I was delighted to be the first cataract surgeon to implant the FDA-approved Alcon Panoptix Trifocal intraocular lens at the Wills Eye Surgery Center in Cherry Hill. Colleagues & ophthalmic device companies continue to inspire with new technologies.

Here’s an Alcon-produced patient-friendly video which explains the highlights of monofocal vs. multifocal / tri-focal lenses:

LEARN MORE ABOUT CATARACTS

A cataract is the clouding which occurs in the natural lens of the human eye. When we look at an object or enjoy colorful scenery, we depend on a clear pathway for light to travel from the outside world to the eye. Light and visual information travel through the cornea, pupil, and lens to the retina. The retina then sends this visual information to the brain.

Cataracts can cause multiple symptoms, including blurred vision, glare, halos, poor contrast and generalized visual discomfort. Patients may have difficulty driving, watching television, focusing on a computer, tablet (iPad, Kindle, Nook), smartphone, or reading. The haziness of vision may be similar to looking through a windshield during a rain or snowstorm. As cataracts progress, patients may feel that their vision no longer lets them enjoy common activities such as driving, watching television or walking safely.

More than 20 million patients in the United States have cataracts with an estimated 30 million patients affected by 2020. With the growth in our population and older patients leading active lives, cataract progression can result in a decrease in quality of life as well as the increase in the risk of falling, fractures, and depression.

Cataracts are treatable by cataract surgery, which is among the most common procedures performed in the United States. Dr. Goel is board certified and perform cataract surgery using the latest technologies and at the state of the art Wills Eye Surgery Center of Cherry Hill.

We often follow patients for many years while their cataracts are developing and until symptoms have an increased impact on daily activities. Patients are encouraged to learn about cataracts and watch our educational YouTube videos. We also use the latest lens technologies and can recommend the proper lens implant to replace the cataract once removed. Intraocular Lens (or IOLs) are commonly tailored to each patient’s eye health and visual demands.

Symptoms:

• Blurred Vision
• Glare/Halos
• Poor Contrast or Dimness of Vision
• Double Vision
• “I can’t see that small line at the bottom of the tv screen”

Visit http://www.reanj.com to learn more about cataract surgery options.  Or call the office at 856-795-8787 to schedule a cataract consultation with Dr. Goel.

I was inspired to create the talk, Growing Your Practice Through Collaborative Partnerships, after listening to podcasts and reading many leadership books in the last few years.

Through collaboration, you can amplify your strengths, shore up your weaknesses, save time and money. Shared authority, resources, and accountability between practices can help you achieve common goals that would otherwise be very difficult or expensive to accomplish.

In this session, I introduce numerous leadership and collaboration concepts to help ophthalmic and medical practices realize their full potential.

You’ll learn:

• The three behaviors of a collaborative leadership style, essential when forming partnerships.
• Common collaboration missteps that can throw your plan off track and how to overcome barriers.
• Leadership and partnership lessons from some of today’s business experts.
• Common themes among Collaborative Leaders, Level 5 Leaders & Serving Leaders.
• The essentials of OKRs – Objectives and Key Results (Andy Grove & John Doerr)

I’ve tried to maximize my commuting and leisure time and have discovered wonderful podcasts which help formulate mental models.  These include:

1. We Study Billionaires Podcast (Preston Pysh and Stig Brodersen)
2. The Knowledge Project (Shane Parrish)
3. Ted Talks
4. Naval Podcast (forgot to mention in talk!)

I reference many books I’ve read recently in this talk including:

1. Peter D. Kaufman (editor) and Charles T. Munger. Poor Charlie’s Almanack: The Wit and Wisdom of Charles T. Munger
2. Morten T. Hansen, Collaboration: How Leaders Avoid the Traps, Build Common Ground, and Reap Big Results
3. Jim Collins, Good to Great: Why Some Companies Make the Leap and Others Don’t
4. Kenneth R. Jennings and John Stahl-West, The Serving Leader: Five Powerful Actions to Transform Your Team, Business, and Community
5. Daniel Goleman, Emotional Intelligence: Why It Can Matter More Than IQ
6. Walter Isaacson, Benjamin Franklin: An American Life
7. John Doerr, Measure What Matters: How Google, Bono, and the Gates Foundation Rock the World with OKRs
8. Ray Dalio, Principles: Life and Work
9. James Clear, Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones
10. Spencer Johnson, M.D., Who Moved My Cheese?: An A-Mazing Way to Deal with Change in Your Work and in Your Life
11. Guy Spier, The Education of a Value Investor: My Transformative Quest for Wealth, Wisdom, and Enlightenment
12. Mohnish Pabrai, The Dhandho Investor: The Low-Risk Value Method to High Returns

