My daughter recently started as a tech at a well respected private practice in Cleveland. Even with a call center, there is frequently an hour hold time for the phones. At the hospital where I work, we receive 66K calls/year. The more I talk to ophthalmic professionals around the US, this is happening everywhere. I've only been in the industry for about a decade, but I had no idea this was such a widespread issue. Is it due to the increasing patient volume or something post-COVID related? I understand there are cracks in healthcare across the board, but certainly this can't continue. I worry about the standard of care when patients can't reach their doctor. Oh, you have a CRAO? If only we could have heard from you sooner, maybe we could have helped.

As the question states - how are you all optimizing IOL picks and deciding on toric vs non toric vs LRIs in cases where Argos and Pentacam have significant differences in cyl measurements?

Hi All,

Just wanted to share some tips for smartphone slit lamp photos. Curious to hear if anyone else has some tips on getting good photos. Here is a video breakdown too:

https://www.instagram.com/p/DYNot92iuEB

1. Turn on the Room Lights

I've found the sensor can have a hard time adjusting exposure as the oculars come in and out of focus. Turning the room lights on seems to improve this for me.

*Edit* TheGhostOfBobStoops suggested turning the lights off and lowering the slit beam to the lowest brightness possible. I think this sounds like a great alternative (basically both techniques are trying to minimize the difference in brightness between the slit lamp beam and ambient brightness.

u/dilateddrama suggested lumination system on the extreme temporal side to minimize the corneal reflection

2. Use a Diffuser

If you just want to take a quick image to follow lets say the size of an ulcer, using the diffuser can really help. You can also use scotch tape in a pinch.

*Edit* BigJarsh91 suggested taking out the plastic mirror in the slit lamp and flipping it around can also create an impromptu diffuser.

3. Brace with your 2nd Hand

I see some people press the phone directly onto the oculars. I've found bracing the phone with your 2nd hand maybe an inch away from the oculars is easier.

4. Lock the Main Camera

Probably the biggest problem people have is not locking the camera. I've seen people tap the 'flower' button to lock the macro mode into place. But ideally you want to lock the main camera. You don't need the macro sensor if photographing through the ocular, you just don't want the phone switching between cameras as the oculars go in and out of focus.

5. Use Burst Mode

You want to take a burst of photos. In a pinch you can also record with video and grab screenshot. Both are much easier than just taking a single photo.

6. Crop the Photo

I find it looks much better if you crop out the content outside the oculars.

What do you all do when taking photos? Any good tips I missed?

Hey guys! So I have been working as an ophthalmic tech for maybe 9 weeks now? I started the 2nd of March. I really have been loving it, however there’s a lot of things that kind of raise yellow flags. I love the patients, the doctors, the staff. But as benefits go, there is really none. I do have insurance but it’s only the catastrophic plan. So nothing is covered until you hit your 6k deductible. Not ideal, but it’s whatever. But I guess it used to be better and they switched and now it’s even worse and then a lot of people left because of it. We also don’t get PTO, I mean I guess you get 1 hour for every 30 hours worked so wooo.. but the biggest thing for me is the amount of stuff I need to do before a patient even sees a doctor. A couple days a week we have 5 patients every 15 mins coming in. It’s complete chaos. We only have 4 techs. There has been not an empty seat in the lobby and people are leaving because it’s taking so long. I feel horrible but I’m barely trained and doing things on my own. We have to do so much with the complete exams with the ophthalmologist patients. It will take 20-30 mins with them before doctor.
Then I was talking to my dad and he raised a good question and I am curious. Why do techs do the refraction? My dad was like “I wouldn’t want someone who’s not a doctor making my glasses prescription. I want a doctor.” And I’m so new with refraction and I would hate to give someone a bad prescription. I mean it’s pretty straight forward now but I think you know what I mean. Some days it just feels like we are just cheap techs to do all the work so the doctor doesn’t have to do as much and can see more people. I felt more appreciated at my old job and that wasn’t much :/

Anyway, thanks for reading if you made it this far. I needed to rant. I don’t want to complain at the work place and cause drama. I have barely been there 2 months and I have known 5 people to leave/get fired so I have no idea what the heck is happening

Just a question for fun thought it'd be interesting to see everyone's views

In what countries do we think ophthalmologist have have the best lifestyle, paid well, are happy etc or is there no clear winners

I'm UK based personally

Ophthalmologist practicing in India: I’ve always been interested in Orbit and oculofacial plastics, but have been recently made to consider Vitreoretina for specialization owing to the high work load and monetary gains.

