The Lens Pod: Recent Episodes

Lens Pod

The Lens Pod is a medical student-run ophthalmology podcast that uses interviews with residents, fellows, and attendings to help medical student learners navigate the road to ophthalmology.

https://lensophthalmology.com/the-lens-pod https://twitter.com/TheLens_oph

Medical Student Hosts: Christopher Le, M4 at University of Maryland Anne Xuan-Lan Nguyen, M3 at McGill University Sunil Ruparelia, M3 at Dalhousie Medicine Emily Xu, M4 at University of Missouri-Columbia

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Too busy to read the Lens? Listen to our weekly summary here! In this week’s episode we discuss…

  • There is a significant association between chronic kidney disease and late age-related macular degeneration.
  • Patients with proliferative diabetic retinopathy treated with panretinal photocoagulation monotherapy had higher rates of vitrectomy, vitreous hemorrhage, and tractional retinal detachment compared to anti-VEGF monotherapy.
  • The curved shape of scleral contact lenses significantly increases Acanthamoeba adhesion compared to flat lenses.

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In this week’s episode we discuss:

  • Two is better than one! Low-level red light therapy in conjunction with orthokeratology contact lenses was more efficacious in reducing axial length progression in children with myopia.
  • Bias reduction tools are associated with increased diversity within ophthalmology residency programs, but certain tools may be more effective than others.
  • Greater axial length and incomplete capsule removal may be associated with an increased risk of retinal detachment in Marfan patients who have undergone lens removal.
  • Machine learning can analyze objective ophthalmic structural and functional data to identify early markers of cognitive impairment.

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Too busy to read The Lens? Listen to our weekly newsletter here! In this week's episode:

  • Utilizing cluster testing in the Fast Progression Assessment through Clustered Evaluation (Fast-PACE) Study identified glaucoma fast progressing glaucoma.
  • Digital access and utilization is decreased in older adults with vision impairment which could affect their ability to utilize telehealth services.
  • New study analyzing the effects of race, gender, and diabetes on corneal complications following cataract surgery.

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In this week’s issue

  • Trabeculectomy and tube shunt surgery were shown to have similar efficacy for preventing visual field loss in glaucoma.
  • Daily aspirin was not shown to prevent the incidence or progression of age-related macular degeneration in a large randomized control trial.
  • Arterial stiffness may be a useful measure in predicting risk of developing glaucoma.
  • Diabetic retinopathy has been shown to be more associated with the use of certain systemic medications.

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In this week's episode:

  • Conbercept, an anti-VEGF agent, was found to be non-inferior to laser therapy for treatment of infants with Zone II retinopathy of prematurity
  • ChatGPT-4 accurately responded to ⅔ of multiple-choice questions related to ophthalmic cases with imaging interpretation, performing better on questions that did not rely on imaging interpretation
  • Culturable SARS-Cov-2 RNA was found in a small proportion of tears of patients with COVID suggesting this may be a potential source of transmission
  • Sympathetic nervous system activity, measured in urine catecholamines was correlated with increases in axial length elongation, suggesting stress can lead to myopia progression

... and more!

To learn more about The Lens, you can follow us on Twitter/X @thelens_oph and visit our website: www. Lensophthalmology.com to subscribe to our newsletter and view our complete research summary for this week.

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In this week's issue:

  • Retinal projection glasses improved visual acuity for patients with corneal disease by directly projecting images onto the retina.
  • A cross-sectional study reveals that vision impairment is associated with depression, anxiety, and social isolation.
  • Blue light filtering intraocular lenses protected against progression of macular atrophy in a cohort of neovascular age-related macular degeneration patients, however did not reduce the incidence of new onset macular atrophy.
  • A new study reveals specific chronology to extracellular matrix deposition and composition in Fuchs endothelial corneal dystrophy.

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In this episode, Dr. Neel Vaidya, a cataract, cornea, and refractive surgeon at Chicago Cornea Consultants and Rush University Medical Center shares what you need to know about lens-based refractive surgery - what it is, what makes it unique, and what post-op examinations look like for lens exchange procedures. There are many great pearls for medical students who have an upcoming ophthalmology rotation or want to learn more about these procedures.

0:54 - What is lens-based refractive surgery?

2:25 - Who are the right candidates?

6:35 - Risks & Benefits

11:20 - EVO-ICL

13:00 - Postoperative exam findings

16:40 - Pearls for your rotation

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In this week's issue:

  • GLP-1 receptor agonist use was associated with lower risk of developing glaucoma.
  • GLP-1 receptor agonists may be associated with worse diabetic retinopathy or diabetic macular edema.
  • At home monitoring for wet AMD had low accuracy compared to in-hospital testing.
  • BMI, tobacco and alcohol use may play a role in glaucoma progression.

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In this week’s issue:

  • Daily supplementation with omega-3 fatty acids did not provide clinically significant prevention of diabetic retinopathy among adults with diabetes.
  • Women are overrepresented among those with mild variants of ABCA4-associated retinopathy, suggesting sex plays a role in disease development.
  • Measurements of corneal epithelium thickness in keratoconus patients using RTVue AS-OCT and MS-39 AS-OCT/Placido topographer are not interchangeable.

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In this week’s issue

  • Subconjunctival steroid injection may be a useful alternative to topical steroids after cataract surgery
  • Older adults with visual impairments are more likely to be unfamiliar with the technology needed to access telemedicine
  • Glaucoma patients with more systemic comorbidities may be less likely to adhere to their topical medication regimen

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  • Phase II trial for LHON found no significant changes in BCVA after topical elamipretide, post-hoc analysis showed improvements in central visual field.
  • Single-nucleotide and rare coding variants in over 30 genes were associated with primary angle-closure (PAC) disease.
  • Higher IOP variability and range is associated with faster rate of GCC thinning, suggesting that IOP variations may independently cause macular changes.
  • Higher levels of saccharin were found in well-controlled AMD patients compared to those with chronically active choroidal neovascularization (CNV).

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In this episode Dr. Kevin Schnieder, a resident at the University of Wisconsin Madison, walks us through what you need to know about orbital fracture as a medical student or resident on call. There are many great pearls for medical students who are starting to think about ophthalmology rotations, who have their first call shift coming up, or want to impress during their away rotations.

1:00- What is an orbital fracture?

1:40- How do people develop orbital fractures?

