Tag Archives: ocular surface

Top Reasons for Poor Premium IOL Outcomes and How to Remedy Them BLOG #8:  Managing the Dissatisfied Patient   Various studies show that up to 25% of patients will be unhappy in some way, either by complaining outright or just leaving the practice and seeking a second opinion.  The old adage of a happy patient [...]

#6 of 10: Top Reasons for Poor Premium IOL Outcomes and How to Remedy Them: Managing the Ocular Surface   Managing patient expectations, the preoperative evaluation, corneal astigmatism, posterior capsular opacification, and addressing cystoid macular edema are all critical in making the premium patient happy with a premium outcome.  However, ignoring the ocular surface, one [...]

The technique of applying vital dyes to examine the ocular surface (cornea, conjunctiva and lid margin) can influence the information gathered.  Flooding the surface with copious amounts of dye is messy, increases the time needed to analyze the stain, and, most importantly, can overwhelm the surface masking subtle findings.  A very small amount of dye [...]

I had an interesting patient in the office a few weeks ago. She was referred to me for potential cataract surgery because of visual symptoms including descriptions of poor quality of vision, generalized blur, and glare and halos during night driving. There was a small cataract, possibly enough to cause the problems, but perhaps not [...]

I once told a class of 1,000 colleagues that lissamine green solution had “changed my life”.  To me, the brilliance of lissamine in solution was far superior to the stain I could achieve with a lissamine strip. Pathology of the ocular surface was easily identifiable and demonstrable to the patient via imaging.  Once satisfied with [...]

It is widely accepted that an abnormal, hyperosmolar tear film cannot successfully support the ocular surface ultimately leading to a loss of mucin-producing goblet cells and an increase in conjunctival and corneal surface desquamation. In general, the cell-to-cell junctions of the corneal epithelium are more resistant to the adverse effects of a dysfunional tear film [...]