Are work opportunities limited for Oculoplasty specialists or is that a myth?

Is it ok to consider Retina as a specialty for a person who wants a good work life balance?

I’ve tried cold emailing, going in person with my resume, and following up with calls, but I haven’t gotten any callbacks. Is there anything i’m doing wrong? Please kindly let me know.

If needed, i’m an african american male (16M) and a junior. I’m also in the USA.

Which are the good ophthalmology apps available for ophthalmology…and their strengths and weaknesses?

After playing around with some IOL calculator stuff, I just came to really appreciate just how incredible the ESCRS IOL Calculator really is.

They put out this calculator total for free, not restricted to ESCRS members, and doesn't have any annoying advertisements.

Can we all just take a second recognize how awesome that is? Also Barrett, Hill, and the rest of these IOL guru's that just put this stuff out there. Incredible.

The Intellectual and Engineering Journey of Charles Kelman and Anton Banko to Develop Phacoemulsification: Insights Based on Newly Identified Documents.

Topic

The development of phacoemulsification by ophthalmologist Charles Kelman and engineer Anton Banko in the 1960s.

Clinical Relevance

Phacoemulsification is now the dominant technique for cataract surgery. Re-examining its development provides insight into how surgical innovations emerge from interactions between clinicians, engineers, and pre-existing technologies.

Methods

We reviewed primary source materials discovered from 2023 to 2025, including the John A. Hartford Foundation files on Kelman, and a newly discovered Jan. 13, 1966 memorandum from Banko, never previously described in the scholarly literature. We interviewed people who knew Kelman, including coworkers.

Results

Kelman wanted to reduce hospitalization after cataract surgery when he was a resident at Wills Eye Hospital in 1960. At that time, hospitalization was necessary because of the relatively large incisions required. Kelman worked on cryoextraction in 1962, and believed freezing could shrink the lens. Kelman’s research program made use of several ideas for small-incision cataract surgery published by other New Yorkers before his 1967 phacoemulsification report: irrigation and aspiration (IA) with a “two-way syringe”, enzymatic or chemical digestion, and disruption with a wire. The pathway which ultimately became successful was: 1) Kelman first proposed extraction by IA with a “two-way syringe”. 2) During the first half of 1965, Kelman had a dentist working in his lab, and investigated a dental-inspired rotary cutting tool with concentric IA elements for cataract surgery. 3) On July 13, 1965, Kelman met with Banko, and they began a program to add ultrasonic energy, as found in dental scalers, to the cutting tool with IA, using longitudinal vibration to reduce iris disinsertion and a titanium tip to reduce flaking. On Aug. 27, 1965, Kelman first tested an ophthalmic phacoemulsifier.

Conclusion

Kelman was focused on small-incision cataract surgery from early in his career. He pursued multiple approaches in parallel, modified pre-existing technologies (cryoextraction, disruption against a wire mesh, irrigation-aspiration devices, rotary cutting instruments, dental ultrasonic devices), and was successful by 1967.

Premed here soon to go to medical school. my hands are usually really dry but sweat in tense situations or when i'm doing miniscule work. While doing research (pipetting) i've found that my hands shake slightly even if my elbow is braced on the table.

I love ophthalmology and the anatomy, physiology, optics, vision science everything and I've wanted to be an eye surgeon since i got my first pair of glasses and learned about surgery, but i'm worried i'll never be able to do the surgery because of these drawbacks.

How true is it that you can get over these things during residency? is there such thing as innate skill needed to be an ophthalmologist? how can you know if you'd be a bad ophthalmologist? I guess I just need reassurance lol

Which country (any country) could one choose where diploma recognition poses no difficulties, and where there is an opportunity to learn how to perform surgery after completing a residency? And how does one find such opportunities? Please help.

I'm a current medical student who is planning to apply this upcoming cycle. Would really appreciate any advice on chances as well as any guidance on what to do next strategy-wise to increase chances of matching.

Background:
Degree: MD

School: T10-25
Any gaps/red flags: None

Scores:
Step 1: Pass
Step 2 CK: Have not taken yet

Clinical Performance:

Total: 4 H, 3 NH, 1 HP

Surgery and medicine grades are both not H. Missed the shelf cutoff by 1-3 questions lol.

