WEBVTT
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Vision can be how we experience the world, how we respond to illness, and how we can shape the way we move through difficult moments.
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And today we're going to explore the relationship between vision, stress, hope, and healing.
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And we are very happy to be joined by our wonderful guest for today, Dr.
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Robin Ross of Global Retna Institute.
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And Dr.
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Ross had also been involved with the Prevail 7, giving her a unique perspective on both the clinical and human sides of caring for patients.
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Dr.
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Ross, welcome back to IC Podcast.
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Welcome.
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I'm glad to be here.
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Thank you, Hazel, for hosting us today.
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We're going to talk about some critical things about hope and healing.
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And patients who have a positive attitude and are able to maintain that positive attitude seem to have a better clinical outcome and a better course.
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Negativity tends to lead to poorer outcomes.
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And creating that environment that patients can obtain their best visual acuity and best outcome is our goal at Global Retin Institute.
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So thanks for hosting.
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So let's begin with something very simple, Doc.
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When we say vision is more than just eyesight, what does this actually mean to you?
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You know, you're gonna have two patients, two twin sisters, both living in a different circumstance, that read the eye chart differently.
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You know, they can be 2020 unhappy or 2020, this is awesome vision.
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So we have to quantitate how patients measure their vision, and that's a simple test of visual acuity reading, but that can be done in many different ways.
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Vision also incorporates your color, your contrast, your spatial sense, your depth perception, your peripheral vision.
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So it's really many details encompass how a patient sees the world.
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And distilling those down and tracking them as metrics over time is very critical.
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Patients that say they're C2020 can still be legally blind because they have no peripheral vision.
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It's like looking through a McDonald's straw.
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So how we measure vision is somewhat imperfect, and trying to get that standardized is what ophthalmologists and optometrists try to do so that we have a metric to gauge how patients are doing.
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But listening is also a critical skill.
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When patients tell you they're doing worse, we have to distill that out of them.
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Is it a fluctuant vision because their ocular surface is changing all the time, or is it actually how they see related to a retina function or an optic nerve function?
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I think that's something that patients sometimes forget.
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We tend to measure vision in numbers like 2020, 2040, 2200, but those numbers don't necessarily tell us how a person actually feels about their vision or how that vision affects their life.
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How important is it for physicians to understand a person behind the visual acuity number doc?
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You know, it's very important.
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You know, I had once had a patient who declined who came in with a retinal detachment.
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So she did come in, and we were busy getting finding a surgery time, and she said, I'm not having surgery.
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And it was only later that she gave me the whole story after we said, okay, tell me what's really going on.
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And it turned out her daughter had committed suicide a couple days ago, and she took over the grandchildren, and there was a bigger picture happening behind the scenes that made her decision, I can't do this right now.
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Even though for us, a retinal detachment is a sense of emergency, and we're we're distilling down, is the macula attached?
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Is it not attached?
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How do we get surgery time?
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We're doing the logistics without really hearing the patient's whole story.
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And it's it's when a patient says, no, I'm not having surgery, that all of a sudden you have to do a step back and find out what's really going on.
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They don't come in going, my daughter committed suicide, I took over the kids.
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That's the part you've got to dig into.
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And that takes time today.
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And we're dealing with a broken healthcare system where, you know, literally you have four to five minutes to get all the information, which is why we encourage patients to, in our office, do their portal, give us that information.
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We actually prep charts before a patient's visit.
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So if I can see something where the patient might benefit from another imaging test when they're here and not have to make a second trip, we're we're really looking at that, or if we can gather some more information before the patient comes in.
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And patients who are proactive with their health care, meaning they're contributing, they're giving you this.
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The old school was you came in with a blank slate and a technician went through your past history over 40 minutes.
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That was today, that's really misuse of time because we could have gotten that all and looked at it and be starting with what's your real problem today?
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Let's spend the time digging into it.
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And that's really where I feel healthcare's come to.
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We have to get the information about the patient and get a little feel for them in advance, what's their goal?
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And maybe they didn't even know, you know, blepharitis and Demedex were there, so they didn't make that a goal.
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But today patients really want front to back.
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What do I need to plan for?
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And it doesn't matter whether they don't have insurance, have insurance, they want the best care.
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And we're in a system that doesn't allow that.
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You know, if you're a Medicare patient today, you don't really realize that Medicare allows you to have one test on one day.
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Well, you want to know everything.
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And many times today that requires multimodal imaging.
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But getting a feel for the patient, what their goal is, what they're really putting in their information portal, when they're putting everything as my eyes burn, my eyes hurt, you know, they're not then coming to me to fix their retina, or maybe they are, but they think the two are connected.
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So looking at what the patient's view is and trying to give them a bigger picture often incorporates technology and showing them images.
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Did you know this was an issue?
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No, no one's ever showed me that.
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So, you know, in the world of creative writing, which I'm very fond of, we always are told to show, don't tell.
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No one wants to hear you went to the bus stop.
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They want something more dramatic of, you know, my neighbor Joe and I sold lemonade and we ended up going this way and we ended up at the bus stop.
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They want the story, they don't want the facts.
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So patients want to see what is it that's contributing to my vision symptoms?
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Because only then are we gonna act on it.
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You know, if somebody, if I don't have any feeling of demodex or glepharitis, but someone shows it to me, I don't want little bugs nesting in my eyelashes gonna be really like, what do we do to get rid of this?
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You know, because I don't want a future problem.
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And when they draw the the connection that it could be associated with bacteria that could lead to me having a complication in 15 years from cataract surgery, then I'm probably gonna do something about it.
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But if I don't see it and feel it and don't think it could be related to my problem getting contacts or my problem getting a good pair of glasses, then I'm probably not gonna act on it.
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So I think that having a holistic approach is very important.
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It subsides this fear that my my dad went blind, my grandmother went blind.
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What am I most fearing in life that could happen to my vision?
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A lot of people come in with these preconceived notions, but they don't have a construct for it.
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So when you distill it down, like, do you smoke?
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No, I don't smoke.
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Did your dad smoke?
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Oh, yeah, he smoked 40 packs a day for two years.
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Well, did you know that that has an eightfold increase in wet macular degeneration?
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Well, I'm not a smoker.
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So we start, you know, distilling out why your disease might behave differently than mom or dad's.
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And these are the the measures you're taking to be proactive with that genetic inheritance.
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So I think those things are really important, giving patients a positive view of things they can do that's within their means to make themselves have the best ocular health is really the goal.
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And I think that gives people hope and encouragement and gives them a construct to think differently that they're not going to end up the blind patient.
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Yes, Doc.
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And as you mentioned, Doc, I I really believe that listening is actually a gift that we can give the patients.
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And it it takes time and trust to build that rapport between the doctor and the patient, or even from the staff and the patient as well.
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Yeah.
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You know, we meet every day about our patients and the patients that are having a more difficult time.
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So we're all on the same page.
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And I think that kind of team huddle, whether it's a virtual team huddle or whether it's us meeting before clinic or after clinic, is really, really important.
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And every practice has to develop what they feel is the best way to give holistic care.
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And that's the struggle today in 2026.
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Yes, doc.
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Everything is just, I think, fast-paced nowadays.
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And next question, Doc.
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When someone receives a diagnosis involving their vision, there can be a tremendous amount of fear for many people.
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The thought of losing vision, as you mentioned previously on our earlier podcast, one of the biggest fear of Americans is losing vision.
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It isn't simply about losing the ability to see.
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They're thinking about will I still be able to work, will I still be independent, will I be able to drive or recognize my family?
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How do you approach a patient who is experiencing this kind of fear?
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Well, we try to be factual, show them where they are in terms of their disease.
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Let's take a disease like macular degeneration.
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Some people come in saying, I saw a doctor, he told me I'd be blind in a year.
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And then we look at the images and they may have just drusen in both eyes.
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And so we give them the construct that we have early intermediate advanced.
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Most of the patients that get referred to a retina specialist are either intermediate or advanced, or they may not have anything.
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So then at that point, I show them multiple images that are high resolution on a 60-inch plasma screen and say, you know, I really don't see any Druzen.
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I've been doing this for 40 years, and it's very mild if we have a few Druzen at all, but I don't see this immediately leading to blindness.
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So we really try to put this in factual terms.
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We defined what the definition of legal blindness is and how far they are from it.
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If they do have something viable, like let's say intermediate macular degeneration, we show them that there's no sign of advanced disease.
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Advanced disease could be geographic atrophy for dry, or it could be wet.
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All wet is considered advanced disease.
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But many of our patients with wet also have geographic atrophy.
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And I think giving patients current research that's very viable, for example, you know, Belete Bio has a product that will go to commercialization next year for geographic atrophy based on two studies.
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You know, the Dragon study was for Stargardt's disease, which is juvenile macular degeneration, and the age-related macular degeneration with geographic atrophy is the phoenix disease.
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So the fact that geographic atrophy for Stargardt's was FD approved for tin Laribant, and it will go to commercialization next year, gives our macular degenerations patients great hope, especially those that were really fearful of the cypher eyes or vague complement inhibitor injections.
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So we talk about things that are coming that are new, that are novel, because we've never had a neuration for macular degeneration.
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So I feel like always having the arsenal of hope is so critical in taking care of eye disease.
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And it doesn't matter what disease it is, but also finding out how they're managing stress.
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For example, something like stress for any reason can cause your blood pressure to skyrocket, and blood pressure has a deleterious impact on macular degeneration, diabetes, other conditions.
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So stress is a big negative.
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So how patients are managing it.
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Are they doing exercise?
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Are they meditating?
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Are they going to church?
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Are they praying every day?
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Whatever they're doing, that has to be encouraged because having that positive mindset is the foundation for all cells in the body.
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So I think that's really, really important.
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Yes, Doc.
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And it takes a lot of listening on the provider side to pour in that fashion, to educate the patient and just let them know that we're going through this together.
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I'm not leaving you on this battle alone.
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I think that's a great sentiment, Hazel.
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We're a team and you know, I get ready for the day.
