Protecting Sight Daily Learning #21: Life, Liberty, and the Pursuit of Public Happiness. #ProtectingSight

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.”

Honored to see Dr. Mackool at the 2014 “Telling It Like It Is” Cataract Surgery Symposium

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!

Firework-Related Ocular Injuries by Year and Month
A, The national estimate of firework-related eye injuries from 1999 to 2017 (n = 34 969), estimated from a representative hospital sample. A 95% CI was not reported in 2012 and 2016 owing to a high coefficient of variation. Data from the representative hospitals (n = 1007) are organized by month (B). Ocular firework injuries most commonly occurred near national holidays.

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

Declaration of Independence (National Archives)

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.

Protecting Sight Daily Learning #20: One Ted Talk, cataract surgery, journal article, and book chapter. The subtleties of cataract surgery and Moby Dick. #ProtectingSight

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

Active and Inactive Lesions

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

What We Saw

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).

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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)

Moby Dick by Herman Melville

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!

Please post a comment & subscribe/follow my blog www.ProtectingSight.com!

Protecting Sight Daily Learning posts are here.

Fireworks, COVID-19, and the risk of eye injury: 10,000 reasons to leave fireworks to the professionals!

Photo by Nicolas Tissot on Unsplash

Every year, about 10,000 people are rushed to the emergency department for fireworks injuries. Ophthalmologists – physicians who specialize in medical and surgical eye care – treat thousands of patients who suffer a range of fireworks-related injuries, from cuts and bruises to damaged corneas, retinas, and ruptured eyeballs.

Image

Many people believe that consumer fireworks are safe. But here’s the explosive truth: Most injuries are caused by legal fireworks parents buy for their children, such as sparklers, firecrackers, bottle rockets, and Roman candles.

Due to COVID-19 social distancing, many public fireworks have been cancelled or postponed (Philadelphia regional listings are here.)  Consumer fireworks sales have increased dramatically (CNN | USA Today), and thus the potential for eye injuries skyrockets as well. 

To help reduce the number of potentially blinding fireworks accidents this holiday, please celebrate only with the pros or via an online show. July 4th can be complete without using consumer fireworks. The safest way to view fireworks is to watch a professional show.  Keep safe distance, wear protective eyewear, and do not touch or handle duds and misfires. 

American Academy of Ophthalmology Fireworks Eye Safety

Consumer fireworks may have fleeting enjoyment. But the risks of permanent injury to the eye and body are great. 65% of all fireworks injuries are to bystanders. It’s the time of year which ophthalmologists dread seeing patients in the ER.

Instagram image @asot_trauma

If you experience a fireworks eye injury, minimize the damage to the eye and seek medical attention immediately. If fireworks injury occurs:

  • Do not rub the eye. Rubbing may make the injury worse
  • Do not attempt to rinse the eye
  • Do not apply pressure to the eye
  • Do not remove objects from the eye
  • Do not apply ointments or take pain medications before seeking medical help

Please also see the excellent EyeSmart article from the American Academy of Ophthalmology on Fireworks Eye Safety.

The best way to enjoy fireworks 2020 is from a socially distanced venue or one of the many shows online!

Please stay safe! #ProtectingSight

Protecting Sight Daily Learning #19: One Ted Talk, cataract surgery, journal article, and book chapter. The magic of the Aravind Eye Care System #ProtectingSight

Welcome to day #19 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 list features the Aravind Eye Hospital:

1. Ted Talk – Thulasiraj Ravilla: How low-cost eye care can be world-class – “India’s revolutionary Aravind Eye Care System has given sight to millions. Thulasiraj Ravilla looks at the ingenious approach that drives its treatment costs down and quality up, and why its methods should trigger a re-think of all human services.” (ted.com)

I traveled to the Aravind Eye Hospital Madurai to perform cataract surgery twice as a resident. In 2000, I performed 68 extracapsular surgeries in 17 days (4 per day). In 2001, I performed around 30 cataract surgeries in a week. I met Dr. V in Madurai and on his occasional trips to the United States. I was inspired by his gentleness of spirit and mission to protect sight throughout India and the world.

Operating as a visiting trainee at Aravind Eye Hospital (2001)

2. Cataract Surgery – MSICS – Manual Small Incision Cataract Surgery – 5 superb cases from the Aravind Eye Hospital System (well worth the 20 minutes!)