Class rank/quartile: My school does not release final quartiles to schools, but I will likely be 3rd (final cutoffs not determined yet). I've heard that residencies can guess what quartile you're in based on distribution in relation to other applicants from my school, and my school historically has had bad match chances for those in 3rd quartile and below (though I'm sure this is influenced by other factors) so I'm pretty worried.

GHHS: No

Research
Publications: 3 accepted (1 first author, 2 middle author; 2 ophtho-related), 1 non-ophtho (first-author) submitted
Presentations/posters/abstracts: 6 presented (2 first author, rest middle-author; 3 ophtho-related), 3 submitted (2 first author, 1 second author; 2 ophtho-related)

Extracurriculars / Leadership:
Leadership experiences: 3, one unique global health experience with high impact
Volunteering experiences: 3

Teaching/mentorship roles: 3

Letters of Recommendation
Ophthalmology letters: 1 well-known chair letter (will likely be decent), 1 mentor (likely just meh), 1 well-connected (will likely be good).

Not super well connected with home ophtho department.

Away Rotations: Have not been accepted into any as of yet, which feels like a sign of how this cycle will go :/

I would like guidance on what step 2 score I should aim for to maximize my chances of matching. Can a strong step 2 score (260+) really make up for my low clinical grades?

I've also heard that general strategy during application season can make a world's difference in matching for both weaker and stronger applicants. I'm wondering what that means and how I can increase my chances.

Thank you so much in advance!

How does it compare to AAO? Debating on going to AAO vs ESCRS this year.

For context I currently do comprehensive in the US.

Thanks for any input!

Does anyone get a sudden hand tremor or has dealt with this in the past when an abrupt movement is made in the eye? For example, if my keratome is dull, and I have to force my entry my hand will suddenly shake. It’s like a burst of adrenaline. I think it’s mostly related to the stressful attendings I work with that don’t allow room for error. If my movements are more controlled and methodical I don’t have this issue. I’m nervous this will be a long term issue though. Any advice? Should I try a beta blocker or sublingual timolol? I’m hoping it will get better with more time and experience.

Looking for thoughts on EHR system, I’m stuck between MaximEyes and Revolution. I heard Rev is too much clicking. Anyone have thoughts on this?

Hello, I am an MS2 at a US MD school

I recently met with an advisor who told me the following for applying for ophthalmology. I’m wondering if any matched ophtho applicants/residents can speak on these points.

1. For context, I would like to end up in a specific city near my home program. This advisor told me to do aways all over the country, 2 to 3 total. Even though it doesn’t interest me to end up there, the argument is that a demonstrates. I’m willing to go anywhere which will increase my odds overall. Is there utility in doing more than one way in a city that I really want to end up in?

2. I was told that, regardless of my application, I should dual apply. I don’t think I have any red flags on my application. Is this necessary?

3. Research here won’t help me. If I have three or more publications, doing a year of just research won’t be of any utility. Is this really the case? Won’t doing this also offer me newfound connections, especially to the place I was working at?

Appreciate any insight

Hello! I am a retina technician at a private practice in Missouri, USA who is about to begin the process of becoming certified for my COA! I’ve worked for my MD for over 2 years and learned so much about the retina, but I know I am at a mild disadvantage being in a sub-specialty for anterior chamber questions.

Any certified technicians- any recommendations for study materials? We plan on using the textbook with online quiz through IJCAHPO. I also saw flash cards being sold as well and wanted to know if anyone has used them?

Thank you!!

Hi friends!

I am an incoming M1 and am really interested in Ophthalmology. The surgeries, technology, and people in the field are sick and I can't get enough. I am reaching out to ask a few broad questions related to the training, the bread and butter, and lifestyle/compensation.

Firstly, what should someone at the beginning of this journey know/what do you wish you knew? Any specific recommendations regarding research, mentorship, or grades during medical school to increase the chances of matching?

Regarding the day-to-day work - how rewarding do you find Ophtho? Are the outcomes good and do you have real, tangible moments where you truly see the impact you had on a patient? Is the balance between surgery and clinic fun and does it help you avoid burnout?

Finally, how is the lifestyle? Do you enjoy your work/life balance and feel fairly paid for the work you do? Any regrets?

I guess I really just want to hear from folks who have walked the path I am about to embark on. Any and all advice/recommendations are appreciated!