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Almost like, you know, when I ran track in college, you had this preparation time of before the meet.
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And I feel like coming to clinic every day, there's preparation time.
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You know, I'm up at 4 a.m.
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I do my meditation, I do my prayer, I do my journaling of what positive things I want to happen for the practice, for the patients, for research, for our nonprofit, for our students, and I keep a vision board because you have to constantly visualize positive things happening for everyone.
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And I found that my vision board always comes to fruition in some way, shape, or form.
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But that's what happens before clinic.
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And then I kind of review charts.
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I'm here by 7 a.m.
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going through all the charts for our patients.
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And as you know, we have a prayer list in our office for patients who are struggling, whether it's terrible diagnosis of cancer, whether they're struggling with you know, we've even had someone's dog on our prayer list.
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Yes.
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Because that was a big stressor for them.
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And we know that pets and the death of a pet is really devastating for patients.
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So, and science has proven that.
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So I think those are all really important things that we do.
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Yes, job.
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I totally agree to that.
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And can anxiety change how a patient perceives things like blurry vision, eye discomfort, floaters, or visual fluctuations?
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Yes, fluctuation of vision can start making a patient who's battling macular degeneration that their vision is suddenly worse.
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And I always show them, um, you know, I always discuss with them that the images are showing improvement.
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You know, you have less drusen, you're you're showing improvement.
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The geographic atrophy is stable.
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But they're like, but you know what?
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When I by the end of the day, my vision's worse.
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And then we have a discussion, and then we'll often take them over to the oculus and do staining, and you'll see staining on their lower lid, and the family will go, Mom, that's like mud on a windshield.
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And then the whole family's involved, and we have that discussion that that's the fluctuation that they're experiencing.
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And they may be snowbirds, so they fluctuate, say, from Seattle where it's humid, then they come here, and then you dig into it.
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Like, do you sleep under a fan?
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Oh, yes.
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All summer long I had my fan on.
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And I said, Well, would you take a blow dryer and blow dry your eyes?
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Well, that's the effect of that, and that's causing fluctuation.
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So all of a sudden you can see the blood pressure come down and that long sigh, and then we tackle the fluctuation so they're not so stressed out about the macular degeneration because naturally the brain's going, oh no, you're getting worse, you're getting worse.
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And once we address that, they can kind of calm down and feel better about their progress.
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So, would it be fair to say that treating the eye is sometimes only one part of helping the patient?
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It is, you know.
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You have uh nine different subspecialties in ophthalmology.
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You have cornea, you have glaucoma, and that specialization is wonderful because we have all this knowledge base in each specialty.
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But I remember the first year we were open here, somebody sent me an epiretinal membrane in the macula that was way off in the far macula.
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So we knew it wasn't having any impact.
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And the patient came in reading 2020 minus two.
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They were so upset about their overall vision.
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So they would be a 2020 unhappy.
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And I was just so excited to tell them, no, it's not your retina.
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This isn't having any impact on your vision.
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Well, the patient's response was, well, then what is it?
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And you know, our retina response was, that's not our job.
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That's not our role.
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We just do retinas.
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And that was the transformation where I realized that having a 2020 unhappy retina patient that really didn't have a retina problem wasn't what they were wanting from us.
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And that we as ophthalmologists are still ophthalmologists, comprehensive first, and we're subspecialists second.
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So that's when our practice kind of did a shift and started adopting technologies that could answer those questions for patients.
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So we are now a much more broad retina practice, even though we're specialty.
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Some of my colleagues would say we're more boutique because we have cataract measuring tools, we have glaucoma visual fields, we have glaucoma lasers, but we've recognized that the times require a more comprehensive approach to give patients an outlook on their whole vision.
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That brings us to something I think incredibly important that the patient is not just an eye, they're a whole person with emotions, relationships, fears, beliefs, hopes, and responsibilities.
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So with that said, let's talk about faith.
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For many patients, especially when they're facing a serious diagnosis or uncertainty about their vision, faith can become a tremendous source of strength.
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From what you've seen in your career, how can faith help patient navigate through difficult medical situations?
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Well, faith is the belief in the unseen.
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And I think when you're there's an old saying, there are no there are no atheists in foxholes.
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So, you know, vision is a battle.
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We're battling to maintain sight, whereas the disappearance of sight is a great loss for us.
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It's a great loss for our practice, it's a great loss for the patient, and it's great a great loss for the community because patients who improve their vision, stabilize their vision, they're impacting lots of people.
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I'm reminded of Robert McNamara, who had a scourge on his career with the Vietnam War and had a second revitalization when the he became head of the World Bank.
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And one of his first trips was to West Africa, and he observed Uncle Zarchius' patients being led by their family members.
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So the blind leading the blind with a stick.
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And he was just so overcome with that that he recognized that one blind person affected the family in the community.
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So he met with Merck once he realized there was a solution to that, and that solution was ivermectin, and he got Merck to deliver ivermectin at no charge, and that started the program Neglected Tropical Diseases.
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So once we recognize patients with vision loss, they impact the roles that they play in the community.
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And I have two really great stories that we're impacting more than just the patient.
00:22:31.049 --> 00:22:36.650
So faith is the belief in the unseen, and we're happy to share that faith.
00:22:36.730 --> 00:22:40.090
And I think everybody's open to someone saying a prayer for them.
00:22:40.250 --> 00:22:45.850
And I see a lot of amazing miracles in my career that are unexplained by science.
00:22:46.009 --> 00:22:48.970
But I'll give you an example of how it impacts patients.
00:22:49.130 --> 00:22:56.009
We recently did a physician's assistant in cardiology who came in to have his floaters removed.
00:22:56.490 --> 00:23:01.210
And in his recovery, he said, Doc, it's been transformative.
00:23:01.529 --> 00:23:07.130
My daughter was on the soccer field and she turned to look at me like, Dad, I just did a great, great thing.
00:23:07.370 --> 00:23:10.809
And I had never seen that smile on her face before.
00:23:11.049 --> 00:23:15.289
And you just realized how much that impacted him for the first time.
00:23:15.450 --> 00:23:20.090
He'd gone 10 years never seeing his kids give you that look like I did a good one.
00:23:20.250 --> 00:23:25.130
And just how it's changed his family's life, just that little, little incident.
00:23:25.289 --> 00:23:28.809
So he brought his kids in so I could meet them, and that was really fun.
00:23:29.210 --> 00:23:42.090
But, you know, I had a CEO once who was going to sell his company prematurely because it took him six hours to do an hour of emails because of the floaters impacting his ability to recognize that.
00:23:42.570 --> 00:23:49.769
And once we removed the floaters, he was able to continue on and didn't sell his company, and now it's gone on to be a great success.
00:23:50.009 --> 00:23:56.490
So you really get to see how people have an impact, whether it's just in their own family or in their career.
00:23:56.730 --> 00:24:05.930
You know, my career started with taking care of floaters and fixing a police officer who'd been shot, and I was like, whoa, got through it without a detached retina.
00:24:06.090 --> 00:24:11.049
And then I had 20 more patients and then a whole career taking care of people with floaters.
00:24:11.370 --> 00:24:21.610
But, you know, realizing that some people who were near suicide over floaters, working with their primary care doctors and getting them out, went off three or four psych medications.
00:24:21.690 --> 00:24:22.890
That was impactual.
00:24:23.049 --> 00:24:39.450
Taking care of Ebola survivors for the last, you know, for those five years of working on Prevail was really transformative because that was a group of people who had a 90% mortality from that disease, lost nine family members, lost their jobs, lost.
00:24:39.930 --> 00:24:45.690
Social status often lost their homes, but they had such gratitude taking care of them.
00:24:46.009 --> 00:24:54.090
And when we finally completed the cataract surgery on them, it was customary in Liberia to take off your cataract patches altogether.
00:24:54.330 --> 00:25:04.250
And hearing Amazing Grace being generally sung, and even my colleagues who are pretty much non-faith-based people just were overcome with tears.
00:25:04.490 --> 00:25:18.090
And just seeing the transformation of those patients and now they could go um reasonable living and go back to work and and get back to their lives, just how a simple cataract surgery can transform lives.
00:25:18.410 --> 00:25:22.330
We don't really recognize that that's a powerful tool.
00:25:22.730 --> 00:25:27.850
You know, the good Lord said take care of the blind, then the deaf and the lame.
00:25:28.009 --> 00:25:30.090
So the blind had a special place.
00:25:30.410 --> 00:25:38.330
And I think that patients should recognize that there is a spiritual component, and prayer is a good thing, meditation's a good thing.
00:25:38.490 --> 00:25:44.570
Whatever you can do to get yourself into a positive state, I think really helps those cells do the best they can.
00:25:44.809 --> 00:25:45.450
Yes, Doc.
00:25:45.690 --> 00:25:55.690
As you mentioned about Prevail Seven, when you got involved into research and clinical care, patients are obviously looking for results.
00:25:56.250 --> 00:26:01.210
But I imagine they're also looking for something else, hope for the future.
00:26:01.529 --> 00:26:08.170
And with that, we you started the Red Rover Ventures, correct, Doc?
00:26:08.570 --> 00:26:10.970
Yes, back in 2004.
00:26:11.529 --> 00:26:20.650
Because we recognized that healthcare capacity, having enough well-trained doctors was critical to countering the growing number of blind in the world.
00:26:20.890 --> 00:26:27.450
So, you know, our first five years we spent going back and forth to northern Brazil to help develop an operating room.
00:26:27.610 --> 00:26:31.450
That was the year 2004, where the first year of intravitreal injections.
00:26:31.690 --> 00:26:45.049
So we trained two Brazilian ophthalmologists to do intravitrial injections, and we developed an operating room because patients in in Redonia were having to travel six hours to Sao Paulo or other parts of Brazil.
00:26:45.289 --> 00:26:51.690
But it was a real learning experience how to do that and how to do it effectively, and we kept growing it.
00:26:51.930 --> 00:27:06.650
And when we came to the Scotts Hill after working in so many countries over time, we recognized that the private public partnership was a really good thing and that we could advance training by ophthalmic simulation.
