Host Dr. Andrew Pouw welcomes Drs. Aakriti Shukla, Mahsaw Mansoor, and Alan Robin to discuss the latest sustainability initiatives in the ophthalmic OR and clinic that reduce waste, economic costs, and environmental impact.

The participants gratefully acknowledge the joint support of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery, the inspiration from physicians at the Aravind Eye Hospital, and the following individuals for their commitments to sustainability in ophthalmology: David Chang, MD, Barbara Erny, MD, Cathleen McCabe, MD, David Palmer, MD, Emily Schehlein, MD, and Cassie Thiel, PhD.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Maura Di Nicola and Basil Williams join host Dr. Jay Sridhar to discuss the latest ongoing ocular oncology clinical trials for the treatment of uveal melanoma and associated complications of radiation therapy.

Their review begins with the DRCR Retina Network’s Protocol AL, which is studying the use of anti-VEGF agents or corticosteroids to reduce the occurrence of radiation retinopathy and consequent vision loss. Drs. Di Nicola and Williams also offer insights about the use of belzupacap sarotalocan (bel-sar) for early-stage choroidal melanoma (CoMpass trial), as well as adjuvant treatment with darovasertib, a protein kinase C inhibitor.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Chris Leffler, pediatric ophthalmologist and medical historian, joins host Dr. Andrew Pouw to discuss his study of the history of ophthalmology, ranging from the origin and use of the term "glaucoma," to the evolution of cataract surgery from antiquity to the modern era.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Annie Wishna and Royce Chen join host Dr. Jay Sridhar to discuss their experiences teaching trainees with surgical anxiety. Throughout the episode, our guests share their personal anecdotes, measures to overcome surgical anxiety, and how to foster a culture that supports psychological improvement.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Rupa Wong and Dagny Zhu join host Dr. Amanda Redfern to share their experience and expertise using social media to successfully promote their ophthalmic practices and enhance their professional careers.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Meghan Berkenstock, Stella Kim, and Lauren Dalvin join the show again to teach us about immune checkpoint inhibitors: game changers in oncology, but with a host of ocular side effects. All eye providers will be seeing more patients on this class of medication, and our panel teaches us what to look for and how to manage it.

Additional resources: the National Comprehensive Cancer Network offers a suite of clinical practice guidelines to help clinicians manage immunotherapy ocular adverse events.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Fasika Woreta and Ekjyot Gill join host Dr. Jay Sridhar to discuss the literature and their experiences surrounding socioeconomic determinants of corneal pathology, and how social risk factors impact access to necessary corneal treatment and surgery.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. David Huang joins the show to share his story of developing optical coherence tomography (OCT), for which he, Dr. James Fujimoto, and Eric Swanson won the National Medal of Technology, the highest award for innovators in the United States, as well as the 2023 Lasker–DeBakey Clinical Medical Research Award, often called "America's Nobel Prize."

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Host Dr. Jay Sridhar invites Drs. Sneha Kannan and Zirui Song to discuss their research group's recent publication in JAMA analyzing the association between private equity ownership and the rate of hospital adverse events, and what the results could indicate for ophthalmologists and other physicians.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

 Host Dr. Andrew Pouw and Dr. Chris Johnson, a leading authority on visual field research, discuss the advent of virtual reality (VR) visual field perimetry, its advantages over conventional bowl perimetry, and how this new diagnostic technology will impact the care for patients with glaucoma.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Recent surveys have shown that a majority of ophthalmologists report musculoskeletal pain in the neck, back, and shoulders. Those who regularly use surgical loupes or perform clinical exams that induce neck flexion—such as when examining for retinopathy of prematurity (ROP)—may be at even higher risk for chronic pain and disability. In today’s episode, Drs. Donny Suh and Safeer Siddicky discuss ergonomics in both the clinic and operating room, and how posture, behavior, and simple ergonomic modifications can help prevent musculoskeletal disease.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Natalie Homer and Andrea Tooley share some major can’t-miss diagnoses in the lids and orbit that carry significant morbidity and mortality, including sebaceous cell carcinoma, orbital tumors, and infectious processes such as mucormycosis and necrotizing fasciitis. Strategies for imaging, histopathology, and management are also discussed.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Emmanuel Chang and Eric Nudleman join host Dr. Ben Young to review Stickler syndrome, when to suspect, and how to diagnose this condition that can lead to significant systemic manifestations and severe vision loss. The panel also discusses the role and evidence for prophylactic treatments to reduce the rate of retinal detachment, which can occur in up to 65% of affected patients.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

