Protecting Sight Daily Learning #33: How your emotions change the shape of your heart. Broken hearts, pseudoexfoliation, loose zonules, Rosai-Dorfman, and tularemia.

Welcome to day #33 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 Sandeep Jauhar: How your emotions change the shape of your heart – ” ‘A record of our emotional life is written on our hearts,’ says cardiologist and author Sandeep Jauhar. In a stunning talk, he explores the mysterious ways our emotions impact the health of our hearts — causing them to change shape in response to grief or fear, to literally break in response to emotional heartbreak — and calls for a shift in how we care for our most vital organ.” (

This was today’s Ted Talk recommendation. I’ve enjoyed Sandeep Jauhar’s articles and social media posts. His talk starts with, “No other organ, perhaps no other object in human life, is as imbued with metaphor and meaning as the human heart.” The 16-minute talk is as mesmerizing as this first sentence. I renew my suggestion to start a day with a Ted Talk. Ted Talks often set the tone for an inspirational day.

2. Cataract Surgery – Richard J. Mackool, MD – Episode 4: Severe Zonule Laxity. “Pseudoexfoliation and a large nucleus that masks zonule laxity is the situation with this eye in which the anterior capsule behavior during capsulorhexis doesn’t alert the surgeon to the true status of the zonule. Using Trypan Blue, 360º viscodissection, a back crack technique, special techniques to rotate the nucleus, capsule retractors and a CTR, I am able to perform zonule-friendly phaco and IOL insertion in an eye that continues to bring surprises throughout the case. The video is necessarily a bit long but I think you will really enjoy this one!”

Well worth the 25 minute investment to watch this case. Dr. Mackool is a master surgeon. If only I had Dr. Mackool’s online resource and Uday Devgan MD’s during residency!

3. Journal – JAMA Clinical Challenges are well written and stimulating. I was cleaning out the office and enjoyed these cases from November 2018.

Color photograph depicting swelling over the right lacrimal gland region with intact epidermis and absence of inflammatory signs.

3A. Journal – Clinical Challenge – Constantinescu AB, Surakiatchanukul T, Shields CL. Unilateral Eyelid Swelling With Submandibular Lymph Node Enlargement. JAMA Ophthalmol. 2018;136(11):1293–1294. doi:10.1001/jamaophthalmol.2018.0801

A, Clinical photograph of child at presentation displaying a right orbital cyst. B, Coronal T2-weighted magnetic resonance image showing a large inferior right orbital cyst displacing the microphthalmic globe superiorly.

3B. Journal – Clinical Challenge – DeMaria L, Shinder R. Hidden Globe in an Infant. JAMA Ophthalmol. 2018;136(11):1295–1296. doi:10.1001/jamaophthalmol.2018.0932

External photograph of the left eye demonstrating periorbital edema, lash crusting, and follicular conjunctivitis with a granuloma in the inferolateral fornix.

3C. Journal – Clinical Challenge – Taubenslag KJ, Michaels MG, Sylvester CL. A Child With Unilateral Conjunctivitis and Elevated Inflammatory Markers. JAMA Ophthalmol. 2018;136(11):1297–1298. doi:10.1001/jamaophthalmol.2018.0936

4. Book Chapter – Herman Melville – Moby Dick. Listened to Chapters 81-86 via See also Sparknotes (narration) and Gutenberg (book text).

See Protecting Sight Daily Learning posts here.

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