2:30- History & work-up

6:35- Imaging

11:20-Operative Management

16:50- Lid lacerations

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In this week's issue:

  • Learn about the geographic distribution of oculofacial plastic surgeons and its correlationto socioeconomic demographics in the United States.
  • A case series of patients with Pseudomonas aeruginosa keratitis shows increasing resistance andvirulence and suggests a novel new therapeutic approach.
  • A new model predicts axial length in children after bilateral cataract surgery to customize intraocular lens selection for the best visual outcomes.
  • Proteomic profiles of aqueous fluid in those with diabetic retinal disease show signs ofinflammation and neuronal dysfunction prior to clinical findings of retinopathy.

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In this week’s issue

  • Canalicular dexamethasone inserts may eventually become an option for lasting relief from inflammatory dry eyes
  • Water-free formulations of cyclosporine are effective in treating inflammatory dry eye, but future studies comparing water-free to standard formulations will show if these changes lead to greater efficacy for this hydrophobic molecule
  • Preoperative chlorhexidine reduces ocular surface bacterial load to a greater extent than povidone iodine - and is better tolerated

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In this week’s issue

  • Topical polihexanide (PHMB) 0.08% monotherapy shown to be an effective treatment for Acanthamoeba keratitis
  • Acetylcholinesterase-inhibitors may decrease risk of developing age-related macular degeneration
  • Artificial intelligence deep learning algorithms accurately screen for diabetic retinopathy using fundus imaging with high sensitivity and specificity
  • Obscurin, an abundant cytoskeletal protein, may be critical to maintaining extraocular muscle function

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In this week’s issue

  • There is no statistically significant increase in the risk of retinal artery and vein occlusions after COVID infection or vaccination
  • COVID vaccination was found to have no statistically significant association with corneal transplant rejection
  • Point of care ultrasound and OCT may prove useful in early screening of papilledema in children

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In this episode Dr. Joel Kovoor, a resident at Henry Ford Health System, walks us through all things Neovascular Glaucoma. There are many great pearls for medical students who are rotating through comprehensive or glaucoma clinics or preparing for away rotations!Time Stamps1:00 - Definition of Neovascular Glaucoma2:30 - Open vs Closed Angle Glaucoma4:10 - Is NVG Open or Closed Angle?6:00 - Where do you look for NVG?8:00 - Visualizing the Angle with Gonioscopy9:58 - Symptoms and History of NVG14:30 - Retinal Exam17:00 - Optic Nerve Thinning19:20 - Working up NVG22:00 - Visual Field Testing24:00 - Including the PCP26:40 - Glaucoma medications31:00 - Laser Treatment

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This episode we speak with Dr. Narmien Murdock about everything you need to know before your first away rotation. The beginning of the episode focuses on tips for being successful as a rotating student. At timestamp 39:30, logistics regarding the away application process are reviewed.

Quick tips:

  • be on time

  • say "yes"

  • do not be afraid to ask how you can best fit in the flow of clinic

  • be willing to learn

  • send thank you emails/notes

  • request feedback for presentations/assignments

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In this episode, we finish our conversation with Dr. Al-khersan by asking him to help us learn indirect ophthalmoscopy and how to use a 90D lens.

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In this episode Dr. Kevin Schneider, a resident at University of Wisconsin, walks us through Thyroid Eye Disease. There are many great pearls for medical students who are rotating in oculoplastics clinics or preparing for ophthalmology rotations in general!

Time Stamps:

1:25: Presenting symptoms of TED

2:59: Physical exam

6:39: Clinical scoring systems

7:50: Oculoplastic-specific exam

13:50: Labs?

15:45: Imaging?

18:30: Course of TED

20:38: Counseling patients with TED

23:30: Surgical intervention

32:30: BCSC rapid fire

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In this episode we walk through a case of diabetic retinopathy (DR) with Dr. Al-khersan. This episode focuses less on the granular details of grading DR and more on how to interpret relevant information from a diabetic eye exam.

Learning points from this episode:

Common causes for decreased vision in diabetes

  • Vitreous hemorrhage
  • Macular Edema
  • Cataracts
  • Tractional Retinal Detachment

Common causes of decreased vision in ANYONE

  • Misplaced glasses?
  • Presbyopia

A framework for taking a solid ocular history for EVERY patient

  • HPI, “what brings you in today?”
  • Past Medical History
  • Medications
  • Drops, if using, frequency, which eye
  • Past Ocular History
  • Past Ocular Surgical History
  • Allergies to drops
  • Glasses Rx

Follow-up questions for the patient:

  • Previous intravitreal injections (anti-VEGF, steroids)?
  • Have they been hospitalized
  • Recent HbA1C, or common at home glucose readings

Ocular Vitals:

  • External (bruising, BCC, lesions, proptosis, ptosis)
  • Visual acuity, best corrected
  • Pupils
  • IOP
  • EOM
  • Confrontational VF

Slit Lamp findings associated with diabetes

  • Rubeosis iridis
  • Hyphema
  • Cataracts
  • Retinal Hemorrhage
  • Vitreous Hemorrhage

Imaging modalities

  • OCT
  • Fluorescein Angiography

The Lens Pod is a podcast intended for educational uses only and reflects the opinions of the hosts and guests.

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Too busy to read the Lens? Listen to our weekly summary here!

In this week’s issue:

  • Use of antihypertensive medications may increase risk of glaucoma and affect IOP.
  • Calcium channel blockers are associated with decreased inner retinal layer thickness on OCT and increased risk of glaucoma.
  • A cohort study from Korea finds fibromyalgia patients at increased risk for optic neuritis.
  • Immune cell populations of patients with dry eye disease have increased T-helper cells associated with more severe signs and symptoms.

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In this week’s issue:

  • Segmental proton beam radiation therapy proves to be an effective and safe treatment for iris melanoma.
  • E-cigarette and cigarette users experience significantly greater severity and frequency of ocular symptoms than those who do not use these products.
  • Corneal sensitivity testing may prove to be an effective proxy for screening of proliferative diabetic retinopathy.
  • Early use of immunosuppressive therapy in the treatment of peripheral ulcerative keratitis in patients with rheumatoid arthritis demonstrates better inflammatory control, decreased recurrence, and improved visual outcomes.

