Telemedicine direct from patient to doctor - a good thing?
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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?
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Surgical repair of leaking trabeculectomy glaucoma filtering bleb
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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 MoreKeep the patient in the loop when docs talk amongst themselves
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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 MoreHow do many of my patients get their drops in their eyes?
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At one point during the night I awoke; with eyes feeling dry, I reached for the drops, lined them up, and proceeded to put one drop on each eyelid before getting each one in my eye. It's no wonder that some of my patients go through their glaucoma drops in just 2 or 3 weeks instead of the full 6 weeks that they should last.
Read MoreDriving - a privilege not a right, no matter how long you've been driving
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I have followed this 46 yo female for the past 8 years with Retinitis Pigmentosa and Chronic Angle Closure Glaucoma. Her visual acuity is 6/7.5 in her right eye and 6/120 in her left eye. She has undergone laser iridotomies in both eyes in 2003, trabeculectomy in the left in 2004 then cataract extraction in 2005 for the inevitable posterior subscapsular cataract associated with her RP and further exacerbated by glaucoma surgery. She currently takes Lumigan qHS and Pilocarpine 2% BID in her right eye and has pressures of 19 in the right and 7 in her left eye. Oh, and, I learned today that she still drives.
Read MoreWhat's the point of Continuing Medical Education anyway? Looking beyond content experts.
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Much of last week was devoted to the annual and somewhat annoying task of reporting my Continuing Medical Education (CME) activity, referred to here in Canada as Continuing Professional Development (CPD). Between that and working on my year-end tax paperwork, it really has not been a fun week! Of course the purpose of this exercise is not just to file paperwork but rather to help us continue to develop as physicians. I had originally intended to write this article on how best to use technology to track these activities but this has evolved into a discussion on how to better ourselves as physicians through CPD activities.
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