Hi professionals,

in researching the current state of accommodating IOLs I try to understand defocus curves.

What I believe to understand so far: anything below 0D (like -2D) is used to describe visual acuity at progressively nearer distances, where distance = 1/diopters in meters. So e.g. 20/20 at -2D equals a 100% acuity at 50cm distance in front of you.

But how do positive diopters come into play? Based on the above formula, 0D should already represent an infinite distance, so what's the meaning of a 20/20 vision at +1D or +2D? Surely it's not just a theoretical measurement taken by placing different lenses in front of the eye, it has to have practical implications.
What are these practical implications and where do they come from mechanistically when 0D already is inifinite distance? Is there a limit to where optimizing positive defocus practically makes sense?

If there's any wrong usage of terms, I'd be happy to have them corrected!

This patient presented with a traumatic subluxated cataract. The bag-IOL complex was fixated to the sclera with capsular tension segment (CTS) using a double-flanged polypropylene 6/0 suture.

Video: https://youtu.be/eop17QYQtYA

Hi, is someone using the Ngenuity and knows the dynamic range value (dB)? I am using the Artevo and see that there is a difference and the Ngenuity is performing significant better. I now that these are HDR cameras but I can not find a value.

Thanks

I’m early in my surgical career and I’m now about 200 cataracts in. I’m pretty comfortable doing horizontal chops using my verges chopper. So now I’m trying to learn vertical chop to widen my surgical skill arsenal so looking into getting either a vertical chopper to use for surgeries (we supply our own instruments in my institution).

Any recommendations based on your experiences? I’m looking at either Seibel vertical (Katena 05-4064R) or Rosen chopper (rumex 7-065).

Hi! I'm starting as an ophthalmic technician on Monday and I was wondering if there is anything I should know/prepare beforehand. I'm getting trained on the job as I have no prior experience with ophthalmology. The clinic works with retinas. I'm feeling nervous but excited to learn!

Hi everyone, I'm a med student preparing to apply for residency soon. Was just wondering how non-ophtho research is perceived in the application process? I have a significant amount of non-ophtho research but only 1 (first-author) pub in ophtho, and a whole bunch of ophtho pubs in submission that are taking really long to come out. I'm worried that my application may be perceived as a late transition to ophtho/lack of commitment to the field... would appreciate any thoughts!

Hello! I’m trying my best to find the software for the Nidek AFC 210 (NAVIS lite) without any success. Nidek was even contacted but they were of no help. Does anyone know how I can acquire the software? Thank you!

I signed up a mentally ill patient for cataract surgery and she showed up today for a pre op exam and A-scan. Today she said she doesn’t want surgery but her conservator says to do it. I said I felt uncomfortable doing cataract surgery on a patient who refuses surgery so I cancelled both eyes.

The conservator got upset and said he wants to file a discrimination complaint against me for discriminating against the mentally ill. (I’m the one who signed her up in the first place!)

Do I have to do the surgery against the patient’s wishes because he’s the conservator?

Even if the conservator himself was the patient, I could say no if I felt uncomfortable doing an elective non-emergent surgery. Was I within my rights to say no or did I mess up?

To start, I'm an OD who works with cornea issues and scleral lenses a lot.

I have a patient who has a sutured IOL after his longstanding PCIOL subluxed. IOL was done by retina MD.

The cornea MD sent him to me for a scleral fitting as he has NK and EBMD, though the EBMD we don't feel is contributing to his vision. His previous RD wasn't impacting his macula and he has just a tiny little patchy ERM.

His sutured IOL appears to be slightly tilted though along the Z axis, i.e. the top of the lens appears tilted back towards the retina while the bottom is closer to the cornea.

How big of an impact on acuity would a vertical tilt like this have, if any? I imagine some, but never having encountered this before, I can't really say how much.

I have seen that Stanford, Wills, and some other universities offer different courses. Which one do you recommend the most that would also be helpful for OKAPs at the end of the day with great efficiency?

Hello everyone. Was wondering if you could give some insight on the types of offers I could upon completion of my training. Was hoping to gain some insight on how this might differ if I were to join a private group. Thank you for your response.

I am able to get into a program but they dont do phacoemulsification, is it even worth it? Should I do it anyways and then go do a fellow?

Has anyone looked into this device yet? Currently the price tag is $75,000 + requires a QR code be scanned to initiate each treatment. QR codes have to be bought in bulk ahead of time. $11,000 investment in QR codes is required to bring the price down to $50 / treatment. Anything less lands you around $90 per treatment.

The current reimbursement from Medicare is approx. $235. The rep is trying to sell this as one would offer annual treatments to all glaucoma and ocular hypertension patients to the gross revenue will rise significantly.

Is this the first insurance-reimbursed procedure that requires the click fee? To my knowledge only processes that required cash payment from the patient (ORA, Femto, etc) had a click fee that was passed on to them.

Do you think this is going to start an ugly trend where the diagnostic companies will try to extort some of the insurance reimbursement?

Considering buying into my practice. Who should I have on my team to make sure that everything makes sense (Business attorney, financial advisor, CPA)?

any and all recs from ppl who have been through this are appreciated!

Thanks!

Current PGY-2 undecided on a subspecialty. The further into training I get, the more I am enjoying the field as a whole, but I have not found one of the subspecialties overwhelmingly more fascinating (from either a content or practice perspective) than the others. I'm someone who I think could be happy in most of the subspecialties. Perhaps the most logical response to my predicament would be 'comprehensive' and thus having a 'touch' of everything in my day-to-day. However, I do like the idea of being focused within a certain domain, as was a driving factor in specializing in ophthalmology in the first place.

My question to those in practice is as follows: if you were entering the field today, what subspecialty would you choose?

Would love to hear differing perspectives, including those who are incredibly happy with the choice they made, and others who may have a unique insight into a certain subspecialty and thus might lean away from it if choosing again.

Thank you in advance for all the insight!

ophthalmic assistant about to take the coa.

i really dont want to say HEY GUYS IM TRANS to the ijcahpo because it's none of anyone's business, but i guess i will if i have to. :/

In your opinion, how many surgeries a year does this entail?

Narrowed choices to these 2 lenses! What would you choose? What are the pros and cons of both? Thanks