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In this week’s issue:

  • The leading causes of childhood blindness include retinopathy of prematurity (31.3%), nystagmus (8.1%), cataract (6.7%), and optic nerve atrophy (6.5%).
  • Adjustable-focus spectacles are useful in under-resourced areas but may not be optimal for younger children and those with astigmatism.
  • Choice of amniotic membrane may have little effect on visual acuity, but corneal surface amniotic membrane transplant could portend an increased risk for symblepharon formation.

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“Too busy to read the Lens? Listen to our weekly summary here! In this week’s episode we discuss…

  • Blindness from trachomatous-induced corneal opacities increases with age and female sex, with significantly higher rates in the African regions.
  • Climate conscious conferences: The 2019 in-person AAO meeting produced significantly more metric tons of CO2 per person than the 2020 virtual meeting.
  • A new study found that chloroquine-induced retinopathy is likely due to impaired ability of lysosome fusion with new endosomes, indicating a defect in lysosome reformation.

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This week we discuss:

  • (TW: suicide) A study on suicide risk after receiving a vision threatening diagnosis.
  • Anti-VEGF dose adjustments for neovascular AMD
  • Fundus imaging and gold standard scleral depressed examination when looking for horseshoe tears.
  • An intraoperative dose of intravitreal bevacizumab following trabeculectomy with MMC and surgical outcomes.

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This month we spoke with Dr. Jessica Randolph, Assistant Professor of Ophthalmology at Virginia Commonwealth University about Diversity, Equity, and Inclusion (DEI) in ophthalmology and how medical students can get involved.

Time Stamps:

7:00- Definitions; why DEI in ophthalmology important

20:30- Socioeconomic status and opportunities; Affirmative Action

27:27- Implications for patient care

34:10- Implicit Bias

43:42- Pipeline Programs for Underrepresented Students

Minority Ophthalmology Mentoring Program: https://www.aao.org/minority-mentoring

Rabb-Venable Excellence in Ophthalmology Program: https://www.rabbvenable.com/

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Too busy to read The Lens? Listen to our weekly summary here! In this week's episode, we discuss:

  • An extended 14-year randomized control trial demonstrated that laser peripheral iridotomy can aid in preventing progression to primary angle-closure glaucoma.
  • Despite some improvement in the newer versions of artificial intelligence chatbots, their ability to generate scientific abstracts remains severely limited.
  • Results from a retrospective cohort study reveals effects of intentionally halting anti-VEGF injections in patients with advanced neovascular AMD.
  • CD63/81+ small extracellular vesicles are enriched in aqueous humor in eyes with retinoblastoma before treatment and in those with more significant tumor burden, suggesting that they are tumor-derived.

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Too busy to read The Lens? Listen to our weekly summary here! In this week's episode:

  • A retrospective study reveals demographic risk factors for open globe injuries requiring repairs and poorer visual outcomes.
  • Mapping of access to laser eye surgery in 5 Midwest states did not reveal shorter travel times despite expansion of surgical privileges to optometrists.
  • Twice-daily pilocarpine for presbyopia treatment showed greater improvements in distance-corrected near visual acuity compared to once-daily dosing
  • Inhibition of CD11b, a component of the complement system, may provide a neuroprotective effect in optic nerve injury.

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In these week issue:

A port delivery system with ranibizumab shows non-inferiority compared to monthly ranibizumab injections

Treatment with low dose atropine nightly for two years shows no difference in spherical equivalent or axial length compared to placebo

A new mobility outcome (MOST, MObility Standardized Test) is validated in measuring disease progression in patients with retinitis pigmentosa

In a mouse model of traumatic optic neuropathy, CD11b is significantly elevated in microglia near the site of injury

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In this week’s issue: 

  • Newly diagnosed glaucoma led to a higher risk of development of dementia, particularly in older adults and those with good visual acuity.
  • Pediatric lensectomy and intraocular lens implantation is associated with visual axis opacification, although risk of VAO was not impacted by age at time of surgery or IOL location.
  • New study reveals risk factors for cataract development after non-infectious anterior uveitis.
  • Although rare, local recurrence of uveal melanoma is associated with greater mortality, particularly of smaller tumors as compared to larger tumors.

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In this week's episode, we discuss:

  • The new Assessment of IntraOcular Lens Implant Symptoms questionnaire was shown to effectively evaluate visual symptoms and satisfaction in patients receiving IOLs.
  • Demographics and social factors are associated with disease severity of microbial keratitis.
  • A new study shows four-point flange intrascleral fixation as a promising technique for plate-haptic trifocal IOL dislocations.
  • Investigating the role of RNA editing on keratins in keratoconus

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Too busy to read the Lens? Listen to our weekly summary here! In this week’s episode we discuss:

  • In the MERIT trial, dexamethasone was superior to methotrexate and ranibizumab in treating persistent or recurrent uveitic macular edema

  • Telemedicine for eye disease detection in michigan identified higher rates of pathology in low-income community clinics compared to national disease prevalence rates

  • A small cohort of keratoconus patients with successful repeat corneal collagen cross-linking (CXL) suggests repeat CXL may a be safe and effective option for progressive disease

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This month we spoke with Dr. Jacquelyn O’Banion, MD, MSc, director of Emory Eye Center's Global Ophthalmology-Emory program (GO-Emory), about global ophthalmology and how medical students can get involved.

Time Stamps:

0:56- Defining global ophthalmology

6:40- Looking for a residency program with global ophthalmology? Ask follow-up questions!

10:30- What is “sustainable global ophthalmology?”

19:00- A lost skill and its relevance to global work

25:00- How foreign strategy can inspire domestic change

29:25- Did you know you could do a global ophthalmology fellowship? Explained here!

34:05- Dr. O’Banion’s advice for medical students looking to get involved in global ophthalmology

40:30- An AAO resource dedicated to looping trainees into global ophthalmology opportunities 

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Too busy to read the Lens? Listen to our weekly summary here! In this week’s episode we discuss:

  • A clinical trial investigates combination therapy with a new anti-VEGF agent, OPT-302, for the treatment of neovascular AMD.
  • Artificial intelligence can be used to help predict best-corrected visual acuity in patients with diabetic macular edema.
  • There is an increased incidence of Demodex blepharitis in post-operative cataract surgery patients.
  • A mouse-model study identified sortilin as a potential pharmacologic target for the treatment of diabetic retinopathy.

