Welcome to day #29 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk – My stroke of insight – Jill Bolte Taylor got a research opportunity few brain scientists would wish for: She had a massive stroke, and watched as her brain functions — motion, speech, self-awareness — shut down one by one. An astonishing story.

I usually visit ted.com and pick a Ted recommendation, trending talk, or one which has a catchy title. Always looking for the hidden Ted treasure. The Ted list of most popular talks of all time is also a great resource. Dr. Taylor’s Ted Talk is #7 on the all-time list (26.7 million views) and well worth the experience.

2A. Cataract Surgery – Uday Devgan MD – Small pupil, PXF, and IFIS – Guest surgeon Dr. Dobrin Boyadzhiev from Bulgaria.

2B. Cataract Surgery – Uday Devgan MD – Review: Double Capsulorhexis for White Cataracts

Uday continues to post great videos filled with pearls.

3. Journal – Lin, E., Ke, M., Tan, B. et al. Are choriocapillaris flow void features robust to diurnal variations? A swept-source optical coherence tomography angiography (OCTA) study. Sci Rep 10, 11249 (2020). https://doi.org/10.1038/s41598-020-68204-x

4A. Book Chapter – Herman Melville – Moby Dick. Listened to Chapter 54 (54 minutes) via LoyalBooks.com. Sparknotes highlights narration. Text available on Gutenberg.

Melville mentions Lord Vishnu and Matsya Avatar. He writes:

Now, by all odds, the most ancient extant portrait anyways purporting to be the whale’s, is to be found in the famous cavern-pagoda of Elephanta, in India. The Brahmins maintain that in the almost endless sculptures of that immemorial pagoda, all the trades and pursuits, every conceivable avocation of man, were prefigured ages before any of them actually came into being. No wonder then, that in some sort our noble profession of whaling should have been there shadowed forth. The Hindoo whale referred to, occurs in a separate department of the wall, depicting the incarnation of Vishnu in the form of leviathan, learnedly known as the Matse Avatar. But though this sculpture is half man and half whale, so as only to give the tail of the latter, yet that small section of him is all wrong. It looks more like the tapering tail of an anaconda, than the broad palms of the true whale’s majestic flukes.

Moby Dick, Chapter 55.

I came across this article by Anu Kumar which is well worth a read: ‘Moby Dick’ says Elephanta has the oldest whale portrait. Where on earth did Melville get that idea? (Scroll.in)

4B. Book Chapter – Simon Sinek, Start With Why. (2009). Chapter 4 (“This in Not Opinion, This is Biology”). (See also Protecting Sight #12)

Sinek writes, “This is the genius of great leadership. Great leaders and great organizations are good at seeing what most of us can’t see.” (page 60).

Welcome to day #28 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk – Nitish Padmanaban – Autofocusing reading glasses of the future. “As you age, you gradually lose the ability to refocus your eyes — a phenomenon as old as humanity itself — leading to a reliance on bifocals, contacts and procedures like LASIK surgery. Electrical engineer Nitish Padmanaban offers a glimpse of cutting-edge tech that’s truly a sight for sore eyes: dynamic, autofocusing lenses that track your sight and adjust to what you see, both near and far.” (ted.com)

I loved this talk. I am a lifelong Benjamin Franklin fan (Franklin’s autobiography & Walter Isaacson’s biography are must-reads) and am dazzled by the potential for this technology to transform lives worldwide in the treatment of presbyopia.

2. Cataract Surgery – Richard Mackool MD – Episode 2: The Impale and Chop Technique. “Using a 2.4mm incision, I remove a fairly dense, 3+ brunescent nuclear cataract from a patient whose other eye has only peripheral vision. I demonstrate using trypan blue to aid visualization of the capsulorhexis, and show how an OVD can be used to actually reposition an anterior subcapsular opacity prior to creating the capsulorhexis. A detailed presentation of the impale and chop technique follows with additional pearls including how to keep the phaco tip cool, and the advantage of using a slightly oversized surgical glove.”

Dr. Mackool is a master surgeon and educator. This video is filled with pearls.

3A. Journal – Corneal Wound Hydration (EyeWiki) – One of the authors posted this article on their LinkedIn profile. Pretty good. Would help if they added photos and/or video. EyeWiki is a resource I use often in the office.

