Protecting Sight #52: Letting go of good & becoming a better person. A nucleus femto, phaco, tuck, Kahook, & Huck.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – Dolly Chugh: How to let go of being a “good” person — and become a better person. “What if your attachment to being a “good” person is holding you back from actually becoming a better person? In this accessible talk, social psychologist Dolly Chugh explains the puzzling psychology of ethical behavior — like why it’s hard to spot your biases and acknowledge mistakes — and shows how the path to becoming better starts with owning your mistakes. “In every other part of our lives, we give ourselves room to grow — except in this one, where it matters most,” Chugh says.” (ted.com)

Good talk and I like the concept. 12 minutes.

2A. Cataract Surgery – Uday Devgan MD – The hemi-nucleus tuck technique. I used this pearl today!

2B. VJCRGS – Ike Ahmed MD – Kahook Dual Blade. Great review of MIGS technologies.

3. Journal article – Femtosecond Laser-Assisted Cataract Surgery Versus Phacoemulsification Cataract Surgery (FACT): A Randomized Noninferiority Trial. Alexander C. Day, Jennifer M. Burr, Kate Bennett, Catey Bunce, Caroline J. Doré, Gary S. Rubin, Mayank A. Nanavaty, Kamaljit S. Balaggan, Mark R. Wilkins on behalf of the FACT group. Ophthalmology, August 2020: p1012–1019. Just read the abstract and you’ll be fine.

Huckleberry Finn book.JPG

4. Book Chapter – Mark Twain, The Adventures of Huckleberry Finn. LoyalBooks.com, SparkNotes, and Gutenberg. Chapters 8-10. Enjoying the free Huck Finn LoyalBooks audio podcast.

c08-61.jpg (179K)
See Protecting Sight Daily Learning posts here.

Protecting Sight #51: The power of social integration & close relationships. OVD, MIGS, and the corneal endothelium. Huck Finn escapes.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk Susan Pinker: The secret to living longer may be your social life. “The Italian island of Sardinia has more than six times as many centenarians as the mainland and ten times as many as North America. Why? According to psychologist Susan Pinker, it’s not a sunny disposition or a low-fat, gluten-free diet that keeps the islanders healthy — it’s their emphasis on close personal relationships and face-to-face interactions. Learn more about super longevity as Pinker explains what it takes to live to 100 and beyond.” (ted.com)

A most enjoyable talk on the power of social integration. 16 minutes.

2A. Cataract Surgery – Uday Devgan MD – Removing OVD from behind the IOL. Great pearls, Uday.

2B. VJCRGS – Ike Ahmed MD – Hydrus Microstent. I plan to watch each of the MIGS videos in the days ahead.

3. Journal article – Srinivasan, Sathish FRCSEd, FRCOpth, FACS. The corneal endothelium and its reactions to surgical procedures. Journal of Cataract & Refractive Surgery: July 2020 – Volume 46 – Issue 7 – p 931-932 doi: 10.1097/j.jcrs.0000000000000265. Well written and a nice big-picture review.

Huckleberry Finn book.JPG

4. Book Chapter – Mark Twain, The Adventures of Huckleberry Finn. LoyalBooks.com, SparkNotes, and Gutenberg. Chapters 6-7. Enjoying the free Huck Finn LoyalBooks audio podcast.

See Protecting Sight Daily Learning posts here.

Protecting Sight #50: Humans have an innate sense of fairness (Ted Talk). MIGS, COVID-19, ocular trauma & Huck Finn.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – Marco Alverà: The surprising ingredient that makes businesses work better. “What is it about unfairness? Whether it’s not being invited to a friend’s wedding or getting penalized for bad luck or an honest mistake, unfairness often makes us so upset that we can’t think straight. And it’s not just a personal issue — it’s also bad for business, says Marco Alverà. He explains how his company works to create a culture of fairness — and how tapping into our innate sense of what’s right and wrong makes for happier employees and better results.” (ted.com)

I loved this talk and especially Alverà’s comment that “humans have an innate sense of fairness.” He strikes me as a Level 5 Leader (ala Jim Collins and Good to Great). 14 minutes.