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In this week’s issue: 

  • Low-fat dietary modification may increase risk of POAG in certain patient populations.
  • A longitudinal, population-based analysis of patients with type 2 diabetes examines the systemic safety profile of intravitreal anti-VEGF injections.
  • Early detection of abnormal corneal and lens densitometry emerges as a potential marker for diabetic keratopathy.
  • A retrospective study from India shows the benefits of medical therapy alone when managing multi-drug resistant keratitis.

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Too busy to read The Lens? Listen to our weekly summary here! In this week's episode:

  • Age-related macular degeneration is associated increased risk of depression in a longitudinal study of patients from a Korean database
  • Exploratory analysis of ophthalmology literature attempts to make sense of productivity and citation metrics in ophthalmology research
  • A sutureless ptosis repair surgery shows promising results in terms of eyelid elevation, symmetry, and complication rate
  • The hypoxia-inducible factor 1-alpha transcription factor emerges as a potential therapeutic target for autoimmune uveitis

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Too busy to read the Lens? Listen to our weekly summary here! In this week’s episode we discuss…

  • Early treatment with steroids for MOG-related optic neuritis showed improved visual outcome in a retrospective study.
  • African-American or Hispanic patients were more likely to be discharged home after hospitalization for ocular firearm injuries, while white patients were discharged to rehab or advanced care facilities.
  • Long-term data from the Early Manifest Glaucoma Trial showed similar visual acuity and visual field data in the treated vs. delayed treatment groups.
  • A deep learning model predicts age from fundus images and investigates the association between retinal age gap and mortality risk.

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Too busy to read the Lens? Listen to our weekly summary here! In this week’s episode we discuss...

Poverty and its impact on glaucoma screening, cost effectiveness in cataract surgery, long-term immunomodulatory therapy vs. steroid therapy in symptomatic ophthalmia, and carotenoids in mouse models for retinopathy of prematurity.

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In this week’s issue: 

  • Anti-VEGF treats the retina … and the cornea? A new study suggests intravitreal injections improve ocular surface disease.
  • EDI enhanced depth imaging-OCT proves particularly useful for evaluating optic disc drusen to answer the age-old question… is it papilledema or pseudopapilledema?
  • Are cataracts after chemotherapy for retinoblastoma foregone conclusion? A recent study investigates

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This week we sit down with Dr. Grace Sun to learn about Women in Ophthalmology, the many ways students can contribute to this important organization, and valuable lessons about stepping outside of your comfort zone. Dr. Sun is the president of Women in Ophthalmology and an Associate Professor of Ophthalmology at Weill Cornell Medical College where she practices as a comprehensive ophthalmologist and cataract surgeon. She received her MD at Weill Cornell Medical College and completed her ophthalmology residency at New York Presbyterian Hospital/Weill Cornell Medical Center. She served as the Program Director of Ophthalmology Residency at Weill Cornell Medicine for 10 years and currently serves as the Director of Ophthalmology Clinical Practice at Weill Cornell in Lower Manhattan.

Time Stamps:

4:24- What is Women in Ophthalmology? What is their mission?

7:41 - Mastering the "nice 'no'”

10:00- The power of women in leadership and their ability to bring attention to structural issues preventing gender equity in ophthalmology

11:02- How medical students/trainees can serve as allies to their female colleagues

17:00- Why representation matters

18:00- What ways are medical students involved in WIO?

21:24- Dr. Sun’s advice on overcoming awkward conference encounters

26:35- Why are fewer women comfortable mentioning their partner’s application status during residency interviews, despite the SF Match offering no couples match option?

Citation: https://doi.org/10.1016/j.jsurg.2022.07.026

29:30- Rethinking the residency training model as a potential solution for dealing with gender equity issues

32:05- Research as an advocacy tool and an investigative tool… we have to ask "why"

36:00- The importance of normalizing conversations about relationships and family planning

39:43- Dr. Sun’s parting message on preserving female representation in ophthalmology and its impact on the field

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Too busy to read the Lens? Listen to our weekly summary here! In this week’s issue:

  • One in eight glaucomatous eyes progresses fast, with progressive central vision loss associated with faster glaucomatous decline.
  • Electronic health records and claims data is helpful to study prevalence and patient trends, but accuracy of data can fluctuate depending on the condition.
  • High blood pressure is associated with an increased risk of retinal vascular occlusion.
  • The genetic factor, T-box factor 3, is required for normal mammalian eye formation.

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In this week’s issue: 

  • Defocus incorporated multiple segments spectacles may slow the rate of myopia progression
  • ChatGPT can’t pass OKAP… yet
  • 5 year data suggest that iStents are safe for the corneal endothelium

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In this week's issue:

  • 1 in 8 eyes undergoing routine glaucoma care were found to have fast progression of their visual field loss
  • Epidemiological data showed that ROP increased from 4.4% to 8.1% between 2003 and 2019, especially in low-income, black, and Hispanic populations
  • 10-year data for tube shunt placement showed good IOP data, but a high rate of worsening visual acuity and tube failure

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In this week's issue:

  • A majority of ophthalmology researchers have incomplete financial disclosures with underreported physician-industry relationships.
  • Risk of retinal vascular occlusion after mRNA COVID-19 vaccination is extremely low and commensurate with historically used vaccines for influenza and Tdap.
  • Ranibizumab and bevacizumab showed different risks for intraocular pressure increase compared to aflibercept in a nondiabetic cohort in Tuscany, Italy.

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This week we speak with Dr. Evan Waxman about community outreach in ophthalmology. Dr. Waxman is a comprehensive ophthalmologist at the University of Pittsburgh. He serves as a professor of Ophthalmology, Vice Chair of Medical & Resident Education, and Director of both the UPMC Eye Center Mercy and the comprehensive ophthalmology division. In this episode he teaches us about the Guerilla Eye Service, a community eye clinic that he founded over 15 years ago, in addition to providing helpful advice for getting involved in community efforts to improve vision health.

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In this week’s issue: 

  • Water-free cyclosporine solution (in perfluorobutylpentane) improves objective measures of dry eye disease as compared to vehicle alone.
  • Laser chorioretinal anastomosis in addition to anti-VEGF therapy may be useful in improving vision and decreasing need for injections in patients with CRVO.
  • Genotype-phenotype correlations are explored in patients with neuronal ceroid lipofuscinoses caused by specific CLN mutations.