3B. Jabs DA. Improving the Diagnostic Criteria for Vogt-Koyanagi-Harada Disease. JAMA Ophthalmol. 2018;136(9):1032–1033. doi:10.1001/jamaophthalmol.2018.2657. This showed up in my Twitter feed today and enjoyed Dr. Jabs’ commentary.

3C. Li AS, Tang PH, Do DV. Serous Macular Detachment in Probable Vogt-Koyanagi-Harada Syndrome. JAMA Ophthalmol. 2020;138(5):e191981. doi:10.1001/jamaophthalmol.2019.1981

4A. Book Chapter – Herman Melville – Moby Dick. Listened to Chapter 54 (54 minutes) via LoyalBooks.com free podcasts. Sparknotes also highlights narration.

4B. Book Chapter – Simon Sinek, Start With Why. (2009). Chapter 3 (The Golden Circle). The best time to read a book is after you’ve watched the Ted Talk! Seriously, great speakers lay the foundation in a 15-20 minute Ted Talk which makes their books much more enjoyable. So far, the Ted Talk is better than the book. (See also Protecting Sight #12)

Welcome to day #27 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk – Honor Harger – How museums help communities heal. “While on lockdown, the galleries of Singapore’s iconic ArtScience Museum were empty — but online, the museum was abuzz. Honor Harger shares how they’re engaging deeply with its visitors through streamed talks, performances and workshops that investigate the COVID-19 landscape and uplift marginalized voices. (This virtual conversation, hosted by TED’s current affairs curator Whitney Pennington Rodgers, was recorded June 17, 2020.)” (ted.com)

I enjoyed Harger’s comment that “art touches the soul.” She speaks eloquently about how COVID amplifies disparities and about communities which are not being spoken to .. or listened to.

2. Cataract Surgery – Uday Devgan, MD – Pars plana anterior vitrectomy. Uday keeps it real and many pearls are shown in this case.

3A. Journal – Patel N, Stagg BC, Swenor BK, Zhou Y, Talwar N, Ehrlich JR. Association of Co-occurring Dementia and Self-reported Visual Impairment With Activity Limitations in Older Adults. JAMA Ophthalmol. 2020;138(7):756–763. doi:10.1001/jamaophthalmol.2020.1562

3B. Friedman DS, Ramulu PY. The Potential for Worse Outcomes of Visual Impairment in Those With Dementia. JAMA Ophthalmol. 2020;138(7):763–764. doi:10.1001/jamaophthalmol.2020.1560

3C. Gillan EC, Ancona-Lezama D, Shields CL. Visual Acuity Loss in a Healthy Man. JAMA Ophthalmol. 2020;138(7):789–790. doi:10.1001/jamaophthalmol.2020.0452

4. Book Chapter – Herman Melville – Moby Dick. Listened to Chapter 51-53 via LoyalBooks.com free podcasts. Sparknotes also highlights narration.

5. Answering the call of AAO, ophthalmologists campaign to ban rubber bullets, tear gas. I enjoyed the opportunity to speak with Ocular Surgery News on the #NoRubberBullets campaign.

The US call has reached India, revamping advocacy for the elimination of pellet guns in Kashmir. With thanks to Dr. Natarajan for his global leadership on this issue.

Welcome to day #26 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk – Novelist Chimamanda Adichie – The danger of a single story. “Our lives, our cultures, are composed of many overlapping stories. Novelist Chimamanda Adichie tells the story of how she found her authentic cultural voice — and warns that if we hear only a single story about another person or country, we risk a critical misunderstanding.” (ted.com)

Wonderful Ted recommendation. Her 2009 Ted Talk resonates today (and especially her observations about immigration). I hope to re-think the biases which promote the single story. This is a remarkable talk (22 million views) and I will seek out Ms. Adichie’s novels.

2. Cataract Surgery – Uday Devgan, MD Expert level dense white cataract surgery. Superb case by Dr. Dave. I learned about performing capsulorhexis with dense white cataracts using a small side port by watching Dr. Devgan’s other videos.

Uday critiqued one of my previous cases in which I perform cataract surgery on patient with a complete white cataract and a history of retinal detachment surgery. Watching numerous cases on cataractcoach.com helped me immensely in this and many complex cases.

With thanks to Dr. Devgan and Dr. Dave for sharing their techniques!

3A. Journal – Case Report – Intracapsular hemorrhage in the setting of pseudoexfoliation syndrome. Digital Journal of Ophthalmology 2020
Volume 26, Number 2. June 20, 2020.