2A. Cataract Surgery – Uday Devgan MD – Draining a choroidal hemorrhage. “Our guest surgeon is Dr. Ramesh Ayyala, the chairman of the USF Eye Institute in Tampa, Florida, who is an internationally known expert in complex cases, particularly with glaucoma. In the video shown here, Dr. Ayyala shows his technique for draining a choroidal hemorrhage and a choroidal effusion. The technique is effective and he has some very important pearls for us such as keeping the anterior chamber pressurized with balanced salt solution infusion throughout the procedure.”

2B. VJCRGS – Robert H. Osher MD & Ike Ahmed MD – Introduction to MIGS. “The Video Journal of Cataract, Refractive and Glaucoma Surgery (VJCRGS) represents a lifelong mission of renowned ophthalmic surgeon and educator, Robert H. Osher, MD, to advance knowledge and surgical training of eye surgeons.”

I plan to watch each of the MIGS videos in the days and weeks ahead.

3. Journal article – Wu, Connie; Patel, Samir N.; Jenkins, Thomas L.; Obeid, Anthony; Ho, Allen C.; Yonekawa, Yoshihiro. Ocular trauma during COVID-19 stay-at-home orders, Current Opinion in Ophthalmology: July 27, 2020 – Volume Publish Ahead of Print – Issue – doi: 10.1097/ICU.0000000000000687

Huckleberry Finn book.JPG

4. Book Chapter – Mark Twain, The Adventures of Huckleberry Finn. LoyalBooks.com (Apple podcast) and Gutenberg. Chapters 1-5.

Seven Common Myths about Children’s Eye Health

See Protecting Sight Daily Learning posts here.

Protecting Sight #49: Sleep is your superpower.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – Matt Walker: Sleep is your superpower. “Sleep is your life-support system and Mother Nature’s best effort yet at immortality, says sleep scientist Matt Walker. In this deep dive into the science of slumber, Walker shares the wonderfully good things that happen when you get sleep — and the alarmingly bad things that happen when you don’t, for both your brain and body. Learn more about sleep’s impact on your learning, memory, immune system and even your genetic code — as well as some helpful tips for getting some shut-eye.” (ted.com)

In college and medical school, I could never study past 10 pm. The grind was real and I treasured my sleep. Walker gives an excellent talk and I hope to learn more about the superpower of sleep. 20 minutes and 11 million views.

2. Cataract Surgery – Ike Ahmed MD & Dr. Felipe Vejarano. Very few people can get ophthalmologists to wake up early & stay up late to learn the great pearls of cataract surgery. #IkeNeedsAHaircut is one of those people. Today’s webinar is available on YouTube.

Slitlamp photograph of the right eye showing corneal verticillata (yellow arrowheads) and fine interspersed corneal crystals (most visible in the white circle).

3A. Journal – Bhat A, Jhanji V. A Man With Bilateral Corneal Verticillata and Corneal Crystals. JAMA Ophthalmol. 2020;138(5):580–581. doi:10.1001/jamaophthalmol.2020.0128

Neuroimaging at presentation.

3B. Long CP, Ediriwickrema LS, Liu CY. Severe Progressive Bilateral Vision Loss With Headaches. JAMA Ophthalmol. 2020;138(5):582–583. doi:10.1001/jamaophthalmol.2020.0362.

A, Axial computed tomography (CT) of the orbits with contrast shows a large destructive lesion in the right sphenoid bone and anterior aspect of the middle cranial fossa. B, A T1-weighted magnetic resonance image (MRI) of the brain and orbits without contrast shows the involvement of the right temporal lobe. The lesion can be seen also involving the right side of the sphenoid bone, orbital apex, and scalp anteriorly. The scale across the bottom of each image is measured in centimeters. A indicates anterior; R, right.