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In this week’s issue: 

  • Areas in the United States with healthcare provider shortages only weakly correlate with eye care providers supply.
  • A new study highlights the epidemiological patterns and mechanisms of Intimate partner violence-related ocular injuries.
  • A meta-analysis reveals that antihypertensives have heterogeneous effects on intraocular pressure and glaucoma depending on class of medication.

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In this week's issue:

  • Posterior open globe injury extension independently portends worse visual and anatomic outcomes.
  • Deep learning algorithms provide insight into neurological dysfunction in Parkinson’s using fundus photographs.
  • The most common eye diagnoses in emergency rooms are conjunctivitis, corneal abrasions, and dry eye.

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In this week's issue we discuss long-term results of corneal crosslinking for keratoconus, the value of nanodroppers, and acute posterior multifocal placoid pigment epitheliopathy's relationship to stroke and TIA.

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In this episode, we speak with Dr. Katherine Hu to learn how medical students and trainees can get involved in ophthalmology advocacy. Dr. Hu attended medical school at Saint Louis University School of Medicine, then completed her ophthalmology residency at the John A. Moran Eye Center at the University of Utah where she is currently completing a cornea fellowship.

Listen now to learn about current legislative policies impacting the field of ophthalmology, improving your confidence in public speaking, and the power of storytelling in advocacy!

Time stamps:

2:00- Check out Moran Eye Center’s “Moran Core” for foundational ophthalmology learning!

3:00- How do physicians, specifically ophthalmologists, contribute to advocacy?

4:00- The optometry scope expansion bill explained.

10:55- An avenue for medical students to get involved in ophthalmology advocacy.

15:00- Public speaking and how to feel more confident.

23:00- Advocacy reimagined.

27:00- The cardinal rule for being involved in advocacy work.

27:45- Believe in the power of your voice– especially as a trainee.

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In this week's research summary we discuss the misrepresentation of complex cataract surgery costs in Medicare reimbursements, the pros and cons of an ocular health community clinic in Michigan, and sexual dimorphism as it pertains to ocular tissue.

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In this week's issue we discuss a prospective study comparing dichoptic therapy to patching in children with amblyopia, deep learning in ultra-widefield autofluorescence imaging in retinitis pigmentosa, plasma exchange in patients with optic neuritis of various etiologies, and postoperative triamcinolone acetonide for surgical repair of open globe trauma.   

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In this week's issue, we discuss the surprising misuse of the term "papilledema" in research publications, the benefit of 0.05% atropine compared to 0.01% when slowing myopic progression, and the distinction between ganglion cell layer monitoring and inner plexiform layer monitoring in glaucoma.

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In this episode, we speak with Dr. Ben Szirth, PhD to learn about the utility of teleophthalmology in clinical practice and its relationship to artificial intelligence and community outreach in ophthalmology. Dr. Ben is the director of the TeleHealth Program at the New Jersey Medical School and leads the Vision Threatening Diseases screening community-based program at the Institute of Ophthalmology and Visual Science in Newark, NJ where he works with current medical students every week.

Episode Timestamps

0:20- Introduction

2:18- Learning about EyeNuk, Inc.’s EyeArt® and its ability to screen for vision threatening diseases

3:24- Another interesting ophthalmology podcast recommendation!

5:40- Explaining how teleophthalmology in partnership with artificial intelligence allows us to bring advanced ocular care to disadvantaged communities

9:17- What is teleophthalmology? – Summarized.

10:00- A novel approach to monitoring Type 1 DM eye disease progression– at Disney World!

12:10- Dr. Ben’s open space model for his Vision Threatening Diseases Screening Program

15:20- Leveraging community leaders and peer advocates to establish and maintain lasting relationships within a community

17:30- Teleophthalmology offers a unique solution to improving access to care

18:31- Artificial intelligence research offers a system to validate the impact of teleophthalmology in ocular health and facilitates funding

22:20- Artificial intelligence and telehealth trend analysis

28:00- The surprising disadvantage of portable screening equipment

31:50- What does artificial intelligence research look like?

35:00- Deep learning explained

40:30- How medical students make a difference in community health

46:00- How teleophthalmology breeds innovation

*No participants of this podcast have any financial disclosures pertaining to research, products, or equipment discussed in this episode.

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In this week's research summary, we discuss the rarity of vaccine associated uveitis, the potential role of diastolic blood pressure in glaucoma damage, the prohibitive cost of cenegermin, and the influence of CDK-1 on lens cell fiber denucleation. 

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In this week's research summary we discuss alcohol consumption increased risk of exfoliation glaucoma, tricyclic antidepressants, insulin, and class III antiarrhythmic agents and association with having to undergo surgical removal of cataracts, and fungal endophthalmitis after cataract surgery from contaminated visco and the benefit of early IOL removal .

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In this week’s research summary we discuss selective laser trabeculoplasty vs. eye drops for initial glaucoma treatment, age and visual impairment, smoking and risks for surgical intervention in patients with thyroid eye disease, and chromosomal abnormalities and risk for metastasis in choroidal melanoma.

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In this week's research summary we discuss the anatomic and functional outcomes of pars plana vitrectomy, the complexities of cataract surgery in retinitis pigmentosa patients, and we revisit postoperative photorefractive keratectomy pain management.

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In this week's research summary we discuss a decreased risk of acanthamoeba keratitis with daily disposable contact lenses, how research prior to residency predicts research activity long-term, medications associated with needing cataract surgery, and using a DNA marker in uveal melanoma to predict metastasis.

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Description:

In this episode, we speak with Dr. Jay Sridhar to learn what students should know before (or after) their first research project. Dr. Sridhar is an associate professor of clinical ophthalmology and the assistant residency program director at Bascom Palmer Eye Institute. During this episode he imparts meaningful advice for all students and provides helpful tips for the research beginner.

Episode Goals:

-After this episode, medical students will understand the value of finding the right research mentor.

-After this episode, students will learn the importance of time management, setting expectations early, and having a peer mentor or colleague proofread your work.

-After this episode, students will learn simple questions to consider when preparing to write a manuscript.

