It's so hard to write an editorial this time of the year. It's cold, it's gloomy, and every time I start something, I just want to plop down in front of the tube and watch some sports. Ah, here's the Super Bowl, you know this has got to be a good game … a good game … a good game…

 … contrast ratio, enhanced-definition, grayscale tracking, digital visual interface, high-definition multimedia interface. "Wow, there's an awful lot to know about these high-definition TVs, huh? How is a person supposed to make an intelligent choice? After all, I'm putting thousands of my hard-earned dollars on the line."

"Well, you can trust us. We've sold millions of these."

"But there are so many variables.  And there's such a wide range of options. But there are no standards. How can you be sure that what I see at home is going to look like this? What if I make the wrong choice … the wrong choice  …

… well, that's all she wrote. And the final score is the Bears 42, the Colts 17.

So, it was just a dream. But what a nightmare. Thank heaven I don't have to cover the electronics industry. I'm safely back in ophthalmology, where there's clarity, and standards, and patients make the effort to educate themselves before choosing to undergo surgery. Sorry, I must have been drifting again.

No, the high-def TV scenario probably isn't relevant to this market. After all, when you Google high-def TV, you get more than 154 million pages. Custom LASIK yields a paltry 2 million.

No one's suggesting either that the surgeon's role and the big-box TV salesman's role are in any way equivalent. But the term "high-def" has actually found its way into the eye-care market recently, so it's not that far-fetched to suggest that some patients may view the decision to undergo custom over standard LASIK as the technical equivalent of choosing high-def.

With elective surgery, medicine's opened the box and let the marketers out. There's no going back. If you're doing refractive surgery, you've got prospective patients showing up everyday who don't know a Zernike from a horizontal scan line. But in an area of refractive surgery that is still evolving and will be for some time, they're relying on their surgeon to know what's real and proven and what's hype. Take a look at this month"s Cover Focus on custom treatment for our latest effort to make sense of it.