A surgical team from NYU Langone Health recently made history when it performed the world's first whole-eye and partial-face transplant in a patient who survived a high-voltage electrical accident. In today's episode, host Dr. Ben Young welcomes Dr. Vaidehi Dedania, a retina specialist and the primary ophthalmologist involved in the case, to discuss the surgery, the patient's progress, and the potential future for similar surgeries.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Adhering to an eye drop regimen can be difficult—especially for elderly patients with glaucoma. Those same patients often face an unexpected additional barrier to care when they run out of their medication and are denied early refills by a pharmacy or coverage by their insurance carrier. In today’s episode, Dr. Kevin McKinney talks about how his own advocacy efforts at the state level helped protect early eye drop refills in Oregon. He advises what other US clinicians can do to advocate for their patients and empower them to receive the care they need, while also helping them administer eye drops effectively.

Resources 

• The latest eye drop prescription refill legislation in your state (American Academy of Ophthalmology)
• Contact your state’s department of insurance (Forbes)
• Sample card for patients to use when requesting early refill of an eye drop prescription (Oregon Academy of Ophthalmology)

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

How do you advise patients who need an intraocular tamponade but also plan to travel into areas of high altitude or by air? When should the surgeon opt for silicone oil instead of gas or air? Drs. Sarah Read and Jack Stringham share their experiences and pearls for managing retinal surgery in these challenging cases.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Where do guide dogs come from? How are they trained, and how do they functionally support patients with visual impairment or blindness? What steps should you follow to "prescribe" a guide dog? Which patients qualify, and how much does it cost? In today’s episode, host Dr. Ben Young invites Jake Koch and his dog Forli from Guide Dogs for the Blind to share everything the ophthalmologist needs to know about guide dogs.

Learn more about the services offered by Guide Dogs for the Blind.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Antibody-drug conjugates (ADCs) are new chemotherapeutic agents that can cause significant ocular side effects. Drs. Meghan Berkenstock, Lauren Dalvin, and Stella Kim review this new class of drugs and how they can affect the eye, providing essential tips for what to look for, when to screen, and how to treat the side effects. 

Prescribing information mentioned in this episode:
Elahere (mirvetuximab soravtansine-gynx)
Tivdak (tisotumab vedotin-tftv)

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Maura Di Nicola and Basil Williams sit down with host Dr. Jay Sridhar to review how retinoblastoma treatments have evolved, including discussion of intra-arterial and intravitreal chemotherapy and liquid biopsy using aqueous humor samples.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Mike Chiang, Dr. Michael Boland, and Kent Mathewson join host Dr. Andrew Pouw to discuss the current state of clinical documentation in ophthalmology, the future of the electronic health record (EHR), the use of scribes, and legal considerations for documentation.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Julie Falardeau and Mike Lee discuss guidelines and pearls for the management of idiopathic intracranial hypertension (IIH) during pregnancy and childbirth. They share how pregnancy shifts the evaluation and management of the initial diagnosis of IIH and how it can affect patients who already have a history of the disease.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. M. Ali Khan, Ajay Kuriyan, and Sarah Read join host Jay Sridhar to discuss recent developments in intravitreal injectable drugs, including 8-mg aflibercept not initially approved by the FDA, the upcoming PDUFA date for on-label bevacizumab, and approaching injections for dry age-related macular degeneration (AMD).

