Slit-Lamp Procedures Every Glaucoma Surgeon Should Know

Avoiding a return trip to the OR for a revision procedure can benefit patients and practices.

Israel Ojalvo, MD, and Manjool Shah, MD

Glaucoma Today

Key Takeaways Taking a patient to the OR for a controlled revision procedure demands a significant amount of time and resources. If a slit-lamp procedure might safely spare a patient a trip to the OR, it is generally worth attempting. Slit-lamp procedures glaucoma surgeons should know include anterior chamber tap, needling, tube sweep, and hyphema drainage. Taking a patient to the OR for a controlled revision procedure holds undeniable appeal, but it also demands a significant amount of time and resources. Urgent additions to an already full surgical schedule often delay or displace other cases. Estimates of OR costs range from approximately $500 to $1,000 per hour in ambulatory surgery centers to $2,000 to $3,000 per hour in hospital-based ORs.1,2 If a slit-lamp procedure might safely spare a patient a trip to the OR, it is generally worth attempting. This article discusses several slit-lamp procedures that every glaucoma surgeon should have in their armamentarium. For all the techniques, the ocular surface may be sterilized with topical antibiotic drops before and after the procedure or with topical povidone-iodine. Re-formation of the anterior chamber (AC) with an OVD is not discussed, as most glaucoma surgeons are familiar with this technique and its utility. AC TAP Practice patterns vary greatly among institutions, but during my (I.O.) training, it was uncommon to go more than a week without performing at least one AC tap.

Becoming a TEDx Speaker

Modern Optometry

A Guide to Implementing LLMs in Practice

Retina specialists can use AI to streamline their communication, if they do it carefully. Here’s how.

Fatima Kalabi, MD; Mohammad Hossein Amirhosseini, BSc, MSc, PhD; and Rodrigo Anguita, MBBS, MD, FEBO, FICO

Retina Today

KEY TAKEAWAYS Large language models are text-generation tools that can help retina specialists draft patient education and correspondences, teach cases, and research documents. Without careful prompting, AI models may overstate the likelihood of visual improvement, omit the need for ongoing treatment, or miss return precautions entirely. Safe adoption requires no patient-identifiable data, institution-approved platforms, careful prompting, and clinician review of every output. Large language models (LLMs) are not reading OCT scans for us yet, but they are changing how we talk to patients, draft correspondence, and prepare trainees for oral examinations. Understanding what they can and cannot do is now a practical clinical skill. For a broad overview of what LLMs are and their potential uses in the clinic, see AI Chatbots in the Retina Clinic. Here, we explore how, exactly, retina specialists can implement these tools safely in their workflow. DRAFTING PATIENT EDUCATION Retinal disease can present significant communication challenges. The difference between wet and dry AMD, the rationale for repeated intravitreal injections, or the urgency of a retinal detachment repair may be obvious to the specialist but bewildering to a newly diagnosed patient. LLMs can produce a first draft of a plain-language explanation, adjust reading level, or reformat content for a patient portal.1,2 In a cross-sectional study of ChatGPT-4 (OpenAI) responses to common questions about retinal detachment, macular hole, and epiretinal membrane surgery, retina specialists judged most answers to be appropriate.