Ophthalmology Against The Rule

Ophthalmology Against The Rule

Ophthalmology Against The Rule (OATR) is a podcast hosted by ophthalmologists Dr Ben LaHood and Dr Nick Andrew. Discussing the simple things often overlooked and the complex things often ignored about ophthalmology. Serious talks about interesting ophthalmic issues in an easy listening podcast.

Episodes

January 27, 2025 194 mins

Spherical aberration is a term often used in ophthalmology and optometry, especially in relation to lens surgeries and intraocular lens design. Recently, IOL manufacturers have been manipulating spherical aberration as a tool to provide a greater range of vision, but rarely explaining the mechanism. Your OATR hosts, Dr Nick Andrew and Dr Ben LaHood, as always, discuss the simple things often overlooked and the complex things often ...

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Disassembling the lens nucleus is a crucial step during cataract surgery. Different techniques may be better suited to different cataract types, require more skill and ultimately make a difference in visual recovery and corneal health. Your Ophthalmology Against The Rule hosts take a detailed look at the MiLoop technique and discuss the pros and cons of various phaco options including femto laser assisted, divide and conquer, and c...

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December 11, 2022 81 mins

Ophthalmologists are performing cataract and refractive lens exchange surgery in younger patients. One of the major risks that eye care professionals need to inform these patients about is retinal detachment yet the evidence to quote from has been scarce and confusing. How age, axial length, gender, and laser capsuotomy, impact the risk needs to be taken into account. So, your OATR hosts, Dr Ben LaHood and Dr Nick Andrew take a dee...

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January 1, 2022 72 mins

Antiseptic preparation of the eye is an absolutely vital step of cataract surgery in order to prevent infection. This treatment must be balanced with minimising harm to the ocular surface. In true OATR style, we take a detailed look at the pros and cons of traditional iodine and more modern chlorhexidine antiseptic solutions. Getting these seemingly minor steps optimised helps to optimise outcomes for patients.

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October 3, 2021 61 mins

Treating dry eye disease is difficult. Trying to treat dry eye disease based on evidence can seem even harder. Omega-3 fatty acid supplements have been on a rollercoaster of popularity in treating dry eye. Evidence appeared to swing from indicating huge benefit to being similar to placebo. Your hosts, Dr Ben LaHood and Dr Nick Andrew analyse the key studies to unravel all an optometrist or ophthalmologist needs to know about Omega-...

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September 12, 2021 45 mins

Oh, you thought we were finished talking about narrow angles? We were just getting warmed up! In this OATR episode, your hosts Dr Ben LaHood and Dr Nick Andrew provide practical tips on interventions for treating narrow angles. Everything from tips on laser iridotomy to IOL calculation in short eyes. Part of our motto is "the simple things often overlooked" and this is definitely one of those topics that is rarely discussed but can...

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August 12, 2021 87 mins

OATR Season 2 is launched with everything you ever wanted to know about narrow angles. We had a lot to catch up on so if you're short on time, the main topic starts at 28 minutes! We received so many questions about narrow angles and glaucoma, cataract surgery, iridotomies and more that it was time your hosts Dr Ben LaHood and Dr Nick Andrew covered this popular topic, as always with an evidence based approach for optometrists, oph...

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January 26, 2021 51 mins

OATR is back for 2021 and we are kicking things off in style with everyone's favourite topic - astigmatism! There are a lot of rumours, myths and arguments around the topic of residual astigmatism after cataract surgery. Some say it gives a depth of focus; that it may be functionally beneficial; or that you can't do much about it as you should not flip the axis. Well your trusty OATR hosts, Dr Ben LaHood and Dr Nick Andrew are here...

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September 6, 2020 52 mins

Myopia progression is a major concern in the worlds of optometry, ophthalmology and the world in general with a predicted 5 billion people being myopic by 2050. The concern is not just needing glasses, but retinal detachment, myopic macula degeneration and blindness. The evidence for how to slow down myopia progression, especially around atropine dosing has been murky. So your hosts Dr Ben LaHood and Dr Nick Andrew clear up the evi...

