Impaired physicians.

Nearly every physician has encountered a doctor who is causing problems in the practice or at the hospital. These include physicians who are impaired because of drug or alcohol abuse. Managing these physicians and helping them get back on track can be difficult and daunting.

The vital two minutes of the patient encounter.

The most critical aspects of a patient encounter are the first and last minutes. Consider these encounters like plays or novels with an introduction, middle, and end. The introduction and conclusion have the greatest impact on patients and are the parts they are most likely to remember.

Long-term surgical and visual outcomes in primary congenital glaucoma: 360 degrees trabeculotomy versus goniotomy.

Purpose: To compare the visual outcome and refractive status of children with primary congenital glaucoma who underwent 360 degrees trabeculotomy or goniotomy as an initial surgical procedure.

Methods: This retrospective study describes 24 eyes (15 patients) with primary congenital glaucoma that underwent 360 degrees trabeculotomy as the initial procedure and 40 eyes (23 patients) that underwent goniotomy as the initial procedure. Inclusion criteria were: (1) diagnosis of primary congenital glaucoma and initial angle surgery before 1 year of age, (2) no other ocular or systemic diseases, (3) 360 degrees trabeculotomy or goniotomy as the first surgical procedure, and (4) ability to obtain an Allen or Snellen visual acuity.