Glaucoma respect

[mmmmaaaaahhhhhh]

Hi all
Junior ophtho resident here with a bit of an interest in a glaucoma career. Seems to me there is not always a ton of respect among many residents and certain subspecialty staff for glaucoma specialists... I have even heard it said that glaucoma isnt a real specialty haha. This seems fairly ubiquitous across my colleagues in different states as well, and I've even heard it echoed on a podcast recently. I'm trying to figure out why this might be? Is it that everybody else just thinks glaucoma is boring/tedious?

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[TexasEye19]

lmao wut

 

[salami bahama]

I never heard that during residency or fellowship, so I'm not sure where that's coming from. I can see how some people just see it as specializing in one disease and how that can be lackluster, but sometimes the surgical management can be challenging. Glaucoma is a common pathway for death of an eyeball, so you can garner referrals from all subspecialties. Which podcast are you listening to? Not everyone thinks glaucoma is boring and tedious.

Sure, there's probably more glory and respect for the glaucoma folks who also tackle complex anterior segment surgeries, but there seems to be a lot of love from both patients and referring doctors being able to prevent someone going blind from glaucoma.

Who cares what other people think? If you take good care of patients, that's all that matters.

 

[increscence]

Never heard this

As they say on this forum, #savetheconj

 

[MstaKing10]

Huge need for glaucoma docs, at least in our community. Mad respect for them. I have never heard this. In private practice a glaucoma doc will be busy quickly

 

[Dusn]

Not at all. The attendings in my residency would refer to cornea as “comprehensive plus” and try to dissuade the residents from doing a fellowship in it. But no one ever said anything bad about a glaucoma fellowship or any other fellowship.

I think the lack of enthusiasm you may be referring to is because patients don’t notice the vision loss until the end. And they don’t notice an improvement after treatment. That’s not very satisfying to a lot of ophthalmologists. But it is still very important.

 

[RetinaDude]

There seems to be a very high demand for glaucoma specialist. In my area, we could certainly use another one. When speaking with one of the glaucoma docs, she says what frustrates her the most are the comprehensive ophthalmologists holding onto the glaucoma pts too long so that they are real train wrecks by the time they get to her. But, she’s very very busy, and got that way quickly out of fellowship

 

[mjohnsonets]

Never heard this either. As many mentioned, glaucoma fellowship-trained docs are in huge demand all over. The number of places in the US that don't need another glaucoma doc can probably be counted on one hand.

Besides, if you really enjoy it, do it. Own it with confidence, get great at it, and people will respect you simply for that reason. That works for almost any kind of human-ing.

 

[CovFEFE]

Never heard of this either.

Glaucoma specialists are respected and appreciated for the important sight-saving work they do. This goes for all ophthalmologists, general and subspecialists.

I never get why some (thankfully it appears to be very rare) would look/talk down an entire subspecialty, i think ppl who do this are just projecting their inner deficiencies/insecurities onto others.

Seriously, if you have to look down on someone else to feel better about yourself, it's time to invest in a mirror.

 

[Pink Eye]

Never heard of this

 

[Bluesclera]

extreme respect for glaucoma -- lots of new techniques and skill sets available to learn during fellowship. Job opportunity is good in most areas.

 

[LightBox]

I do both cornea and glaucoma, and I'm about 10x busier with glaucoma stuff than with cornea. I like Cornea, but in my community, there is not as much need. Actually, I hate PKPs lol (EK is awesome).

 

[ball123]

At a top ten program and all my residents and seniors love the glaucoma rotation. I’ve never heard anyone put it down. It’s probably the most innovative field right now. Lots of cool, amazing surgeries! It also makes you better, more comfortable at anterior segment surgeries if you end up doing comp.

Lately we’ve had more people go into glaucoma than retina/plastics/cornea 🤷

Magbe 15 years ago it was maybe little boring but not anymore

 

[DrZeke]

I agree with most of the sentiments here. I personally don't love glaucoma, because of the disease itself being difficult to treat and heterogeneous and not necessarily well understood. However, I have mad respect for my colleagues and believe that their field has expanded so much over the last 10-15 years.

I would just like to caution all of you and say this...

Depending what region you are in or where your program is, sometimes people have interesting ideas that are not shared at the national level or outside of that region. I think in some less academic programs that don't encourage reading, or if you have been limited to a geographic location you might end up with some interesting views from your attendings.

My best advice is to seek out lectures, articles, and even national meetings that will expose you to the true heart of whatever subspecialty you are interested in. Sometimes you even have to go outside your program to find the appropriate subspecialty mentor. Don't be discouraged. Do what you think it right and fulfilling to you.

 

[Dusn]

That's a good point DrZeke.

I'd also ignore what other residents think. At certain programs, the sub-specialty attendings spend no time with residents in clinic. Therefore, the residents may not know very much. Sometimes they think "red" on the OCT RNFL grid means that the patient has glaucoma. They also don't know what to look for on gonio, if they even ever do a gonio, and they're just going through clinic trying to find cataracts to operate on. And if the ancillary staff in the residency clinic suck then they might not even be getting reliable fields or images. Of course they're going to find glaucoma uninteresting.

A lot of subspecialties in medicine only become interesting when you are able to get reliable data to work with and know all the intricacies to look for.

 

[ophtho838]

Never heard of this. But it doesn’t matter anyway. Retina is where you really want to be—you just don’t know it yet.

 

[Anterior Chamber]

Glaucoma is fine. It's not the hardest subspecialty to get a fellowship but that doesn't mean it's no good.

 

[Etorphine]

perspective is not grounded in reality
glaucoma attendings are 99% of people who do tubes/trabs and no one else will go there. there is always a need for someone to be able to do these