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Your Ophthalmology Against The Rule hosts bring you everything you ever wanted to know about PCO from prevention during cataract surgery, influences of IOL design and surgery technique, through to management with YAG posterior capsulotomy. This topic will be of interest to optometrists and ophthalmologists as capsule opacity is a common reason for referral. The growth in numbers of multifocal and premium lenses being implanted mean...

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August 6, 2020 51 mins

Angle Kappa is one of those terms that gets thrown about at every ophthalmology meeting but does anyone really know what it means, what to do with that information or even what angle kappa really is? Your Ophthalmology Against The Rule hosts explain in simple language everything you want or need to know about angle kappa. They also discuss the real life practicalities of when and where this information is useful and why you may wan...

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June 26, 2020 46 mins

Your OATR hosts discuss the pros and cons of using OCT of the Disc and OCT of the Macula for detecting, monitoring and making treatment decisions in glaucoma. Looking after glaucoma patients used to involve a visual field and disc photos. OCT of the disc and nerve fibre layer revolutionised management. Now, OCT of the ganglion cell layers at the macula adds even more information. We answer the question of which is more important in...

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May 31, 2020 42 mins

It is high time that your Ophthalmology Against The Rule hosts Dr Ben LaHood and Dr Nick Andrew looked at the case for medical marijuana in ophthalmology. The ability of marijuana to lower intraocular pressure is well known but is it ready to be used as a routine glaucoma medication? Let us inhale all the evidence on this controversial topic and present the current and future role of marijuana in eye care.

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Your Ophthalmology Against The Rule hosts Dr Ben LaHood and Dr Nick Andrew discuss the latest evidence and their views on refining the outcome of second eye cataract surgery. Modern IOL calculation formulae are very good at predicting a refractive outcome but not yet perfect. Can we improve any further by considering how the first eye responded to surgery? This may seem like a simple question on the surface but there are other issu...

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May 8, 2020 44 mins

Ocular dominance is a term that often is thrown around when thinking about cataract and laser surgery, especially with regards to monovision. Despite this, testing of ocular dominance is often poorly understood and performed. This can lead to post-operative headaches - literally! In this episode of Ophthalmology Against The Rule, we discuss the strengths and weaknesses of different tests of ocular dominance and what they may imply ...

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Your hosts of Ophthalmology Against The Rule, Dr Ben LaHood and Dr Nick Andrew take a deep look at the evidence for and against different wavelength filtering IOL options. Some higher energy wavelengths of light potentially can be detrimental to macula health, cause glare and affect sleep. Available IOL technology now offers surgeons the ability to filter certain wavelengths in the blue and violet spectrum. There are IOL choices ou...

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We conclude our Ophthalmology Against The Rule miniseries on surgically induced astigmatism (SIA) by discussing the concepts of internal astigmatism, posterior corneal astigmatism, IOL tilt and decentration. Total SIA or internal SIA are commonly spoken terms but not often discussed or defined. We shed some light on what they are all about and whether they can be measured currently.

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In part two of this Ophthalmology Against The Rule miniseries on surgically induced astigmatism (SIA), Dr Ben LaHood and Dr Nick Andrew discuss the practicalities of assessing and calculating SIA for each surgeon. This includes what measures are needed, when to measure and tools to give you all those numbers you read about in the journals. 

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On this special episode Dr Ben LaHood and Dr Nick Andrew discuss COVID19 for eye care professionals and cover specifically what ophthalmologists and optometrists can do to keep themselves and their patients safe during the pandemic.

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Surgically Induced Astigmatism (SIA) is a poorly understood part of every cataract surgery and IOL calculation. Understanding, minimising and making SIA more consistent can lead to more predictable refractive outcomes. In the first part of this three part mini-series we get down to basics with understanding exactly what SIA is all about. 

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