Young solo eye doc here. I’ll try to keep it short. I am in a crowded market with a couple very large players who dominate the cataract market. These players are well oiled sales-machines.

I often get patients who come to me for their surgery as a second opinion bc they don’t feel like said other practices have their best interests at heart.

Now I feel like this is an opportunity to market against them to appeal to patients who want a doc who will do what is right rather than what earns more. I am torn because it doesn’t feel right to essentially insinuate that another MD is not an ethical MD (even though I don’t believe they are). Thoughts?

Edit- Thank you for all the comments/feedback. I tend to agree, badmouthing others is no way to go about it and will ultimately hurt my own brand. I will continue to fight the good fight.

I'm going to be starting a new job soon as an opthalmic tech at an eye care center after previously working at a retail store that only did basic eye exams for glasses prescriptions and contact lens fittings. So with my new job I would be seeing "sicker" eyes than what I'm used to.

I have really bad emetophobia to the point where I cannot be in the same room as somebody who is actively throwing up or if there is vomit in the room. I have to calm myself down and try not to cry as it's truly a phobia. Even people looking green or saying that they feel like they're nauseous or going to be sick will put me on edge.

My question to other opthalmic techs in clinical settings or even other professionals in this field: how often do you see patients throw up, and do you think having a phobia like this means I shouldn't be working as a tech?

I really want to help people and that is the reason why I wanted to get into a more clinical setting and move away from just upselling glasses to people. The prescreening process of my last job is what made me want to continue down that path. I've thought a lot about the different areas of medicine and thought that opthamology seemed like a subset that wouldn't see as much vomit as other professions.

As an aside, I'm not squeamish about "gross" things in general (at least to the extent of most people), so other bodily fluids wouldn't bother me, it's just vomit.

Any insight or advice about this would be greatly appreciated, I really want to be able to do the best I can as a tech.

During my 2 week internship at an ophthalmology clinic I quickly got very interested in opthalmology and still miss my time there months later. Out of all examination methods that I could participate in, I enjoyed looking at the retina the most with a slit lamp.

That's why I recently came across the idea to buy a cheap as hell slit lamp from Ebay (<200€ - I'm still in the German equivalent of High School) and possibly repair it since the chances of getting a functioning one seems near zero at my budget. Sadly all the listings that specify the slit lamp being untested or broken don't actually say what might be wrong with it so here I am asking you all what could actually break in a slit lamp. What comes to my mind is either the actual lamp burning out or the lenses being dusty / wet / have fungus which both seem cheap to fix/to clean. Is there anything else that maybe might pose a problem?

Any help is appreciated!

I have been working as a tech at this practice for two years and recently began independent study for the Ophthalmic Assistant exam, however I must also have documentation of 1,000 hours working in clinic to qualify to take the exam without attending university. The doctors will not provide me with this unless I sign a contact to stay for another year, which makes me uneasy given the way I have been treated by management and coworkers thus far. Is this common practice?

Im doing a research year before residency and feel like the BCSC is too in depth to read casually and Wills is more a bulleted overview of managing a clinic patient. Are there any good books that can be read more casually to get a good foundational base before residency?

Or an experienced surgeon with more than 2000 phacos done, how am I supposed to find a suitable paying job which will also let me operate

Hi everyone, I work in ophthalmology but am not a photographer, I have a question I am too embarrassed to ask at work for fear it would be seen as an obvious or dumb question. When FAF is performed, do you set the reference at baseline (like you do for OCT)? Thanks for your help!

Hey everyone,

Ophthalmology was the best specialty I experienced during my elective training, but I can’t shake off a bit of anxiety. In medical school, I only had limited exposure to ophthalmology, and I’m concerned that my knowledge of the field’s diseases isn’t where it should be.

During my elective training, I found the specialty fascinating, even though I didn’t fully understand most of the notes and diseases.

Is it normal to have limited knowledge about ophthalmology and to feel like you're starting almost from scratch in residency?

What are your surgery numbers for catract surgery per day? How have you improved your workflow to improve throughput in theatre? What slows you down? What speeds you up?

Ophthalmologist, general and surgical retina.

Does anyone know how to redraw the c/d circle of the nerve head when taking a RNFL? I know how to reposition the grid but sometimes it still won't draw the nerve properly.

Edit: Adding that I'm a tech.