3C. Tran J, Allen RC. A Mass in the Greater Wing of the Sphenoid in a Pediatric Patient. JAMA Ophthalmol. 2020;138(5):584–585. doi:10.1001/jamaophthalmol.2020.0372.

Aesop's Fables by Aesop

4. Book Chapter – Aesop’s Fables via LoyalBooks.com Apple podcast.

Warren Buffett often mentions Aesop’s Fables during the Berkshire Hathaway annual meetings. This podcast includes 25 fables and is filled with life lessons. Worth listening to again and again.

Buffett recites an Aesop fable.

5. Regional Eye Associates August newsletter: Seven Common Myths about Children’s Eye Health. Includes in-person & virtual back-to-school tips!

I recently hand-delivered 100 N-95 masks to ophthalmology colleagues and staff on the frontlines at the Wills Eye Hospital.  The gift was arranged through a generous donation by LanceSoft and my brother, Al. With thanks for helping colleagues on the front lines!

See Protecting Sight Daily Learning posts here.

Protecting Sight #48: The Opposites Game. Pseudoexfoliation and the risk of dislocated IOLs. Tom Sawyer’s hunt for treasure & dramatic ending.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – Brendan Constantine: The Opposites Game. “A classroom erupts into a war of words as students grapple with a seemingly simple prompt: what is the opposite of a gun? This animation is part of the TED-Ed series, ‘There’s a Poem for That,’ which features animated interpretations of poems both old and new that give language to some of life’s biggest feelings. [A TED-Ed Production, a film by Anna Samo + Lisa LaBracio, poem by Brendan Constantine, poem performed by Brendan Constantine, sound Design by Weston Fonger, animation & Design by Anna Samo + Lisa LaBracio, animation Produced by Gerta Xhelo].” (ted.com)

This is a TED-Ed production. I tend to prefer Ted Talks in front of an audience (shying away from the COVID-inspired Zoom chats). This Ted-Ed talk is 4 minutes, fast paced, and worth a watch.

2. Cataract Surgery – Richard Mackool MD – Episode 7: Dense Brunescent Nuclear Cataract with Pseudoexfoliation. “An 87 year old patient presents with a dense brunescent nuclear cataract, pseudoexfoliation and a central corneal dry spot with opacification. Enhancing my visualization is key, as is being able to constantly visualize the edge of the anterior capsule during phacoemulsification. The use of my second instrument to protect the posterior capsule is also discussed.”

Dr. Mackool’s videos are filled with pearls.

3. Journal – Risk Factors for Intraocular Lens Dislocation After Phacoemulsification: A Nationwide Population-Based Cohort Study. Ga-In Lee, Dong Hui Lim, Sang Ah Chi, Seon Woo Kim, Dong Wook Shin, Tae-Young Chung. AJO. p86–96. Good article. Table 3 & the conclusion is all you need.

4. Book Chapter – Mark Twain – The Adventures of Tom Sawyer. Chapters 24-35 via LoyalBooks.com Apple podcast. See also Sparknotes (narration) and Gutenberg (book text).

Finished The Adventures of Tom Sawyer! The LoyalBooks Apple podcast is excellent and free. A fun story. Will take a Mark Twain break before re-visiting with Huck Finn.

See Protecting Sight Daily Learning posts here.

Protecting Sight #47: Three secrets of resilient people. Cosmetic iris implants can cause blindness.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – Lucy Hone – 3 secrets of resilient people “Everyone experiences loss, but how do you cope with the tough moments that follow? Resilience researcher Lucy Hone shares three hard-won strategies for developing the capacity to brave adversity, overcome struggle and face whatever may come head-on with fortitude and grace.” (ted.com)

I applied her 3rd pearl immediately (and hope to implement daily). Worth a watch. 16 minutes.

2A. Cataract Surgery – Uday Devgan MD – Mastering Divide-and-Conquer – Guest surgeon Dr. Neto Rosatelli (Brazil). I learned divide and conquer as an ophthalmology resident. Nice technique.