3B. Journal – Image – Melanin-producing central ulcer caused by an Exophiala species. Shyam A. Patel, MD, MBA, Charles D. Salisbury, MD, Stephen M. Hamilton, MD. Digital Journal of Ophthalmology 2020. Jan 13, 2020 Volume 26, Number 1

4. Book Chapter – Herman Melville – Moby Dick. Listened to Chapter 48-50 via LoyalBooks.com free podcasts. Sparknotes also highlights narration.

Welcome to day #25 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk – Norman Lear: An entertainment icon on living a life of meaning. “In the 1970s (and decades following), TV producer Norman Lear touched the lives of millions with culture-altering sitcoms like All in the Family, The Jeffersons and Good Times, pushing the boundaries of the era and giving a primetime voice to underrepresented Americans. In an intimate, smart conversation with Eric Hirshberg, he shares with humility and humor how his early relationship with “the foolishness of the human condition” shaped his life and creative vision.” (ted.com)

Norman Lear’s Ted Talk is an instant classic. I typically watch a Ted Talk in the morning, and feel a sense of inspiration for the day. It was an honor to listen to his storytelling and timeless wisdom. I’m surprised that this Ted Talk “only” has 1.1 million views (The top talks have 50 million+). Among the first 25 Ted Talks I’ve posted, this one is certainly a top 5.

2. Cataract Surgery – Richard Mackool, MD. Fundamentals Episode 1: Phaco Fundamentals. “In this first issue of Mackool Online Fundamentals CME, we demonstrate basic incision techniques, discuss fundamental surgical principles, methods of nucleus division and cortex removal, foldable IOL insertion and rotation, as well as sutureless incision closure.”

As I’ve mentioned in previous posts, I visited Dr. Mackool twice in the early 2000s to watch him perform surgery. This is a wonderful tutorial filled with surgical pearls. I plan to keep posting his Fundamentals in order.

3. Journal Article – Retinitis Pigmentosa, Part 2: Research on Patient Management. Written By: Xian Hui Lim, MBBS, Daniel S.W. Ting, MD, PhD, and Adrian Koh, MBBS, FRCS, MMED, FRCOphth, FAMS. Edited By: Ingrid U. Scott, MD, MPH, and Bennie Jeng, MD. EyeNet July 2020.

(See also Retinitis Pigmentosa, Part 1: Understanding the Basics EyeNet June 2020)

The Juliette RP Vision Foundation supports scholarships for visually impaired college students.  Founded by ophthalmologist and friend Rob Melendez MD, the Juliette Foundation provides a wonderful opportunity to give back and invest in education. They plan to award 10 scholarships and 2 research grants each year. I was delighted to join friends Jeff Maltzman MD & Sidney Gicheru MD in sponsoring a scholarship for the #NightForSight2019 event.

4. Book Chapter – Herman Melville – Moby Dick. Listened to Chapter 33-47 via LoyalBooks.com free podcasts. Sparknotes also highlights narration.

Welcome to day #24 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk – Shekinah Elmore MD MPH. Shekinah Elmore: The courage to live with radical uncertainty. “When your future is uncertain, how do you keep moving forward? In this courageous talk, oncologist and cancer survivor Shekinah Elmore shares how she embraced life after a rare genetic diagnosis — and explains why she believes doctors have a duty to help their patients learn to live with radical uncertainty.” (ted.com)

This was featured on the Ted homepage as a new talk. I loved Dr. Elmore’s story and her message. Have a box of tissues handy. Inspired to continue working on patient communication and advocacy.

2. Cataract Surgery – Uday Devgan MD – Review: fixing beginner mistakes. This is an excellent case for all levels. I’ve done stop & chop for many years and enjoy learning new techniques. Obsessed with phaco efficiency. Phaco-chop is an art form.

3. Journal Article – New Cancer Tx, New Ocular Side Effects. Novel cancer treatments are leading to myriad ocular side effects. How to manage the long-term cancer patient in your office. EyeNet, July 2020

This is an excellent article. Plan to copy/print the list of ophthalmic symptoms related to immunotherapy for the exam rooms.

4. Book Chapter – Herman Melville – Moby Dick. Listened to Chapter 32 via LoyalBooks.com free podcasts. Sparknotes also highlights narration. Melville certainly loves his details in this chapter.

