Pupil Pod

Andrea Tooley, MD, joins Sila Bal, MD, MPH, to review a case of a 33-year-old woman who presented with sudden onset periorbital pain and edema on her left side. On examination, vision was 20/20 with normal IOP and extraocular movements. Dr. Tooley walks through important orbital examination findings that physicians should evaluate in every patient with an orbital concern. Listen to gain insights i...

Brian Shafer, MD, and Sila Bal, MD, MPH, discuss important glaucoma studies that guide clinical practice and provide a deep understanding of how to manage patients. They review the Early Manifest Glaucoma Treatment Trial, the Collaborative Normal-Tension Glaucoma Study, the Advanced Glaucoma Intervention Study, and several others. Listen to gain insights into the benefits, effects, and approaches...

Avni P. Finn, MD, MBA, joins Sila Bal, MD, MPH, to discuss a case in which a 47-year-old man with a history of hypertension and type-2 diabetes presented with a sudden decrease in vision in his left eye. After observing tortuous retinal vasculature and intraretinal hemorrhages on dilated examination, Dr. Finn suspected branch retinal vein occlusion (BRVO). Drs. Bal and Finn further discuss the dia...

Nicole R. Fram, MD, joins Sila Bal, MD, MPH, to discuss a case of a 68-year-old woman who presented as unhappy with her quality of vision 2 months after refractive cataract surgery. Dr. Fram reviews her typical preoperative screening process for refractive cataract patients, focusing on the ocular surface, patient lifestyle, and other diagnostic tools. She also describes how she educates patients...

In this episode, Ehsan Rahimy, MD, talks to Sila Bal, MD, MPH, about a case of a 13-year-old girl who presented with floaters and decreased visual acuity for 2 weeks. Examination revealed 1+ vitreous cells with a focal area of necrotizing chorioretinitis. Dr. Rahimy outlines his approach to this case and his framework for making a diagnosis. He then explains how to navigate treatment strategies fo...

Diana Laura, MD, joins Sila Bal, MD, MPH, to share a case in which a 22-week-old gestational infant girl presented to the NICU with respiratory distress and concern about retinopathy of prematurity (ROP). Dr. Laura explains the screening criteria for ROP in premature infants and reviews the identifying factors for ROP stages 0 through 5. Drs. Bal and Laura also discuss information and findings fro...

In this case review, Lisa K. Feulner, MD, PhD, describes a case of a 73-year-old woman who presented with gradually decreasing vision 3 years after cataract surgery. Host Sila Bal, MD, MPH, and Dr. Feulner discuss how to approach these patients and review the potential conditions that could influence decreased vision, such as ocular surface disease, glaucoma history, medications, etc. Dr. Feulner...

Sahar Bedrood, MD, PhD, joins Sila Bal, MD, MPH, to present a case of a 45-year-old woman who came to the emergency room reporting headache, nausea, blurred vision, and rainbow halos. Upon initial examination the patient’s visual acuity was 20/100 and had an acutely elevated IOP of 51 mm Hg OD. Dr. Bedrood discusses how she initially approached this patient and stresses the value of obtaining a de...

In this episode, P. Dee G. Stephenson, MD, joins Sila Bal, MD, MPH, to review a case of cataract surgery evaluation for a 72-year-old patient with a history of an unknown eye infection, astigmatism, and an anterior stromal scar. Dr. Stephenson outlines her approach to preoperative planning and evaluation for all patients and describes how she counsels them about lens options based on their individ...

Robert Melendez, MD, MBA, sits down with Sila Bal, MD, MPH, to discuss the case of a 32-year-old woman with a history of high myopia who came to the office for evaluation for refractive surgery. Dr. Melendez discusses which patients make good candidates for the EVO ICL (STAAR Surgical) versus traditional corneal refractive surgery. The two surgeons discuss the preoperative workups required for the...

Jayanth Sridhar, MD, joins Sila Bal, MD, MPH, to discuss a case in which a 32-year-old man presented with floaters and decreased visual acuity for 2 weeks. Upon examination, imaging revealed peripheral whitening of the retina and opacification with areas of hemorrhages. Dr. Sridhar explains his approach in cases of infectious retinitis, outlines treatment strategies, and highlights the importance...

In this episode, Morgan Micheletti, MD, joins Sila Bal, MD, MPH, to review a case of a 65-year-old woman with a history of high myopia and radial keratotomy who presented with pseudoexfoliation, a poorly dilated pupil, and a 3+ nuclear sclerotic cataract. Dr. Micheletti describes how he manages IOL calculations and preoperative assessments for patients with previous refractive surgery and outlines...