00:27:06.730 --> 00:27:17.289
So we came here in 2017 with a dream of developing a simulation center, and we opened that center in 2023 through support of patients that were grateful for their care.
00:27:17.450 --> 00:27:22.330
And we bring the first doctors internationally and the first medical students.
00:27:22.570 --> 00:27:25.450
We've been growing it since 2023.
00:27:25.769 --> 00:27:31.370
And we just got a grant to bring 20 international physicians here for training.
00:27:31.610 --> 00:27:38.009
But unfortunately, there's an executive order pausing international visa applications were at a hold.
00:27:38.330 --> 00:27:44.650
But it's been a great joy to see the international ophthalmologists become leaders of their countries.
00:27:44.809 --> 00:27:50.250
And we've had Rwanda, uh, Tanzania, Uganda, Haiti.
00:27:50.410 --> 00:27:58.650
It's been a collaboration and seeing those physicians starting their careers grow and seeing their expertise increase.
00:27:58.809 --> 00:28:18.330
And the collegial environment, uh, that working with Focus in Chicago, uh, University of Illinois, our colleagues come together, seeing our vendors give us their about-to-expire disposables for the doctors to practice on, seeing our med students get excited about the future of ophthalmology is great fun for me.
00:28:18.490 --> 00:28:21.930
So it's been a great joy, and we continue to pursue those goals.
00:28:22.330 --> 00:28:23.049
Yes, Doc.
00:28:23.130 --> 00:28:35.370
It's not only fulfilling, but it's also life-changing to see those people or those professionals start their career and develop the kind of passion that you also have for patients.
00:28:35.690 --> 00:28:38.090
And that's really what I call exponential impact.
00:28:38.170 --> 00:28:49.690
And that's the goal for me with our patients, getting them well so they can go, whether it's volunteering in the community, whatever they're doing, that's the exponential impact that we can have as ophthalmologists.
00:28:50.009 --> 00:28:50.570
Yes, doc.
00:28:50.730 --> 00:28:52.730
It's like passing the gift forward.
00:28:53.210 --> 00:28:54.650
Yeah, it's seeing it grow.
00:28:54.809 --> 00:28:57.930
And that's that's really what the excitement is for me.
00:28:58.250 --> 00:29:00.570
So thanks for having us today, Hazel.
00:29:00.890 --> 00:29:01.529
Yes, Doc.
00:29:01.610 --> 00:29:02.410
You're very welcome.
00:29:02.570 --> 00:29:07.450
And before we wrap up, do you have any practical advice for patients?
00:29:07.529 --> 00:29:14.809
Like, for example, someone is listening right now who has been diagnosed with an eye condition and is feeling stressed or frightened.
00:29:14.970 --> 00:29:15.930
What would you tell them?
00:29:16.170 --> 00:29:18.490
I'd tell I'd tell them to be persistent.
00:29:18.730 --> 00:29:25.769
You know, there's this story in the Bible about a person named Bartimaeus, and he kept yelling.
00:29:26.090 --> 00:29:29.610
You know, he wanted to meet Jesus, and he was persistent.
00:29:29.850 --> 00:29:37.769
So I think people who are persistent, they're doggedly persistent, get to the truth and get to the best outcome.
00:29:37.930 --> 00:29:40.890
And he was healed for his persistence.
00:29:41.049 --> 00:29:44.090
And I think we have to be persistent in all we do.
00:29:44.170 --> 00:29:47.930
Uh, it has to be our passion and our pursuit of excellence.
00:29:48.090 --> 00:29:50.490
So I tell patients, don't ever give up.
00:29:50.650 --> 00:29:55.049
Keep doggedly doing what you're doing, keep pursuing the best outcome.
00:29:55.210 --> 00:30:00.970
If there's something not going right, be open to finding a better solution.
00:30:01.210 --> 00:30:06.170
Email, call, do whatever you have to to get to the bottom of it.
00:30:06.330 --> 00:30:08.490
The wonderful thing is we now have the internet.
00:30:08.730 --> 00:30:13.210
So you can do research, you can reach out to people, but don't ever give up.
00:30:13.370 --> 00:30:21.049
You know, when I came to Phoenix, we were asked to talk about a meteorologist who committed suicide in Michigan.
00:30:21.210 --> 00:30:28.090
And I had just moved from Michigan, so channel 12 called here, and I didn't want to start my career being associated with that.
00:30:28.410 --> 00:30:30.410
But one of my colleagues, Dr.
00:30:30.730 --> 00:30:35.370
and I went on channel 12 to talk about being relentless about seeking help.
00:30:35.529 --> 00:30:41.130
But if you don't get an answer from the ophthalmologist you're with, you know, reach out to someone else.
00:30:41.289 --> 00:30:45.130
But we never want patients to get so forlorn that they're to that point.
00:30:45.370 --> 00:30:51.289
Reach out to your primary care doctor, you know, send an email, do whatever you have to to get assistance.
00:30:51.370 --> 00:30:56.090
Reach out to the societies who will guide you to the next ophthalmologist.
00:30:56.570 --> 00:30:58.090
So but don't give up.
00:30:58.890 --> 00:30:59.930
Exactly, Doc.
00:31:00.170 --> 00:31:07.850
And what are some healthy ways patients can manage stress while they're going through treatments or a new diagnosis?
00:31:08.170 --> 00:31:13.610
I find breathing, like I have a phobia about going to the dentist, so I learned to box breathe.
00:31:13.690 --> 00:31:23.370
It doesn't take take a lot, but if you watch a video, Google box breathing, you know, we train our Navy SEALs to box breathe during stress and in combat.
00:31:23.529 --> 00:31:30.330
And it's really, you know, holding your breath, breathing out, and all of a sudden you'll see your heart rate and blood pressure drop.
00:31:30.490 --> 00:31:33.450
So if you can learn to box breathing, that's really, really great.
00:31:33.690 --> 00:31:40.490
A squeezy ball, you know, a squeezy ball reduces when patients have come in for their injections.
00:31:40.570 --> 00:31:42.170
You know, we always have music on.
00:31:42.330 --> 00:31:47.049
You know, classical music actually has been shown to reduce stress by about 30%.
00:31:47.370 --> 00:31:51.370
There's anesthesia studies on it, but squeezy ball is another tool.
00:31:51.529 --> 00:31:55.529
When your brain's directed to do something else, you can reduce that stress.
00:31:55.690 --> 00:32:01.210
So squeezing, walking, uh, sitting out early morning, meditating, try to do those things.
00:32:01.450 --> 00:32:05.450
But restricting yourself from social media probably is also important.
00:32:06.170 --> 00:32:09.450
We have this overall media salt of information.
00:32:09.610 --> 00:32:11.930
I think it's more than our brains can really handle.
00:32:12.090 --> 00:32:17.049
So stepping aside from social media, you know, eliminating toxic people.
00:32:17.289 --> 00:32:25.130
I once had a dean who is in multiple toxic groups present with central cirrus, which is associated with stress.
00:32:25.289 --> 00:32:29.210
The natural reaction for stress is to release steroid, cortisol.
00:32:29.529 --> 00:32:34.970
And if you're in that constant stressor, that can have a negative impact on your macula.
00:32:35.130 --> 00:32:40.650
So that stress can attack an RPE cell and a pump and allow fluid to accumulate.
00:32:40.890 --> 00:32:43.289
So that's a very common occurrence.
00:32:43.370 --> 00:32:45.289
So we know stress is a negative.
00:32:45.450 --> 00:32:50.809
So we have two nervous systems, our sympathetic fight or flight, and we have our parasympathetic.
00:32:50.970 --> 00:32:56.410
And recently there's been a lot of data being done on the neuropod, the pulsetto.
00:32:56.490 --> 00:33:07.529
I don't have any financial interest in either, but those are vagus nerve stimulators that help reset the chronic burnout, chronic stress by activating the vagus system.
00:33:07.769 --> 00:33:14.570
So for some people, they're doing that in the morning and in the evening or just in the morning to kind of reduce their stress.
00:33:14.730 --> 00:33:19.930
Hopefully, you're not watching social media while you're doing that, but there are other mechanisms to counter that.
00:33:20.250 --> 00:33:29.130
I think the world is already filled with a lot of stress, or and you add in social media, which adds stress, pressure onto someone.
00:33:29.370 --> 00:33:33.769
So limiting your screen time would also be a good advice to patients.
00:33:34.009 --> 00:33:34.330
Yes.
00:33:34.650 --> 00:33:39.289
And I'd like to finish with a few rapid fire questions, Doc.
00:33:39.769 --> 00:33:43.049
First one, what word best describes vision?
00:33:43.289 --> 00:33:43.769
Critical.
00:33:44.009 --> 00:33:45.529
One word that describes hope.
00:33:45.769 --> 00:33:46.330
Necessary.
00:33:46.570 --> 00:33:50.250
One thing a patient should never be afraid to ask their ophthalmologist.
00:33:50.650 --> 00:33:53.049
Never afraid to ask their ophthalmologist.
00:33:53.529 --> 00:33:54.890
How am I really doing?
00:33:55.210 --> 00:33:58.809
Yes, I think that's one hard question for every patient.
00:33:59.049 --> 00:34:01.370
No, but it has to be an open dialogue.
00:34:01.529 --> 00:34:07.529
You know, we adopted an app Clara that's part of patients' charts so they could text.
00:34:07.690 --> 00:34:11.690
You know, we're all afraid to ask a question or the doctor's too busy.
00:34:11.929 --> 00:34:14.090
But there's always downtime.
00:34:14.329 --> 00:34:20.090
So we adopted the app Clara so people can text in with questions or concerns.
00:34:20.329 --> 00:34:25.210
Some people are shy, which keeps them from getting cataract surgery, so I have to coach them.
00:34:25.369 --> 00:34:32.090
Now you just came in telling me you can't drive or you're driving to dinner at three o'clock because dusk is difficult for you.
00:34:32.329 --> 00:34:33.529
Now, when you go see Dr.
