Mini neuropatties for mitomycin Trabeculectomy to avoid retained foreign body (video)

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Mini neuropatties for mitomycin Trabeculectomy to avoid retained foreign body (video)

A couple of months ago, when I could not find one of the two mitomycin soaked 8x8mm instrument wipe sponges I had placed in the sub-tenon’s space, the first time this has happened in an estimated 2,000 surgical cases over 16 years, I thought…well, this won’t ever happen again. When it happened again a couple of weeks ago; I knew that it was time to change my technique of mitomcyin application.

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

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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.

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Telemedicine direct from patient to doctor - a good thing?

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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?

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Surgical repair of leaking trabeculectomy glaucoma filtering bleb

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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.

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Keep the patient in the loop when docs talk amongst themselves

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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.

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How do many of my patients get their drops in their eyes?

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How do many of my patients get their drops in their eyes?

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.

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