My thoughts in Ophthalmology
Warm Welcome..!!
In our daily practice as eye doctors, we may converse with God about one of the most beautiful structures of the human body: the eye.
Here I present to the world my philosophy as an eye doctor.
— Dr. Dhaval Patel, MD
These are short reflections gathered while operating, teaching and seeing patients. Some are serious and some are light-hearted. Read them as a conversation between colleagues, not as clinical guidance.
Phacoemulsification
- The day you do phacoemulsification just like playing a video game, you really like phaco.
The day you prefer doing phacoemulsification more than playing your favourite video game, you are in love with phaco. - Learning phacoemulsification is just like learning to play a game…
Initially it is always difficult…
Then it becomes easy…
Then you just like to play it…
Then you love it…
Then you cannot live without it… - Phacoemulsification is a technique of removing a 10 mm lens through a 5 mm capsulorrhexis from a 2 mm incision.
(This is the easiest definition I use to explain it to my patients.) - The most difficult step of topical phacoemulsification surgery is applying a good drape, which is done by your assistant… :-)
- Every surgeon remembers the first capsulorrhexis that went exactly where they wanted it to go. Hold on to that feeling; it will carry you through the difficult days.
- Good phaco is quiet phaco. A stable chamber and unhurried hands say more about a surgeon than speed ever will.
The Glaucoma Mystery
- The philosophical complexity of glaucoma is such that those who know the most about it are least confident in treating it, and those who know the least about it are most confident in treating it.
- In glaucoma, the patient rarely notices what we save, only what we could not. That is why the most important work happens long before the patient feels anything is wrong.
- Treat the patient, not just the number. Pressure is what we can change; the optic nerve is what we are really protecting.
Cataract
- With my little experience as a cataract surgeon, the wisdom I have gained is:
"We just remove cataracts; God gives vision."
- The operation takes minutes; the trust behind it takes much longer. Time spent explaining to a patient before surgery is never wasted.
On Complications
- Every surgeon who operates will face complications. The ones who never talk about them are not the ones who never have them.
- A complication is an event. How you respond to it — calmly, honestly and with your patient first — is your character.
- For the emotional side of this, read my Prayer of the Cataract Surgeon; for the practical side, see the Posterior Capsular Tear Management Flowchart.
On Patients
- Patients may forget the name of their operation, but they never forget how you spoke to them the day before it.
- The eye we examine belongs to a person with a job, a family and fears. Examine the eye; see the person.
On Learning and Teaching
- Residency is not about how many cases you do, but how many you truly understand.
- The best teachers were once confused residents too; they simply never forgot what it felt like.
- Read, operate, reflect — and repeat.
Continue Reading
- Prayer of the Cataract Surgeon — a personal letter to God written during training
- Phaco Tips & Tricks
- Basic Phaco Chop Techniques
- Glaucoma notes on RPC Rounds
- New to RPC Rounds? Start here
Looking for an eye specialist in Ahmedabad? Learn about our Eye Department or book a consultation with Dr. Dhaval Patel.