Time stamps:

Part I: Intro, Icebreaker, & Life Advice

1:48- Dr. Sridhar’s hang-gliding excursion

4:28- Discussing our inner voice and Dr. Sridhar’s podcast recommendation

6:00- Dr. Sridhar’s non-ophthalmology book recommendations

7:15- Seize the day and the additions of small moments

Part II: The Research Basics

10:20- The value of finding the right research mentor

13:20- Set expectations early, articulate how much time you can give, NEVER ghost

14:40- Early skills that any student can contribute

15:30- Have a peer mentor double check your work BEFORE sending to your PI

17:35- Don’t put all your research eggs in one basket/PI

18:20- Three branches of research: basic science, translational, clinical

20:55- Authorship order

Part III: Navigating your First Project

22:35- Start with one project

24:40- Sending a “cold” email of interest to a potential PI

26:00- Case reports

26:38- What’s my target journal?

29:05- What’s my backup plan

Part IV: Research as it applies to my residency application

31:28- How many publications do I need to be a competitive ophthalmology applicant?

34:00- Don’t participate in research at the expense of other medical student responsibilities

37:20- “Good medical students = good residents”

40:13- Helpful tips

46:00- Parting advice

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In this week's research summary we discuss space travel and its effects on the posterior pole, the evolution of surgical experience in residency, and bevacizumab vs dexamethasone in the setting of diabetic retinal disease.

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In this week's research summary we discuss the influence of gender and race in keratoplasty for Fuchs’ endothelial corneal dystrophy, the impact of optimal search engine practices, the relevance of Merkel cell polyomavirus in Merkel Cell Carcinoma, and metformin usage as it pertains to age-related macular degeneration.

To subscribe to our weekly newsletter visit https://lensophthalmology.com 

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In this week's research summary we discuss the Affordable Care Act's impact on eye-related ED visits, parental leave policies for ophthalmologists, the role of vitrectomy for vitreous opacities, and DMEK grafts. 

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Episode 10: Introduction to Glaucoma (part 2) Description: In this episode, we speak with Dr. Andrew Pouw to get a broad overview of glaucoma. Dr. Pouw is a glaucoma specialist and clinical assistant professor at the University of Iowa and also the co-host of the popular ophthalmology podcast Eyes for Ears. Episode Goals: After listening to this episode, medical students should be able to: ● Acquire a general understanding of imaging tools and interpretation of visual fields and OCT ● Acquire knowledge of some pressure lowering drop mechanisms used in glaucoma management ● Acquire knowledge of laser and surgical management options for glaucoma Time Stamps: Limitations of perimetry - 0:50 Staging glaucoma using visual fields - 3:12 3 Questions for every visual field - 5:15

What is it? - 5:35 Is it real? - 8:26 Is this worse? - 12:34

Evidence based reliability indicies by Yohannan et al - 20:41 Which side is the nasal side in a VF print out? - 21:48 Eyes4Ears visual fields episode - 23:52 Cirrus OCT discussion - 26:24 Normal disc area and other parameters - 33:42 Neuroanatomical concordance in OCT and VF - 34:50 Discussion on pressure lowering drops - 35:47 Two categories for drops - 36:16 Glaucoma surgeries - 39:31 Pseudoexfoliative glaucoma and cataract surgery - 41:30 Laser options in clinic - 42:54 Tips for medical students in the glaucoma OR - 46:34 Advice for medical students on their glaucoma rotation - 50:11 Plug for Eyes4Ears and the Buddy Call Series - 51:22 Links:  Sample 24-2 Visual Field (http://eyerounds.org/tutorials/VF-testing/VF-tutorial-6.gif) Sample Cirrus OCT printout (https://media.springernature.com/lw685/springer-static/image/art%3A10.1186%2Fs40942-020-0208-5/MediaObjects/40942_2020_208_Fig1_HTML.png)  Yohannan et al on VF reliability indicies (https://pubmed.ncbi.nlm.nih.gov/28676280/) Yohannan et al on OCT signal strength (https://pubmed.ncbi.nlm.nih.gov/31648802/) Top cap reference (not 100% absolute rules) - https://www.optometrystudents.com/pearl/guide-cap-colors-commonly-prescribed-drugs/

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Episode 10: Introduction to Glaucoma (part 1)

Description:

In this episode, we speak with Dr. Andrew Pouw to get a broad overview of glaucoma. Dr. Pouw is a glaucoma specialist and clinical assistant professor at the University of Iowa and also the co-host of the popular ophthalmology podcast Eyes for Ears.

Episode Goals:

After listening to this episode, medical students should be able to:

● Acquire a general understanding of the breadth of practice for glaucoma

● Acquire knowledge of the pathophysiology of glaucoma and aqueous humor generation and drainage pathways

● Describe the common examination techniques in glaucoma

Time Stamps:

Introductions - 0:41

Eyes for ears and Dr Steven Flynn recommendation for medical students and junior residents - 2:47

What is the glaucoma subspecialty? - 3:32

Overview of aqueous humor pathways - 6:34

Can you drop IOP too low? - 9:29

Measuring IOP - 11:32

Central corneal thickness and IOP - 14:15

Why do eyes have different pressure goals? - 16:45

Pearl when to not measure IOP using Goldmann applanation tonometry - 19:17

Slit lamp exam findings in glaucoma - 19:54

Pearl about superior and inferior quadrants - 26:52

Tilted optic nerves - 30:10

GONE project - 31:55

Drance hemorrhages - 33:53

Pearl about contextualizing cup to disc ratios - 36:40

What is gonioscopy? - 37:52

Gonioscopy.org - 43:48

Links: Eyes for Ears glaucoma episodes (https://eyesforears.net/episodes/category/Glaucoma)

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Episode 9: Introduction to Ocular Oncology

Description:

In this episode, we speak with Dr. Carol Shields to get a broad overview of ocular oncology. Dr. Shields is Chief of the Ocular Oncology Service at Wills Eye Hospital and Professor of Ophthalmology at Thomas Jefferson University in Philadelphia. She completed her ophthalmology training at Wills Eye and subsequently did fellowship training in ocular oncology, oculoplastic surgery, and ophthalmic pathology.

