So, another calendar turns over. For me, December general resurrects concerns over the ever-faster passage of time and similar themes. Not this year, and I blame Las Vegas. The shows, the casinos, the unusually friendly local women who greet you on your way to pre-dawn meetings and breakfasts, truly a bizarre bazaar of excess and extravagance.

Less so than the usual October timing, one thing a mid-November AAO meeting does is present a more obvious opportunity to reflect on the state of ophthalmology. And by many indications, things could hardly be better. Though meeting planners habitually cite "the highest attendance ever," this year's record-breaking numbers (27,000+) from the Academy seem genuine, based, unscientifically, on the crowded educational sessions and the exhibit hall traffic.

More than such numbers, though, the level of innovation in an industry or profession is generally a better indicator of its overall health. The obvious leaders this year are the pharmaceutical advances in treating retinal disease. Expanded options in "presbyopic" intraocular lenses have revived interest and hope among cataract surgeons. Refractive surgery may not have such major advances to point to this year but like much of the rest of the profession, there are many, perhaps lower-level advances and refinements that suggest a robust performance in 2006.

Based then on the premise, if it's not broken, break it, we decided to focus our cover story this month on helping you take advantage of the high cotton. Senior editor Chris Kent gathered a score of practical, implementable ideas that can add to your profitability and efficiency.

For those who may be thinking bigger and seeing this as prime time to make the technology plunge, Kevin Corcoran shares a stepwise, dispassionate and organized approach to assessing big-ticket purchases and avoiding buyer's remorse.

These may or may not turn out to be the good old days, but things sure seem like they're good and getting better in ophthalmology. Here's hoping you, your family and your patients can take advantage.