Protecting Sight Daily Learning #28: A technology to help 2 billion worldwide. We’ve come a long way since Benjamin Franklin’s bifocals!

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.” (

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.

Optical coherence tomography (OCT) taken at presentation (A) shows serous detachment and 2 months later (B) shows complete resolution of Vogt-Konayagi-Harada disease (VKH). Baseline OCT results revealed bilateral, large, and serous retinal detachments at the macula with multiple fibrinous septae (yellow arrowheads) in the subretinal fluid, typical of VKH. Two months of oral prednisone, administered at 60 mg, daily, and subsequently tapered, resulted in a marked resolution of subretinal fluid with evidence of disruption to the outer retina and retinal pigment epithelium. Similar findings were present in the fellow eye.
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

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 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)

A listing of Protecting Sight Daily Learning posts is here.

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