00:34:33.690 --> 00:34:35.849
So-and-so, you have to say the same thing.
00:34:36.009 --> 00:34:37.529
Oh, I'm afraid to tell her.
00:34:37.690 --> 00:34:45.529
No, you have to tell her because that's what Medicare guidelines say for being eligible for cataract surgery.
00:34:45.690 --> 00:34:47.929
You have to articulate your symptoms.
00:34:48.170 --> 00:34:53.690
So we sometimes have to coach those shy patients, but other people uh are very prolific.
00:34:53.929 --> 00:34:54.409
Yes, doc.
00:34:54.570 --> 00:35:06.889
I think it's also because when a patient is confronted with a diagnosis, they get a little too stressed, they don't ask questions, and then when they get home, they start to contemplate and realize things.
00:35:07.049 --> 00:35:08.969
Well, I didn't ask this, I didn't ask that.
00:35:09.130 --> 00:35:13.210
And then that's when they get to realize they needed to ask things.
00:35:13.369 --> 00:35:23.449
So it's nice that you've incorporated Clara with the practice so that patients can somehow reach out to to you or the staff for their questions or clarifications.
00:35:23.690 --> 00:35:25.130
And last question, Doc.
00:35:25.369 --> 00:35:28.730
What does vision is more than just eyesight mean to you?
00:35:28.969 --> 00:35:41.289
That means having a dream, a vision board for the next thing that can help patients, always looking to the future, always being hopeful, always being expectant.
00:35:41.610 --> 00:35:51.130
It's not just reading the eye chart, you know, and a patient says, I'm having this difficulty with my good eye, you're thinking of what ways can we improve that?
00:35:51.289 --> 00:35:59.369
What ways can what and is something coming in the future that might give them hope so they have a target of where they're striving to get to?
00:35:59.610 --> 00:36:02.570
So it's not just their vision's 2020.
00:36:02.730 --> 00:36:11.529
A 2020 person could be could be debilitary to someone who's an artist or an architect that just does fine 2010 letters all day.
00:36:11.929 --> 00:36:17.690
We have to listen, we have to put into consideration what they do, what their goal is, what their passion is.
00:36:17.929 --> 00:36:18.969
Is it artistry?
00:36:19.130 --> 00:36:20.809
Are they having difficulty with the colors?
00:36:20.969 --> 00:36:25.769
I envision um, you know, different artists have had through history.
00:36:25.849 --> 00:36:31.130
There's been art books on vision and and history of art history.
00:36:31.529 --> 00:36:48.250
So there's many artists who have struggled and then had to transform from foil painting to sculpture because it's tactile, but really listening to what the patient's trying to get to, their vision is part our vision, what they want to get to.
00:36:49.530 --> 00:36:56.010
And you add those together of all the patients you see, it's somewhat of a impressionist painting of where we're going.
00:36:56.170 --> 00:37:15.369
And I'll sum that up with right now, we're expecting for macular degeneration patients that will have an oral medication for geographic atrophy, we'll soon have gene therapy for uh wet macular degeneration, we'll have a prima chip for artificial vision as the first goal to give patients formed vision.
00:37:15.610 --> 00:37:26.010
So as I look at my vision board, I recognize that we require directional navigation to get the equipment we need to be ready for that.
00:37:26.170 --> 00:37:31.130
It's not just, okay, it's here now, it's going to take us six months to get ready for it.
00:37:31.369 --> 00:37:34.090
We're already getting ready for what we're expecting to come.
00:37:34.250 --> 00:37:35.530
So that's my vision.
00:37:35.690 --> 00:37:38.570
You know, for example, we're building an in-office operating room.
00:37:38.650 --> 00:37:43.289
We're adding technology that will be ready for those goals when they occur.
00:37:43.610 --> 00:37:44.970
Thank you so much, Doc.
00:37:45.369 --> 00:37:57.130
Thank you so much for joining us, sharing your stories, and today's conversation reminds us that when we're talking about fishing, we're simply not just talking about the eyes, but an entire person.
00:37:57.690 --> 00:38:12.889
We're talking about the fear that someone can feel, along with the diagnosis, the stress that can accompany uncertainty, the importance of support, and the role that faith and hope can play in helping someone move forward.
00:38:13.130 --> 00:38:22.490
Medicine gives us treatments, technology, research, and innovations, but the patient brings something equally important into that journey.
00:38:22.730 --> 00:38:27.929
Their hope, resilience, relationships, and belief in a better tomorrow.
00:38:28.010 --> 00:38:31.610
And perhaps that's why vision is really more than just the eyesight.
00:38:31.929 --> 00:38:35.130
Thank you so much for joining us on IC Podcast today.
00:38:35.289 --> 00:38:41.690
If you enjoyed this conversation, please subscribe and share this episode with someone who might benefit from it.
00:38:41.769 --> 00:38:47.769
And join us for our next conversation about the science, technology, and human stories behind ophthalmology.
00:38:47.929 --> 00:38:52.889
Until next time, keep looking forward and keep seeing beyond what is in front of you.
00:38:53.130 --> 00:38:56.650
We don't just treat eyes, we care for the person behind that vision.
00:38:56.889 --> 00:38:57.610
Thanks, Hazel.
00:38:57.769 --> 00:38:58.250
Thank you, dog.
00:38:58.490 --> 00:38:59.849
We'll see you again next time.
00:02:52.810 --> 00:03:01.849
Vision can be how we experience the world, how we respond to illness, and how we can shape the way we move through difficult moments.
00:03:01.930 --> 00:03:07.129
And today we're going to explore the relationship between vision, stress, hope, and healing.
00:03:07.289 --> 00:03:12.329
And we are very happy to be joined by our wonderful guest for today, Dr.
00:03:12.409 --> 00:03:15.050
Robin Ross of Global Retna Institute.
00:03:15.210 --> 00:03:15.769
And Dr.
00:03:15.930 --> 00:03:24.090
Ross had also been involved with the Prevail 7, giving her a unique perspective on both the clinical and human sides of caring for patients.
00:03:24.329 --> 00:03:24.569
Dr.
00:03:24.650 --> 00:03:26.729
Ross, welcome back to IC Podcast.
00:03:27.129 --> 00:03:27.530
Welcome.
00:03:27.610 --> 00:03:28.490
I'm glad to be here.
00:03:28.569 --> 00:03:30.409
Thank you, Hazel, for hosting us today.
00:03:30.650 --> 00:03:34.969
We're going to talk about some critical things about hope and healing.
00:03:35.129 --> 00:03:44.409
And patients who have a positive attitude and are able to maintain that positive attitude seem to have a better clinical outcome and a better course.
00:03:44.649 --> 00:03:47.610
Negativity tends to lead to poorer outcomes.
00:03:47.769 --> 00:03:55.530
And creating that environment that patients can obtain their best visual acuity and best outcome is our goal at Global Retin Institute.
00:03:55.610 --> 00:03:56.810
So thanks for hosting.
00:03:57.769 --> 00:04:00.810
So let's begin with something very simple, Doc.
00:04:01.050 --> 00:04:06.329
When we say vision is more than just eyesight, what does this actually mean to you?
00:04:06.730 --> 00:04:14.969
You know, you're gonna have two patients, two twin sisters, both living in a different circumstance, that read the eye chart differently.
00:04:15.209 --> 00:04:20.409
You know, they can be 2020 unhappy or 2020, this is awesome vision.
00:04:20.889 --> 00:04:32.409
So we have to quantitate how patients measure their vision, and that's a simple test of visual acuity reading, but that can be done in many different ways.
00:04:32.730 --> 00:04:41.850
Vision also incorporates your color, your contrast, your spatial sense, your depth perception, your peripheral vision.
00:04:42.009 --> 00:04:46.889
So it's really many details encompass how a patient sees the world.
00:04:47.129 --> 00:04:53.370
And distilling those down and tracking them as metrics over time is very critical.
00:04:53.689 --> 00:04:59.769
Patients that say they're C2020 can still be legally blind because they have no peripheral vision.
00:04:59.930 --> 00:05:02.090
It's like looking through a McDonald's straw.
00:05:02.250 --> 00:05:14.090
So how we measure vision is somewhat imperfect, and trying to get that standardized is what ophthalmologists and optometrists try to do so that we have a metric to gauge how patients are doing.
00:05:14.329 --> 00:05:16.810
But listening is also a critical skill.
00:05:16.970 --> 00:05:22.090
When patients tell you they're doing worse, we have to distill that out of them.
00:05:22.250 --> 00:05:33.210
Is it a fluctuant vision because their ocular surface is changing all the time, or is it actually how they see related to a retina function or an optic nerve function?
00:05:33.529 --> 00:05:35.930
I think that's something that patients sometimes forget.
00:05:36.090 --> 00:05:50.090
We tend to measure vision in numbers like 2020, 2040, 2200, but those numbers don't necessarily tell us how a person actually feels about their vision or how that vision affects their life.
00:05:50.409 --> 00:05:56.569
How important is it for physicians to understand a person behind the visual acuity number doc?
00:05:56.889 --> 00:05:58.009
You know, it's very important.
00:05:58.169 --> 00:06:03.689
You know, I had once had a patient who declined who came in with a retinal detachment.
00:06:03.850 --> 00:06:11.370
So she did come in, and we were busy getting finding a surgery time, and she said, I'm not having surgery.
00:06:11.610 --> 00:06:20.730
And it was only later that she gave me the whole story after we said, okay, tell me what's really going on.
00:06:20.889 --> 00:06:34.810
And it turned out her daughter had committed suicide a couple days ago, and she took over the grandchildren, and there was a bigger picture happening behind the scenes that made her decision, I can't do this right now.
00:06:34.970 --> 00:06:42.009
Even though for us, a retinal detachment is a sense of emergency, and we're we're distilling down, is the macula attached?
00:06:42.090 --> 00:06:43.129
Is it not attached?
00:06:43.289 --> 00:06:44.810
How do we get surgery time?
00:06:44.970 --> 00:06:49.129
We're doing the logistics without really hearing the patient's whole story.