3A. Journal article – Efficacy of Intracameral Moxifloxacin Endophthalmitis Prophylaxis at Aravind Eye Hospital. Aravind Haripriya, MD, David F. Chang, MD, Sathvik Namburar, Anand Smita, MS, Ravilla D. Ravindran, MD. Ophthalmology 2016;123:302-308. A landmark study.

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Figure 1. Charity population endophthalmitis rate over time, including the 10 months immediately before and the 8 months immediately after routine initiation of direct intracameral (IC) moxifloxacin (Moxi) prophylaxis. Each point on the timeline represents a 2-month consecutive period.

4. Book Chapter – Herman Melville – Moby Dick. I love the free podcasts available by LoyalBooks.com. Listened to Chapter 3.

Moby Dick by Herman Melville

5. July 2020 Regional Eye Associates newsletter – The latest issue on sunglasses protection and fireworks safety is here.

Please post a comment & subscribe/follow my blog www.ProtectingSight.com!

Protecting Sight Daily Learning posts are here.

Protecting Sight Daily Learning #18: One Ted Talk, cataract surgery, journal article, and book chapter. Healthy vs. Unhealthy Love. #ProtectingSight

Welcome to day #18 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 – Katie Hood – The difference between healthy and unhealthy love. “In a talk about understanding and practicing the art of healthy relationships, Katie Hood reveals the five signs you might be in an unhealthy relationship — with a romantic partner, a friend, a family member — and shares the things you can do every day to love with respect, kindness and joy. ‘While love is an instinct and an emotion, the ability to love better is a skill we can all build and improve on over time,’ she says.” (ted.com)

This was a Ted recommendation for me today. Excellent pearls with lessons which can be applied immediately.

2. Cataract Surgery – Uday Devgan MD – What is different about this cataract?

Uday’s pearls continue to inspire. Watching his videos taught me how to handle white cataracts much more safely and efficiently. He also featured one of my cases of white cataracts below and here.

3A. Journal article Delayed Retinal Breaks and Detachments after Acute Posterior Vitreous Detachment. Joshua H. Uhr, Anthony Obeid, Turner D. Wibbelsman, Connie M. Wu, Hannah J. Levin, Hannah Garrigan, Marc J. Spirn, Allen Chiang, Arunan Sivalingam, Jason Hsu. Ophthalmology April 2020, 516-522.

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Ophthalmology April 2020, 516-522.

3B. Pictures & Perspectives – Conjunctival Fungal Ball Mimicking Melanoma. Katherine Chuang, Alexander Vortmeyer, Shaohui Liu. Ophthalmology April 2020, p. 534.

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Ophthalmology April 2020, p. 534.

4. Book Chapter – Herman Melville – Moby Dick. I love the free podcasts available by LoyalBooks.com. Listened to Etymology and Extracts (29 minutes) and Chapters 1-2 (24 minutes).

Moby Dick by Herman Melville

5. July 2020 Regional Eye Associates newsletter – One of my COVID goals was to create a monthly practice newsletter. You can view the latest issue on sunglasses protection and fireworks safety here.

I hope you enjoy these selections.

Please post a comment & subscribe/follow my blog www.ProtectingSight.com!

Protecting Sight Daily Learning posts are here.

Protecting Sight Daily Learning #17: One Ted Talk, cataract surgery, journal article, and book chapter. #ProtectingSight

Welcome to day #17 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 – Tracy Edwards – Stop being a bystander in your own life. “‘Life doesn’t go from A to B — it’s messy,’ says sailing legend Tracy Edwards. In this inspiring talk, she tells how she went from teenage misfit to skipper of the first all-female crew in the toughest race on the seas — and how she now helps young people around the world achieve their dreams, too.” (ted.com)

I was initially interested in this Ted Talk based on the title and feature as one of the “Newest Talks.” Inspirational talk with many life lessons. Excellent video footage & photos which are a nice substitute to a live audience in a pre-COVID Ted Talk world.

2. Cataract Surgery – Shannon Wong MD – Is Cataract Surgery Boring? Panoptix with an open posterior capsule. Posterior capsulorhexis.

Excellent narrative and discussion of the pursuit of perfection. Dr. Wong expertly handles a routine case which suddenly turns complicated. Enjoyed watching his technique, and especially his pearls on remaining calm when a routine case suddenly becomes challenging.