I’ve enjoyed participating in the Wills Eye Hospital resident teaching courses on cataract surgery pearls & techniques.  With the 2-day course coming up this week — one on suturing and the second on basic phacoemulsification techniques — I wanted to share pearls and online resources.  This post is ideal for ophthalmology residents in training and colleagues engaged in lifelong learning.

I offer the following pearls for ophthalmology residents as they start the journey of cataract surgery:

1. Watch videos.  When I was a resident, I’d watch VHS tapes & DVDs of top ophthalmologists performing cataract surgery.  I enjoyed the calmness of watching world-renowned surgeons share their pearls on difficult cases (Howard Gimbel MD chief among them).  I visit CataractCoach.com daily and friend Uday Devgan, MD has created a cutting edge channel for cataract surgery pearls.
2. Watch surgeons in the operating room through the microscope AND from 5-10 feet away.  Learn to appreciate hand movements from a distance.  Focus on patient head positioning, surgeon posture and where senior colleagues rest their hands.
3. Make a list of every item you need for surgery.  Glove size, Microscope PD, routine and complicated cataract cases all use various instruments, etc.  Take photos of the cataract surgery phaco settings for sculpting, quadrant removal, etc. You may operate in different facilities and will want to give the OR team your preferred items.  Make a list of special items you want on-hand for difficult cases.
4. Also issues to make you as comfortable as possible.  Do you like lights on or off during surgery?  Music in background?  Is the surgeon chair comfortable and appropriate? Ergonomics is critical and especially during the early days of microscopic surgery.
5. Record all of your cases and watch back in real-time.  No fast forwarding allowed!  During my 3rd year of residency and early years in practice, I watched every case in real-time and often with my brother, Sonny Goel MD, a cataract & refractive surgeon.  I still remember the pearls of an independent observer as he reviewed my cases with me.  Be able to explain and minimize all time delays between steps and during the procedure.
6. Every second counts in the operating room.  If an OR team member needs to leave the room to get a special instrument, have the instrument on-hand for future cases.  I will not enter a room unless a Malyugin Ring, Vision Blue, and other special devices are in the room before I operate.
7. Start performing functions with your non-dominant hand.  Cataract surgery is a bi-manual technique and you’ll want to be able to use both hands easily during surgery.  I would try writing, shaving, etc. with my non-dominant hand as a resident.
8. Make copies of dictations from various cataract surgeons.  Surgeons have numerous techniques, and you’ll find surgery note dictations helpful as your style evolves.  Develop special templates for complicated cases.                                                 
9. Calculate your own intraocular lens powers.  I use 7 formulas to optimize & select the intraocular lens power.  This includes older generation formulas (SRK/T, Holladay 1, Holladay 2, Hoffer Q) and newer generation formulas (Barrett Universal II, Ladas, and Kane, currently free online).  I also calculate lens powers for in-the-bag, sulcus, and ACIOL before surgeries.  I use special colored sheets (red for right eye (OD) and light blue for left eye (OS)) as an added patient safety measure.

Here are some blog posts and videos on suturing and cataract surgery techniques.  I may add more links in the weeks ahead.  I hope this is a helpful start.

Suturing Pearls:

1. Uday Devgan, MD Basic Principles of Ophthalmic Suturing

2. Uday Devgan, MD Review: Basic Principles of Suturing with 10-0 Nylon

3. Mayo Clinic Corneal Suturing Techniques (Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6)

4. Christopher Teng, MD How to Suture Efficiently in Ophthalmology (no sound, but less than 2 minute video with text and great pearls)

Cataract Surgery Pearls:

1. Howard Gimbel MD – When I was a resident, an ophthalmology device company sent all residents a VHS tape of Dr. Gimbel performing 5-6 cataract surgeries, telecast live to an ophthalmology conference.  I watched Dr. Gimbel’s videos hundreds of times (for many years, every week and on the night before I operated!).  Here’s a recent video from on Effective Fracturing in Cataract Surgery.