I'm a UK based resident. Our equivalent of AAO is the Royal College and it's very bad in comparison. Very little in terms of resources for residents. Just wondering if it's worth getting a AAO membership to access their resources?

Good day all.

First, I saw other posts where people were asked to better identify themselves. I am the nephew of an Opthalmologist, based in South Africa.

Really hope I can find some information/assistance here.

I have a Carl Zeiss Visucam nm/fa that had a faulty HDD. I have managed to get the required software and replaced the faulty drive. Unfortunately, I do not have a backup of the licenses for the device and Zeiss in unable/unwilling to assist with retrieving them. I do not have an activation code as it was only provided with the original invoice which was discarded some 5 years ago. Zeiss is not willing to provide this either.

I do have a system Ghost file which Zeiss uses to restore machines to factory condition, but this does not include license files.

The device was working perfectly till the HDD issue. Any help/info would be greatly appreciated.

1. Are these devices able to test/demo with no license files installed? Currently, I am unable to get access to the capture module. Chatgpt advises that the licenses are required to access the capture module. Zeiss was unable to confirm. If I cannot get this functional, a colleague has offered to purchase it for parts. Is there any other way to test and confirm the hardware is functional without the licenses?

2. Would this device work if I copied the license files from another Visucam or are these license files locked to the hardware in some way?

3. Does anybody have experience getting this sort of info from Zeiss? Is it normal for them to refuse this info? They were being really helpful and suddenly just stopped and said "absolutely not".

My apologies if I have posted this to the wrong place. Never posted to reddit before and figuring it out as I go.

Thanks in advance for any help and guidance you guys are able to provide.

KD

Apologies if this sounds naive but I hear everyone mention it. I'm a PGY4. Looking to work in Comp soon.

If PE isn't the way, what is? Hospital based practice? Full academia? Private practice? What's the best for lifestyle? Hospital, where residents help with call?

I would encourage all medical professionals on this forum to google “Social Security Disability Listing of Impairments.” I would encourage everyone to read the entirety of the preface of 2.00 - Special Senses and Speech.

A section I would like to highlight is: A. 5. How do we measure best-corrected visual acuity? (iii) “We will not use the results of pinhole testing or automated refraction acuity to determine your best-corrected central visual acuity. These tests provide an estimate of potential visual acuity but not an actual measurement of your best-corrected central visual acuity.”

Full disclosure, I am not a physician, however I work with individuals applying for disability benefits. I came across an example today in which medical records documented OS 20/200, OD CF, PH NI. This is technically not acceptable for SSA policy. If you and your patient are frustrated with the disability process, review your documentation, do your exams/progress notes include best corrected visual acuity with manifest refraction?

Seeing my first lens particle glaucoma patient and curious what others experience has been.

Otherwise routine cataract surgery presents PO1 with IOP 25, thought, ok some retained viscoelastic, nothing to worry about. Comes back for week 1 f/u with IOP in the high 30s. Minimal inflammation, I found a small nuclear piece on gonio. Started her on cosopt and figured we could watch it with barely any inflammation and such a small piece. Comes back a week later and IOP is unchanged (concern for non-compliance), add diamox and other drops, discuss how to take drops, etc. IOP unchanged next week and so we went to the OR for an AC washout. Removed the piece and swept under the iris and as much of the capsular bag as possible. Left her IOP low and PO1 IOP was 45. Now comes in 4 days later and IOP is 40 while taking brim, cosopt, latan, and diamox (250 as 500 caused major side effects).

I hate to jump to another surgical intervention, but don't feel comfortable letting her eye sit at this IOP any longer. Any recommendations? I'm guessing we have macrophages with lens fragment trapped in the TM. I'm thinking of a micropulse to avoid opening her eye up again but wondering if we need a more advanced procedure if this isn't going to resolve on its own.

Hi! I attend a T20 medical school and got an equal mix of H/HP/P. Additionally, I only HPed surgery and internal medicine. I passed both pediatrics and obgyn. Overall, this places me at about the 35% percentile for my class.

Otherwise, I have about 20-25 presentations, 7 published abstracts, and about 5 first and second author manuscripts accepted or submitted. I have okay leadership and weaker volunteering. I will likely not get AOA or GHS.

Lastly, I passed Step 1 but am waiting on my Step 2 score - this will likely be around 255-260 based on practice test scores.

