Ophthalmology

A patient presented to me recently with a history of cataract surgery in the left eye done a year ago.

He had a wide superior scleral tunnel incision and what appeared to be an anterior chamber IOL with the part of the haptics above the iris at the angle and the rest of the IOL in the sulcus. The anterior segment was quiet and without inflammation, and the patient's only complaint was the poor vision, which was 20/800.

While a medical student at USC, I was fortunate to interact with Stephen Ryan, MD, as both dean of the medical school as well as professor of ophthalmology. He will certainly be remembered as a giant as well as a gentleman in the ophthalmology world.

I had the pleasure of recently attending the Oregon Academy of Ophthalmology annual meeting in Portland. I enjoyed connecting with many colleagues and friends, including Devin Gattey, MD, with whom I did a charity trip to Vietnam, and Yujen Wang, MD, who was a co-intern with me many years ago. I even managed to spend a few hours enjoying the city and visiting the Casey Eye Institute, but the highlight of the meeting was the content of the presentations.

Social media has become the new buzz in many businesses, which see it as an avenue for increased revenue. People trust their own social circle and friends, and if one of them makes a sincere recommendation in support of a product, an event, a business or even a surgeon, it carries a lot of weight. But the key here is a sincere recommendation — not a recommendation that a friend may be making in return for monetary compensation. There are many businesses that extend discounts to customers ...

Like many of you, my passion is ophthalmology, and I'd rather read Ocular Surgery News than the Los Angeles Times. During the long weekend, I was able to enjoy Thanksgiving dinner with my family and then attend a University of Toronto ophthalmology symposium where I learned more than I contributed.

Upon my return home to Los Angeles, I received an email written by Blake Acohido, MD, a senior ophthalmology resident who spent his Thanksgiving performing charity surgeries on a mission trip to Fiji with the Hawaiian Eye Foundation (HEF). The HEF is an organization that has devoted decades to providing eye care, primarily cataract surgeries, to thousands of underserved people throughout the Pacific and Asia.

This patient is a young man in his 20s with his whole life ahead of him. In an unfortunate car accident, he suffered a ruptured globe from a glass shard that lodged inside his vitreous cavity.

After a repair of the inferior corneoscleral laceration, he had a pars plana vitrectomy to remove the glass foreign body and repair his retina. He ended up with a macular scar, a disfigured pupil and a significant degree of exotropia.

This patient is a 52-year-old man who developed cataracts a few years ago and underwent successful cataract surgery with implantation of accommodating silicone IOLs. He had a beautiful result and recovery of excellent vision, until a surfboard hit his right eye and caused a macula-on retinal detachment.

When operating with beginning surgeons, I’m often asked, “How can a surgeon tell if the IOL is upside down?”

Because of the angulation and geometry, many IOLs will have a different optical result and undesirable effective lens position in the eye if inserted upside down.

July marked the start of my 13th year teaching ophthalmology residents, and I hope that I can continue doing it for at least another 30. Working with these bright young minds has become the highlight of my week, which is a mix of my private, non-academic practice and part time with UCLA residents at a large county hospital.