OATR is back for 2021 and we are kicking things off in style with everyone's favourite topic - astigmatism! There are a lot of rumours, myths and arguments around the topic of residual astigmatism after cataract surgery. Some say it gives a depth of focus; that it may be functionally beneficial; or that you can't do much about it as you should not flip the axis. Well your trusty OATR hosts, Dr Ben LaHood and Dr Nick Andrew are here to consider the evidence and see whether we need to rid the world of residual astigmatism. Listen in to hear the verdict and learn some tips to improve astigmatic outcomes.

Ophthalmology Against The Rule

Residual Astigmatism

Myopia progression is a major concern in the worlds of optometry, ophthalmology and the world in general with a predicted 5 billion people being myopic by 2050. The concern is not just needing glasses, but retinal detachment, myopic macula degeneration and blindness. The evidence for how to slow down myopia progression, especially around atropine dosing has been murky. So your hosts Dr Ben LaHood and Dr Nick Andrew clear up the evidence and discuss why treatment is so important.

Myopia Progression

Your Ophthalmology Against The Rule hosts bring you everything you ever wanted to know about PCO from prevention during cataract surgery, influences of IOL design and surgery technique, through to management with YAG posterior capsulotomy. This topic will be of interest to optometrists and ophthalmologists as capsule opacity is a common reason for referral. The growth in numbers of multifocal and premium lenses being implanted means that it is more important than ever to think about how to safely manage PCO and maintain optimal vision for your patients. 

Posterior Capsule Opacification and YAG Laser Capsulotomy

Angle Kappa is one of those terms that gets thrown about at every ophthalmology meeting but does anyone really know what it means, what to do with that information or even what angle kappa really is? Your Ophthalmology Against The Rule hosts explain in simple language everything you want or need to know about angle kappa. They also discuss the real life practicalities of when and where this information is useful and why you may want to consider angle kappa when selecting an IOL for cataract surgery.

Angle Kappa in Cataract Surgery

Your OATR hosts discuss the pros and cons of using OCT of the Disc and OCT of the Macula for detecting, monitoring and making treatment decisions in glaucoma. Looking after glaucoma patients used to involve a visual field and disc photos. OCT of the disc and nerve fibre layer revolutionised management. Now, OCT of the ganglion cell layers at the macula adds even more information. We answer the question of which is more important in what situations and what to look for.

OCT in Glaucoma

It is high time that your Ophthalmology Against The Rule hosts Dr Ben LaHood and Dr Nick Andrew looked at the case for medical marijuana in ophthalmology. The ability of marijuana to lower intraocular pressure is well known but is it ready to be used as a routine glaucoma medication? Let us inhale all the evidence on this controversial topic and present the current and future role of marijuana in eye care.

Marijuana and Ophthalmology

Your Ophthalmology Against The Rule hosts Dr Ben LaHood and Dr Nick Andrew discuss the latest evidence and their views on refining the outcome of second eye cataract surgery. Modern IOL calculation formulae are very good at predicting a refractive outcome but not yet perfect. Can we improve any further by considering how the first eye responded to surgery? This may seem like a simple question on the surface but there are other issues to consider such as biometry error and IOL manufacturing tolerances. This lively discussion is sure to make you think about how you tackle this scenario and may change your practice.

Refining the Second Eye in Cataract Surgery

Ocular dominance is a term that often is thrown around when thinking about cataract and laser surgery, especially with regards to monovision. Despite this, testing of ocular dominance is often poorly understood and performed. This can lead to post-operative headaches - literally! In this episode of Ophthalmology Against The Rule, we discuss the strengths and weaknesses of different tests of ocular dominance and what they may imply for decision making in the clinic.

Ocular Dominance Testing

Your hosts of Ophthalmology Against The Rule, Dr Ben LaHood and Dr Nick Andrew take a deep look at the evidence for and against different wavelength filtering IOL options. Some higher energy wavelengths of light potentially can be detrimental to macula health, cause glare and affect sleep. Available IOL technology now offers surgeons the ability to filter certain wavelengths in the blue and violet spectrum. There are IOL choices out there that could impact the long term ocular health of patients so it is essential to know the facts before permanently implanting an IOL during cataract surgery.

Yellow IOLs vs Clear IOLs - Pros and Cons of IOL Filter Choices in Cataract Surgery

We conclude our Ophthalmology Against The Rule miniseries on surgically induced astigmatism (SIA) by discussing the concepts of internal astigmatism, posterior corneal astigmatism, IOL tilt and decentration. Total SIA or internal SIA are commonly spoken terms but not often discussed or defined. We shed some light on what they are all about and whether they can be measured currently.

Surgically Induced Astigmatism in Cataract Surgery (An Ophthalmology Against The Rule miniseries part 3 of 3)

In part two of this Ophthalmology Against The Rule miniseries on surgically induced astigmatism (SIA), Dr Ben LaHood and Dr Nick Andrew discuss the practicalities of assessing and calculating SIA for each surgeon. This includes what measures are needed, when to measure and tools to give you all those numbers you read about in the journals. 

Surgically Induced Astigmatism in Cataract Surgery (An Ophthalmology Against The Rule miniseries part 2)

On this special episode Dr Ben LaHood and Dr Nick Andrew discuss COVID19 for eye care professionals and cover specifically what ophthalmologists and optometrists can do to keep themselves and their patients safe during the pandemic.

COVID19 - Ophthalmology and the Coronavirus (An Ophthalmology Against The Rule Special Episode)

Surgically Induced Astigmatism (SIA) is a poorly understood part of every cataract surgery and IOL calculation. Understanding, minimising and making SIA more consistent can lead to more predictable refractive outcomes. In the first part of this three part mini-series we get down to basics with understanding exactly what SIA is all about. 

Surgically Induced Astigmatism in Cataract Surgery (An Ophthalmology ATR miniseries)

The first episode of Ophthalmology Against The Rule podcast. Introducing your hosts Dr Ben LaHood and Dr Nick Andrew, their backgrounds and specialty interests as well as looking at what exciting discussions are coming soon.

Ophthalmology Against The Rule Introduction

Ophthalmology Against The Rule (OATR) is a podcast hosted by ophthalmologists Dr Ben LaHood and Dr Nick Andrew. Discussing the simple things often overlooked and the complex things often ignored about ophthalmology. Serious talks about interesting ophthalmic issues in an easy listening podcast.