Baxter's Blog

This is my guide to the treatment of severe corneal fungal ulcers in low-income and middle-income countries. As we all know, fungal ulcers are more common in the tropics. In the States there are around 1,500 cases yearly ---more commonly in warmer humid climates ( southern Florida ). Fortunately Read more:

I wanted to write again on glaucoma as we all see many patients with glaucoma everywhere --- many unfortunately with severe, advanced, end-stage glaucoma when we first see them. As you know, glaucoma is the second leading cause of blindness in the world after unoperated cataracts. Most of what I Read more:

Recently an ophthalmologist in a developing country asked me when I would start a patient with ocular hypertension ( mid-20’s IOP and a normal cup / disc ratio ) on therapy. I wanted to follow up about that. Perhaps this would be a good conversation to have with eye care providers in emerging Read more:

Recently I was able to show a health care provider two separate patients with an eyelash caught / embedded under a pterygium on the bulbar conjunctiva. I have seen this previously simply an incidental finding. At first our optometrist thought this black linear lesion was a suture but after gently Read more:

Visual Field testing ( perimetry ) is useful but often the first test is unreliable. Someone should stay in room with patient and have them look straight ahead. The test is worthless if patient is looking all around. The patient needs to be instructed on how to take the test. Give patient a Read more:

#1. Get a history from the mother. What is the eye problem? Was the child born pre-mature. ? Does the mother think the child can see? Has any other eye doctor seen the patient. What was their opinion? Ask the child some easy questions. Establish eye contact with the child. #2. Let the child sit Read more:

#1. If the V.A. is 20/60 or 20/70 with both eyes open without glasses then that may be sufficient vision. Everyone does not need to see 20/30 at distance. Many patients know their numbers but not their letters. May need to have patient read numbers rather than letters. #2. If the Read more:

#A. Get a good history. Did the patient use to see well in that eye or always poor vision ( lazy eye). Any hx of old trauma? #B. Check IOP. Look at that eye with slit lamp.Is the cornea OK? Is the cataract displaced ( subluxated )? Below is three step evaluation for a mature cataract Read more:

This is the second part ( continuation ) of MSICS suggestions after the SEE course. After hydrodissection / hydrodelineation and a capsulotomy, if possible spin the nucleus  before you rotate  it up through pupil into A.C.  If unable to spin then just rock nucleus east / west and north/ Read more:

Well here I am. I finally made it.
All my ophthalmic life I have wanted to work for / with Medecins Sans Frontieres ( MSF ) / Doctors Without Borders. Recently MSF, NYC told me I was the first ophthalmologist they have ever recruited. Currently I’m here in Monrovia, Liberia seeing post-Ebola Read more:

I would like to do something a little different with this blog and to make some observations / comments about medicine and beyond. First I would like to give you some of my favorite quotes / expressions of 2016: #1. Don’t quit your day dream. #2. Gracious plenty. ( Southern expression ). #3. Read more:

Medecins Sans Frontieres / Doctors Without Borders is usually an emergency / crisis health organization rather than a developmental health NGO. As they frequently state, they go where others don’t. They are happy enough eventually to hand over their operations / programs to other NGO’s ( Read more: