We’ve all had challenging days at work: One of those days that tests your abilities and forces you to rise to the occasion. Writers might find themselves interviewing someone who offers answers as readily as a Scotsman gives up his irn bru (I am speaking from experience, I will never give my bru up). Meanwhile, doctors may have to deal with difficult patients, IT systems may fail, and the list goes on.
But have you ever had to flatten the retina of a serving prime minister of a major nuclear power? What about performing eye operations during a natural disaster like a hurricane? Or handling the stresses of a particularly difficult cataract surgery? Can you imagine what it must be like to treat multiple patients who were shot in the face with pellet guns during violent protests?
Wonder no more, by viewing Tricky Procedures: Wars, Storms and Celebrities… Oh My! one of the first symposiums to take place at the CAKE & PIE Expo (C&PE) 2021. With three doctors from three continents, the symposium was a fascinating insight into some of the more unusual situations ophthalmologists may find themselves in.
Time to flatten the PM’s retina
The first speaker was Dr. Richard Packard, a senior consultant at Arnott Eye Associates, Cavendish Medical (London, England). He described his experience of flattening the retina of former British Prime Minister Margaret Thatcher, while she was still in power in 1983. The formidable politician complained of flashes and floaters in her eye for three days, and Dr. Packard diagnosed her with a u-shaped retinal tear with subretinal fluid.
Beginning with a series of argon laser burns around the tear, Dr. Packard then operated for an hour using a radial suckle to seal the retinal tear while the prime minister’s bodyguards were right next door. The story broke, the doctor found himself on the front pages, and Thatcher’s outcome was “good with unaided vision of 6/6+”. Dr. Packard was pleased with the outcome, and especially so after finding himself in Britain’s premier satirical magazine Private Eye!
Cataract: Keep calm and operate on
Cataract surgery might be one of the more common ophthalmologic procedures, but that doesn’t mean it isn’t stressful. Dr. William Trattler, an ophthalmologist at the Center for Excellence in Eye Care (Miami, Florida), offered his most valuable tips on staying cool with cataracts — including taking inspiration from sports stars, like NBA basketball players.
Dr. Trattler recommends that you maintain focus, be confident, control your emotions — and most importantly enjoy what you’re doing! Practicing mindfulness can be very helpful, as well as understanding that you should be pursuing excellence, not perfection.
Dr. Trattler also described how both he and his father treated patients during Hurricane Andrew in 1992, a deadly hurricane that blasted its way through Florida. In one case, they effectively managed a corneal laceration on just auxiliary power, without running water or air-conditioning, and successfully treated the injury. Kudos!
No one wants a pellet to the eye
If you know your politics, then you’ll know that Kashmir is one of the more troubled regions in the world. Prof. Dr. S. Natarajan, the chairman and managing director at Aditya Jyot Eye Hospital (Mumbai, India), reported on a study of 777 patients with pellet gun-related ocular injuries that occurred during widespread violence in the region in 2016. Nearly 98% of patients were male, and half were younger than 30.
Just over 60% of patients underwent a slit lamp examination, which found that corneal abrasion or lamellar laceration was present in 1% of patients, traumatic contact was found in 26%, and hyphema was found in 26%. Most injuries (93%) were monocular, while only 5% were binocular. Dr. Natarajan warns against the severe impacts of pellet gun injuries, and that while visual acuity outcomes may be poor, surgery should still be considered.
Editor’s Note: A version of this article was first published in Issue 2 of CAKE & PIE POST, C&PE 2021 Edition. The CAKE & PIE Expo 2021 was LIVE on June 18-19. All sessions are available on demand until July 19 at expo.mediamice.com upon login.
