Pupil Pod

Pupil Pod

See one. Do one. Teach one. A case-based podcast hosted by Sila Bal, MD, MPH, featuring all stages of the journey through ophthalmology, from first year residents to the leading experts. Learning by sharing.

Episodes

Astigmatism Management During Cataract Surgery

September 9, 2025 • 33 mins
In this episode, instead of reviewing just one case, Sila Bal, MD, MPH, invites Neda Shamie, MD, to share her insights into challenging cases of astigmatism management during cataract surgery. Dr. Shamie explains how modern patients have higher expectations for optimized refractive outcomes and reviews her preferred techniques for astigmatism management in these cases. They discuss limbal relaxing incisions, arcuate incisions, and ...
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Case Review: Retrobulbar Optic Neuritis

August 11, 2025 • 34 mins
In this episode, John Chen, MD, PhD, joins Ogul Uner, MD, to share his experience in neuro-ophthalmology. In the case discussed, a 32-year-old woman presented with decreased vision and pain in her right eye for 1 week, and examination revealed a rapid afferent pupillary defect. The patient also mentioned she had experienced numbness in her right arm 1 year ago. Dr. Chen explains why he would suspect retrobulbar optic neuritis in th...
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Case Review: Diagnosing Neovascular AMD

June 30, 2025 • 30 mins
Katherine Talcott, MD, joins Ogul Uner, MD, to review a case of a 70-year-old woman with a history of intermediate dry age-related macular degeneration (AMD). The patient now presented with wavy lines in her vision in the right eye, and dilated exam showed several large drusen in both eyes with no retinal hemorrhages. OCT of the right macula showed fibrovascular pigment epithelial detachments with retinal pigment epithelium and flu...
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Case Review: White Dot Syndromes (Part 1)

June 6, 2025 • 26 mins
Jordan Deaner, MD, vitreoretinal surgeon and uveitis specialist at Wills Eye Hospital, talks to Ogul Uner, MD, about white dot syndromes, a group of inflammatory chorioretinopathies. In the discussed case, a 35-year-old woman presented with photopsias in both eyes, and dilated examination showed 1+ vitreous cells and gray-white lesions in both eyes. Dr. Deaner explains what additional questions he would ask about this patient’s his...
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Case Review: Dermatochalasis, Periorbital Rhytids, and Mid-Face Volume Loss

May 9, 2025 • 22 mins
Julie Woodward, MD, oculoplastic and orbital surgeon, joins host Sila Bal, MD, MPH, to discuss surgical and nonsurgical treatment options for facial aesthetics and rejuvenation. In the case discussed, a 62-year-old woman presented with complaints of looking tired and was interested in rejuvenation options. Examination revealed mild dermatochalasis, periorbital rhytids, mid-face volume loss, and jowling. Dr. Woodward shares insights...
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Case Review: SICS for Bilateral Dense Cataracts

April 1, 2025 • 36 mins
Jeff Pettey, MD, MBA, joins the podcast to review a case of a 75-year-old woman who presented with blurred vision. She had nuclear sclerosis with uniform brunescence in her right eye, an intumescent white cataract in her left eye, and poor red reflex in both eyes. Dr. Pettey reviews this patient’s options for cataract removal and explains the indications and key steps of small-incision cataract surgery (SICS). 
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Case Review: Rhegmatogenous Retinal Detachment

March 7, 2025 • 29 mins
Ogul Uner, MD, invites Scott Oliver, MD, to the podcast to review a case of a 60-year-old man who presented with new flashes, floaters, and blurriness in his inferior field of vision in his right eye. The patient is a high myope with a relative afferent pupillary defect and pigmented cells in the anterior vitreous, with OCT imaging showing a macula-off retinal detachment. Dr. Oliver shares his approach to this case, reviews risk fa...
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Case Review: Pigment Dispersion Syndrome

February 18, 2025 • 22 mins
In this episode, Kingsley Okafor, MD, joins Ogul Uner, MD, to review a case of a 40-year-old man who presented with intermittent visual changes, pain, and halos in his left eye. On examination, the patient had an IOP of 19 mm Hg, mild myopia, pigment on the corneal endothelium, and midperipheral transillumination iris defects in both eyes. Dr. Okafor reviews findings for pigment dispersion syndrome (PDS) and risk factors for develo...
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Case Review: Suspected Stevens-Johnson Syndrome

January 28, 2025 • 26 mins
Cohost Ogul Uner, MD, invites the original host of the podcast, Sila Bal, MD, MPH, to discuss a case of possible Stevens-Johnson syndrome (SJS). The patient is a 55-year-old woman with a recent treatment of ibuprofen and doxycycline for cellulitis on her left foot. She was referred to Dr. Bal due to a concern for SJS. Dr. Bal outlines how patients with SJS typically present and describes her diagnosis and treatment approach in thes...
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Case Review: Hemifacial Spasm