Welcome to day #23 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk – Joshua Prager – Joshua Prager: Wisdom from great writers on every year of life. “As different as we humans are from one another, we all age along the same great sequence, and the shared patterns of our lives pass into the pages of the books we love. In this moving talk, journalist Joshua Prager explores the stages of life through quotations from Norman Mailer, Joyce Carol Oates, William Trevor and other great writers, set to visualizations by graphic designer Milton Glaser. “Books tell us who we’ve been, who we are, who we will be, too,” Prager says.”

This was a Ted trending talk. Only 6 minutes and filled with great insights. I have often compared myself with others based on age (such as, “Gee, I’m now 43 and at this age John F. Kennedy was inaugurated as president.”). I will seek out Prager’s work and look forward to more musings of great writers on every year of life.

2. Cataract Surgery – Uday Devgan MD – Uday makes it easy to share cutting edge content. Enjoyed two of his videos today.

A. Tough posterior capsule opacity

2B. Cataract Surgery in Silicone Oil Eyes – The silicone oil pearls are superb.

I’d also recommend watching Jorge Calzada’s videos and the pearls he shares on Ike Ahmed’s webinars (Prism Eye Rounds May 27 is one of many I’ve enjoyed on complicated cataracts)

3. Journal Article – Horner’s Syndrome (EyeWiki) – Congratulations on EyeWiki’s 10 year anniversary! I often use EyeWiki when I’m in the lane with a patient to look up the latest diagnostic and management pearls. Today I reviewed the finer details of Horner’s Syndrome. Highly recommend the YouTube videos below on anatomic pathways. And a shout-out to Andrew Lee, MD for his video on pharmacologic testing.

4. Book Chapter – Herman Melville – Moby Dick. I love the free podcasts available by LoyalBooks.com. Listened to Chapter 28-31. I also review Sparknotes to appreciate the subtleties in the narration.

A listing of Protecting Sight Daily Learning posts is here.

Welcome to day #22 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk – Nora McInerny – We don’t “move on” from grief. We move forward with it. “In a talk that’s by turns heartbreaking and hilarious, writer and podcaster Nora McInerny shares her hard-earned wisdom about life and death. Her candid approach to something that will, let’s face it, affect us all, is as liberating as it is gut-wrenching. Most powerfully, she encourages us to shift how we approach grief. ‘A grieving person is going to laugh again and smile again,’ she says. ‘They’re going to move forward. But that doesn’t mean that they’ve moved on.'” (ted.com)

This was a Ted recommendation for me. McInerny is a wonderful story teller (have a box of tissues handy). Many life lessons within.

2. Cataract Surgery – Uday Devgan MD – Bilateral brunescent same day cataract surgery. The gift of sight is for both the patient and the surgeon. Uday is remarkable and performed this case for free.

3A. Journal Article – Impact of social distancing, face masks and eye protection on SARS-CoV-2 transmissionThe Lancet, in press. An AAO ONE Network “Editor’s Choice” and an excellent article.

3B. Ophthalmic Images – Lu P, Huang J. Bilateral Iris Metastasis From Pulmonary Adenocarcinoma. JAMA Ophthalmol. 2018;136(9):e182381. doi:10.1001/jamaophthalmol.2018.2381

4. Book Chapter – Herman Melville – Moby Dick. I love the free podcasts available by LoyalBooks.com. Listened to Chapter 17-27. I also review Sparknotes to appreciate the subtleties in the narration.

Fellow Elis (& Cantabs) may also enjoy the end of Chapter 24. Melville writes:

And, as for me, if, by any possibility, there be any as yet undiscovered prime thing in me; if I shall ever deserve any real repute in that small but high hushed world which I might not be unreasonably ambitious of; if hereafter I shall do anything that, upon the whole, a man might rather have done than to have left undone; if, at my death, my executors, or more properly my creditors, find any precious MSS. in my desk, then here I prospectively ascribe all the honor and the glory to whaling; for a whale-ship was my Yale College and my Harvard.

A listing of Protecting Sight Daily Learning posts is here.

Welcome to day #21 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Today’s theme honors July 4th, the Declaration of Independence, and the Pursuit of Happiness:

1. Ted Talk – Caroline Winterer: America’s pursuit of happiness and why it’s gone wrong. “We are so preoccupied with happiness that the Declaration of Independence guarantees our right to pursue it. But are we doing it right? Historian Caroline Winterer argues that what the founding fathers meant was public happiness, the need for citizens to work collectively toward a robust democracy. ‘Only public happiness,’ she explains, ‘creates the umbrella of stability under which we can pursue private happiness.'” (ted.com)

Found Professor Winterer’s talk by searching “independence” on the Ted app. Very much enjoyed her 10 minute talk.

