After a hiatus, we're back this week to talk about corneal grafts, starting with selection criteria. Learn what disqualifies a donor cornea from being a transplant candidate, the preservation times and transport media, and the basics of the Cornea Donor Study.
In this episode, we present four neuro-ophth cases to Dr. Jonathan Trobe, division head of Neuro-Ophthalmology at the Kellogg Eye Center, where he dissects them to find the seemingly small details that can get us and our patients into big trouble if missed. Join along in his case analysis, and see if you can find where mistakes were made so you can avoid them yourself!
Dr. Trobe went to Harvard Medical School, did his residency at Wills Eye, a neuro-ophth fellowship at Bascom Palmer, then a full neurology residency at the University of Miami. He's also served in the US Air Force, and is a tireless supporter of medical education, having won the teaching award at the University of Michigan countless times.
Learn about the board testable exotic conditions that can affect the eye and surrounding bones:
- Unifocal eosinophilic granuloma of the bone,
- Multifocal eosinophilic granuloma of the bone (previously called Hand-Schuller-Christian disease)
- Diffuse soft tissue histiocytosis (previously called Letterer-Siwe disease)
Learn about the unusual condition juvenile xanthogranuloma, the four adult xanthogranulomas (Adult xanthogranuloma, Necrobiotic xanthogranuloma, Adult xanthogranuloma with asthma and periocular involvement, and Erdheim-Chester disease), and basics about histiocytes and giant cells.
Haven't read about PPS Maculopathy? Just because it isn't in your BCSC yet doesn't mean you won't need to learn about this newly described disease. We learn about it here from the man who first discovered it, Dr. Nieraj Jain, vitreoretinal surgeon and ophthalmic genetics expert at the Emory Eye Center. Learn how he came to realize he was seeing a previously undescribed disease associated with a commonly used drug, how you can recognize it, and some of the techniques Dr. Jain used to show the strength of the association.
This week, we return to acute angle closure and discuss how to manage this challenging disease. All residents will eventually need to know how to tackle this in the ED!
We reference this video during the episode, a demonstration of the Argon Laser Peripheral Iridoplasty technique, by Dr. Christopher Teng: https://www.youtube.com/watch?v=l2NYixE_0xQ
He also has videos demonstrating the traditional Laser Peripheral Iridotomy technique as well:
This week we review the Age-related Eye Diseases Studies (AREDS) which resulted in the AREDS and AREDS2 vitamin supplements for patients with age-related macular degeneration. Learn the finer points of when to actually prescribe them, the evidence behind them, and what to do in those odd edge cases.
With the massive changes in non-urgent patient care caused by the COVID-19 pandemic, ophthalmology was one of the most affected specialties in the US and the World, with significant drops in patient volume with the initial shutdowns, and difficulty adapting as many other specialties did by delivering care remotely; ie with telemedicine.
Dr. Grayson Armstrong is the first and only telemedicine fellow in ophthalmology at Mass Eye and Ear, and so has made it his job of trying to solve the problem of teleophthalmology. Join us as he takes on a tour of where we're at now, tips on how to do effective tele-ophtho starting today, and where we're headed in the near future.