2. Richard J. Mackool, MD – I visited Dr. Mackool at his Astoria, NY practice & surgery center twice early in my career.  The first time was in 2002 and the second in 2006.  Dr. Mackool is a brilliant ophthalmologist and cutting edge cataract surgeon.  His columns and surgical pearls have guided me for two decades.  His 2019 Mackool Online Fundamentals: Episode 1, Phaco Fundamentals is an ideal starting point for the busy resident and lifelong learner.  And in 3-D online!

3. Uday Devgan, MD – I love cataractcoach.com!  Here’s a link to his complete list of videos.  Start with his routine cataract surgery case here.

4. My guest submission on CataractCoach.com “Bleeding from a Pupil Expander!  Now What?” is here.

5. Lisa Brothers Arbisser, MD Routine Cataract Surgery (2012) here.

6. Dr. Takayuki Akahoshi performs 10,000 cataract surgeries a year.  Here is a case he performed on a grade V cataract using ICG (indocyanine green) and a pre-chopping technique.  This case had a Cumulative Dissipated Energy (CDE) = 9.86.  (Keep a personal log of your aspiration time, CDE, and fluid exchange throughout residency!)

7. This is an example of my cataract surgery technique video in which I describe each step of surgery in a patient-friendly manner (you’ll never look at an M&M candy the same again).

8. I also include a white cataract in which I used Vision blue here.

PS. A most successful suturing & phaco course! The Wills Eye Hospital Measey Ophthalmic Surgery Training (MOST) Lab is a game changer in ophthalmology microsurgery training. Congrats to colleagues and leaders for helping the next generation in the journey of #ProtectingSight & #EmpoweringLives. #BelievingIsSeeing

I will continue to add pearls & links to this blog post.  Please send me helpful links & comments below or via social media: YouTube | Twitter | Instagram | LinkedIn

Ravi D. Goel M.D. is a cataract surgeon & comprehensive ophthalmologist at Regional Eye Associates in Cherry Hill, NJ.  He is also an instructor at Wills Eye Hospital. #ProtectingSight #EmpoweringLives #BelievingIsSeeing

Patients are increasingly presenting to my office with difficulty with night vision, including glare and halos with nighttime driving.  I was delighted to post an article on the American Academy of Ophthalmology EyeSmart patient education site, which can be found here.

I’ve also included the article’s text below.

I graduated from college in May 1993 and went straight to my state medical school.  My student loan debt was $100k+ after 4 years (I missed out on the NYU College of Medicine’s remarkable tuition free initiative earlier this week). When I saw Troy Aikman’s tweet earlier today asking for a Twitter ophthalmology consult, I Googled the former Dallas Cowboys QB’s name and learned he signed an 8-year, $50 million deal the same week I had taken my anatomy final! (link)

I love Twitter and have embraced the American Academy of Ophthalmology’s hashtags #ProtectingSight & #EmpoweringLives. I also follow many ophthalmology colleagues, eye hospitals and ophthalmology related organizations.

I have the privilege of being an on-call phone consultant when colleagues have difficulty finding an ophthalmologist in their local communities (including the Great State of Texas!).  One friend who was then-president of the American Medical Association called me with a curbside question while managing patients in his ER. (Emergency Medicine colleagues know how to get the information they need to help patients with efficiency!) Ophthalmology is a visual specialty, and the patient history and clinical findings dictate management.

The American Academy of Ophthalmology has a detailed Preferred Practice Pattern for conjunctivitis management (link). A patient friendly guide is here. (“Pink eye,” or “red eye” are among the many descriptions for this acute or chronic condition.)

Acute conjunctivitis is a common ailment which affects upto 6 million people in the US yearly. Viral conjunctivitis is the most common cause, followed by bacterial conjunctivitis. The cost of antibiotics therapy for bacterial conjunctivitis alone is estimated to be $377 million to $857 million per year (Azari AA in JAMA 2013; 310(16): 1721-1730. doi:10.1001/jama.2013.280318 ). In addition, allergic conjunctivitis affects 15-40% of the population.