2B. Cataract Surgery – Ike Ahmed MD – Management of discontinuous capsulorhexis during cataract surgery. Revisited this case while looking for Ike’s iris explantation video (below).

Figure 2

3A. Journal – Mansour AM, Ahmed IIK, Eadie B, et al . Iritis, glaucoma and corneal decompensation associated with BrightOcular cosmetic iris implant. British Journal of Ophthalmology 2016;100:1098-1101.

#IkeNeedsAHaircut posted a case he performed on the explantation of a BrightOcular cosmetic iris implant. He linked to the BJO article above.

4. Book Chapter – Mark Twain – The Adventures of Tom Sawyer. Chapters 18-23 via LoyalBooks.com Apple podcast. See also Sparknotes (narration) and Gutenberg (book text).

5. AAO Draws Global Support in Condemnation of Rubber Bullets. by Peter Downs. #NoRubberBullets

See Protecting Sight Daily Learning posts here.

Please send me feedback. Would appreciate suggestions of Ted Talks, cataract videos, and journal articles to learn from and share.

Protecting Sight #46: An idea is a network. Loved the metaphors! (Ted Talks) The morning glory optic disc & Tom Sawyer’s triumphant return.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – Steven Johnson – Where good ideas come from (September 2010). “People often credit their ideas to individual ‘Eureka!’ moments. But Steven Johnson shows how history tells a different story. His fascinating tour takes us from the ‘liquid networks’ of London’s coffee houses to Charles Darwin’s long, slow hunch to today’s high-velocity web.” (ted.com)

18 minutes and filled with pearls. (I’m surprised that this Ted talk “only” has 5 million views!). Johnson spoke well about metaphors, which reminded me of a recent Ted Talk I posted about the Art of the Metaphor, by James Geary, here. Both are top 10 Ted Talks.

2A. Cataract Surgery – Uday Devgan MD – Cataract Quiz: What’s wrong with the IOL? Excellent case by guest surgeon Sourabh D. Patwardhan, FRCS, MD.

Morning glory disc anomaly
EyeWiki on Morning Glory Disc, © 2019 American Academy of Ophthalmology

3A. Journal – Poillon G, Henry A, Bergès O, Bourdeaut F, Chouklati K, Kuchcinski G, Caputo G, Lecler A. On behalf of the Morning Glory Disc Anomaly Study Group, Optic Pathways Enlargement on MRI in patients with Morning Glory Disc Anomaly, Ophthalmology (2020), doi: https://
doi.org/10.1016/j.ophtha.2020.06.060. Found in my Twitter feed today. Wait for the journal article as the PDF is hard to read vs. final version.

Image
Authors found 9 of 40 morning glory disc anomaly patients had enlargement of the anterior ipsilateral optic pathways suggesting malformation as the etiology #MorningGlory #MRI #OpticDisc http://ow.ly/B4VW50AwIjk

4. Book Chapter – Mark Twain – The Adventures of Tom Sawyer. Listened to Chapters 11-17 via LoyalBooks.com Apple Podcast (free). See also Sparknotes (narration) and Gutenberg (book text).

The narration on the free podcast is excellent. Highly recommend.

5. (Bonus) – I was interviewed, with Dr. Natarajan, on the rubber bullets and tear gas eye safety campaigns: AAO Draws Global Support in Condemnation of Rubber Bullets. by Peter Downs. #NoRubberBullets

See Protecting Sight Daily Learning posts here.

Please send me feedback. Would appreciate suggestions of Ted Talks, cataract videos, and journal articles to learn from and share.

Protecting Sight #45: 39th POTUS Jimmy Carter on the mistreatment of women and human rights abuses worldwide. International cataract surgeons share phaco pearls.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – 39th US President Jimmy Carter – Why I believe the mistreatment of women is the number one human rights abuse . “With his signature resolve, former US President Jimmy Carter dives into three unexpected reasons why the mistreatment of women and girls continues in so many manifestations in so many parts of the world, both developed and developing. The final reason he gives? ‘In general, men don’t give a damn.’ ” (ted.com)

A compelling Ted talk by the 39th President of the United States. 16 minutes and a lifetime of wisdom.