00:06:49.289 --> 00:06:56.810
And it's it's when a patient says, no, I'm not having surgery, that all of a sudden you have to do a step back and find out what's really going on.
00:06:56.969 --> 00:07:01.449
They don't come in going, my daughter committed suicide, I took over the kids.
00:07:01.610 --> 00:07:03.610
That's the part you've got to dig into.
00:07:03.930 --> 00:07:05.769
And that takes time today.
00:07:06.009 --> 00:07:19.689
And we're dealing with a broken healthcare system where, you know, literally you have four to five minutes to get all the information, which is why we encourage patients to, in our office, do their portal, give us that information.
00:07:20.009 --> 00:07:23.209
We actually prep charts before a patient's visit.
00:07:23.370 --> 00:07:37.370
So if I can see something where the patient might benefit from another imaging test when they're here and not have to make a second trip, we're we're really looking at that, or if we can gather some more information before the patient comes in.
00:07:37.610 --> 00:07:43.050
And patients who are proactive with their health care, meaning they're contributing, they're giving you this.
00:07:43.290 --> 00:07:50.969
The old school was you came in with a blank slate and a technician went through your past history over 40 minutes.
00:07:51.209 --> 00:08:00.089
That was today, that's really misuse of time because we could have gotten that all and looked at it and be starting with what's your real problem today?
00:08:00.250 --> 00:08:02.170
Let's spend the time digging into it.
00:08:02.329 --> 00:08:06.170
And that's really where I feel healthcare's come to.
00:08:06.329 --> 00:08:12.649
We have to get the information about the patient and get a little feel for them in advance, what's their goal?
00:08:12.889 --> 00:08:20.329
And maybe they didn't even know, you know, blepharitis and Demedex were there, so they didn't make that a goal.
00:08:20.569 --> 00:08:23.129
But today patients really want front to back.
00:08:23.290 --> 00:08:24.649
What do I need to plan for?
00:08:24.730 --> 00:08:30.089
And it doesn't matter whether they don't have insurance, have insurance, they want the best care.
00:08:30.250 --> 00:08:33.049
And we're in a system that doesn't allow that.
00:08:33.210 --> 00:08:39.529
You know, if you're a Medicare patient today, you don't really realize that Medicare allows you to have one test on one day.
00:08:39.690 --> 00:08:41.289
Well, you want to know everything.
00:08:41.450 --> 00:08:44.889
And many times today that requires multimodal imaging.
00:08:45.049 --> 00:09:02.089
But getting a feel for the patient, what their goal is, what they're really putting in their information portal, when they're putting everything as my eyes burn, my eyes hurt, you know, they're not then coming to me to fix their retina, or maybe they are, but they think the two are connected.
00:09:02.569 --> 00:09:12.730
So looking at what the patient's view is and trying to give them a bigger picture often incorporates technology and showing them images.
00:09:12.889 --> 00:09:14.490
Did you know this was an issue?
00:09:14.730 --> 00:09:16.649
No, no one's ever showed me that.
00:09:16.889 --> 00:09:22.889
So, you know, in the world of creative writing, which I'm very fond of, we always are told to show, don't tell.
00:09:23.129 --> 00:09:25.210
No one wants to hear you went to the bus stop.
00:09:25.289 --> 00:09:34.170
They want something more dramatic of, you know, my neighbor Joe and I sold lemonade and we ended up going this way and we ended up at the bus stop.
00:09:34.410 --> 00:09:37.610
They want the story, they don't want the facts.
00:09:37.850 --> 00:09:43.049
So patients want to see what is it that's contributing to my vision symptoms?
00:09:43.370 --> 00:09:45.850
Because only then are we gonna act on it.
00:09:46.009 --> 00:09:57.529
You know, if somebody, if I don't have any feeling of demodex or glepharitis, but someone shows it to me, I don't want little bugs nesting in my eyelashes gonna be really like, what do we do to get rid of this?
00:09:57.690 --> 00:10:00.250
You know, because I don't want a future problem.
00:10:00.490 --> 00:10:11.289
And when they draw the the connection that it could be associated with bacteria that could lead to me having a complication in 15 years from cataract surgery, then I'm probably gonna do something about it.
00:10:11.450 --> 00:10:21.850
But if I don't see it and feel it and don't think it could be related to my problem getting contacts or my problem getting a good pair of glasses, then I'm probably not gonna act on it.
00:10:22.170 --> 00:10:25.690
So I think that having a holistic approach is very important.
00:10:26.170 --> 00:10:31.529
It subsides this fear that my my dad went blind, my grandmother went blind.
00:10:31.769 --> 00:10:35.529
What am I most fearing in life that could happen to my vision?
00:10:35.769 --> 00:10:41.129
A lot of people come in with these preconceived notions, but they don't have a construct for it.
00:10:41.370 --> 00:10:44.170
So when you distill it down, like, do you smoke?
00:10:44.329 --> 00:10:45.129
No, I don't smoke.
00:10:45.210 --> 00:10:46.009
Did your dad smoke?
00:10:46.089 --> 00:10:48.889
Oh, yeah, he smoked 40 packs a day for two years.
00:10:49.049 --> 00:10:54.009
Well, did you know that that has an eightfold increase in wet macular degeneration?
00:10:54.170 --> 00:10:55.450
Well, I'm not a smoker.
00:10:55.610 --> 00:11:01.370
So we start, you know, distilling out why your disease might behave differently than mom or dad's.
00:11:01.450 --> 00:11:08.009
And these are the the measures you're taking to be proactive with that genetic inheritance.
00:11:08.250 --> 00:11:19.289
So I think those things are really important, giving patients a positive view of things they can do that's within their means to make themselves have the best ocular health is really the goal.
00:11:19.450 --> 00:11:27.609
And I think that gives people hope and encouragement and gives them a construct to think differently that they're not going to end up the blind patient.
00:11:27.849 --> 00:11:28.490
Yes, Doc.
00:11:28.569 --> 00:11:35.210
And as you mentioned, Doc, I I really believe that listening is actually a gift that we can give the patients.
00:11:35.289 --> 00:11:43.769
And it it takes time and trust to build that rapport between the doctor and the patient, or even from the staff and the patient as well.
00:11:44.089 --> 00:11:44.730
Yeah.
00:11:45.289 --> 00:11:50.970
You know, we meet every day about our patients and the patients that are having a more difficult time.
00:11:51.130 --> 00:11:53.049
So we're all on the same page.
00:11:53.450 --> 00:12:02.089
And I think that kind of team huddle, whether it's a virtual team huddle or whether it's us meeting before clinic or after clinic, is really, really important.
00:12:02.490 --> 00:12:08.170
And every practice has to develop what they feel is the best way to give holistic care.
00:12:08.329 --> 00:12:10.970
And that's the struggle today in 2026.
00:12:11.849 --> 00:12:12.650
Yes, doc.
00:12:13.210 --> 00:12:16.329
Everything is just, I think, fast-paced nowadays.
00:12:16.490 --> 00:12:18.410
And next question, Doc.
00:12:18.569 --> 00:12:26.730
When someone receives a diagnosis involving their vision, there can be a tremendous amount of fear for many people.
00:12:26.970 --> 00:12:34.650
The thought of losing vision, as you mentioned previously on our earlier podcast, one of the biggest fear of Americans is losing vision.
00:12:34.890 --> 00:12:37.849
It isn't simply about losing the ability to see.
00:12:38.089 --> 00:12:45.210
They're thinking about will I still be able to work, will I still be independent, will I be able to drive or recognize my family?
00:12:45.369 --> 00:12:48.730
How do you approach a patient who is experiencing this kind of fear?
00:12:49.049 --> 00:12:54.089
Well, we try to be factual, show them where they are in terms of their disease.
00:12:54.250 --> 00:12:56.730
Let's take a disease like macular degeneration.
00:12:56.890 --> 00:13:01.690
Some people come in saying, I saw a doctor, he told me I'd be blind in a year.
00:13:01.930 --> 00:13:06.250
And then we look at the images and they may have just drusen in both eyes.
00:13:06.410 --> 00:13:10.890
And so we give them the construct that we have early intermediate advanced.
00:13:10.970 --> 00:13:17.609
Most of the patients that get referred to a retina specialist are either intermediate or advanced, or they may not have anything.
00:13:17.849 --> 00:13:27.210
So then at that point, I show them multiple images that are high resolution on a 60-inch plasma screen and say, you know, I really don't see any Druzen.
00:13:27.369 --> 00:13:36.009
I've been doing this for 40 years, and it's very mild if we have a few Druzen at all, but I don't see this immediately leading to blindness.
00:13:36.410 --> 00:13:39.769
So we really try to put this in factual terms.
00:13:39.930 --> 00:13:45.049
We defined what the definition of legal blindness is and how far they are from it.
00:13:45.210 --> 00:13:53.690
If they do have something viable, like let's say intermediate macular degeneration, we show them that there's no sign of advanced disease.
00:13:53.849 --> 00:13:59.930
Advanced disease could be geographic atrophy for dry, or it could be wet.
00:14:00.089 --> 00:14:02.650
All wet is considered advanced disease.
00:14:02.809 --> 00:14:06.809
But many of our patients with wet also have geographic atrophy.
00:14:06.970 --> 00:14:20.329
And I think giving patients current research that's very viable, for example, you know, Belete Bio has a product that will go to commercialization next year for geographic atrophy based on two studies.
00:14:20.410 --> 00:14:30.970
You know, the Dragon study was for Stargardt's disease, which is juvenile macular degeneration, and the age-related macular degeneration with geographic atrophy is the phoenix disease.
00:14:31.210 --> 00:14:47.289
So the fact that geographic atrophy for Stargardt's was FD approved for tin Laribant, and it will go to commercialization next year, gives our macular degenerations patients great hope, especially those that were really fearful of the cypher eyes or vague complement inhibitor injections.
00:14:47.529 --> 00:14:56.650
So we talk about things that are coming that are new, that are novel, because we've never had a neuration for macular degeneration.
