Experts InSight

The unprecedented payment cuts that the Centers for Medicare and Medicaid (CMS) proposed over the summer were finalized on October 31. The disastrous impact on cataract surgery reimbursements alone will amount to an 11% reduction in payment. In today's emergency episode, host Dr. Andrew Pouw welcomes back three guests to rally ophthalmologists to take action: Dr. John McAllister, the Academy's Secretary for Federal Affairs; Brandy Keys, the Academy's Director of Health Policy; and Rebecca Hyder, the Academy's Vice President of Government Affairs.  Physicians shouldn't have to choose between staying open and serving their Medicare patients. Congress needs to hear directly from ophthalmologists like you before these cuts are enacted. Please, make your voice heard. Use this easy form to reach Congress. Essential Academy Resources: Contact Congress Now: www.aao.org/act-now Summary of CMS Medicare Physician Fee Schedule Past podcast episode: CMS Cuts Rock Ophthalmology For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

In this call to action, Drs. Robert Mazzoli, Stuart Seiff, and Jon Perlstein share the scope of issues surrounding ophthalmic trauma care in the United States and a roadmap for improving it, including how we can translate experiences from the military into our own set of Damage Control Ophthalmology (DCO) guidelines. Referenced article: A Call to Action and Roadmap for Improving Emergency Treatment of Ophthalmic Trauma in the United States For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Michelle Cabrera and Alejandra de Alba join host Dr. Ben Young to discuss the finer points of what makes pediatric cataract surgery so challenging—because it's not "just" scaled-down adult cataract surgery. Referenced article: Management of Infantile and Childhood Retinopathies: Optimized Pediatric Pars Plana Vitrectomy Sclerotomy Nomogram For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Thomas Gallagher joins host Dr. Amanda Redfern to share how to ethically and effectively disclose medical errors to patients. During the past 20 years, Dr. Gallagher's research has explored the intersection of healthcare quality, accountability, and communication. He has led a variety projects focused on the optimal response to adverse events and errors in healthcare, and developing systematic programs for preventing and responding to such events. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Marc Toeteberg-Harms and Soshian Sarrafpour join host Dr. Andrew Pouw to discuss micropulse transscleral laser therapy for glaucoma, a less invasive procedure compared with traditional continuous-wave cyclophotocoagulation. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Host Dr. Amanda Redfern welcomes Dr. Claudia Prospero Ponce, a neuro-ophthalmologist and ocular pathologist, to share her unique perspective on how to diagnose giant cell arteritis (GCA) when temporal artery biopsies are not classically positive.  For more information about pathological markers in GCA, check out this paper referenced in the episode: Sultan H, Smith SV, Lee AG, Chévez-Barrios P. Pathologic Markers Determining Prognosis in Patients With Treated or Healing Giant Cell Arteritis. Am J Ophthalmol. 2018;193:45-53. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Nisha Mehta, founder of Physician Side Gigs, and Dr. Jim Dahle, founder of The White Coat Investor, join host Dr. Jay Sridhar to discuss the One Big Beautiful Bill Act and its implications for physicians and ophthalmologists in particular. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