2A. Cataract Surgery – Uday Devgan MD – Dense Cataract Vertical Chop. Guest surgeons Dr. RK Tadanki (Guntur, India) and Dr. Sunil Kumar (Ranchi, India). I watch Uday’s cases often and especially on the morning of surgery. Today was no different.

2B. Cataract Surgery – Ike Ahmed MD – Pediatric Posterior Capsulorhexis. Ike shares his talents with us “mere mortals” (Uday’s words). I’ve seen Ike narrate this case and Uday’s pearls are excellent as well. #IkeNeedsAHaircut

3A. Journal – EyeNet July 2020 – Journal Highlights. EyeNet is one of the most widely read ophthalmic journals. The article highlights in this section are superb.

4. Book Chapter – Mark Twain – The Adventures of Tom Sawyer. Listened to Chapters 7-10 via LoyalBooks.com Apple Podcast (free). See also Sparknotes (narration) and Gutenberg (book text).

The narration on the free podcast is excellent. Highly recommend.

See Protecting Sight Daily Learning posts here.

Please send me feedback. Would appreciate suggestions of Ted Talks, cataract videos, and journal articles to learn from and share.

Protecting Sight #44: The New Yorker’s Comma Queen. Cataract surgery, iStents, and The Adventures of Tom Sawyer.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – Mary Norris: The nit-picking glory of The New Yorker’s Comma Queen. ” ‘Copy editing for The New Yorker is like playing shortstop for a Major League Baseball team — every little movement gets picked over by the critics,’ says Mary Norris, who has played the position for more than thirty years. In that time, she’s gotten a reputation for sternness and for being a ‘comma maniac,’ but this is unfounded, she says. Above all, her work is aimed at one thing: making authors look good. Explore The New Yorker’s distinctive style with the person who knows it best in this charming talk.” (ted.com)

A favorite pursuit among young Yale Daily News reporters was to read copy before each edition was published. I still marvel over commas — with much amusement, I must say — and delight with the proper use of dashes, semi-colons, and the occasional exclamation point. (!)

This was a Ted trending talk. Super fun. 10 minutes.

2. Cataract Surgery – Richard J. Mackool, MD – Episode 6: Phacoaspiration of a nuclear cataract in a 78 year old patient. Dr. Mackool writes, “Utilizing high vacuum, removal of a 2+ nuclear cataract is accomplished without ultrasound.” Excellent. 9 minutes.

Figure thumbnail gr1

3A. Journal – Prospective, Randomized, Controlled Pivotal Trial of an Ab Interno Implanted Trabecular Micro-Bypass in Primary Open-Angle Glaucoma and Cataract: Two-Year Results. Thomas W. Samuelson, Steven R. Sarkisian Jr., David M. Lubeck, Michael C. Stiles, Yi-Jing Duh, Eeke A. Romo, Jane Ellen Giamporcaro, Dana M. Hornbeak, L. Jay Katz for the iStent inject Study Group. Ophthalmology, June 2019, p811–821.

Figure thumbnail gr1

3B. Journal – Phthiriasis Palpebrarum Treated with Oral Ivermectin. Justin H. Dredge, Timothy W. Winter, Adel E. Alset. Ophthalmology, June 2019, p791.

Figure thumbnail gr1

3C. Journal – Isolated Uveal Amyloidoma in the Absence of Systemic Amyloidosis. Guy S. Negretti, Caroline Thaung, Mandeep S. Sagoo. Ophthalmology, June 2019, p828.

4. Book Chapter – Mark Twain – The Adventures of Tom Sawyer. Listened to Chapters 5-6 via LoyalBooks.com Apple Podcast (free). See also Sparknotes (narration) and Gutenberg (book text).

See Protecting Sight Daily Learning posts here.

Please send me feedback. Would appreciate suggestions of Ted Talks, cataract videos, and journal articles to learn from and share.

Protecting Sight #43: A new way to study the brain’s invisible secrets. From Moby Dick to The Adventures of Tom Sawyer.

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, short story or significant work.

Here’s today’s list:

1. Ted Talk – Ed Boyden – A new way to study the brain’s invisible secrets. “Neuroengineer Ed Boyden wants to know how the tiny biomolecules in our brains generate emotions, thoughts and feelings — and he wants to find the molecular changes that lead to disorders like epilepsy and Alzheimer’s. Rather than magnify these invisible structures with a microscope, he wondered: What if we physically enlarge them and make them easier to see? Learn how the same polymers used to make baby diapers swell could be a key to better understanding our brains.” (ted.com)

This was a Ted trending talk. Great innovative concepts. Well worth a watch. 13 minutes.

2A. Cataract Surgery – Uday Devgan MD Spiral Capsulorhexis Technique (Guest surgeon Dr. Ashraf Armia). “After needle decompression of the cataract, using a spiral technique for the capsulorhexis has a distinct advantage: if there is any pressure on the capsule, the capsule tissue can immediately be brought centrally to terminate the capsulorhexis and prevent radial extension. This video features expert surgeon Dr Ashraf Armia from Egypt and he demonstrates his technique for the spiral capsulorhexis. This helps to prevent the dreaded Argentinian Flag Sign and gives the surgeon a high level of control.”

2B. Cataract Surgery – Dr. Ashraf Armia – PEAR shaped capsulorhexis (YouTube). Excellent technique.

Fundus autofluorescence (A) demonstrating multiple, discrete hyperautofluorescent lesions throughout the posterior pole, concentrated along the superior arcades; spectral-domain optical coherence tomography (B) shows small, localized subretinal fluid pockets at the site of these lesions.

3A. Journal – JAMA Ophthalmology Clinical Challenge – Patel SN, Kim SJ. Sudden Onset of Multiple Green Spots in the Eyes of a Woman With Breast Cancer. JAMA Ophthalmol. 2020;138(4):412–413. doi:10.1001/jamaophthalmol.2019.5288

A, Fundus photograph of the left eye demonstrates a central maculopathy with focal gray discolored lesions and yellow-orange pigmentation. B, Scanning laser ophthalmoscopy and spectral-domain optical coherence tomography (SD-OCT) of the same eye reveal ellipsoid zone disruption and vertical hyperreflective bands. Similar findings were present in the fellow eye.

3B. Journal – JAMA Ophthalmology Clinical Challenge – Zhu I, Mieler WF, Francis AW. A Mysterious Central Scotoma in a Teenage Male Patient. JAMA Ophthalmol. 2020;138(4):414–415. doi:10.1001/jamaophthalmol.2019.5383

Orbital noncontrast imaging studies. Noncontrast computed tomography (CT) (A) and magnetic resonance imaging (B), images of the orbit. Computed tomography demonstrates inflammatory changes of the right medial orbital wall (arrowhead). Magnetic resonance imaging demonstrates inflammatory changes at the right orbital apex (arrowhead). Both images demonstrate nasosinal inflammation.

3C. Journal – JAMA Ophthalmology Clinical Challenge – Geyman LS, Pham CM, Aakalu VK. Acute-Onset Visual Acuity Loss in a Man With Advanced Diabetes Mellitus. JAMA Ophthalmol. 2020;138(4):416–417. doi:10.1001/jamaophthalmol.2019.5388

4. Book Chapter – Mark Twain – The Adventures of Tom Sawyer. Listened to Chapters 1-4 via LoyalBooks.com Apple Podcast (free). See also Sparknotes (narration) and Gutenberg (book text).

See Protecting Sight Daily Learning posts here.

Please send me feedback. Would appreciate suggestions of Ted Talks, cataract videos, and journal articles to learn from and share.