Most patients have tried artificial tears. Many find that they help — for an hour or two. The fact that drops alone often don't solve dry eye is not a failure of the patient; it's a clue that something more specific is happening on the ocular surface that needs more specific intervention. Dry eye is a diagnostic category, not a single condition. The most successful treatment plans match the type of dry eye to the right intervention. The ladder of…
The eye is a photosensitive organ. It responds to light continuously, and over decades of cumulative UV exposure, that response includes damage. Three of the most common adult eye conditions — cataracts, macular degeneration, and pterygium — are accelerated by ultraviolet radiation. The good news: protection is straightforward and meaningful. What UV does to the eye Two bands of ultraviolet light reach the surface of the earth — UVA and UVB. Both are absorbed by structures of the eye. UVB…
Eye health is a lifelong project. The conditions that cause vision loss in adulthood — cataracts, age-related macular degeneration, glaucoma, diabetic eye disease — develop over years or decades, often silently. The behaviors that protect or harm long-term eye health are accumulated, also over years. There is no single dramatic action that determines outcomes; there is a steady pattern of attention that shapes what your vision will be like at 70, 80, and beyond. This article distills the most useful…
This is the personal essay among the more clinical articles on this site. I've thought about putting it down for some time, and the request to mark twenty years in practice was the right occasion. The lessons that matter most to me as a surgeon — the ones that shape how I work today — are not the technical ones. The technical knowledge is the floor. What matters more, decades in, is the framework that surrounds the technique. The right…