00:14:56.890 --> 00:15:02.890
So I feel like always having the arsenal of hope is so critical in taking care of eye disease.
00:15:02.970 --> 00:15:08.569
And it doesn't matter what disease it is, but also finding out how they're managing stress.
00:15:08.809 --> 00:15:20.890
For example, something like stress for any reason can cause your blood pressure to skyrocket, and blood pressure has a deleterious impact on macular degeneration, diabetes, other conditions.
00:15:21.130 --> 00:15:22.970
So stress is a big negative.
00:15:23.130 --> 00:15:25.289
So how patients are managing it.
00:15:25.450 --> 00:15:26.809
Are they doing exercise?
00:15:26.970 --> 00:15:28.009
Are they meditating?
00:15:28.170 --> 00:15:29.849
Are they going to church?
00:15:30.009 --> 00:15:31.210
Are they praying every day?
00:15:31.369 --> 00:15:39.849
Whatever they're doing, that has to be encouraged because having that positive mindset is the foundation for all cells in the body.
00:15:39.930 --> 00:15:41.690
So I think that's really, really important.
00:15:42.490 --> 00:15:43.049
Yes, Doc.
00:15:43.289 --> 00:15:54.089
And it takes a lot of listening on the provider side to pour in that fashion, to educate the patient and just let them know that we're going through this together.
00:15:54.250 --> 00:15:56.490
I'm not leaving you on this battle alone.
00:15:56.809 --> 00:16:00.329
I think that's a great sentiment, Hazel.
00:16:00.490 --> 00:16:03.289
We're a team and you know, I get ready for the day.
00:16:03.450 --> 00:16:09.769
Almost like, you know, when I ran track in college, you had this preparation time of before the meet.
00:16:09.930 --> 00:16:13.289
And I feel like coming to clinic every day, there's preparation time.
00:16:13.369 --> 00:16:14.730
You know, I'm up at 4 a.m.
00:16:15.130 --> 00:16:34.250
I do my meditation, I do my prayer, I do my journaling of what positive things I want to happen for the practice, for the patients, for research, for our nonprofit, for our students, and I keep a vision board because you have to constantly visualize positive things happening for everyone.
00:16:34.410 --> 00:16:39.690
And I found that my vision board always comes to fruition in some way, shape, or form.
00:16:39.849 --> 00:16:41.930
But that's what happens before clinic.
00:16:42.009 --> 00:16:43.609
And then I kind of review charts.
00:16:43.690 --> 00:16:44.809
I'm here by 7 a.m.
00:16:45.049 --> 00:16:46.809
going through all the charts for our patients.
00:16:46.970 --> 00:16:58.970
And as you know, we have a prayer list in our office for patients who are struggling, whether it's terrible diagnosis of cancer, whether they're struggling with you know, we've even had someone's dog on our prayer list.
00:16:59.049 --> 00:16:59.289
Yes.
00:16:59.529 --> 00:17:01.369
Because that was a big stressor for them.
00:17:01.529 --> 00:17:06.490
And we know that pets and the death of a pet is really devastating for patients.
00:17:06.730 --> 00:17:08.890
So, and science has proven that.
00:17:09.049 --> 00:17:11.769
So I think those are all really important things that we do.
00:17:12.089 --> 00:17:12.809
Yes, job.
00:17:12.970 --> 00:17:14.250
I totally agree to that.
00:17:14.569 --> 00:17:23.130
And can anxiety change how a patient perceives things like blurry vision, eye discomfort, floaters, or visual fluctuations?
00:17:23.690 --> 00:17:31.130
Yes, fluctuation of vision can start making a patient who's battling macular degeneration that their vision is suddenly worse.
00:17:31.369 --> 00:17:37.609
And I always show them, um, you know, I always discuss with them that the images are showing improvement.
00:17:37.690 --> 00:17:40.970
You know, you have less drusen, you're you're showing improvement.
00:17:41.289 --> 00:17:43.690
The geographic atrophy is stable.
00:17:43.849 --> 00:17:45.289
But they're like, but you know what?
00:17:45.690 --> 00:17:48.490
When I by the end of the day, my vision's worse.
00:17:48.730 --> 00:17:58.970
And then we have a discussion, and then we'll often take them over to the oculus and do staining, and you'll see staining on their lower lid, and the family will go, Mom, that's like mud on a windshield.
00:17:59.130 --> 00:18:05.049
And then the whole family's involved, and we have that discussion that that's the fluctuation that they're experiencing.
00:18:05.210 --> 00:18:12.569
And they may be snowbirds, so they fluctuate, say, from Seattle where it's humid, then they come here, and then you dig into it.
00:18:12.650 --> 00:18:14.170
Like, do you sleep under a fan?
00:18:14.329 --> 00:18:14.970
Oh, yes.
00:18:15.210 --> 00:18:17.130
All summer long I had my fan on.
00:18:17.210 --> 00:18:20.250
And I said, Well, would you take a blow dryer and blow dry your eyes?
00:18:20.410 --> 00:18:23.210
Well, that's the effect of that, and that's causing fluctuation.
00:18:23.369 --> 00:18:37.930
So all of a sudden you can see the blood pressure come down and that long sigh, and then we tackle the fluctuation so they're not so stressed out about the macular degeneration because naturally the brain's going, oh no, you're getting worse, you're getting worse.
00:18:38.089 --> 00:18:43.690
And once we address that, they can kind of calm down and feel better about their progress.
00:18:44.009 --> 00:18:50.490
So, would it be fair to say that treating the eye is sometimes only one part of helping the patient?
00:18:50.730 --> 00:18:51.690
It is, you know.
00:18:51.930 --> 00:18:55.849
You have uh nine different subspecialties in ophthalmology.
00:18:55.930 --> 00:19:04.329
You have cornea, you have glaucoma, and that specialization is wonderful because we have all this knowledge base in each specialty.
00:19:04.650 --> 00:19:13.930
But I remember the first year we were open here, somebody sent me an epiretinal membrane in the macula that was way off in the far macula.
00:19:14.009 --> 00:19:15.930
So we knew it wasn't having any impact.
00:19:16.089 --> 00:19:19.450
And the patient came in reading 2020 minus two.
00:19:20.170 --> 00:19:22.650
They were so upset about their overall vision.
00:19:22.730 --> 00:19:25.049
So they would be a 2020 unhappy.
00:19:25.289 --> 00:19:28.970
And I was just so excited to tell them, no, it's not your retina.
00:19:29.210 --> 00:19:31.690
This isn't having any impact on your vision.
00:19:31.930 --> 00:19:35.210
Well, the patient's response was, well, then what is it?
00:19:35.369 --> 00:19:38.410
And you know, our retina response was, that's not our job.
00:19:38.569 --> 00:19:39.450
That's not our role.
00:19:39.529 --> 00:19:40.650
We just do retinas.
00:19:41.049 --> 00:19:51.610
And that was the transformation where I realized that having a 2020 unhappy retina patient that really didn't have a retina problem wasn't what they were wanting from us.
00:19:51.769 --> 00:19:58.730
And that we as ophthalmologists are still ophthalmologists, comprehensive first, and we're subspecialists second.
00:19:58.970 --> 00:20:07.130
So that's when our practice kind of did a shift and started adopting technologies that could answer those questions for patients.
00:20:07.529 --> 00:20:13.370
So we are now a much more broad retina practice, even though we're specialty.
00:20:13.529 --> 00:20:30.410
Some of my colleagues would say we're more boutique because we have cataract measuring tools, we have glaucoma visual fields, we have glaucoma lasers, but we've recognized that the times require a more comprehensive approach to give patients an outlook on their whole vision.
00:20:30.809 --> 00:20:44.410
That brings us to something I think incredibly important that the patient is not just an eye, they're a whole person with emotions, relationships, fears, beliefs, hopes, and responsibilities.
00:20:44.730 --> 00:20:47.690
So with that said, let's talk about faith.
00:20:48.009 --> 00:20:58.090
For many patients, especially when they're facing a serious diagnosis or uncertainty about their vision, faith can become a tremendous source of strength.
00:20:58.650 --> 00:21:05.850
From what you've seen in your career, how can faith help patient navigate through difficult medical situations?
00:21:06.170 --> 00:21:08.009
Well, faith is the belief in the unseen.
00:21:08.330 --> 00:21:14.410
And I think when you're there's an old saying, there are no there are no atheists in foxholes.
00:21:15.210 --> 00:21:17.690
So, you know, vision is a battle.
00:21:17.850 --> 00:21:24.250
We're battling to maintain sight, whereas the disappearance of sight is a great loss for us.
00:21:24.490 --> 00:21:36.330
It's a great loss for our practice, it's a great loss for the patient, and it's great a great loss for the community because patients who improve their vision, stabilize their vision, they're impacting lots of people.
00:21:36.490 --> 00:21:48.730
I'm reminded of Robert McNamara, who had a scourge on his career with the Vietnam War and had a second revitalization when the he became head of the World Bank.
00:21:48.890 --> 00:21:56.250
And one of his first trips was to West Africa, and he observed Uncle Zarchius' patients being led by their family members.
00:21:56.410 --> 00:21:58.970
So the blind leading the blind with a stick.
00:21:59.130 --> 00:22:06.490
And he was just so overcome with that that he recognized that one blind person affected the family in the community.
00:22:06.730 --> 00:22:20.009
So he met with Merck once he realized there was a solution to that, and that solution was ivermectin, and he got Merck to deliver ivermectin at no charge, and that started the program Neglected Tropical Diseases.
00:22:20.170 --> 00:22:25.769
So once we recognize patients with vision loss, they impact the roles that they play in the community.
00:22:25.850 --> 00:22:30.890
And I have two really great stories that we're impacting more than just the patient.
00:22:31.049 --> 00:22:36.650
So faith is the belief in the unseen, and we're happy to share that faith.
00:22:36.730 --> 00:22:40.090
And I think everybody's open to someone saying a prayer for them.
00:22:40.250 --> 00:22:45.850
And I see a lot of amazing miracles in my career that are unexplained by science.
