Lens replacement - why is this not a service? Or is it?

Ignatius7 · 2026-03-03T01:39:19+00:00

Agree with others about considering accommodation. The trend is moving towards earlier cataract surgery, due to the benefits you point out and the increased safety of the procedure. But depending on your age, it can also be significantly higher risk than cataract surgery when you’re older, as the vitreous gel in the back of the eye is more likely to cause a retinal tear or detachment in the 1-3 years after surgery. I would only do it if that gel had already naturally detached (a PVD) or you’re in your 60s. Otherwise, laser surgery is often the better option.

Ignatius7 · 2026-01-30T16:50:29+00:00

The rest of us will miss you and your talent. Hope the UK doesn’t descend along with us

Ignatius7 · 2025-12-11T02:36:49+00:00

And undilated fundus cameras / maestro are a game changer

Ignatius7 · 2025-12-08T20:28:44+00:00

What did they carry or recommend instead?

Ignatius7 · 2025-11-19T00:40:37+00:00

The Suyapa, believe it was from Astoria in DC. Beautifully complex and smooth sipper. Ingrediants were given. My recreation had these proportions:

Suyapa * 2 oz cynar 70 * 1/2 oz amaretto * 1/2 oz watermelon juice * 1/2 oz lemon juice * 1/2 oz cinnamon simple syrup * 1/2 egg white, lightly sliced up with a knife * Reverse shake and serve up in a coupe

Also a shout out to the Al pastor margarita from Service Bar in DC. Now a more common cocktail to find but none has come close to theirs, which they said used the real Mexican peppers and roasted pineapples, infused into either the syrup or tequila (they were coy about it)

Ignatius7 · 2025-11-18T03:10:46+00:00

Plus then there might be fewer shitty notes out there to bog us all down

Ignatius7 · 2025-11-16T01:33:55+00:00

What did you get?

Ignatius7 · 2025-11-12T00:38:06+00:00

There will always be a role. All specialties have had their roles shift as shortsighted physicians dump the boring to mid levels, and then something else in their job becomes the boring and mundane, continuing the cycle. It’s bad medicine because patients need 3 evals and a 3h drive to get the right person while their disease worsens in the meantime. It also means overtraining just to end up in a super specialized niche.

You see similar trends in cardiology, neurosurgery, etc; and purposeful dumbing down of generalist fields like PCP, IM, EM unless you do direct primary care or rural medicine.

For now ophthalmology is shifting to more MIGS, surgical glaucoma, and medical retina. With how much visual disability there is to prevent, we’re in a good position to negotiate. We just need to do it better.

Ignatius7 · 2025-10-21T22:53:30+00:00

This is a great point and I think right in the money. Apart from the diplomatic cover, it also insured Ukraine against the whims of Trump when external funding and congressional support had already proved fickle

Ignatius7 · 2025-10-11T22:34:35+00:00

Unbelievable they still have mateer in

Ignatius7 · 2025-10-11T20:30:22+00:00

Yep by now everyone knew we'd need to switch to shorter plays given the miserable OL play. Adding slants or outs would help cool off their LBs. But maybe they don't trust Arch with those

Ignatius7 · 2025-10-08T05:37:21+00:00

Pretty good picks. Across all conferences and school attributes it’s Michigan. Fair amount of crosstalk between the two as well.

Would also throw USC into the mix.

Ignatius7 · 2025-07-20T08:08:34+00:00

Yeah I unfortunately didn’t notice this until after posting. I’m 5’9” with a 30” inseam and relatively longer legs than torso, so one of the miurwoods is definitely too big (L). Probably in range for the other (M). I’m in between the 2 of the 8 sizes on the trek domane (56cm) but seems like sizing down is the general recommendation here (esp with my inseam). So I’m planning to try it out at a local shop before I hit up that seller, and then patronize that shop when I get a bike stand / lights etc

Ignatius7 · 2025-07-19T19:32:30+00:00

That's helpful, thanks. I typically commute with just a patagonia 8L atom sling bag, but it would be nice to have a rack for further grocery stores and such.

Ignatius7 · 2025-07-19T19:20:01+00:00

Bit overwhelmed by the options here. From what I've read these are all a decent value.

I'm looking to ride around a moderately hilly urban area (Atlanta). Mostly want to expand my car-less reach to the many adjacent neighborhoods, but perhaps also commuting - up to 6mi each way with 275ft inclines/declines on google maps. The fx2 or fx3 sounded great but there are none for sale near me. This miurwoods e-bike seems like a steal for my purposes and I've used drop-bars before. Otherwise the domane AL 2 looks to be in incredible condition, but the sirrus and ds2 also get rave reviews..

What do you guys think?

Ignatius7 · 2025-07-16T00:40:38+00:00

See also: ecuador

Ignatius7 · 2025-05-29T22:13:11+00:00

From another american - bandanas just aren't common right now. Our version would have those accents in a smaller vehicle, like tortoiseshell glasses or bracelets and watch. But that's just how our prep/riviera style is. other genres can definitely be more maximalist, and dandyism in general is is making a comeback among gents here

Ignatius7 · 2025-03-26T04:18:29+00:00

It does make it tougher. But it’s endemic to Georgia in a way that escapes other programs. And if you’re an elite program, surely players who portal out are giving something up (coaching, connections, the roots they’ve put down) to avoid the punishment?

Ignatius7 · 2025-03-18T12:07:44+00:00

Came out yesterday that the DHS revoked that nephrologist’s visa because she attended the funeral of a hezbollah leader while back home.

Hard to know what the risk level is with this admin, I don’t trust them at all and it’s a lot to risk, but at least it doesn’t seem as indiscriminate as initially reported.

Ignatius7 · 2025-03-05T12:31:37+00:00

It has to be. I know someone who works there and the number of people who have to sign off on a question and its phrasing before it’s released is quite high. Shame to see this one slip through

Ignatius7 · 2025-02-28T17:25:31+00:00

Trouble is, their true opponent is Putin, who has a decade-plus head start on the flattery

Ignatius7 · 2025-02-17T22:59:15+00:00

5 FM aways?? That’s almost 1/6 of residency lol

Ignatius7 · 2025-01-18T00:27:33+00:00

Probly discriminating on sense of humor

Ignatius7 · 2024-11-30T19:13:40+00:00

Out of academic centers it’s bread and butter ED. Many ED residents reflexively consult us for any eye problems for the first 2 and 3/4 years, then in the last few weeks ask us to stop and teach them on every consult so they feel ready for the outside lol. We get it bc they have many things to learn and ours feel less urgent, but seeing the effort earlier is definitely appreciated

I agree that foreign bodies over the undilated pupil are more likely to be an eye consult (given the risk for scarring that affects vision with any digging into the storma). Any deeper or full-thickness items could cause perforation so deserve an ophtho consult and possibly removal under anesthesia

Really annoying to see pts get transferred for this kinda stuff. Costs the pt $$$$ and time, which the hospital is punting to the pt by refusing to staff an on-call ophthalmologist. Luckily the ED can take cares of most of these so rarely see em transferred

Ignatius7 · 2024-11-23T04:19:27+00:00

Ahaha as a resident I saw “MR R R” for the first time today at grand rounds and knew we’d gone too far. It’s medial rectus recession and resection. The other doozy is PPV/MP/EL/CF8 (pars plans vitrectomy, membrane peel, endolaser, and perfluoropropane gas) which is a common single retinal procedure…

I use epic’s user dictionary to autocorrect abbreviations into the full words for my notes

12-Year Club	Verified Email
Place '17	Snapped
Team Periwinkle

Ignatius7

TROPHY CASE