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A patient called our office reporting a floater that started three days prior and was followed by loss of vision. My front desk triaged the call and scheduled the patient for an appointment two hours later that morning. The...
I have a habit of perseverating on patients that present as clinical oddities. Patient whose clinical diagnostic puzzles may not be particularly pathological or emergent, just out of the box, keeping me interested. One particular patient, I see every...
The new mantra of keratoconic care: Diagnose early, Stop progression, Rehabilitate vision. The following case will demonstrate the ability of corneal collagen crosslinking to stop progression of keratoconus. This case shows the clinical benefits of crosslinking in a twenty-year-old...
Persistent keratitis, corneal ulcers, keratoconjunctivitis sicca, chronic exposure keratopathy, corneal neovascularization, and neurotrophic disease can be especially difficult to treat. Steroids, antibiotics, cyclosporin, lifitegrast and amniotic membranes may fail in some cases. Insurance may not cover medications deemed medically necessary. For some,...
Have you ever worked with a really tough contact lens patient, refined and dispensed the “perfect” fitting contact lens only to find out at follow-up that after very minimal wear time the lens becomes uncomfortable, vision blurs or fluctuates,...
As imaging technologies continue to develop, OCT brings us anterior segment applications. On the forefront is anterior segment OCT of the epithelial layer of the cornea. Optovue (FREMONT, CA) obtained U.S. Food and Drug Administration (FDA) approval for its epithelial...
Some of the more common things I hear when talking with colleagues about referrals to ophthalmology are these: I have a great relationship with Dr. OMD. They send me letters back and they send the patient back for post-op care. My OMD is...
If I’m being honest, I almost always cringe when I see our pediatric surgeon calling my cell phone. He’s the nicest guy in the world. However, it typically means he’s sending someone my way. Odds are it’s almost always...
I am a bit of an over-achiever. I want all my patients to have perfect outcomes, and I don’t like surprises. When I send a patient for surgery, I make a note in my referral letter as to what the...
Over the past few years, there seems to be an explosion of attention given to meibomian gland dysfunction/disease (MGD). First described by Dr. Donald Korb and associates (what’s new? He has brought us GPC, lid wiper epitheliopathy, and a...
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