Eyeworld

133 February 2018 EW MEETING REPORTER drainage could be associated with poor lacrimal pump function, ectro- pion, punctal stenosis, canalicular disease, "high" obstruction, or "low" obstruction. He suggested a number of options for evaluation, includ- ing probing and irrigation, dye disappearance test, Jones dye tests, dacryoscintigraphy, and dacryocys- tography. Editors' note: Dr. Bartley has no finan- cial interests related to his presentation. Dr. Kherani has financial interests with Allergan (Dublin, Ireland) and Novartis (Basel, Switzerland). Managing the unhappy multifocal patient and patient satisfaction John Berdahl, MD, Sioux Falls, South Dakota, spoke about how to manage the unhappy multifocal patient. "We're trying to avoid that unhappy patient in a sea of other- wise very happy patients," he said. He first seeks to understand why the patient is unhappy with the out- come. boarded the helicopter, however, because they were flying low to the ground and were shot at with several missiles. However, when the heli- copter was flying over the ocean, he knew they were home free. Oculoplastics symposium Femida Kherani, MD, Vancouver, Canada, spoke about ptosis in her presentation. Ptosis is the abnormal fall or droop of the upper eyelid, and it may be classified as congenital or acquired. Dr. Kherani said the preop- erative exam is the most important part of treatment. Vital signs to look for include the levator function, pal- pebral fissure height, eyelid crease, marginal reflex distances, the visual field, and a dryness assessment. George Bartley, MD, Rochester, Minnesota, discussed excessive tear- ing, which he said may be caused by increased lacrimation or decreased drainage. Etiology of increased lac- rimation could include entropion, trichiasis, exposure, foreign bodies, lid margin disease, tear deficiency/ instability, or trigeminal nerve stimulation. Etiology of decreased that hostile troops on the ground would fire at them. On this day, the ground troops fired missiles at Capt. O'Grady and another pilot. The pilots thought they were in the clear, but unexpectedly, one of the missiles went between the two planes, and another struck Capt. O'Grady's plane. Capt. O'Grady was ejected from his aircraft, which was breaking apart, and as he began to parachute to the ground, he scanned the entirety of the area around him, where he could see cities, open farm- land, hills, mountains, villages, and farmhouses. Unfortunately, he said, when you're shot down over a war zone, you land on top of the people who shot you down. Capt. O'Grady landed in some trees, ran about 200 yards, and hid under some branches before anyone on the ground arrived at his location. Capt. O'Grady was aware of many people walking around him, most of them armed. From then on, he had to be particularly careful with any movements so that he was not detected. He could see the ene- my walking near him, and every so often, they would fire guns random- ly, trying to find him. At this point, Capt. O'Grady had no food, limited water, and his radio battery would only last a few hours. Eventually, he had to seek higher terrain for the radio to work; his signal was picked up on June 8. After confirming his identity, a rescue mission was coordinated for Capt. O'Grady. Though it was risky to pull off a daytime rescue mis- sion, it was ultimately decided that they should send in forces to rescue him as soon as possible. Early that morning, U.S. Marines brought in a helicopter to rescue Capt. O'Grady. He said that helicopter was one of the most beautiful things he has ever seen. They weren't completely out of danger when Capt. O'Grady and manage everything. "You can't go into a successful business and change everything about it," he said. Ms. Simerson said there will always be options for practices, and you can survive as a solo oph- thalmologist or as part of a larger practice. Mr. Owens added that it's im- portant to "do your due diligence" if you get approached by private equity. He suggested talking to peo- ple from all sides of the process. It's important to understand all the pros and cons, he said. Mr. Corcoran added that there shouldn't be a time component or hurry in your decision. Relax, take a deep breath, and do your due diligence. Editors' note: Mr. Corcoran has finan- cial interests with Corcoran Consulting Group (San Bernardino, California). Ms. Simerson has financial inter- ests with Alcon (Fort Worth, Texas), Precision Eye Services (Bloomington, Minnesota), and Omeros (Seattle). Mr. Owens is a partner in the Washington, D.C. office of Arnold & Porter Kaye Scholer, with clients who are manufac- turers of products and services as well as providers of services. Special guest speaker This year's special guest speaker was United States Air Force Captain Scott O'Grady, who shared his experience when his military plane crashed over Bosnia. Capt. O'Grady was rescued after 6 days. To survive, he said, "It really came down to evaluating what I cherish most in life." This included his faith, love for his family, and love for his country. On the day he was shot down, June 2, 1995, Capt. O'Grady was flying a patrol mission from where he was stationed in Italy to enforce a no-fly zone over Bosnia. Though his mission was one of peacekeeping and patrolling, there was a possibly continued on page 134 View videos from Hawaiian Eye 2018: EWrePlay.org Zaina Al-Mohtaseb, MD, discusses how inflammation plays a role in eye rubbing in keratoconus.

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