COMPLEX CASE MANAGEMENT
Doing No Harm
By Robert J. Weinstock, MD
In his account of a cataract surgery case in a 70-year-old woman presenting with bilateral, subtle epiretinal membranes (ERMs) and an otherwise unremarkable ocular examination, Dr. Weinstock outlines his thought process when the patient showed interest in multifocal and extended depth of focus IOLs. When the patient was sent to a retina surgeon for an evaluation, it was determined that a complete posterior vitreous detachment reduced the risk of worsening the ERMs or of the patient developing cystoid macular edema or vitreomacular traction after cataract surgery. In the end, Dr. Weinstock’s do-no-harm approach was to implant monofocal IOLs bilaterally.
Resolution at Last
By George O. Waring IV, MD
Rendering a fourth opinion for a patient who presented with a longstanding history of difficulty with recurrent hemorrhages, inflammation, and glaucoma since cataract surgery on her right eye, Dr. Waring decided to pursue IOL exchange after diagnosing uveitis-glaucoma-hyphema syndrome. Aside from encountering a fibrosed nasal haptic, the procedure went as planned, and the patient had full resolution of inflammation and intraocular hemorrhages, stable IOP, and recovered excellent corrected visual acuity. He noted, however, that using a superonasal surgical approach in the patient’s right eye was awkward and required him to perform surgery with his nondominant left hand.
A Name Synonymous With Excellence in Eye Care
By Rochelle Nataloni, Contributing Editor
Profiling Williamson Eye Center (WEC) in Baton Rouge, Louisiana, Ms. Nataloni compares this practice to a sweeping family saga spanning half a century and three generations. Building this eye care empire took years, with one component of the practice’s success being the Williamson Cosmetic Surgery Center (WCSC). In this article, Shelly Williamson Esnard, a physician assistant and managing partner of WCSC, outlines five pointers that she’s learned from managing the practice: (1) search engine marketing and optimization ensure that interested patients find your practice, (2) social media can be an effective resource, (3) patient events offer a high return on investment, (4) diversification of procedures offers protection during downturns, and (5) future focus should always include adding new services.