Épisodes

  • Post-op Drop Madness
    Apr 20 2022

    Join White as he discusses the burden cataract post-operative regimens place on both patients and staff, and ways to “stop the madness.” He also gives a history of cataract post-op and the breakthroughs that led to today’s most common regimens.

    • Disclaimer :09
    • Intro :24
    • Let’s talk about post-op drop regimens for cataract surgery :35
    • Financial disclosures :53
    • Asking specialists from around the country two important questions 1:40
    • Question 1: ”What is your definition of health?” 3:05
    • The “best” answer 3:47
    • Question 2: ”What is your perioperative cataract surgery drop regimen?” 4:12
    • The most common regimens 5:18
    • The rise in publications about using antibiotics inside the eye 9:23
    • “Revolutionaries” who stopped using steroids post-op to reduce patient drop burden 10:19
    • One drop of topical NSAID a day vs. steroids post-op 12:23
    • White’s study: moxifloxacin vs. moxifloxacin and dexamethasone 14:27
    • How can we get to a “dropless” situation? 17:40
    • Why are patients continuing with topical antibiotics when they’re also using intracameral antibiotic injections? 20:16
    • There should be fewer eye drops and medications in eye drops surrounding cataract surgery 22:05
    • “Stop the madness” - Reducing the post-op medication burden on both patients and staff 24:58
    • Outro 25:43

    We’d love to hear from you! Send your comments/questions to Dr. White at ophthalmology@healio.com. Follow us on Twitter @Healio_OSN and @DarrellWhite.

    Disclosures: White reports no relevant financial disclosures.

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    26 min
  • Unnecessary Care?
    Mar 2 2022

    What is unnecessary care? What does it look like in the real-world? Join White as he defines “medically unnecessary care” and shares a personal story.

    • Disclaimer :09
    • Intro :24
    • Today we’ll talk about unnecessary care :38
    • Financial disclosures :52
    • Defining unnecessary care, or medically unnecessary care 1:05
    • Unnecessary care in the real-world setting 2:24
    • A case of “unnecessary care” 6:50
    • Thanks for listening 19:40

    We’d love to hear from you! Send your comments/questions to Dr. White at ophthalmology@healio.com. Follow us on Twitter @Healio_OSN @DarrellWhite

    Disclosures: White reports no relevant financial disclosures.

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    20 min
  • Folly of FLACS
    Nov 13 2020

    Join White as he discusses the history of cataract surgery and where femtosecond laser-assisted cataract surgery, or FLACS, fits in. He also explains what he believes to be follies of FLACS and why some people continue to use this procedure.

    • Disclaimer :09
    • Intro :24
    • Today we’ll talk about femtosecond laser-assisted cataract surgery, or FLACS :36
    • Financial disclosures :57
    • The history of cataract surgery and where FLACS fits in 1:21
    • The lens supplies about 1/3 of the focusing ability of the human eye 3:35
    • Scheie Eye Institute 5:42
    • The discovery of poly(methyl methacrylate) 6:14
    • Extracapsular cataract extraction 7:14
    • Cataract surgery moves almost entirely to posterior chamber 7:44
    • The YAG laser 18:40
    • Phacoemulsification 19:21
    • All of these procedures were paid for by health insurance 11:41
    • The Crystalens 17:00
    • A petition for patients to have the right to pay to upgrade their implant experience 17:37
    • The era of refractive cataract surgery 19:03
    • A false timeline 19:32
    • Comparing things properly, you find a small difference between two surgeries 22:29
    • The impressive engineering of femtosecond lasers 23:30
    • Why do people use the femtosecond laser surgery? 24:53
    • I do a bit of work as a defense expert in malpractice cases 26:42
    • There are some bright spots here 29:21
    • Calling out two groups who don’t let patients decide whether they want FLACS 30:48
    • I have respect for them, but I don’t think there is justification for doing FLACS based on outcomes 36:13
    • Throwing a bone to the proponents of FLACS 37:14
    • That’s my take on FLACS 38:56

    We’d love to hear from you! Send your comments/questions to Dr. White at ophthalmology@healio.com. Follow us on Twitter @Healio_OSN @DarrellWhite

    Disclosures: White reports being a consultant to Allergan, Bruder, EyePoint, Eyevance, Kala, Novartis, Ocular Therapeutix, Omeros, Rendia, Sun and Tearlab; speaker for Allergan, Eyevance, Kala, Novartis, Omeros and Sun; and ownership in Ocular Science.

