DiscoverBlind Spot - The Eye Doctor's Podcast
Blind Spot - The Eye Doctor's Podcast
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Blind Spot - The Eye Doctor's Podcast

Author: Zale Mednick

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Blind Spot is the Eye Doctor's Podcast that challenges eye care specialists to examine their own blind spots in the clinical and surgical management of eye disease. Each episode features a different guest expert and focuses on a particular clinical diagnosis or surgical challenge in ophthalmology. The show is hosted by Toronto-based ophthalmologist Dr. Zale Mednick.
28 Episodes
28. Dry Eye Pearls

28. Dry Eye Pearls


July is Dry Eye Awareness month.  In this episode, five cornea specialists each contribute a tip on how to better diagnose and manage dry eye.  Speakers includ Dr. Clara Chan, Dr. Chris Rapuano, Dr. Ashley Brissette, Dr. Tanya Trinh, and host Dr. Zale Mednick. This episode is sponsored by Sun Pharma Canada
While there are specific guidelines for diagnosis, not every patient falls easily into a particular category of glaucoma.  Many times, it can be challenging to place some patients neatly into one of the glaucoma buckets.  So what are some tips that can help us in diagnosing these grey cases that may or may not be glaucoma?  And how does this impact treatment decisions? Are there certain cases in which it’s okay to monitor a patient and wait for glaucoma progression?  Or should all patients suspected of having glaucoma be treated at the first visit? Dr. Irfan Kherani joins the podcast.
Recurrent Corneal Erosion Syndrome (RCES) is an extremely uncomfortable condition for patients to live with.  With so many management options, including ointments, bandage contact lenses, superficial keratectomy, anterior stromal puncture, and PTK, what actually works best?  Wills Eye Hospital Cornea Specialst Dr. Chris Rapuano joins the podcast. This episode is sponsored by Sun Pharma Canada -
The incidence of musculoskeletal injuries in ophthalmology is probably higher than you think. Whether it's an acute injury or a chronic injury from poor posture and positioning, ophthalmologists and optometrists are at high risk for long-term back pain and other musculoskeletal problems, due to the nature of our work. So how can we better at keeping ourselves healthy, both in the short-term and in the long-run? Dr. R. Rishi Gupta joins the podcast.
The toric intraocular lenses (IOL) is a mainstay in the treatment of astigmatism during cataract surgery.  Many people have different thresholds, however, for when they would consider a toric IOL.  What is the appropriate amount of astigmatism that warrants treatment with a toric lens?  Does the threshold vary if a premium lens is being used?  What lens implantation techniques can be implemented to achieve the best possible results with a toric lens?  This episode is sponsored by Sun Pharma Canada -
LASIK has been the procedure of choice in refractive surgery for many years now.  But over the last decade, the development of SMILE has changed the landscape in refractive surgery.  Especially popular in Europe and China, many ophthalmologists are offering their patients SMILE in place of LASIK.  So what exactly is SMILE, and why do many view it as a superior alternative to LASIK?  Dr. Walter Sekundo, the developer of the SMILE procedure, joins the podcast.
As excitement grows regarding the upcoming solar eclipse, anxiety is also increasing amongst patients.  How should we be counseling concerned patients regarding the solar eclipse and what precautions they should be taking to protect their eyes? Dr. Tina Felfeli joins the podcast.
Traditionally, most of us were taught that after cataract surgery, a patient should be assessed on day one, week one, and month one.  But what are these recommendations based on?  Practically speaking, does our typical survellance of post-operative cataract surgery patients make sense, or are we overly dogmatic in our approach? Dr. Uday Devgan, aka 'The Cataract Coach', joins the podcast.
The traditional paradigm is that when a patient presents with acute angle closure due to pupil block, a peripheral iridotomy (PI) must be performed immediately. But in reality, is this always the best approach? Is it safe to treat medically for a period of time before the PI? In which situations might a PI actually exacerbate the acute angle closure? Dr. Ike Ahmed joins the podcast.
We all know that keratoconus is very highly associated with eye rubbing. But in general, the widely held belief has been that keratoconus is just associated with eye rubbing, one of multiple factors that leads to the condition. But have we gotten it wrong? Is eye rubbing not merely associated with keratoconus, but actually the sole causative factor of keratoconus? Has there been a huge blind spot in our basic understanding of keratoconus development and progression? Dr. Damien Gatinel joins the podcast.
Acetazolamide is a common and important medication used in ophthalmology. It is used as a treatment for both high intraocular pressure and high intracranial pressure. Yet despite its many uses, many ophthalmologists feel nervous when prescribing it due its potential side effects and the concern of sulfa allergy. And while caution is always a good thing, have we perhaps overstated the risks with acetazolamide to such a point that we don’t use it enough? What exactly is sulfa allergy, and does it even apply to acetazolamide? And how dangerous is acetazolamide, and how should we be counseling patients when prescribing it? Dr. Deborah Friedman joins the podcast. Learn more about Dr. Friedman at