For Mr. Aikman (whom I have not examined) and patients with similar symptoms, I recommend ophthalmology consultation. Specialists consider the zebras of rare conditions when they hear the horse hoofbeats of common infections. In the absence of immediate ophthalmology availability I recommend:

1. Maintain contagious precautions – Wash your hands and your workplace frequently. Do not shake hands and avoid door knobs. Literally walk with your hands in your pockets. Take time off work and keep kids out of school as you may cause others to become infected.

2. Discontinue contact lenses (if you wear them) – With any pink eye or conjunctivitis, stop wearing contact lenses and throw away the current case and contact lens solutions.

3. Seek medical (preferably ophthalmology) consultation immediately – As the American Academy of Ophthalmology Preferred Practice Pattern alludes, there are numerous vision threatening conditions which need to be assessed in a timely fashion and treated immediately. Azari offers a helpful algorithm for clinicians and patients to approach suspected acute conjunctivitis:

The AAO Preferred Practice Pattern has a helpful high yield summary paragraph:

“The ophthalmologist plays a critical role in breaking the chain of transmission of epidemic adenoviral conjunctivitis, primarily by educating the patient and family about proper hygiene. Infected individuals should be counseled to wash hands frequently with soap and water (as opposed to sanitizer only) and use separate towels, and to avoid close contact with others during the period of contagion. Avoiding contact with others is especially important for individuals in professions with high potential for transmission, such as health care workers and child care providers. While the exact length of the period of infectivity is variable, many consider 7 days from the onset of symptoms as the contagious period, because the recovery of virus from infected cases drops off after 7 days of infection.43 However, other studies have suggested that patients should be considered potentially contagious for at least 10 to 14 days.44,45″

Good luck to Mr. Aikman.  With his public stature, I hope this potentially contagious conjunctivitis can be limited from spreading to colleagues and fans.

And #FlyEaglesFly!

—-

Ravi D. Goel M.D. is a cataract surgeon & comprehensive ophthalmologist at Regional Eye Associates in Cherry Hill, NJ.  He is also a clinical instructor at Wills Eye Hospital.  His patient-friendly YouTube cataract surgery educational videos are here.

I finished ophthalmology residency in 2001.  Since 2002, I’ve attended every American Academy of Ophthalmology Mid-Year Forum (left early circa 2007 for a friend’s premiere at the NY Metropolitan Opera.  I also missed two days in 2015 when my practice partner served as president-elect of our state society).  I’ve attended as a member of the Young Ophthalmology (YO) committee, Leadership Development Program (LDP), American Academy of Ophthalmic Executives (AAOE) and as a representative to outside organizations (AMA Ophthalmology Section Council).  I’ve also enjoyed the privilege of speaking at numerous Mid-Year Forum educational sessions.

The Academy’s Mid-Year Forum (#AAOMYF) originally included state and speciality society leaders, Academy volunteers & committee members, representatives to outside organizations, international leaders and the Academy’s board of trustees.  Since 2004, the Academy has welcomed residents and fellows to serve as Academy Advocacy Ambassadors.  The program was started by members of my Leadership Development Program (LDP) VI class (Jen & Beth!) and has evolved into one of the Academy’s growth areas of leadership development & YO engagement (“YO” = Young Ophthalmologist, coined circa 2000).

To make the most of the Mid-Year Forum, I offer the following suggestions to Advocacy Ambassadors:

Wednesday night – Meet mentors, colleagues and residents from your state.  During the dinner briefing, you’ll learn about the key issues which ophthalmology faces at the federal level.  Try to identify three talking points which will help when you meet Members of Congress and their staff.

Thursday – Capitol Hill Visits – You’ll travel to Capitol Hill and meet Congressional offices on both the House and Senate side.  Have your running shoes on!  You will want to speak with your mentors and fellow residents who will be attending.  Do not be disappointed if you do not meet directly with your Member of Congress.  Legislative Assistants (LAs) and Congressional staff are well versed in health care issues and in fact are wonderful liaisons with Congressional offices on key issues.  Your perspective as a young ophthalmologist is critical to the ophthalmology efforts to protect sight.  If you offer to follow-up on an issue, write down names, emails and follow-up!  If the Congressional office requests more information beyond the “leave behind” packets which the Academy has prepared, alert Academy staff on the post-meeting forms.