2. Cataract Surgery – Richard J. Mackool, Sr. MD – Humans, Happiness, and the Wonder of New. “In his 2013 Charles D. Kelman Innovator’s Award lecture, Richard J. Mackool Sr, MD, shares highlights of his long career mixed with humorous skits (don’t miss the eyeball driving a toy car) and family memories. The internationally recognized cataract surgeon, author and lecturer has been in practice for more than 40 years. Dr. Mackool is the founder and director of the Mackool Eye Institute and Laser Center in New York, and professor of ophthalmic surgery at the New York Eye and Ear Infirmary and NYU Medical Center.”

I visited Dr. Mackool’s Eye Institute twice during the early years of practice. Dr. Mackool is a master surgeon and I remember him sharing the idea of placing viscoelastic under the anterior capsule. He also gifted me a signed copy of his book on phaco pearls!

3. Journal Article – Assessment of Firework-Related Ocular Injury in the US. Shiuey EJ, Kolomeyer AM, Kolomeyer NN. JAMA Ophthalmol. 2020; 138(6): 618–623. doi:10.1001/jamaophthalmol.2020.0832

4. Significant work – NPR Reads The Declaration Of Independence – This is my favorite NPR episode! I remember waking up to the reading a few years ago and mesmerized by my favorite NPR voices reading the Declaration. I now seek out the yearly episode on npr.org.

5. Please check out my July 4th blog post on #FireworksSafety: Fireworks, COVID-19, and the risk of eye injury: 10,000 reasons to leave fireworks to the professionals!

A listing of Protecting Sight Daily Learning posts is here.

Welcome to day #20 of my daily learning journal. My goal is to watch one Ted Talk and one cataract surgery each day. In addition, I plan to read one journal article and read/listen to a book chapter, short story or significant work.

Here’s today’s list:

1. Ted Talk = Frederick Balagadde – Bio-lab on a microchip (April 2010)- “Drugs alone can’t stop disease in sub-Saharan Africa: We need diagnostic tools to match. TED Senior Fellow Frederick Balagadde shows how we can multiply the power and availability of an unwieldy, expensive diagnostic lab — by miniaturizing it to the size of a chip.” (ted.com)

“TED Senior Fellow Frederick Balagadde invented the micro-chemostat, a first-of-its-kind, dime-sized piece of transparent plastic that can orchestrate the behavior of living cells.” (ted.com)

This was a “Surprise me!” Ted Talk pick. Excellent 6-minute talk.

2. Cataract Surgery – Uday Devgan MD – The subtleties of cataract surgery – Another superb post by Uday. It’s less than 4 minutes and worth watching many times.

3A. Journal articles. Ocular Toxoplasmosis: A Refresher. Written By: Nikhila Khandwala, MS, and Cagri G. Besirli, MD, PhD. Edited By: Ingrid U. Scott, MD, MPH, and Bennie H. Jeng, MD. This infection of the retina and choroid caused by the intracellular parasite Toxoplasma gondii is the leading cause of posterior uveitis worldwide. EyeNet April 2020

3B. A Case of Corneal Crystals. Written By: Kenneth J. Taubenslag, MD, Daniel Geisler, MD, Alex Mammen, MD, and Jean C. Harwick, MD, FACS
Edited By: Ingrid U. Scott, MD, MPH. EyeNet April 2020

3C. Pictures & Perspectives – Natural Course of Ruptured Retinal Arterial Macroaneurysm: red to white to resolved, count fingers to 20/25 in one year. Kuan-Jen Chen, MD. Ophthalmology Retina, Volume 4, Number 6. (With thanks to the AAO social media team for posting great cases).

4. Book Chapter – Herman Melville – Moby Dick. I love the free podcasts available by LoyalBooks.com. Listened to Chapter 4-16. Starting to review Sparknotes to appreciate the subtleties in the narration.

Ophthalmology colleagues, you may enjoy Melville’s comment in Chapter 1, “Were Niagara but a cataract of sand, would you travel your thousand miles to see it?” (Guttenberg.org)

5. Please check out my July 4th blog post on #FireworksSafety: Fireworks, COVID-19, and the risk of eye injury: 10,000 reasons to leave fireworks to the professionals!

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Protecting Sight Daily Learning posts are here.