3A. Journal article – Branch Retinal Vein Occlusion in a Young Man. Wei-Shan Tsai, Fang-Ling Chang, Ming-Shan He. Ophthalmology, April 2020, p. 510. (Case report)

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Branch Retinal Vein Occlusion in a Young Man. Wei-Shan Tsai, Fang-Ling Chang, Ming-Shan He. Ophthalmology, April 2020, p. 510. (Case report)

3B. Effect of Gas Tamponade on the Intraocular Lens Position and Refractive Error after Phacovitrectomy: A Swept-Source Anterior Segment OCT Analysis. Nobuhiko Shiraki, Taku Wakabayashi, Hirokazu Sakaguchi, Kohji Nishida. Ophthalmology, April 2020, p511–515.

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Ophthalmology, April 2020, p511–515.

4. Book Chapter – Jane Austen. Pride and Prejudice. Chapter 46-61 via LoyalBooks.com podcast. Finished! A most enjoyable book. I watched the online lecture below after finishing the book. Also plan to watch the Jane Austen and her times video below.

Pride and Prejudice by Jane Austen

I hope you enjoy these selections.

Please post a comment & subscribe/follow my blog www.ProtectingSight.com!

Protecting Sight Daily Learning posts are here.

Protecting Sight Daily Learning #16: One Ted Talk, cataract surgery, journal article, and book chapter. #ProtectingSight

Welcome to day #16 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 other piece of significant work.

Here’s today’s list:

1. Ted Talk – Jonny Sun – You are not alone in your loneliness – “Being open and vulnerable with your loneliness, sadness and fear can help you find comfort and feel less alone, says writer and artist Jonny Sun. In an honest talk filled with his signature illustrations, Sun shares how telling stories about feeling like an outsider helped him tap into an unexpected community and find a tiny sliver of light in the darkness.” (ted.com)

This was a Ted’s latest recommendation for me which matched my interest of “personal growth.” I continue to be impressed with Ted speakers and especially those who can convey meaningful concepts in less than 12 minutes.

2. Cataract Surgery – Yamane Technique & sutured IOL – A couple of good cases to watch.

3. Journal article – EyeNet February 2020 – Complicated Phaco Cases. Excellent Q&A with pearls on challenging cases.

4. Book Chapter – Jane Austen. Pride and Prejudice. Chapter 41-45 via LoyalBooks.com podcast. Excellent narration & quite addictive.

Pride and Prejudice by Jane Austen

I hope you enjoy these selections.

Please post a comment & subscribe/follow my blog www.ProtectingSight.com!

Protecting Sight Daily Learning posts are here.

Protecting Sight Daily Learning #15: One Ted Talk, cataract surgery, journal article, and book chapter. #ProtectingSight

Welcome to day #15 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 other piece of significant work.

Here’s today’s list:

  1. Ted Talk – Julian Treasure – How to speak so that people want to listen. “Have you ever felt like you’re talking, but nobody is listening? Here’s Julian Treasure to help. In this useful talk, the sound expert demonstrates the how-to’s of powerful speaking — from some handy vocal exercises to tips on how to speak with empathy. A talk that might help the world sound more beautiful.” (ted.com)

This is the 6th most viewed Ted Talk (42.4 million), with superb pearls in a 10-minute talk. Well worth watching twice.

2. Cataract Surgery – Uday Devgan MD – Fluidic Analysis during Phaco Chop. I watched this twice! Superb fluidic analysis of a dense, complicated cataract.

Fundus Photo

3. Journal article – EyeNet February 2020 – Diagnosis and Management of Optic Disc Pits. Written By: Christopher Schiefer, Mona A. Kaleem, MD, and Rachid Aouchiche, MD. Edited By: Ingrid U. Scott, MD, MPH, and Bennie H. Jeng, MD

Pride and Prejudice by Jane Austen

4. Book Chapter – Jane Austen. Pride and Prejudice. Chapter 22-40 via LoyalBooks.com podcast. Excellent narration & can be quite addictive.

5. (BONUS) Read my latest blog post on blue light blocking glasses: “Blue light blocking glasses should go the way of Kmart’s “Blue Light Special” … into extinction. Blue light filtering glasses have unproven benefits to patients and the public.”

I hope you enjoy these selections.

Please post a comment & subscribe/follow my blog www.ProtectingSight.com!

Protecting Sight Daily Learning posts are here.