Thursday-Saturday Mid-Year Forum – attend as many events as you can and meet colleagues from your state and subspecialty.  The Surgical Scope Fund (SSF) and OPHTHPAC host receptions with modest contribution levels ($50 for Advocacy Ambassadors, $500 for other attendees).  These are optimal opportunities to meet colleagues who volunteer hundreds of hours outside of their clinical practices to move medicine forward.  If you have a specific interest (“Hey, I want to write an article for EyeWiki & EyeNet” or “I’d love to learn more about international ophthalmology”), feel free to reach out to connect with key leaders.

The Academy’s Mid-Year Forum is the premiere meeting to learn about health care policy, challenges and solutions for ophthalmology.  The pearls you learn now will serve you well once you finish residency & fellowship.  I’ve formed lifelong friendships and interacted with colleagues worldwide in a shared mission of #ProtectingSight & #EmpoweringLives.

See you soon!

Ravi

PS. 1. Bring your business cards!

2. Tweet early & often: #AAO2018 #MYF2018 @RaviDGoel

The text came from a college classmate who is also an Emergency Medicine physician. She and I caught up over the weekend when I asked her to donate to our college class’ upcoming 25th reunion gift. She declined and cited a wonderful endowed scholarship she had recently created in her mother’s memory for under-represented medical students who are “first in their family” to pursue advanced degrees.

I also have the privilege of being one of my classmate’s on-call phone consultants when she has difficulty finding an ophthalmologist in her local community. (Another friend who was then-president of the American Medical Association once called me with a curbside question while managing patients in his ER. Emergency Medicine colleagues know how to get the information they need to help patients with efficiency!) Ophthalmology is a visual specialty, and the patient history and clinical findings dictate management.

My classmate texted, “Do you watch CNN? Poor Erin Burnett trying to hide a terrible r conjunctivitis or something…. please tweet her to take a day off!!! Poor girl is sick w adenovirus or rhinovirus ! Give her second a chance!!! She looks crazy!!!”

I immediately tuned to CNN, “The Most Trusted Name in News,” which I turn to daily along with NPR, ABC World News Tonight, the NY Times, and the Oldest College Daily.

The CNN segment included Ms. Burnett interviewing the expert on the recent UFO project. The numerous cameras kept going in and out with minimal time allotted to the anchor asking questions. A most unusual and adaptive technique. I turned to my iPad and took a quick screenshot of Ms. Burnett at the end of the segment.At low resolution, a viewer can appreciate the anchor’s “pink eye” with upper eyelid ptosis (secondary drooping of the right upper eyelid from inflammation) and conjunctival redness. On higher resolution, the findings are confirmed.

She likely also had light sensitivity, though it was difficult to assess with CNN strategic video angles.

The American Academy of Ophthalmology has a detailed Preferred Practice Pattern for conjunctivitis management (link). A patient friendly guide is here.

Acute conjunctivitis is a common ailment which affects upto 6 million people in the US yearly. Viral conjunctivitis is the most common cause, followed by bacterial conjunctivitis. The cost of antibiotics therapy for bacterial conjunctivitis alone is estimated to be $377 million to $857 million per year (Azari AA in JAMA 2013; 310(16): 1721-1730. doi:10.1001/jama.2013.280318 ). In addition, allergic conjunctivitis affects 15-40% of the population.

For Ms. Burnett (whom I have not examined) and patients with similar symptoms I recommend ophthalmology consultation (a bias and specialists consider the zebras of rare conditions when they hear the horse hoofbeats of common infections). In the absence of immediate ophthalmology availability I recommend:

1. Maintain contagious precautions – Wash your hands and your workplace frequently. Do not shake hands and avoid door knobs. Literally walk with your hands in your pockets. Take time off work and keep kids out of school as you may cause others to become infected.

2. Discontinue contact lens (if you wear them) – With any pink eye or conjunctivitis, stop wearing contact lens and throw away the current case and contact lens solutions.