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

In June 2023, the regional Medicare Administrative Contractors (MACs) almost uniformly introduced draft policy language indicating cessation of coverage for many minimally invasive glaucoma surgery (MIGS) procedures, including goniotomy and cyclophotocoagulation. In today's episode, host Andrew Pouw is joined by Dr. Alan Robin, the first executive vice president of the American Glaucoma Society, and Dr. Pradeep Ramulu, chief of the Glaucoma Division at the Johns Hopkins Wilmer Eye Institute, to discuss MACs, clinical evidence for MIGS, and advocacy efforts underway to protect patient access to MIGS procedures.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Host Dr. Jay Sridhar welcomes Dr. Gareth Lema to discuss his group's recent study published in Ophthalmology that quantified the amount of eye drop waste in ophthalmic clinics and the implications for practice. When handled appropriately, argues Dr. Lema, eye drops can be used until the FDA-regulated expiration date, and thus help reduce both their carbon footprint and costs while still providing safe and effective patient care.

Read more: Tan JM, Chen B, Vail D et al. Ophthalmic drop waste due to self-imposed use cessation dates. Ophthalmology. 2024, Jul 1:S0161-6420(24)00391-9.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Anita Kohli and Imran Jivraj discuss the evaluation and management of patients with functional vision loss, also known as nonorganic or nonphysiologic visual loss, a phenomenon in which exam findings do not support an underlying organic etiology. Drs. Kohli and Jivraj offer pearls for how to handle both adult and pediatric patients.

Functional vision loss can be challenging to identify and manage, and it's important to diagnose correctly as multiple studies have shown that there can be an association between functional vision loss and psychosocial stressors or other psychiatric diagnoses, especially among children. 

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Cornea specialist Dr. Travis Redd discusses the recent outbreak of extensively drug-resistant corneal infections associated with artificial tears and that has led to cases of permanent vision loss and death. Dr. Redd also reviews the challenges and risks of multi-use eye drop bottles.

Since January 2023, the CDC, FDA, and state and local health departments have been investigating a multistate outbreak involving a rare, drug-resistant strain of Pseudomonas aeruginosa bacteria. As a result, the CDC has urged discontinued use of EzriCare Artificial Tears, and in February the FDA issued an additional warning about Delsam Pharma’s Artificial Eye Ointment.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Ophthalmic genetic counselor Molly Marra and Dr. Lesley Everett discuss the pearls and pitfalls of genetic testing, especially in cases of suspected inherited retinal dystrophy. As discussed in the episode, the National Society of Genetic Counselors offers great tools to find genetic counselors who can advise you and your patients in the diagnostic journey.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Guillermo Amescua joins host Jay Sridhar to discuss novel approaches to infectious keratitis, including surgical approaches and corneal cross-linking.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Michael Chiang, R. V. Paul Chan, and J. Peter Campbell, members of the Imaging and Informatics in Retinopathy of Prematurity (i-ROP) Research Consortium, discuss the latest advances in ROP screening, treatment, and management.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Since its medical discovery, botulinum toxin (Botox) has found increasing use in ophthalmic practice. Drs. Natalie Homer and Andrea Tooley review the common cosmetic and functional uses of Botox, as well newer applications beyond the treatment of strabismus and facial spasms.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Though most people with glaucoma manage well with an eye drop or two and retain their functional vision, a subgroup of glaucoma patients worsen catastrophically over time. Is it possible to identify which group your glaucoma patients will be in? And when should the comprehensive ophthalmologist consider escalation or referral to a glaucoma specialist? Drs. Aakriti Shukla and Sean Rivera join host Andrew Pouw to look at the data and discuss strategies that work across various practice settings and patient populations.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Nisha Mehta, founder of the social media groups Physician Side Gigs and Physician Community, joins to discuss the state of physician burnout in 2023 and how side gigs outside of medicine can offer freedom and improved wellness.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Syphilis is on the rise nationally, and with it the prevalence of ocular syphilis is increasing. Drs. Steve Yeh and Chris Conrady join host Ben Young to discuss what clinicians need to know about the ophthalmic manifestations of syphilis and how to manage the disease when it strikes the eye.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Whether in academic or private practice, ophthalmologists are often asked to see and manage patients with orbital trauma. These consults can be challenging: how soon do patients need to be seen, which require urgent care, and when should they be referred to oculoplastic and orbital surgery? In this episode, Drs. Natalie Homer and Andrea Tooley break down their approaches to oculofacial fractures, eyelid and canalicular lacerations, and intraocular foreign bodies.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Tamara Fountain joins host Dr. Ben Young to discuss strategies to avoid medical mistakes, how to recognize cognitive biases that can lead to diagnostic error, and what we can learn from the airline industry to improve patient safety.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Sarah Read, M. Ali Khan, and Ajay Kuriyan join a group discussion on intraocular tamponades used after vitrectomy. How do air, gas, and silicone oil differ? What are the advantages and drawbacks of each? In what scenarios are they most effective, and how do patients respond to their use? And what are the current unmet needs with these tamponade agents?