00:22:46.009 --> 00:22:48.970
But I'll give you an example of how it impacts patients.
00:22:49.130 --> 00:22:56.009
We recently did a physician's assistant in cardiology who came in to have his floaters removed.
00:22:56.490 --> 00:23:01.210
And in his recovery, he said, Doc, it's been transformative.
00:23:01.529 --> 00:23:07.130
My daughter was on the soccer field and she turned to look at me like, Dad, I just did a great, great thing.
00:23:07.370 --> 00:23:10.809
And I had never seen that smile on her face before.
00:23:11.049 --> 00:23:15.289
And you just realized how much that impacted him for the first time.
00:23:15.450 --> 00:23:20.090
He'd gone 10 years never seeing his kids give you that look like I did a good one.
00:23:20.250 --> 00:23:25.130
And just how it's changed his family's life, just that little, little incident.
00:23:25.289 --> 00:23:28.809
So he brought his kids in so I could meet them, and that was really fun.
00:23:29.210 --> 00:23:42.090
But, you know, I had a CEO once who was going to sell his company prematurely because it took him six hours to do an hour of emails because of the floaters impacting his ability to recognize that.
00:23:42.570 --> 00:23:49.769
And once we removed the floaters, he was able to continue on and didn't sell his company, and now it's gone on to be a great success.
00:23:50.009 --> 00:23:56.490
So you really get to see how people have an impact, whether it's just in their own family or in their career.
00:23:56.730 --> 00:24:05.930
You know, my career started with taking care of floaters and fixing a police officer who'd been shot, and I was like, whoa, got through it without a detached retina.
00:24:06.090 --> 00:24:11.049
And then I had 20 more patients and then a whole career taking care of people with floaters.
00:24:11.370 --> 00:24:21.610
But, you know, realizing that some people who were near suicide over floaters, working with their primary care doctors and getting them out, went off three or four psych medications.
00:24:21.690 --> 00:24:22.890
That was impactual.
00:24:23.049 --> 00:24:39.450
Taking care of Ebola survivors for the last, you know, for those five years of working on Prevail was really transformative because that was a group of people who had a 90% mortality from that disease, lost nine family members, lost their jobs, lost.
00:24:39.930 --> 00:24:45.690
Social status often lost their homes, but they had such gratitude taking care of them.
00:24:46.009 --> 00:24:54.090
And when we finally completed the cataract surgery on them, it was customary in Liberia to take off your cataract patches altogether.
00:24:54.330 --> 00:25:04.250
And hearing Amazing Grace being generally sung, and even my colleagues who are pretty much non-faith-based people just were overcome with tears.
00:25:04.490 --> 00:25:18.090
And just seeing the transformation of those patients and now they could go um reasonable living and go back to work and and get back to their lives, just how a simple cataract surgery can transform lives.
00:25:18.410 --> 00:25:22.330
We don't really recognize that that's a powerful tool.
00:25:22.730 --> 00:25:27.850
You know, the good Lord said take care of the blind, then the deaf and the lame.
00:25:28.009 --> 00:25:30.090
So the blind had a special place.
00:25:30.410 --> 00:25:38.330
And I think that patients should recognize that there is a spiritual component, and prayer is a good thing, meditation's a good thing.
00:25:38.490 --> 00:25:44.570
Whatever you can do to get yourself into a positive state, I think really helps those cells do the best they can.
00:25:44.809 --> 00:25:45.450
Yes, Doc.
00:25:45.690 --> 00:25:55.690
As you mentioned about Prevail Seven, when you got involved into research and clinical care, patients are obviously looking for results.
00:25:56.250 --> 00:26:01.210
But I imagine they're also looking for something else, hope for the future.
00:26:01.529 --> 00:26:08.170
And with that, we you started the Red Rover Ventures, correct, Doc?
00:26:08.570 --> 00:26:10.970
Yes, back in 2004.
00:26:11.529 --> 00:26:20.650
Because we recognized that healthcare capacity, having enough well-trained doctors was critical to countering the growing number of blind in the world.
00:26:20.890 --> 00:26:27.450
So, you know, our first five years we spent going back and forth to northern Brazil to help develop an operating room.
00:26:27.610 --> 00:26:31.450
That was the year 2004, where the first year of intravitreal injections.
00:26:31.690 --> 00:26:45.049
So we trained two Brazilian ophthalmologists to do intravitrial injections, and we developed an operating room because patients in in Redonia were having to travel six hours to Sao Paulo or other parts of Brazil.
00:26:45.289 --> 00:26:51.690
But it was a real learning experience how to do that and how to do it effectively, and we kept growing it.
00:26:51.930 --> 00:27:06.650
And when we came to the Scotts Hill after working in so many countries over time, we recognized that the private public partnership was a really good thing and that we could advance training by ophthalmic simulation.
00:27:06.730 --> 00:27:17.289
So we came here in 2017 with a dream of developing a simulation center, and we opened that center in 2023 through support of patients that were grateful for their care.
00:27:17.450 --> 00:27:22.330
And we bring the first doctors internationally and the first medical students.
00:27:22.570 --> 00:27:25.450
We've been growing it since 2023.
00:27:25.769 --> 00:27:31.370
And we just got a grant to bring 20 international physicians here for training.
00:27:31.610 --> 00:27:38.009
But unfortunately, there's an executive order pausing international visa applications were at a hold.
00:27:38.330 --> 00:27:44.650
But it's been a great joy to see the international ophthalmologists become leaders of their countries.
00:27:44.809 --> 00:27:50.250
And we've had Rwanda, uh, Tanzania, Uganda, Haiti.
00:27:50.410 --> 00:27:58.650
It's been a collaboration and seeing those physicians starting their careers grow and seeing their expertise increase.
00:27:58.809 --> 00:28:18.330
And the collegial environment, uh, that working with Focus in Chicago, uh, University of Illinois, our colleagues come together, seeing our vendors give us their about-to-expire disposables for the doctors to practice on, seeing our med students get excited about the future of ophthalmology is great fun for me.
00:28:18.490 --> 00:28:21.930
So it's been a great joy, and we continue to pursue those goals.
00:28:22.330 --> 00:28:23.049
Yes, Doc.
00:28:23.130 --> 00:28:35.370
It's not only fulfilling, but it's also life-changing to see those people or those professionals start their career and develop the kind of passion that you also have for patients.
00:28:35.690 --> 00:28:38.090
And that's really what I call exponential impact.
00:28:38.170 --> 00:28:49.690
And that's the goal for me with our patients, getting them well so they can go, whether it's volunteering in the community, whatever they're doing, that's the exponential impact that we can have as ophthalmologists.
00:28:50.009 --> 00:28:50.570
Yes, doc.
00:28:50.730 --> 00:28:52.730
It's like passing the gift forward.
00:28:53.210 --> 00:28:54.650
Yeah, it's seeing it grow.
00:28:54.809 --> 00:28:57.930
And that's that's really what the excitement is for me.
00:28:58.250 --> 00:29:00.570
So thanks for having us today, Hazel.
00:29:00.890 --> 00:29:01.529
Yes, Doc.
00:29:01.610 --> 00:29:02.410
You're very welcome.
00:29:02.570 --> 00:29:07.450
And before we wrap up, do you have any practical advice for patients?
00:29:07.529 --> 00:29:14.809
Like, for example, someone is listening right now who has been diagnosed with an eye condition and is feeling stressed or frightened.
00:29:14.970 --> 00:29:15.930
What would you tell them?
00:29:16.170 --> 00:29:18.490
I'd tell I'd tell them to be persistent.
00:29:18.730 --> 00:29:25.769
You know, there's this story in the Bible about a person named Bartimaeus, and he kept yelling.
00:29:26.090 --> 00:29:29.610
You know, he wanted to meet Jesus, and he was persistent.
00:29:29.850 --> 00:29:37.769
So I think people who are persistent, they're doggedly persistent, get to the truth and get to the best outcome.
00:29:37.930 --> 00:29:40.890
And he was healed for his persistence.
00:29:41.049 --> 00:29:44.090
And I think we have to be persistent in all we do.
00:29:44.170 --> 00:29:47.930
Uh, it has to be our passion and our pursuit of excellence.
00:29:48.090 --> 00:29:50.490
So I tell patients, don't ever give up.
00:29:50.650 --> 00:29:55.049
Keep doggedly doing what you're doing, keep pursuing the best outcome.
00:29:55.210 --> 00:30:00.970
If there's something not going right, be open to finding a better solution.
00:30:01.210 --> 00:30:06.170
Email, call, do whatever you have to to get to the bottom of it.
00:30:06.330 --> 00:30:08.490
The wonderful thing is we now have the internet.
00:30:08.730 --> 00:30:13.210
So you can do research, you can reach out to people, but don't ever give up.
00:30:13.370 --> 00:30:21.049
You know, when I came to Phoenix, we were asked to talk about a meteorologist who committed suicide in Michigan.
00:30:21.210 --> 00:30:28.090
And I had just moved from Michigan, so channel 12 called here, and I didn't want to start my career being associated with that.
00:30:28.410 --> 00:30:30.410
But one of my colleagues, Dr.
00:30:30.730 --> 00:30:35.370
and I went on channel 12 to talk about being relentless about seeking help.
00:30:35.529 --> 00:30:41.130
But if you don't get an answer from the ophthalmologist you're with, you know, reach out to someone else.
00:30:41.289 --> 00:30:45.130
But we never want patients to get so forlorn that they're to that point.
00:30:45.370 --> 00:30:51.289
Reach out to your primary care doctor, you know, send an email, do whatever you have to to get assistance.
00:30:51.370 --> 00:30:56.090
Reach out to the societies who will guide you to the next ophthalmologist.
00:30:56.570 --> 00:30:58.090
So but don't give up.
00:30:58.890 --> 00:30:59.930
Exactly, Doc.
00:31:00.170 --> 00:31:07.850
And what are some healthy ways patients can manage stress while they're going through treatments or a new diagnosis?
