons for the reduction. In the 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:

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:

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