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

The role of private equity (PE) in ophthalmology has shifted the practice landscape during the past 10 years. While proponents of PE investment tout the benefit of extra access to capital and resources, critics fear that these partnerships lead to a loss of autonomy and potential risk to patient care. In this episode, Drs. Dagny Zhu, Omar Shakir, and Ravi Parikh review the current published data about PE in ophthalmology and share their personal perspectives on its real-world impact on clinical practice.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Paul Gaudio and Ninani Kombo join Dr. Ben Young to review pearls and common challenges in the diagnosis and treatment of intermediate uveitis.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Anita Kohli and Imran Jivraj discuss the evaluation and treatment of isolated third, fourth, and sixth cranial nerve palsies, including when to order testing and imaging. 

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Amanda Bicket and Lori Provencher join Dr. Andrew Pouw to discuss omidenepag isopropyl (Omlonti), the recently FDA-approved eye drop for treating elevated IOP in patients with primary open-angle glaucoma or ocular hypertension.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Amanda Redfern speaks with Drs. Maggie Hymowitz and Donna Kim about the role of the ophthalmic hospitalist, a burgeoning profession in ophthalmology with increased demand. The discussion ranges from how to get started in the field, benefits and challenges of the role, and future directions.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Ben Young takes the reigns as host, welcoming Drs. Pavlina Kemp and Roni Levin to discuss tips and tricks—and pitfalls to avoid—when seeing and managing patients with neurocognitive developmental delay.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

In this second half of a discussion on secondary IOLs, Drs. Brenton Finklea and Fasika Woreta rejoin the show to talk about the benefits and risks of scleral-fixated and scleral-sutured IOLs, and surgical techniques for improving their safety and effectiveness.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Brian Do shares his diagnostic and therapeutic approach to herpetic uveitis, from the front of the eye to the back. Discussion ranges from anterior uveitis to acute retinal necrosis, including surgical management from the perspective of a retinal surgeon.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Sarah Read, M. Ali Khan, and Ajay Kuriyan join a group discussion on incorporating newly approved medications into practice, focusing on real-world examples of Vuity (pilocarpine drops), brolucizumab, and drugs for dry AMD in trial.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

The Centers for Medicare and Medicaid Services (CMS) created the new G2211 add-on code to address the resource cost and effort to build patient relationships with those impacted by chronic and complex conditions. Use of this new add-on code is dependent on ophthalmologists building strong long-term relationships with patients to benefit their longitudinal care. Drs. Lee Alward and Young Kwon join host Dr. Andrew Pouw to share their experiences and wisdom for building trust and rapport towards a valuable patient–physician relationship.

Factsheet on HCPCS Code G2211 Visit Complexity Add-on Code: www.aao.org/g2211-code

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Pavlina Kemp and Matthew Weed discuss 2 recent publications in major ophthalmology journals: the first examining strabismus surgery patterns in an IRIS Registry study, and the second evaluating the association between outdoor activity and myopia progression.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Daniel Choi and Meron Haile discuss approaches to achieving sustainability in the ophthalmology operating room, including data on the carbon footprint of ophthalmic surgery, recommendations from major US organizations, and lessons from healthcare systems outside the United States.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Anita Kohli and Amanda Redfern discuss how to approach the patient who presents with sudden permanent vision loss in one eye, including when to refer for urgent stroke workup, the differential diagnosis, treatment options for ischemic optic neuropathy, and future directions in this field.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Brenton Finklea and Fasika Woreta discuss indications for IOL removal or exchange and walk through their clinical and surgical decision-making for secondary intraocular lenses, focusing on anterior chamber and iris-sutured IOLs.

For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.