After 10 years, I'm back

[idoc]

Well SDN, it's been a minute. But, after almost 9 years in private practice, something reminded me to check back in with the old ophthalmology forum. This place used to be my go to online community back in med school and residency, and in 2004, we actually started the anonymous board score/interview postings, to let people know what types of scores are needed to get interviews. Regardless, the past 9 years has been such a wild ride, and I'm happy to be a resource to anyone on here looking for some perspectives. My real name is Gary Wortz, and I'm in private practice in Lexington, KY. I actually have a podcast where I discuss current topics called "Ophthalmology Off the Grid" that has been a lot of fun to create and hopefully could be a good resource if you are looking for practical tips about what its like in practice. I will say this, I am still so glad that I chose ophthalmology and would be happy to share anything I can to help others who are just starting out. Glad to be back.

Gary

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[Rob_Hooke]

Hi, idoc. First, thanks for posting this. I've been wanting to ask some questions about the field and this is the perfect opportunity.

I'm an incoming M1 and first became interested in ophtho after interviewing with an ophthalmologist during the app cycle. I think I would really like to enter a surgical/procedural field, and the eye is fascinating.

The most important question that I have is why are you passionate about ophthalmology? What made you choose ophtho over any other specialty?

Also, what changes to the field do you foresee occurring over the next 20 years?


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[idoc]

Hi, idoc. First, thanks for posting this. I've been wanting to ask some questions about the field and this is the perfect opportunity.

I'm an incoming M1 and first became interested in ophtho after interviewing with an ophthalmologist during the app cycle. I think I would really like to enter a surgical/procedural field, and the eye is fascinating.

The most important question that I have is why are you passionate about ophthalmology? What made you choose ophtho over any other specialty?

Also, what changes to the field do you foresee occurring over the next 20 years?


Sent from my iPhone using SDN mobile

Rob,

From my perspective, there is no other field of medicine as rewarding as ophthalmology, especially as a cataract and refractive surgeon. As a cataract surgeon, I have the opportunity to impact thousands of patients' lives every year in a dramatic way. Imagine being able to restore vision to a patient. There really is almost nothing as rewarding as being there to watch them read the eye chart and being amazed at how their lives have been changed forever. The technology aspect of this field is always growing, and will continue to do so. We definitely are keen on adopting new technology and techniques which make this a fun field that is continuously stimulating. What do the next 20 years hold? Who knows. Perhaps pharmacologic therapies that reverse cataracts for some patients, and better robotics to help improve our surgical precision. Maybe remote surgery through Augmented Reality interfaces? Not sure but it will always be rewarding to help restore sight to the blind and impaired. Definitely check it out. You won't regret it.

 

[corneainterviewseason]

Rob,

From my perspective, there is no other field of medicine as rewarding as ophthalmology, especially as a cataract and refractive surgeon. As a cataract surgeon, I have the opportunity to impact thousands of patients' lives every year in a dramatic way. Imagine being able to restore vision to a patient. There really is almost nothing as rewarding as being there to watch them read the eye chart and being amazed at how their lives have been changed forever. The technology aspect of this field is always growing, and will continue to do so. We definitely are keen on adopting new technology and techniques which make this a fun field that is continuously stimulating. What do the next 20 years hold? Who knows. Perhaps pharmacologic therapies that reverse cataracts for some patients, and better robotics to help improve our surgical precision. Maybe remote surgery through Augmented Reality interfaces? Not sure but it will always be rewarding to help restore sight to the blind and impaired. Definitely check it out. You won't regret it.

Idoc, I agree that ophthalmology is incredibly rewarding, especially cataract surgery. One thing I struggle with is rising patient expectations with cataract surgery. I think rising expectations can be a good thing, because it means we are generally producing better and better results. But, that also comes with a downside. It seems that the vast majority of patients I've seen in training are happy after surgery, especially if my attendings have explained their options clearly and given them realistic expectations. However, there are still a minority that end up unhappy, even when the target is nearly hit (20/25 +2, for example, with distance target). It seems when I go home at night and reflect on the day, I remember and dwell on the 1 patient that was unhappy, instead of the 9 that were happy. Is this something that you deal with, or am I strange in feeling this way?