00:31:08.170 --> 00:31:13.610
I find breathing, like I have a phobia about going to the dentist, so I learned to box breathe.
00:31:13.690 --> 00:31:23.370
It doesn't take take a lot, but if you watch a video, Google box breathing, you know, we train our Navy SEALs to box breathe during stress and in combat.
00:31:23.529 --> 00:31:30.330
And it's really, you know, holding your breath, breathing out, and all of a sudden you'll see your heart rate and blood pressure drop.
00:31:30.490 --> 00:31:33.450
So if you can learn to box breathing, that's really, really great.
00:31:33.690 --> 00:31:40.490
A squeezy ball, you know, a squeezy ball reduces when patients have come in for their injections.
00:31:40.570 --> 00:31:42.170
You know, we always have music on.
00:31:42.330 --> 00:31:47.049
You know, classical music actually has been shown to reduce stress by about 30%.
00:31:47.370 --> 00:31:51.370
There's anesthesia studies on it, but squeezy ball is another tool.
00:31:51.529 --> 00:31:55.529
When your brain's directed to do something else, you can reduce that stress.
00:31:55.690 --> 00:32:01.210
So squeezing, walking, uh, sitting out early morning, meditating, try to do those things.
00:32:01.450 --> 00:32:05.450
But restricting yourself from social media probably is also important.
00:32:06.170 --> 00:32:09.450
We have this overall media salt of information.
00:32:09.610 --> 00:32:11.930
I think it's more than our brains can really handle.
00:32:12.090 --> 00:32:17.049
So stepping aside from social media, you know, eliminating toxic people.
00:32:17.289 --> 00:32:25.130
I once had a dean who is in multiple toxic groups present with central cirrus, which is associated with stress.
00:32:25.289 --> 00:32:29.210
The natural reaction for stress is to release steroid, cortisol.
00:32:29.529 --> 00:32:34.970
And if you're in that constant stressor, that can have a negative impact on your macula.
00:32:35.130 --> 00:32:40.650
So that stress can attack an RPE cell and a pump and allow fluid to accumulate.
00:32:40.890 --> 00:32:43.289
So that's a very common occurrence.
00:32:43.370 --> 00:32:45.289
So we know stress is a negative.
00:32:45.450 --> 00:32:50.809
So we have two nervous systems, our sympathetic fight or flight, and we have our parasympathetic.
00:32:50.970 --> 00:32:56.410
And recently there's been a lot of data being done on the neuropod, the pulsetto.
00:32:56.490 --> 00:33:07.529
I don't have any financial interest in either, but those are vagus nerve stimulators that help reset the chronic burnout, chronic stress by activating the vagus system.
00:33:07.769 --> 00:33:14.570
So for some people, they're doing that in the morning and in the evening or just in the morning to kind of reduce their stress.
00:33:14.730 --> 00:33:19.930
Hopefully, you're not watching social media while you're doing that, but there are other mechanisms to counter that.
00:33:20.250 --> 00:33:29.130
I think the world is already filled with a lot of stress, or and you add in social media, which adds stress, pressure onto someone.
00:33:29.370 --> 00:33:33.769
So limiting your screen time would also be a good advice to patients.
00:33:34.009 --> 00:33:34.330
Yes.
00:33:34.650 --> 00:33:39.289
And I'd like to finish with a few rapid fire questions, Doc.
00:33:39.769 --> 00:33:43.049
First one, what word best describes vision?
00:33:43.289 --> 00:33:43.769
Critical.
00:33:44.009 --> 00:33:45.529
One word that describes hope.
00:33:45.769 --> 00:33:46.330
Necessary.
00:33:46.570 --> 00:33:50.250
One thing a patient should never be afraid to ask their ophthalmologist.
00:33:50.650 --> 00:33:53.049
Never afraid to ask their ophthalmologist.
00:33:53.529 --> 00:33:54.890
How am I really doing?
00:33:55.210 --> 00:33:58.809
Yes, I think that's one hard question for every patient.
00:33:59.049 --> 00:34:01.370
No, but it has to be an open dialogue.
00:34:01.529 --> 00:34:07.529
You know, we adopted an app Clara that's part of patients' charts so they could text.
00:34:07.690 --> 00:34:11.690
You know, we're all afraid to ask a question or the doctor's too busy.
00:34:11.929 --> 00:34:14.090
But there's always downtime.
00:34:14.329 --> 00:34:20.090
So we adopted the app Clara so people can text in with questions or concerns.
00:34:20.329 --> 00:34:25.210
Some people are shy, which keeps them from getting cataract surgery, so I have to coach them.
00:34:25.369 --> 00:34:32.090
Now you just came in telling me you can't drive or you're driving to dinner at three o'clock because dusk is difficult for you.
00:34:32.329 --> 00:34:33.529
Now, when you go see Dr.
00:34:33.690 --> 00:34:35.849
So-and-so, you have to say the same thing.
00:34:36.009 --> 00:34:37.529
Oh, I'm afraid to tell her.
00:34:37.690 --> 00:34:45.529
No, you have to tell her because that's what Medicare guidelines say for being eligible for cataract surgery.
00:34:45.690 --> 00:34:47.929
You have to articulate your symptoms.
00:34:48.170 --> 00:34:53.690
So we sometimes have to coach those shy patients, but other people uh are very prolific.
00:34:53.929 --> 00:34:54.409
Yes, doc.
00:34:54.570 --> 00:35:06.889
I think it's also because when a patient is confronted with a diagnosis, they get a little too stressed, they don't ask questions, and then when they get home, they start to contemplate and realize things.
00:35:07.049 --> 00:35:08.969
Well, I didn't ask this, I didn't ask that.
00:35:09.130 --> 00:35:13.210
And then that's when they get to realize they needed to ask things.
00:35:13.369 --> 00:35:23.449
So it's nice that you've incorporated Clara with the practice so that patients can somehow reach out to to you or the staff for their questions or clarifications.
00:35:23.690 --> 00:35:25.130
And last question, Doc.
00:35:25.369 --> 00:35:28.730
What does vision is more than just eyesight mean to you?
00:35:28.969 --> 00:35:41.289
That means having a dream, a vision board for the next thing that can help patients, always looking to the future, always being hopeful, always being expectant.
00:35:41.610 --> 00:35:51.130
It's not just reading the eye chart, you know, and a patient says, I'm having this difficulty with my good eye, you're thinking of what ways can we improve that?
00:35:51.289 --> 00:35:59.369
What ways can what and is something coming in the future that might give them hope so they have a target of where they're striving to get to?
00:35:59.610 --> 00:36:02.570
So it's not just their vision's 2020.
00:36:02.730 --> 00:36:11.529
A 2020 person could be could be debilitary to someone who's an artist or an architect that just does fine 2010 letters all day.
00:36:11.929 --> 00:36:17.690
We have to listen, we have to put into consideration what they do, what their goal is, what their passion is.
00:36:17.929 --> 00:36:18.969
Is it artistry?
00:36:19.130 --> 00:36:20.809
Are they having difficulty with the colors?
00:36:20.969 --> 00:36:25.769
I envision um, you know, different artists have had through history.
00:36:25.849 --> 00:36:31.130
There's been art books on vision and and history of art history.
00:36:31.529 --> 00:36:48.250
So there's many artists who have struggled and then had to transform from foil painting to sculpture because it's tactile, but really listening to what the patient's trying to get to, their vision is part our vision, what they want to get to.
00:36:49.530 --> 00:36:56.010
And you add those together of all the patients you see, it's somewhat of a impressionist painting of where we're going.
00:36:56.170 --> 00:37:15.369
And I'll sum that up with right now, we're expecting for macular degeneration patients that will have an oral medication for geographic atrophy, we'll soon have gene therapy for uh wet macular degeneration, we'll have a prima chip for artificial vision as the first goal to give patients formed vision.
00:37:15.610 --> 00:37:26.010
So as I look at my vision board, I recognize that we require directional navigation to get the equipment we need to be ready for that.
00:37:26.170 --> 00:37:31.130
It's not just, okay, it's here now, it's going to take us six months to get ready for it.
00:37:31.369 --> 00:37:34.090
We're already getting ready for what we're expecting to come.
00:37:34.250 --> 00:37:35.530
So that's my vision.
00:37:35.690 --> 00:37:38.570
You know, for example, we're building an in-office operating room.
00:37:38.650 --> 00:37:43.289
We're adding technology that will be ready for those goals when they occur.
00:37:43.610 --> 00:37:44.970
Thank you so much, Doc.
00:37:45.369 --> 00:37:57.130
Thank you so much for joining us, sharing your stories, and today's conversation reminds us that when we're talking about fishing, we're simply not just talking about the eyes, but an entire person.
00:37:57.690 --> 00:38:12.889
We're talking about the fear that someone can feel, along with the diagnosis, the stress that can accompany uncertainty, the importance of support, and the role that faith and hope can play in helping someone move forward.
00:38:13.130 --> 00:38:22.490
Medicine gives us treatments, technology, research, and innovations, but the patient brings something equally important into that journey.
00:38:22.730 --> 00:38:27.929
Their hope, resilience, relationships, and belief in a better tomorrow.
00:38:28.010 --> 00:38:31.610
And perhaps that's why vision is really more than just the eyesight.
00:38:31.929 --> 00:38:35.130
Thank you so much for joining us on IC Podcast today.
00:38:35.289 --> 00:38:41.690
If you enjoyed this conversation, please subscribe and share this episode with someone who might benefit from it.
00:38:41.769 --> 00:38:47.769
And join us for our next conversation about the science, technology, and human stories behind ophthalmology.
00:38:47.929 --> 00:38:52.889
Until next time, keep looking forward and keep seeing beyond what is in front of you.
00:38:53.130 --> 00:38:56.650
We don't just treat eyes, we care for the person behind that vision.
00:38:56.889 --> 00:38:57.610
Thanks, Hazel.
00:38:57.769 --> 00:38:58.250
Thank you, dog.
00:38:58.490 --> 00:38:59.849
We'll see you again next time.