Is it still possible to match? I would also be fine with a few other specialities but wanted to rule out ophthalmology first.

I find difficulties to view the macula when patient is looking at my ear, when i move the slit lamp beam to the temporal side almost always either i am viewing it monocularly or there is a lot of glare on it, but if i try moving the lens i lost the entire view, could anyone give me some tips

I’m a recent fellowship graduate. At the time, I was very committed to finding a non-PE, multispecialty group. I was geographically restricted due to family, so I spent a lot of time traveling back home to vet each practice. Ultimately, I narrowed it down to one practice I really liked. However, after a couple of months of discussion, they decided to pause hiring another anterior segment specialist due to a recent retina specialist hire. At that point, I felt completely lost and scrambling due to financial responsibilities, limited time off to travel, and hearing that my peers had signed contracts months earlier.

In the end, I signed with a multispecialty group that had recently been sold to PE (the area is dominated by PE, and I genuinely couldn’t find anything else 😭). Reading through many posts on this topic has made me regret it.

That said, now that I’m in the geographic area I wanted, what advice can anyone provide about the job search? How much earlier should one begin looking? What’s the best way to “look” while actively working in the area? Please help me undo my sellout behavior

I'm a resident at a program where we dont have EyesI or any of those virtual simulators, virtual reality etc. I struggle with my rrhexis. For one thing, just properly grabbing the flap once I make it-do I need to tilt my Utratas deeper in? The flap is just so flimsy, it's not the same as practicing with the Kitaro Kit!

Anyone have any tips? Anyone who was in a similar boat to me? I know most may say use the virtual simulators but we do not have it.

Hi all – I am finishing up my last year in optometry school in the US considering residency training in low vision rehabilitation. Throughout OD school and my externship rotations, I've enjoyed providing care for patients who have significant impacts to their activities of daily living as a result of their reduced vision secondary to various different pathology. Anecdotally, I also have often heard from patients and other ODs the need for more low vision doctors and services.

I’m curious—under the premise that by default ophthalmology tends to manage more advanced and end-stage ocular diseases where low vision services might be especially needed, how often do you find yourselves referring to low vision optometrists? Do you agree that there’s an unmet need for these services?

I'm looking to purchase a new lens, but I'm not sure which one to choose..

Incoming med student curious about ophtho salaries here. I've been looking at the MGMA data from a couple years back, the anonymized salaries reported from that survey a couple days back, and all the online stuff like medscape surveys. Ophtho has the lowest average of just about all surgical subspecialties with an average/median salary in the high 300's to low 400's. Compared to just about any other surgical field, ophthos (all except retina) are making less in median and 90th percentile work. Is there a reason for this? How bad do you think it'll be for ophthos salary-wise in 10 years given how aggressively reimbursement cuts are coming for the bread/butter?

If I want to practice in a smaller midwest metro (STL, Tulsa, Des Moines, KC, or Milwaukee) pp or in academics in the same type of location, what's realistic starting vs in 10 years in salary (after partnering, buy-ins, shares, and all)?

I guess I wanted to make this post as a warning to future readers. Throughout my training, everywhere I turned and everyone I talked to said the WQE is the same as OKAPS. “Study the same way and you’ll be fine.” That was not my experience at all. I think the OKAPS focused on a lot of minutia, like specific gene mutations or random associations. The WQE focuses a lot more on management, like how would you manage this complication, or workup this weird presentation. A lot of the answers were for sure debatable, and often times you would pick both answers in the “real world.” I felt a little blindsided by the test itself, but still managed to pass. Despite knowing this now, I’m not sure how I would’ve studied differently. Don’t know if the questions are like this every year, or they decided to change up the qbank this year.

(For background information, I did ok on okaps (70,59,47 percentiles). Most of my studying was done through anki. Never opened bcsc. For pgy2/3 I used ophthoquestions, and for pgy4/WQE I used AAO qbank.)

Hey guys,

For a PGY-2, after studying Dr Flynn’s PowerPoints in AAO, what would be the most efficient material to choose? Ace Anki cards or EyeGuru? Or do you have any other suggestions? I am worried about the OKAP! Would appreciate your suggestions!

Obviously very shocked and disappointed. Not sure what to do. Any advice or encouragement would be appreciated. Anyone in the same boat please feel free to message me. I mostly hear about people struggling with the oral boards, but haven't heard much of anyone who failed written so I'm feeling awful.