Episode Goals:

After listening to this episode, medical students should be able to:

● Acquire a general understanding of the breadth of practice for ocular oncology

● Describe the common examination and imaging techniques in ocular oncology

● Describe common pathologies seen and procedures/surgeries performed in ocular oncology

Time Stamps:

Introductions - 0:30

What is ocular oncology? - 2:20

How did you discover ocular oncology?  - 3:30

How can students explore ocular oncology? - 5:00

How do you become an ocular oncologist? - 6:40

Overview of eyelid tumors - 9:05

Overview of conjunctival tumors - 15:05

Overview of conjunctival tumors - 15:05

Overview of orbital tumors - 23:25

Overview of intraocular tumors - 31:06

Additional resources - 42:50

Conclusions - 44:20

Links: https://www.willseye.org/

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Episode 8: Clinic and OR Do's and Dont's

Description:

In this episode, we speak with Dr. Rishi Gupta to get some helpful tips that students can use when beginning a clinically or surgically based ophthalmology elective. Dr. Gupta attended medical school at University of Toronto and completed his ophthalmology residency at University of Ottawa. Following this, he completed his retina fellowship at McGill University. Dr. Gupta also has a keen interest in medical education, and has published a book called “Reflections of a Pupil” outlining his journey through medical training and practice.

Episode Goals:

After listening to this episode, medical students should be able to:

● Feel more comfortable in an OR setting

● Feel more comfortable in a clinical setting

Time Stamps:

Introductions - 0:30

Clinic resources and tips - 3:20

Reflections of a Pupil - 6:50

Experiences from training - 7:05

Ophthalmology OR - 8:05

Tips for being an active learner - 10:00

Experiences in the OR - 13:25

Conclusions - 14:15

Links:

Tim Root OphthoBook: https://timroot.com/ Slit lamp techniques: https://www.slideshare.net/optometristiem.lv/slit-lamp-illumination-techniques

Also be sure to check out the book, Reflections of a Pupil by Dr. Rishi Gupta!

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Episode 7: Introduction to Neuroophthalmology

Description:

In this episode, we speak with Dr. Kalla Gervasioto learn about what medical students should know before their first neuro-ophthalmology clinic and OR. Dr. Gervasio completed her ophthalmology residency at Wills Eye Hospital where she was selected as Chief Resident and Text Editor of the newest edition of the Wills Eye Manual.

Episode Goals:

After listening to this episode, medical students should be able to:

  • Acquire a general understanding of the breadth of practice for the neuro-ophthalmology subspecialty.
  • Describe the common examination and imaging techniques in the neuro-ophthalmology clinic
  • Describe common pathologies seen and procedures/surgeries performed on the neuro-ophthalmology service.

Time Stamps:

Introductions - 0:30

What is Neuroophthalmology - 4:00

Tips for medical students - 7:30

Overview of anatomy - 9:15

Common examination techniques - 15:00

Minor procedures - 21:00

Blepherospasm - 21:30

Common pathologies to review before starting - 23:30

Origins of interest in neuroophthalmology - 30:00

Common questions on rotations - 33:00

Links:

Tim Root OphthoBook: https://timroot.com/ Slit lamp techniques: https://www.slideshare.net/optometristiem.lv/slit-lamp-illumination-techniques

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Episode 6: Introduction to Cornea Description:

This week, we talk about the cornea subspecialty for the medical student learner with Dr. Jimmy Hu who is a private practice attending who also is an instructor at New York Eye and Ear Infirmary.

Episode goals:

After listening to this episode, medical students should be able to:

  • Acquire a general understanding of the breadth of practice for the cornea subspecialty

  • Describe the common examination and imaging techniques for the cornea

  • Describe common pathologies seen and procedures/surgeries performed on the cornea service

Time stamps:

3:03 What is the cornea subspecialty and what makes it unique?

6:18 Brief overview of anatomy of the cornea

10:20 An intro to dye drops

13:01 Brief intro to corneal topography

14:03 What is regular versus irregular astigmatism?

17:25 An aside on keratoconus and Steph Curry

20:15 Working up corneal ulcers

27:21 Most common corneal surgeries

28:30 Corneal transplant surgeries (PK vs DALK, DMEK vs DSEK)

34:50 Dr.Hu’s advice for medical students in the OR

40:00 Dr.Hu’s youtube channel and patient info sheets

Links:

  • Tim Root OphthoBook: https://timroot.com/
  • Slit lamp techniques: https://www.slideshare.net/optometristiem.lv/slit-lamp-illumination-techniques
  • Corneal ulcer example: https://www.reviewofcontactlenses.com/article/no-pain-no-gain
  • Dr. Hu’s youtube channel: https://www.youtube.com/channel/UC7TWhyT-YahM_nJQUq41A2A
  • Dr. Hu's patient infographs (to be added!)

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Description:

This week, we talk about the pediatric ophthalmology and strabismus sub-specialty for the medical student learner with Dr. Angeline Nguyen from the University of Southern California.

Episode goals:

After listening to this episode, medical students should be able to:

  • Acquire a general understanding of the breadth of practice for the pediatric ophthalmology subspecialty
  • Describe the pathophysiology of retinopathy of prematurity and when to screen newborns
  • Describe the difference between amblyopia and strabismus and related treatment options

Time stamps:

3:08 What is the connection between strabismus and pediatric ophthalmology?

4:30 Favorite aspects of pediatric ophthalmology and dispelling misconceptions

8:18 Most common reasons for patients to see a pediatric ophthalmologist

9:34 General advice and practical tips for a medical student rotating on pediatric ophthalmology

13:12 Retinopathy of prematurity introduction

17:00 The ROP exam

19:43 Treatment options for ROP

20:18 When to screen (30 weeks 1500 grams)

21:18 Amblyopia & Strabismus

25:42 Breaking down some of the jargon around gaze deviations

29:22 Clarifying misconceptions on tropias and phorias

30:50 Key parts of history for strabismus

31:38 The impact of verbal staging on examination

34:30 When to treat to prevent amblyopia

35:14 Surgical treatment options for strabismus

36:17 Botox for strabismus

38:20 The pediatric ophthalmology OR as a medical student

39:22 Final takeaways

40:30 Plug for Dr. Sudha Nallasamy at CHLA’s upcoming work

Links:

Who Moved My Cheese - https://bookshop.org/books/who-moved-my-cheese-an-a-mazing-way-to-deal-with-change-in-your-work-and-in-your-life/9780399144462

Tim Root Website - https://timroot.com/

AAO simulators - https://www.aao.org/interactive

Botox in strabismus - https://eyewiki.aao.org/Botulinum_Toxin_Use_In_Strabismus

Sticker chart for kids - https://ortopadusa.com/product-category/shop/reward-posters/

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Hello everyone, this was our first episode that we recorded so the format is slightly different, but we hope you enjoy it and find it educational all the same!