In July, the Centers for Medicare and Medicaid (CMS) proposed catastrophic changes to Medicare reimbursement systems that, if finalized, will significantly affect ophthalmology and all specialty care. The impact on cataract surgery reimbursements alone would amount to an 11% reduction in payment. In today's episode, host Dr. Andrew Pouw welcomes three guests to discuss these highly complex and concerning cuts: Dr. John McAllister, the Academy's Secretary for Federal Affairs; Brandy Keys, the Academy's Director of Health Policy; and Rebecca Hyder, the Academy's Vice President of Government Affairs. Listen, share, and advocate to help us prevent these changes. Related Academy Resources: Summary of CMS Medicare Physician Fee Schedule Impact of the Efficiency Adjustment Impact to Indirect Practice Expense (PE) For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Prithvi Sankar and Sriram Balasubramanian discuss a personal journey through vision loss, from both the ophthalmologist and patient perspective. Host Dr. Ben Young invites these two friends to share their lessons of grief, denial, and ultimate acceptance of a difficult diagnosis—in this case, retinitis pigmentosa—and what physicians can do to help their patients through these life-changing events. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Bradley Katz joins host Dr. Amanda Redfern to share updates on the diagnostic imaging of optic disc drusen and current research efforts from the Optic Disc Drusen Consortium, an international alliance of researchers focused on optic nerve disorders. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Durga Borkar and Yashaswini Singh join host Dr. Jay Sridhar to discuss their recent publication regarding private equity (PE) acquisition and access to retinal detachment surgery. According to the study, physicians in PE-acquired practices decreased their number of retinal detachment repairs by nearly 20% after acquisition, potentially negatively impacting access to care and patient outcomes. Discussed in today's podcast: Singh Y, Cardenas GB, Torabzadeh H, Whaley CM, Borkar D. Private Equity-Owned Physician Practices Decreased Access To Retinal Detachment Surgery, 2014-22. Health Affairs. 2025 May;44(5):589-596. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Elyse McGlumphy and Soshian Sarrafpour join host Dr. Andrew Pouw to talk about the range of and reasons for intraocular pressure (IOP) variance, as well as the studies debating its significance for glaucoma. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Host Dr. Ben Young invites Drs. Roni Levin and Evan Silverstein to review the current state of amblyopia treatment, ranging from the mainstays of patching and atropine drops to novel advances such as dichoptic therapy. Below are some references regarding dichoptic therapy that were discussed in this episode: Xiao S, Angjeli E, Wu HC, Gaier ED, et al. Luminopia Pivotal Trial Group. Randomized controlled trial of a dichoptic digital therapeutic for amblyopia. Ophthalmology. 2022 Jan;129(1):77-85. Wygnanski-Jaffe T, Kushner BJ, Moshkovitz A, Belkin M, Yehezkel O. CureSight Pivotal Trial Group. An eye-tracking-based dichoptic home treatment for amblyopia: A multicenter randomized clinical trial. Ophthalmology. 2023 Mar;130(3):274-285. Koc I, Bagheri S, Chau RK, Hoyek S, et al. Cost-effectiveness analysis of digital therapeutics for amblyopia. Ophthalmology. 2025 Jun;132(6):654-660. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. John Kitchens and Andy Schimel join host Dr. Jay Sridhar to discuss current and emerging applications for artificial intelligence (AI) relevant to both patients and physicians. The sweeping conversation covers resources for low-vision patients, as well as how large language models (LLMs) such as ChatGPT and Gemini can improve efficiency, creativity, and accuracy in a variety of clinical, professional, and other settings.  For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Chris Conrady and Akbar Shakoor join host Dr. Ben Young to teach us about why intraocular inflammation (IOI) sometimes occurs after intravitreal injections, how to differentiate these cases from endophthalmitis, and how to manage this potentially blinding condition. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Advocacy and policy leaders Dr. Michael Repka and Rebecca Hyder join host Dr. Andrew Pouw to share their experiences and perspectives about the Academy's work engaging with policy stakeholders. The conversation reviews recent government healthcare funding debates that may affect Medicaid and the Children's Health Insurance Program (CHIP). For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

In today's episode, host Dr. Amanda Redfern invites Dr. Nancy Newman to share updates in the treatment of Leber hereditary optic neuropathy (LHON), covering several clinical trials underway that involve idebenone and gene therapy.  For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

In today's episode, host Dr. Jay Sridhar is joined by Dr. Bobeck Modjtahedi to discuss the American Academy of Ophthalmology's new guidelines on autoimmune retinopathy (AIR), recently published in Ophthalmology Retina. A member of the Academy's task force on AIR and lead author, Dr. Modjtahedi discusses a new diagnostic framework for categorizing AIR as probable, possible, or unlikely based on specific clinical criteria. The guidelines address the challenges in diagnosing this rare condition that mimics inherited retinal diseases, and outline a standardized approach to classification for both clinical practice and research. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Drs. Davinder Grover and Ronald Fellman join host Dr. Andrew Pouw to discuss their latest innovative surgical advancement: interventional valve-enhancing trabeculotomy (iVEnT), an angle-based minimally invasive glaucoma surgery (MIGS) procedure. Compared with a traditional goniotomy, this alternative approach may be less invasive, sparing tissue and offering faster visual recovery for glaucoma patients. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.

Dr. Michael Puente joins host Dr. Ben Young to share his experience founding the first eye clinic specifically for adult and pediatric patients with intellectual developmental delay. Dr. Puente provides practical tips for all ophthalmologists to improve their care for this vulnerable population. For all episodes or to claim CME credit for selected episodes, visit www.aao.org/podcasts.