December 6, 2024 • 24 mins
In this case, a 55-year-old man presented with an uncontrollable spasm on the right side of his face. Sila Bal, MD, invites oculofacial surgeon Julie Woodward, MD, to explain how she would approach the examination of this patient, describing the questions she would ask to obtain a detailed family and medical history and determine if the condition is a hemifacial spasm, blepharospasm, or myokymia. She shares insights into distinguis...
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Case Review: Diagnosing Proliferative and Nonproliferative Diabetic Retinopathy

November 20, 2024 • 35 mins
Sila Bal, MD, MPH, welcomes Vivienne Hau, MD, PhD, to review a case of a 56-year-old man with a history of ocular hypertension and type 2 diabetes who presented with mild nuclear sclerotic cataracts and a decrease in vision in both eyes. Dilated examination showed tortuous renal vasculature, scattered hemorrhages, cotton wool spots, and hard exudates in both eyes. Dr. Hau describes these clinical findings and explains next steps fo...
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Case Review: Addressing Poor Medication Compliance With Interventional Glaucoma

November 8, 2024 • 28 mins
Sila Bal, MD, MPH, invites I. Paul Singh, MD, to discuss a recent case in which a 72-year-old pseudophakic patient with open-angle glaucoma inquired about alternatives to topical treatments due to compliance issues. Dr. Singh reviews the benefits of more interventional treatment options such as selective laser trabeculoplasty and drug delivery platforms and explains how he counsels patients about these options.
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Case Review: Risk Factors for Age-Related Macular Degeneration

October 7, 2024 • 32 mins
Aleksandra Rachitskaya, MD, FASRS, reviews a case of a 70-year-old woman with a history of hypertension and type-2 diabetes who presented with changes to the macula. On dilated exam, small macular drusen was observed in both eyes. Dr. Rachitskaya discusses the additional questions she would consider to better understand the patient’s risk factors for age-related macular degeneration (AMD), geographic atrophy, and more.
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Case Review: Elevated IOP and Disc Thinning

September 24, 2024 • 33 mins
Sila Bal, MD, MPH, invites Rachel Simpson, MD, to review a case of a 56-year-old woman who presented with elevated intraocular pressure with inferior and superior disc thinning. The patient had not undergone an eye examination in 10 years and experienced no other visual symptoms. Dr. Simpson reviews how she would proceed after these findings, describing the questions she would ask regarding family history of glaucoma and potential ...
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Case Review: The Six Ps of Orbital History

August 30, 2024 • 26 mins
Sarah A. Avila, MD, an oculoplastic and orbital surgeon, joins Sila Bal, MD, MPH, to review a case of an 8-year-old boy who presented with worsening redness and swelling of his left eyelid over 3 days. He had normal findings on dilated examination with full extraocular motility. Dr. Avila reviews her approach to these cases, describes important orbital exam findings and considerations, and highlights the ‘six Ps’ of orbital history...
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Case Review: Interstitial Keratitis

August 2, 2024 • 32 mins
William Trattler, MD, joins Sila Bal, MD, MPH, to discuss a case of a 31-year-old woman who presented with pain and decreased vision in her right eye. Slit lamp examination revealed conjunctival injection and a unifocal area of stromal haze with no epithelial defects. Dr. Trattler explains further diagnostic strategies for this case to help determine the best treatment. He also reviews approaches to suppress inflammation in differe...
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Case Review: Chronic Bilateral Conjunctivitis

July 8, 2024 • 25 mins
Beeran Meghpara, MD, joins Sila Bal, MD, MPH, to review a case in which a 16-year-old boy with a scaly rash on his elbows also presented with a 1 month history of photophobia and mucoid discharge in both eyes. Dr. Meghpara explains how he would approach a patient with this history, what questions to ask, and what diagnoses he would consider. Drs. Bal and Meghpara discuss further examination findings and relevant treatment approache...
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Case Review: Retinal Artery Occlusions

June 27, 2024 • 23 mins
Caroline Baumal, MD, joins Sila Bal, MD, MPH, to discuss a case in which a 53-year-old man with a history of hypertension and type 2 diabetes presented with sudden painless loss of vision in his left eye. Dr. Baumal explains that a dilated exam revealed the retina had an opaque appearance with a cherry red spot, causing her to suspect central retinal artery occlusion (CRAO). Listen to gain insights into additional risk factors, pat...
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Case Review: Idiopathic Orbital Inflammation

May 10, 2024 • 30 mins
Andrea Tooley, MD, joins Sila Bal, MD, MPH, to review a case of a 33-year-old woman who presented with sudden onset periorbital pain and edema on her left side. On examination, vision was 20/20 with normal IOP and extraocular movements. Dr. Tooley walks through important orbital examination findings that physicians should evaluate in every patient with an orbital concern. Listen to gain insights into the approach to idiopathic orbi...
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Glaucoma Study Review

April 26, 2024 • 32 mins
Brian Shafer, MD, and Sila Bal, MD, MPH, discuss important glaucoma studies that guide clinical practice and provide a deep understanding of how to manage patients. They review the Early Manifest Glaucoma Treatment Trial, the Collaborative Normal-Tension Glaucoma Study, the Advanced Glaucoma Intervention Study, and several others. Listen to gain insights into the benefits, effects, and approaches to lowering IOP.
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