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    40 min
  • Harsh Truths of Treating Perioperative Dry Eye
    Oct 7 2020

    In this episode, White shares the harsh truths about treating perioperative dry eye, including who, when and for how long. Spoiler: Treated dry eye leads to better outcomes.

    • Disclaimer :09
    • Intro :24
    • Treating dry eye around the time of cataract surgery and laser refractive surgery :36
    • This talk will focus on cataract surgery 1:04
    • Financial disclosures 1:26
    • The harsh truths about treating the perioperative dry eye 2:07
    • Harsh truth #1 3:11
    • Harsh truth #2 4:11
    • Harsh truth #3 13:25
    • Harsh truth #4 14:25
    • Harsh truth #5 17:17
    • Harsh truth #6 18:11
    • Take-home message 25:20

    We’d love to hear from you! Send your comments/questions to Dr. White at ophthalmology@healio.com. Follow us on Twitter @Healio_OSN @DarrellWhite

    Disclosures: White reports being a consultant to Allergan, Bruder, EyePoint, Eyevance, Kala, Novartis, Ocular Therapeutix, Omeros, Rendia, Sun and Tearlab; speaker for Allergan, Eyevance, Kala, Novartis, Omeros and Sun; and ownership in Ocular Science.

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    27 min
  • EMR Follies, Part Two
    Dec 20 2018

    In this episode, Darrell White, MD, continues his analysis of the impact of electronic medical records (EMR), also known as electronic health records (EHR) on private ophthalmic practices.    

    Disclaimer :09

    Introduction :20

    Financial disclosures :36

    The impact of implementing an EMR at SkyVision 1:39

    Lessons learned from being forced into change 3:50

    Would engineers design a cockpit on a fighter jet without having flown in one? 4:45

    The spoken word should be the goal in the next generation of EMRs 5:55

    Once the focus shifts from the patient to the screen, the quality of that experience plummets 8:20

    Can we find a way to have the same medical record on every platform? 9:10

    Next, let’s go back and figure out who owns this mess 13:00

    Have you ever tried to get a copy of a medical record from an EMR company? 21:00

    Somewhere, somehow, some institution needs to say “enough” 23:20

    The essence of medicine is finding the right story 24:49

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    28 min
  • EMR Follies, Part One
    Dec 18 2018

    In this episode, Darrell White, MD, takes a deep dive into the recent history of the impact of electronic medical records (EMR), also known as electronic health records (EHR) on private ophthalmic practices.    

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    29 min
  • 01 How I came to start a podcast about eye care
    Jun 28 2018

    In this inaugural episode, Darrell White, MD, gives the background of how he came to be Healio.com/OSN’s first podcaster, starting out from blogging, to The Dry Eye columnist to podcaster. While becoming known as Healio.com/OSN’s dry eye disease expert, he delves into his background as an anterior segment ophthalmologist with a cross-interest in business and the ongoing arc of his career.

    • Disclaimer :09
    • Introduction: “You have been reading my blog posts, haven’t you?” 1:00
    • It’s great you’re a dry eye expert, but do you still operate? 2:22
    • Who am I and why should you care what I think? 2:51
    • The arc of an ophthalmology career 3:23
    • Starting out in private practice 3:57
    • How did I get into ophthalmology? 4:45
    • Thinking about the intersection between health care and commerce 9:10
    • Finding your voice by taking care of patients 10:40
    • Lessons learned starting a private practice during an economic recession 11:59
    • Demographics are on the side of the ophthalmologist 13:25
    • Making the connection between industry and patient care 14:34
    • Let’s have a conversation about ideas 14:38
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    17 min
  • 02 Thoughts on conflicts of interest in ophthalmology
    Jun 28 2018

    In episode 2, Darrell White, MD, gives his opinion on conflicts of interest in ophthalmology. From pens given out by companies to selecting which IOL to use, he puts into context what potential conflicts of are compared with what could be called true conflicts of interest and how it is affecting eye care and medical practice in general.

    • Disclaimer :09
    • Introduction :25
    • White’s personal financial disclosures and consulting agreements 2:02
    • The state of eye care and medicine and what conflict of interest truly means 3:29
    • Starting with the “absolutely ridiculous bordering on asinine rules” 3:47
    • Ball point pens, penlights and more 3:54
    • Lunch provided to staff by industry 6:10
    • Defining potential conflicts of interest 11:16
    • Is profit a conflict of interest? 12:00
    • Conflict of interest in the exam room 14:26
    • Fluoroquinolones and conflicts 16:05
    • IOL choice and potential conflicts 17:32
    • “It’s not a slippery slope; it’s a cliff” 20:33
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    23 min