 

[EyeDR_oo]

Well SDN, it's been a minute. But, after almost 9 years in private practice, something reminded me to check back in with the old ophthalmology forum. This place used to be my go to online community back in med school and residency, and in 2004, we actually started the anonymous board score/interview postings, to let people know what types of scores are needed to get interviews. Regardless, the past 9 years has been such a wild ride, and I'm happy to be a resource to anyone on here looking for some perspectives. My real name is Gary Wortz, and I'm in private practice in Lexington, KY. I actually have a podcast where I discuss current topics called "Ophthalmology Off the Grid" that has been a lot of fun to create and hopefully could be a good resource if you are looking for practical tips about what its like in practice. I will say this, I am still so glad that I chose ophthalmology and would be happy to share anything I can to help others who are just starting out. Glad to be back.

Gary

Welcome back to the party Dr. Wortz! For anyone interested in ophthalmology you should probably check out his podcasts, they are a wonderful free resource that we were actually just talking about in a previous forum. Goes over everything from the business to basic science. Anyway for any people seriously interested in ophthalmology you have an unbelievable resource right here!!
- Eric

 

[idoc]

Idoc, I agree that ophthalmology is incredibly rewarding, especially cataract surgery. One thing I struggle with is rising patient expectations with cataract surgery. I think rising expectations can be a good thing, because it means we are generally producing better and better results. But, that also comes with a downside. It seems that the vast majority of patients I've seen in training are happy after surgery, especially if my attendings have explained their options clearly and given them realistic expectations. However, there are still a minority that end up unhappy, even when the target is nearly hit (20/25 +2, for example, with distance target). It seems when I go home at night and reflect on the day, I remember and dwell on the 1 patient that was unhappy, instead of the 9 that were happy. Is this something that you deal with, or am I strange in feeling this way?

The problem we have with cataract surgery is that patients want to believe a narrative that we hold the magic tools of lasers and lenses and that surely we are going to be able to "fix" them. When we discuss the risks, benefits and alternatives to surgery, we generally talk about cataract surgery being very low risk. However, this often translates to "we almost always make everyone perfect, so don't worry". No matter what you tell them, and how clear you try to make it, most patients have a very hard time convincing themselves to sign up for a surgery they think won't make them perfect. Added to that is the litany of decisions the patient must make with regard to lenses and perhaps refractive upgrades, and it is a recipe for misconception. So, when you have a patient who is 20/25 and unhappy, it is not the fault of the surgical technique...it is more likely a problem with communicating expectations. However, we all go through this and I don't have a perfect answer. It will likely always feel insulting when you restore 99% of a patients correctable vision with an insurance covered surgery and they are complaining about the 1% left over. However, its part of the gig. On the other hand, I recently took care of a young man who was monocular with a silicone oil filled eye and white cataract in his only eye. He was LP, and I was trying to get him to HM or CF. He was turned away by many other good ophthalmologists, however I felt that I needed to try. I successfully removed the lens without breaking the bag or losing the oil and the next day he was 20/400 and felt like he had a new lease on life. SO GRATEFUL! Just goes to show you its all about perspective and expectations.

 

[WildWing]

Thanks for returning to forum. Longshot but thought I'd post. I will be just beginning medical school next year. While living in Korea 6 or 7 years ago I had a severely botched Lasek surgery. The result of which is severe photophobia, eye twitching, wandering and inability to hold focus, along with dry painful eyes. Seeing an opthomologist is not practical at the moment and I am worried that these symptoms are my major hurdle to eventually practicing medicine. Is there any advice you can give to alleviate symptoms? Most effective over the years has been a tablespoon of milk thistle and a tablespoon of dandelion root powders every few hours and boiled flaxseed porridge for breakfast. Greens and fish also seem to help slightly. Also, what stuctures in the eye could have been damaged by the surgery? Thanks sincerely for your time.

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