Keynote talk on the optic nerve in glaucoma

Keynote talk on the optic nerve in glaucoma

Here is a video of the slides used from the 19Feb2010 discussion with our residents at UBC on the optic nerve in glaucoma. This was designed as an interactive discussion with the residents asked to read in advance pages 47-61 of the American Academy of Ophthalmology BCSC manual on glaucoma, two references by Stephen Drance et al on the clinical appearance of the optic nerve, and a chapter in Fingeret, Flanagan, and Liebmann’s “The Essential HRT Primer” discussing progression. 

Read More

Under-serviced? How about over-doctoring being the problem here?

Under-serviced? How about over-doctoring being the problem here?

Here’s a problem that goes against the common mis-perception about practicing medicine in Canada. While we often hear false allegations from mostly Republicans in the United States that there is inadequate access to medical care in Canada, I have found out recently that many of my patients are over-doctoring.

Read More

Would you just observe glaucoma patient with IOP of 39mm Hg?

Would you just observe glaucoma patient with IOP of 39mm Hg?

I was sure I would not tweet any consults from this day as I still had many cases that I wanted to write about in greater detail here on my blog, but I couldn’t resist tweeting and now talking more about this particular patient presenting with rather high intraocular pressure but no other risk factors for glaucoma.

Read More

Telemedicine direct from patient to doctor - a good thing?

Telemedicine direct from patient to doctor - a good thing?

Once in awhile, patients of mine e-mail me an extreme close-up photo of their eye seeking my opinion. Is this a good way to practice medicine?

Read More

Surgical repair of leaking trabeculectomy glaucoma filtering bleb

Surgical repair of leaking trabeculectomy glaucoma filtering bleb

A common late complication of trabeculectomy (glaucoma filtration surgery) is wound leak occurring many years after the surgery, especially when an antimetabolite such as Mitomycin-C was used at the time of the original surgery. This video shows my surgical technique for excising the non-viable leaky conjunctival tissue and advancing fresh tissue from the surrounding area.

Read More

Keep the patient in the loop when docs talk amongst themselves

Keep the patient in the loop when docs talk amongst themselves

I had a patient recently left out of the loop as a colleague and I debated her fate and care! A large proportion of my patients live hundreds of kilometres away who are referred for surgery. I am often left with the challenge of co-managing them with the referring eye care professional without getting to examine them myself. Unfortunately for this patient, the referring ophthalmologist and I spent so much time talking amongst ourselves that we hadn't realized that the patient was not being kept informed of our thought processes.

Read More