A central retinal artery occlusion is arguably one of the worst ocular events that can occur, given its extremely poor visual prognosis. As such, our efforts to find an effective treatment for CRAO have been extensive, but in many regards, inadequate. There are certain treatment options that we all learn in residency to try and halt a CRAO, but for the most part, many of these techniques are fairly unproven and don’t work so well. So what does actually work? And is the evidence for TPA strong enough that we should be routinely recommending it in appropriate cases? Dr. Rishi Gupta joins the podcast. Learn more about Dr. Gupta at more about Dr. Gupta's books at
Over the past two decades, Botox and Fillers have changed the landscape of cosmetic plastic surgery, including the field of oculoplastics. But how exactly to Botox and Fillers work, and more importantly, how should patients be counseled on these elective treatments? And from a philosophical standpoint, has the world of cosmetic surgery gone too far in 'de-aging' the population and perhaps further stigmatizing the natural process of getting older? Oculoplastics specialist Dr. Harmeet Gill joins the podcast.
Blepharitis is a common diagnosis, but it’s also an umbrella term that encompasses many different clinical disorders which require varying treatment approaches. Many patients struggle with chronic blepharitis, where it’s tough to find an effective treatment. So what exactly is the best approach to blepharitis? How does one differentiate staph blepharitis from demodex? What are the most effective treatments on the market? And from a preventative standpoint, what exactly is lid hygiene, and is it something we should routinely be recommending to our patients? Dr. Ashley Brissette joins the podcast. Check out Dr. Brissette's Eye Care Products Follow Dr. Brissette on Social Media Instagram @abrissettemd TikTok @abrissettemd
Flashes and floaters is one of the most common presenting complaints to eye care professionals. And while most of us understand the general pathophysiology of the vitreous separating from the retina, some of the nuances may not be as clear. Why do flashes and floaters persist so differently in patients? Why do flashes and floaters continue even after a vitrectomy? How common are retinal tears when one experiences new symptoms? And how, ultimately, should this affect our guidelines for monitoring patients who have new flashes and floaters? Dr. Efrem Mandelcorn joins the podcast. This episode is sponsored by Canadian Eye Care Today. Access the journal at
Viral conjunctivitis is one of the most common presentations to eye care professionals. It’s typically easy to diagnose, and traditionally, the treatment has simply been cool compresses and observation. But have we been too lax in our treatment of viral conjunctivitis? What, if any, are the roles of steroids, iodine, and antivirals in the treatment of this common condition? Dr. Francis Mah joins the podcast.
Over the past twenty-five years, LASIK has become one of the most commonly performed ocular procedures. As refractive surgery has become more popular in general, LASIK still remains the mainstay option in younger non-presbyopic populations. Whereas eye care professionals used to be more hesitant about recommending LASIK, the sentiment has largely shifted. But how safe is LASIK and other refractive surgeries? With it becoming so common, have we perhaps overlooked some of the shortcomings of LASIK? Or alternatively, is the boom in refractive surgery justified and actually an important part of the progression of ophthalmology? Dr. Guy Kezirian, Founder of the Refractive Surgery Alliance, joins the podcast.
Lipiflow and IPL have become mainstays in the treatment of meibomian gland disease. But while they might be effective in some cases, they are also quite expensive to patients. Which begs the question – how effective are lipiflow and IPL when compared to more conventional treatments? Is there a way to predict which patients will benefit most from these treatments? Ultimately, how should Lipiflow and IPL factor into the treatment algorithm for meibomian gland disease in a way that is clinically advantageous while also cost-sensitive to the patient? Dr. Ashley Brissette joins the podcast. Check out Dr. Brissette's Eye Care Products Follow Dr. Brissette on Social Media Instagram @abrissettemd TikTok @abrissettemd
Femtosecond Laser Assisted Cataract Surgery (FLACS) has been around for over a decade, yet there isn’t necessarily consensus amongst the eye care community as to how this technology should be implemented within cataract surgery. Some advocate strongly for FLACS, citing greater reliability and precision than traditional cataract surgery. Others have argued, however, that even if the femtosecond technology has improved accuracy, this doesn’t necessarily mean that it translates to better cataract surgery results. Dr. Eric Donnenfeld joins the podcast.
It is not uncommon for parents to come into the pediatric ophthalmology clinic with concerns that their child is myopic. For many of us, especially in years past, we might have said ‘Don’t worry about it. There’s not too much we can do anyway.’ But as the rates of myopia have continued to increase over the last several decades, more attention has been given to this topic. Some have even referred to a ‘myopia epidemic’ that has developed. So why is this important, if at all? Should we be concerned about the rising rates of myopia? What is causing this? And ultimately, should our concern level be high enough to warrant starting treatment in some of these patients? Dr. Rupa Wong joins the podcast. Dr. Rupa Wong's