Reflections on Fellowship So Far

With half a year behind them, current glaucoma fellows share their favorite pearls to date.

Viviana Barquet, MD; Gio Campagna, MD; Teresa Horan, MD; and Timothy Truong, MD

Glaucoma Today

VIVIANA BARQUET, MD Glaucoma fellowship is an exciting and challenging time that goes by faster than some may realize. As I embark on the second half of my fellowship, I am armed with several useful takeaways from my experience so far. Ask Questions During fellowship, you work very closely with your attendings, whether in clinic or the OR. Knowing the reasoning behind their preferences, treatment paradigms, and interpretation of glaucomatous disease will influence your own reasoning. Do not be afraid to ask questions or discuss challenging cases. Mix It Up Each attending has their own surgical approach, and, as a fellow, it is important to learn their different techniques. Not only will this allow you to curate your own preferences, but it will also be beneficial if you are faced with a case in which you must deviate from your standard approach. Additionally, familiarizing yourself with various surgical instruments and materials is important, as you may have different equipment available to you in practice. Developing a toolbox with a variety of skills and techniques will help you manage unexpected situations. Hit the Books Study and prepare for a case by reading operative reports or pearls you have jotted down, watching videos, or practicing in the wet lab as if you were going to do the case on your own.

Did We Underestimate Pediatric Keratoconus?

Turns out, it’s more prevalent than formerly believed.

Modern Optometry

HOT TOPIC Keratoconus More Prevalent in Youth Than Previously Thought According to a new study published in Eye & Contact Lens: Science & Clinical Practice and supported by the International Keratoconus Academy of Eye Care Professionals and the Illinois College of Optometry, the prevalence of keratoconus in the pediatric population is higher than previously believed. The study used Scheimpflug tomography to examine patients in a limited population between 3 and 18 years of age. The study separated the participants (n = 2,007) into three categories: 1) those without keratoconus, 2) keratoconus suspects, and 3) those with definite keratoconus based on the final diopter measurement and back corneal surface elevation value measured at the thinnest point. Six participants had keratoconus (prevalence of 1:334) and three were keratoconus suspects (prevalence of 1:669). When these factors are combined, the total prevalence of keratoconus suspects and those with definite keratoconus is 1:223. These results indicate a substantially higher prevalence of keratoconus in children than has been previously reported, even among adults, which is commonly accepted at 1:2,000. (Some literature reports this adult prevalence can range between 1:50 and 1:750.) The study’s authors advocate for performing this sensitive screening for keratoconus at its earliest manifestation or suspicion as part of a standard pediatric comprehensive eye exam. (Read more here.) My Two Cents It’s good that the study’s authors advocate for Scheimplug imaging on children at the earliest possible juncture; however, it’s just not realistic for most kids—or optometry practices. Very few clinics can afford this technology. I can’t imagine everyone rushing out to purchase the equipment to use the machine as a screening test that likely will not be billable.

The State of Optometry’s Financial Health

Five takeaways from the largest income survey conducted in optometry.

Aaron Neufeld, OD

Modern Optometry

Between late 2023 and early 2024, ODs on Finance conducted a large income and net worth survey of optometrists (see Get the Full Picture). A total of 1,912 optometrists responded, and the results were eye opening, to say the least. Some of the results are promising, in terms of the fiscal viability of our profession, while other areas seem to be in definite need of improvement, and all of this is punctuated by what we believe to be a significant gap in financial education.