Sila Bal, MD, MPH, welcomes Dagny Zhu, MD, to the Pupil Pod to discuss a case in which a 37-year-old woman was interested in learning about all options in refractive surgery. Dr. Zhu explains how she approached this consultation and outlines the differences in patient selection, limitations, and potential complications for LASIK, PRK, SMILE, and other refractive procedures. The two also discuss co...

Sila Bal, MD, MPH, continues her conversation with Iqbal Ike K. Ahmed, MD, FRCSC, regarding surgical options for patients with glaucoma. In this episode, they review a case of a 57-year-old man with pseudoexfoliation glaucoma who inquired about laser therapy as an option over eye drops. Dr. Ahmed explains which types of glaucoma are the most appropriate for treating with selective laser trabeculop...

Sila Bal, MD, MPH, welcomes Iqbal Ike K. Ahmed, MD, FRCSC, in the first of a two-part episode to review a case of a 68-year-old man with a history of primary open-angle glaucoma who experienced progression of a visual field defect and glaucomatous optic neuropathy. Dr. Ahmed shares insights into when to proceed with incisional surgery in these patients and discusses relative contraindications and...

Sila Bal, MD, MPH, welcomes Daniel S. Choi, MD, to discuss the case of a 65-year-old woman with Fuchs endothelial dystrophy who was interested in a corneal transplant. Dr. Choi outlines the surgical steps and indications for penetrating keratoplasty (PKP), Descemet stripping endothelial keratoplasty (DSEK), and Descemet membrane endothelial keratoplasty (DMEK). He also explains the potential posto...

In this special live episode of Pupil Pod, hosted by YoungMD Connect, Sila Bal, MD, MPH, and Brent Kramer, MD, reviewed the unique case of an 18-year-old woman with decreased vision and recurrent corneal erosion as a manifestation of complex regional pain syndrome (CRPS)—a degenerative nerve condition. Dr. Kramer outlined his approach to the case, including the diagnostic testing he performed, and...

Sila Bal, MD, MPH, invites David Khorram, MD, to discuss his experiences in global ophthalmology and how health care workers in remote regions of low- to middle- income countries treat ophthalmic patients. Dr. Khorram shares insights into the epidemiology of trachoma and how it is transmitted and treated. He also explains the advantages of performing manual small-incision cataract surgery over ext...

Sila Bal, MD, MPH, is joined by Neda Shamie, MD, to discuss the demographics and risk factors for the development of keratoconus and the genetic predisposition, environmental risk factors, and clinical manifestations of the disease. Dr. Shamie also shares expert insight into treatment approaches for each stage of keratoconus severity.

Sila Bal, MD, MPH, welcomes Amenze Osa Oriaifo, MD, to the Pupil Pod to discuss the potential risk factors for patients with primary open-angle glaucoma (POAG), ocular hypertension, and normal-tension glaucoma. Dr. Osa shares findings from the Early Manifest Glaucoma Trial on the effectiveness of lowering IOP for patients with new POAG and results from the Ocular Hypertension Treatment Study. The...

Sila Bal, MD, MPH, continues her discussion with guest Elizabeth Shanika Esparaz, MD, in the second of a two-part episode of Pupil Pod’s diabetic retinopathy series. In the previous episode, Drs. Bal and Esparaz broke down the risks associated with proliferative diabetic retinopathy (PDR). This episode dives into the take-home points and clinical applications from the Diabetic Retinopathy Study an...

Sila Bal, MD, MPH, welcomes Jesse L. Berry, MD, to the Pupil Pod to discuss a complicated case of a 14-month-old patient who presents to the clinic with strabismus and leukocoria. Together, Drs. Bal and Berry run down the differences between heritable and nonheritable retinal diseases and provide a deep dive on the methods for identifying, treating, and managing retinoblastoma.

Sila Bal, MD, MPH, and Eric Gaier, MD, PhD, discuss a case of a 4-year-old girl with mydriasis, ocular pain, and vision loss. The physicians provide tips for identifying neuro-ophthalmic diseases that can lead to vision loss before examining treatments for third nerve palsy. 

Sila Bal, MD, MPH, welcomes Neda Shamie, MD, to the Pupil Pod to discuss lens selection for a patient prior to cataract surgery. The pair review the Helmholtz accommodation theory, patient selection for the different types of IOLs, advancements in presbyopia treatment, and more.

Sila Bal, MD, MPH, welcomes Neda Nikpoor, MD, to the Pupil Pod to discuss some of the criteria when screening a patient prior to refractive surgery. Drs. Bal and Nikpoor discuss the most important parts of a patient’s social and medical history prior to operation, the risks which may present when operating on patients with preexisting ocular conditions, and other crucial conversations to have with...