I’ve always appreciated how Review’s readers are the type of physicians who stick with what works, but are always willing to listen to a new way of doing things as long as the data is there to back it up.

I was thinking of them when I read the surprising statistics quoted in our narrow-angles feature (p. 42) regarding how exceedingly rare it is for a physician to actually perform gonioscopy. It was especially surprising in light of a follow-up statistic that nearly 19 percent of malpractice litigation brought against ophthalmologists is related to a failure to diagnose or a mismanagement of angle-closure glaucoma.

I suppose to an outside observer like myself, it seemed like gonioscopy was one of the normal array of diagnostic exams ophthalmologists undertook regularly, but that doesn’t appear to be the case. Maybe the arguments—and techniques—laid out by the article’s authors will make the exam more appealing and easier to do for many physicians.

Another interesting revelation was the assertion by some physicians in our article on IOL calculations (p. 34) that surgeons may be approaching the limit of accuracy for their lens computations. Again, this seemed like the sort of topic that was always going to be an issue. The revelation makes sense, however, considering the high accuracy of today’s formulas and equipment. (In spite of the fact that some practices may be nearing the accuracy limits, that’s not the case for everyone, and the experts have many tips and techniques surgeons can use to hone their accuracy even further.)

The third topic that’s probably surprising to a lot of ophthalmolgists comes from the realm of retina, specifically vitreous opacities. Again, as an outside observer, in years past I noticed that floaters were almost always off-limits for any kind of treatment, with the risk not being viewed as worth the reward. In the feature on floater treatment (p. 50), the attitudes toward these opacities seems to have changed slightly, however. Now, in certain well-circumscribed circumstances, physicians say they’re finding that they may be able to help rid patients of these maddening opacifications. 

All in all, it was interesting to hear about some of these revelations, and it’ll be just as interesting to see how you, our readers, respond to them.

Shifting gears, I’d like to share some glad news from a little closer to home. On June 25th, our colleague and friend, Chief Medical Editor Mark H. Blecher, MD, was honored for his dedication to Wills Eye Hospital, its patients and its resident physicians at the hospital’s annual Wills Eye Ball. I’ve worked with Mark since Review’s beginnings back in 1994 and have always been struck by his intelligence, discernment and dedication to ophthalmology. Congratulations on the honor, Mark! It’s well-deserved, indeed.



— Walter Bethke
Editor in Chief