Description:

This week, we talk about the retina sub-speciality for the medical student learner with Dr. Benjamin Young from the University of Michigan.

Episode goals:

After listening to this episode, medical students should be able to:

  • Acquire a general understanding of the breadth of practice for the retina subspecialty
  • Describe the common examination and imaging techniques for the posterior segment.
  • Describe common pathologies seen and procedures/surgeries performed on the retina service.

Time stamps:

0:55 What is retina subspecialty and what makes it unique?

3:14 Favorite aspects of retina subspecialty

4:27 Different methods of examining the posterior segment

12:46 Tips for indirect ophthalmoscopy and examining posterior segment

19:48 Common in-office procedures

23:38 Other procedures like PRP and laser retinopexy

27:00 What is a vitrectomy and when to perform

32:03 First time OR tips

32:57 Takeaways: top skills to practice

34:00 Closing remarks

Links:

  • Eyes For Ears Podcast: https://eyesforears.net/
  • Tim Root OphthoBook: https://timroot.com/
  • EyeRounds: https://eyerounds.org/
  • EyeWiki: https://eyewiki.org/Main_Page
  • OCT anatomy review: https://www.octscans.com/anatomy-review.html
  • EyeGuru OCT Essentials: https://eyeguru.org/essentials/interpreting-octs/

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Description:

This week, we talk about oculoplastics for the medical student learner with Dr. Andrea Tooley from the Mayo Clinic.

Episode goals:

After listening to this episode, medical students should be able to:

  • Acquire a general understanding of the breadth of practice for the oculoplastics subspecialty
  • Describe the common examination and imaging techniques in oculoplastics clinic
  • Describe common pathologies seen and procedures/surgeries performed on the oculoplastics service.

Time stamps:

2:59 What is oculoplastics and what makes it unique?

4:40 Tips for first-time medical learners in oculoplastics

7:30 Top anatomical structures to learn and know

11:12 Common examination techniques and skills to learn

19:19 In office or minor procedures

22:17 Related rotations/topics for oculoplastics

29:20 A brief aside on Teprotumumab for thyroid eye disease

31:45 Approach to eyelid lumps and bumps

36:12 Common surgeries in the oculoplastics OR

46:40 Surgeries performed outside academic centers

48:42 First time OR tips

51:32 Takeaways

53:34 Closing remarks

Links:

  • Practical Ophthalmology Text: https://store.aao.org/practical-ophthalmology-8th-edition.html
  • Eyes for Ears Podcast: https://eyesforears.net/
  • AAO Oculoplastics Education Center (images of eyelid lumps and bumps): https://www.aao.org/oculoplastics-center/oculoplastics-education-center
  • AAO Careers in Ophthalmology Oculoplastics Video: https://www.youtube.com/watch?v=wswGbU8ZUpU

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Description:

This week, we talk about ophthalmology emergencies and ED consults with Dr. Grayson Armstrong from Massachusetts Eye and Ear

Episode goals:

After listening to this episode, listeners should be able to:

  • Appreciate the breadth of common ophthalmic emergencies and trauma
  • Present a basic workup and have a differential for common ophthalmic complaints presenting to the ED

Time stamps:

2:30 How common are eye emergencies?

3:45 What are some of your favorite parts of ophthalmology?

4:47 What do you enjoy most about managing eye emergencies?

5:56 Benign and worst case scenario for the AAO’s 6 causes of urgent referral for ophthalmology

9:23 Red flags and what information you should always get when evaluating a patient

12:39 The outside-in approach for working up ocular trauma patients

14:10 Lid lacs at the medical student level

15:52 Exam techniques when working up vision loss

17:47 Painful vision loss differential and assessment

20:20 Orbital compartment syndrome tidbits

22:00 Painless vision loss

24:45 Red eye

28:36 Takeaways and tips for eye ED consults

Links:

Tim Root’s website - https://timroot.com/

AAO medical student website - https://www.aao.org/medical-students

AAO White Paper for things medical students should know - https://www.aao.org/Assets/edca7d7c-ccb0-4b97-bca4-66b4328a91fc/637157338302800000/appendix-of-ms-white-paper-with-links-pdf?inline=1

Video of cell and flare - https://timroot.com/cell-and-flare-in-the-eye-video/

Ophthalmic Edge Acronym app (great resource for rotations!!)- https://ophthalmicedge.org/physician/ophthalmic-acronyms-app-available-now/#

Eye Tea Official Twitter - https://twitter.com/eyeteaofficial?lang=en

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This week, we talk about comprehensive ophthalmology and general tips for the ophthalmology rotation for the medical student learner with Dr. Thomas Oetting from the University of Iowa

Goal of episode: After listening to this episode, medical students should be able to:

Acquire a general understanding of the breadth of practice in comprehensive ophthalmology

Describe the basic work-up for an eye patient and “vital signs” of the eye

Understand the basic functions of the slit lamp

Describe some key patient considerations when evaluating cataracts

Time stamps: 4:15 What is comprehensive ophthalmology? 7:59 Is there anything you recommend medical students should brush up on before their first day in comprehensive ophthalmology? 13:15 What can medical students do in comprehensive ophthalmology clinic that you have found helpful or useful, that was also beneficial for student learning? 23:20 Thoughts on the “vital signs of the eye” 33:00 A brief aside on hippus 35:58 Pearls and pitfalls for the slit lamp exam 43:10 Insight on cataract evaluation 52:05 Approaching the cataract OR 59:49 Takeaways 1:03:00 Closing remarks

Links:

Basic Eye Exam (including slit lamp) - https://webeye.ophth.uiowa.edu/eyeforum/atlas-video/basic-eye-exam.htm Cataract surgery for greenhorns - https://eyerounds.org/tutorials/cataract-oetting.htm AAO Careers in Ophthalmology: Comprehensive Ophthalmology https://www.youtube.com/watch?v=6vHrwcKk9S8 Hippus by Stanley Thompson: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/575589 https://lensophthalmology.com/the-lens-pod https://twitter.com/TheLens_oph

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In episode 0 of season 1 of The Lens Pod, we introduce the podcast hosts - Chris Le, Anne Xuan-Lan Nguyen, Sunil Ruparelia, and Emily Xu - and discuss the goals of the podcast, and give a peak behind the scenes and some things to look forward to with the rest of our inaugural season.