Protecting Sight Daily Learning #14: One Ted Talk, cataract surgery, journal article, and book chapter. #ProtectingSight

Welcome to day #14 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 other piece of significant work. Often, that’s the daily minimum and a great motivator as I start the day.

Here’s today’s list:

  1. Ted Talk – The power of vulnerability. “Brené Brown studies human connection — our ability to empathize, belong, love. In a poignant, funny talk, she shares a deep insight from her research, one that sent her on a personal quest to know herself as well as to understand humanity. A talk to share.”

This is the 4th most viewed Ted Talk (48.5 million), and a talk I plan to watch again many times. “The power of vulnerability” is applicable to business and personal relationships. Many opportunities to learn and grow.

2. Cataract Surgery – Dr Ashvin Agarwal Demystifying cataract surgery on clouded corneas – I traveled to Dr. Agarwal’s Eye Hospital in 2007 for LASIK training. Dr. Ashvin Agarwal presents remarkable cases in a 15 minute potpourri.

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High Iris Insertion in Axenfeld-Rieger Syndrome. Ophthalmology. VOLUME 127, ISSUE 6, P768, JUNE 01, 2020

3A. Journal articles – OphthalmologyHigh Iris Insertion in Axenfeld-Rieger Syndrome. Erin A. Boese, Douglas B. Critser, John H. Fingert. June 2020 – Case Report.

3B. Natural History of Geographic Atrophy Secondary to Age-Related Macular Degeneration: Results from the Prospective Proxima A and B Clinical Trials. Ophthalmology. Volume 127, Issue 67, P769-783, June 1, 2020

Pride and Prejudice by Jane Austen

4A. Book Chapter – Jane Austen. Pride and Prejudice. Chapter 15-21 via LoyalBooks.com podcast. Excellent narration.

4B. Book Chapter – Simon Sinek, Start With Why. (2009). Chapter 2. He’s building a good story after the Ted Talk.

5. (BONUS) Happy National Sunglasses Day! Prolonged sun exposure raises the risk of eye diseases such as cataract, growths on the eye & cancer. Which sunglasses offer the best defense? Check out the American Academy of Ophthalmology article “The Sun, UV Light and Your Eyes.”

I hope you enjoy these selections.

Please post a comment & subscribe/follow my blog www.ProtectingSight.com!

Protecting Sight Daily Learning posts are here.

Blue light blocking glasses should go the way of Kmart’s “Blue Light Special” … into extinction. Blue light filtering glasses have unproven benefits to patients and the public. #BlueLight

Photo by John Adams on Unsplash

I’m often asked by patients about the benefit of blue light glasses. Proponents of blue light filtering glasses make claims of decreasing the risks for a number of eye diseases, including cataracts and macular degeneration.

However, there is little science to back up the claims. A remarkable expose by CBC took an undercover reporter to various national optical chains. This secret shopper was met with sales pitches that touted the benefits of blue light filtering glasses, including one which claimed that the blue light filtering glasses prevented cancer. The up-charge of $20 to $100 was especially concerning.

Wills Eye Hospital colleague and retina specialist Sunir Garg, MD, a clinical spokesperson for the American Academy of Ophthalmology, expertly critiqued the hidden-camera claims made. This is video which is well worth a 12 minute investment and includes an optics analysis by Oxford University Professor John O’Hagan. Professor O’Hagen is at the Public Health England’s centre for radiation, chemical and environmental hazards. (Also see an excellent article in The Guardian here.)

Patients concerned with blue light and eye disease may wish to review an EyeSmart article, “Blue Light and Digital Eye Strain” from the American Academy of Ophthalmology.

The AAO article states:

  • Blue light from computers will not lead to eye disease. It is true that overexposure to blue light and UV light rays from the sun can raise the risk of eye disease, but the small amount of blue light coming from computer screens has never been shown to cause any harm to our eyes.
  • Sleep can be improved without special eyeglasses. You don’t need to spend extra money on blue light glasses to improve sleep— simply decrease evening screen time and set devices to night mode.
  • Digital eye strain is not caused by blue light. The symptoms of digital eye strain are linked to how we use our digital devices, not the blue light coming out of them.

My advice is that blue light filtering glasses should go the way of the Kmart Blue Light Special … back into extinction.

“Attention Kmart Shoppers!” Kmart Blue Special last flashed in 1991! (Revived intermittently since 2001 according to Wikipedia. See also new4jax.com)