3. Seek medical (preferably ophthalmology) consultation immediately – As the American Academy of Ophthalmology Preferred Practice Pattern alludes, there are numerous vision threatening conditions which need to be assessed in a timely fashion and treated immediately. Azari offers a helpful algorithm for clinicians and patients to approach suspected acute conjunctivitis:

The AAO Preferred Practice Pattern has a helpful high yield summary paragraph:

“The ophthalmologist plays a critical role in breaking the chain of transmission of epidemic adenoviral conjunctivitis, primarily by educating the patient and family about proper hygiene. Infected individuals should be counseled to wash hands frequently with soap and water (as opposed to sanitizer only) and use separate towels, and to avoid close contact with others during the period of contagion. Avoiding contact with others is especially important for individuals in professions with high potential for transmission, such as health care workers and child care providers. While the exact length of the period of infectivity is variable, many consider 7 days from the onset of symptoms as the contagious period, because the recovery of virus from infected cases drops off after 7 days of infection.43 However, other studies have suggested that patients should be considered potentially contagious for at least 10 to 14 days.44,45″

Good luck to Ms. Burnett and the CNN team! (I hope this potentially contagious conjunctivitis can be limited from spreading to colleagues).

—-

Ravi D. Goel M.D. is a cataract surgeon & comprehensive ophthalmologist at Regional Eye Associates in Cherry Hill, NJ.  He is also a clinical instructor at Wills Eye Hospital.  His patient-friendly YouTube cataract surgery educational videos are here.

Dear Ophthalmology Colleagues,

I’ve started to read the MIPS Manual: A Primer and Reference from the EyeNet Supplement (August 2017).

My practice plans to use the IRIS Registry web portal for MIPS reporting. The IRIS Registry dashboard eases confusion. The EyeNet Supplement (August 2017), Page 10, states that EHR vendors may also submit for all three performance categories. IRIS Registry (also free for AAO members) is a better fit for my practice this year.

There are 3 MIPS performance category baskets:
1. Quality – IRIS Registry does the calculation and suggests which measures to submit (with green flags!).
2. ACI  (Advancing Care Information) – Practices need to select measures to submit.
3. IA – (Improvement Activities) – Practices need to select measures to submit.

Here’s my plan to achieve maximum benefit from the 2017 MIPS cycle:

1. Watch the Academy’s 2-minute video “How to Avoid a 2019 MIPS Penalty”by George Williams, MD, Academy Secretary for Federal Affairs.  The page includes instructions to report a single quality measure before December 31, 2017 to avoid 2019 penalties.  My practice uses IRIS Registry AND I still plan to submit some claims-based quality measures.
2. Review the AMA’s “MIPS Action Plan – 10 Keys Steps for 2017” (Opens as PDF)  The AMA web portal for MIPS Action Plan is here.  (It pays to be an AMA Member!)
3. Review the Academy’s EyeNet Supplement (August 2017).  Have a highlighter ready and circle measures you can meet easily.  The supplement is initially overwhelming so plan ahead.
4. If you participate in IRIS Registry, login into IRIS Registry portal and click MIPS in the left hand column (easier from desktop vs. tablet). This is where the rubber hits the road.  I had my greatest ANXIETY RELIEF when I logged into IRIS Registry and reviewed the MIPS information.  The 3 performance category baskets are outlined and I could more easily understand (with EyeNet graphics) which measures to submit. (See below)
5. Develop a September action plan so that you can meet the measures needed to report successfully.  If you plan on going for more than the minimum (#1 above) then you’ll need to develop a plan in September and start no later than October 2.
6. I will continue to add and edit pearls in the weeks ahead. If you send me a pearl (in the comment section below or via @RaviDGoel), I will add with credit in this blog.

—–

My IRIS Registry Dashboard currently looks like this:

1. Quality – We need to submit 6 of 15 measures which the IRIS Registry is extracting from our EMR. Some measures have green flags, some red flags and some gray flags. I plan to monitor this so that we can submit for the full year if we have at least 6 measures with green flags.

2. ACI -Advancing Care Information – Here are the measures which IRIS Registry has for ACI. I will plan to master the mandatory measures and then use the EyeNet Supplement to see which other measures we need to submit to maximize our score.

3. IA – (Improvement Activities) – Here also, I will work with my team to identify the best measures to meet the IA component. IRIS Registry is a big help.

The IRIS Registry Dashboard will allow you to keep score along the journey.

Happy Labor Day weekend!

Please revisit this page for additional pearls and suggestions for measures which are more easily achievable with EMR.

Ravi

—

Ravi D. Goel M.D. is a cataract surgeon & comprehensive ophthalmologist at Regional Eye Associates in Cherry Hill, NJ.  He is also a clinical instructor at Wills Eye Hospital.  His patient-friendly YouTube cataract surgery educational videos are here.