Protecting Sight #184: How you can use impostor syndrome to your benefit. A floppy iris & Malyugin Ring. Bjerrum’s glaucoma haemorrhagicum & the Drance hemorrhage. Crafting a narrative.

Welcome to my daily learning journal. My daily goal is to watch one Ted Talk and one cataract surgery. I also plan to read one journal article and read/listen to a book chapter, podcast, or significant work.

Here’s today’s list:

1. Ted Talk – Mike Cannon-Brookes: How you can use impostor syndrome to your benefit. “Have you ever doubted your abilities, feared you were going to be discovered as a “fraud”? That’s called “impostor syndrome,” and you’re definitely not alone in feeling it, says entrepreneur and CEO Mike Cannon-Brookes. In this funny, relatable talk, he shares how his own experiences of impostor syndrome helped pave the way to his success — and shows how you can use it to your advantage, too.” (

I thought I was the only one who suffered from imposter syndrome! This is an extraordinary talk.

2. Cataract Surgery – Uday Devgan MD – This sign means I need a pupil ring. Dr. Devgan writes in part, “Iris prolapse to the paracentesis incision is the sign that lets me know immediately that we will need to use a pupil ring. This paracentesis is about 1 mm (or smaller) in width and even still, this allows iris to prolapse and plug the incision. By inserting the pupil expansion ring, we are able to expand the dilation to 6.25 mm while also holding the iris away from our surgical instruments.”

Dr. Devgan handles these cases with ease. I love the Malyugin Ring.

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3. Stephen Michael Drance, OC, MD (1925–2020). Chauhan, Balwantray. Ophthalmology Glaucoma (published online, November 27, 2020)

Dr. Drance led an extraordinary life. I’ve been writing “Drance hemorrhage” for two decades. Its sign often makes me sit back and carefully review every ophthalmic and visual field finding anew. This often extends patient visits and changes glaucoma management. Rest in peace, Dr. Drance. Your ground-breaking work protected sight in millions worldwide.

Drance hemorrhage, Courtesy of G. A. Cioffi, MD., ( Multimedia Image)

Wilde, C., Poostchi, A., Narendran, R. et al. Prevalence of optic disc haemorrhages in an elderly UK Caucasian population and possible association with reticular pseudodrusen—the Bridlington Eye Assessment Project (BEAP): a cross-sectional study (2002–2006)Eye 33, 580–586 (2019).

The article states, “Originally reported by Bjerrum [1], the term ‘glaucoma haemorrhagicum’ was used to describe patients with glaucoma and DH. ” (Bjerrum J. Om en tilfojeke til den saedvanlige synsfelfundersogelse samt om synfelet ved glaukom. Nord Ophthalmol Tskr. 1889;2:141–85.)

It will be extraordinary to see how AI responds to the Drance hemorrhages in the years ahead.

4. The Knowledge Project (Shane Parrish) Episode 85: Bethany McLean: Crafting a Narrative — “Best-selling author of The Smartest Guys in the Room and All the Devils are here, Bethany McLean, discusses how to write a story, the behaviors of CEO’s, visionaries and fraudsters and so much more.”

Superlatives aside, this is a wonderful episode and filled with remarkable insights and pearls.

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