Nothing special, but kinda priceless no? 😁

The FDA target action date for Outlook Therapeutics' Lytenava (ONS-5010 / bevacizumab-vikg) is set for July 29, 2026.

If approved, it becomes the first FDA-sanctioned ophthalmic formulation of bevacizumab specifically indicated for wet AMD.

About 2.7 million off-label compounded Avastin injections are administered annually in the US. Approval of an on-label alternative introduces significant operational shifts:

1.Compounding & Safety: Eliminates dependence on compounding pharmacies and risks around silicone oil droplets or batch contamination.

1. Payer Mandates: Expect commercial payers and Medicare Advantage plans to enforce strict step-therapy policies, requiring Lytenava before approving higher-cost anti-VEGF agents (Vabysmo, Eylea HD).

2. Practice Economics: Moves clinics from low-margin off-label compounded syringes toward standard ASP+6% buy-and-bill models.

For those colleagues in active practice or med leadership:

How is your institution or clinic preparing for this?

Do you anticipate payers completely pulling coverage for repackaged cancer-label Avastin once an on-label option is available?

https://www.managedhealthcareexecutive.com/view/fda-sets-goal-date-for-ophthalmic-version-of-bevacizumab

Hey all,

Fresh pgy2 here. Been doing lots of intravitreals with subconj lido. I cause subconj heme in ~80% of my patients. Would appreciate tips on how to improve.

Right now I angle the needle bevel up and anteriorly away from the cornea and attempt to barely graze the conj before infiltrating. Patients dont feel the actual injection, but its kinda bummer to see them after with red, bloody eyes.

Thank you!

I'm just curious how others handle it but I'm still in the early stages of taking call and trying to get better at starting a reasonable treatment plan.

Do most people just reference whatever Will's says and call it day for call purposes and then manage it at the next follow-up with an attending? Or do people use chatGpt or openevidence?

Just curious, specifically for attendings and residents on here, what hobbies do you do in your free time?

I play video games, work out (if I can force myself), and binge shows or movies. Thinking of getting into indoor climbing as well, though it hurts my hands.

I’m a student applying this year. Basically with signals going up to 15 this year, I’ve heard some programs are only going to be interviewing students that signal them and I wanted to know if others have heard the same.

I just got into Retina and I’ve been using the pen light to check angles which I’m still learning since I’ve been there only a month.
There’s times that the doctor can’t even tell if it’s narrow, open or closed angle. I use the oct but I was trying to find a picture online of what it looks like when it’s open, narrow and closed but couldn’t find any.
From my understanding this picture is showing narrow angle

Hi everyone,

Before starting this project, I spent time working in market intelligence and data analytics for a global OCT manufacturer (not fun). If my time on the inside taught me one crucial lesson, it’s this:

Buyer ignorance is their absolute biggest weapon. Choosing an OCT device is a massive investment, but comparing them often means wading through curated sales pitches, hidden costs, and marketing fluff rather than hard data.

I’m currently developing an independent, data-driven platform designed to flip the script and help eye care professionals compare OCT devices objectively. The platform is entirely based on official specifications, manufacturer patents, and scientific publications. Access to the portal will be 100% free, and the methodology behind all ratings and comparisons will be fully transparent and publicly available.

Here is what I have built/planned so far:

• Objective comparisons: Side-by-side specs, technology differences, and model variations without the marketing spin.
• Clinical evidence & studies: Direct integration with PubMed and other scientific databases. It pulls actual clinical trials, independent model comparisons, and peer-reviewed papers. I know clinical references are the bottom line, so I already have this partially built out alongside the patent data.
• Total cost of ownership (TCO) calculator: Factoring in maintenance, software licenses, and service contracts over time.
• Manufacturer news feed: Automated aggregator pulling updates directly from manufacturers' official channels.
• Global distributor list: Searchable by country.
• Used market aggregator: A section compiling listings for refurbished/used devices.
• Community reviews & forum: A place for honest feedback from actual users.
• Anonymous pricing database (Optional): A crowdsourced, highly secure, and strictly anonymous questionnaire where users can input actual purchase prices, service costs, and add-on fees to fight opaque pricing in the industry.

Since this is built for you, I want to make sure I’m focusing on the right things. I don't have a live domain to share just yet, but before I finalize the core architecture, I’d love your input:

1. What else would you want to see? Are there any specific pain points you face when buying or maintaining an OCT?
2. What should I drop? Are any of the features listed above unnecessary or too cluttered?
3. Would you be willing to anonymously share your pricing data to help build a transparent cost database for the community?

Any feedback, harsh or otherwise, is hugely appreciated!

Hi there,

Junior resident here - I feel like I continually get confused by the use of pilocarpine in AAC, and when it's appropriate Vs when it might make things worse.

I get that miosis can pull the iris tissue out of the angle, allowing aqueous to access the TM. But if pilocarpine also causes the lens-iris diaphragm to shift forwards, isn't this simply worsening pupillary block? Is it a balance between the two, and the miotic action wins?

I've also had several scenarios where there has been at least a fair phacomorphic component to the AAC, so I've been quite nervous to prescribe pilo, but my senior colleagues aren't worried and give this anyway. The rational given is that the greater component of the AAC is due to pupil block and so the pilo will be helpful. Any tips on how to judge this? 😅

Any advice on the use of pilocarpine greatly appreciated, especially if delivered as if I'm 5 years old!

I have recently started working with this OCT machine, but the slowness of the operating system is frustrating. The 1 TB hard drive is completely full, and I constantly have to wait for the database to load. Is there any way to automatically delete all patients, without manually deleting them one by one? There's around 900 GB of data, and all of them are just old records if patients who will never come again.

I used the Archive function, but further disk cleaning does not work, it says that there is already enough space on the disk, like 100 GB. I am afraid of deleting data folder because data will be cleaned, and database will stay the same 😢

Yeah, we don't have Zeiss engineers here in the city and in the region.

Hey all, im an American Board-certified ophthalmologist currently practicing in the U.S. I completed an ACGME ophthalmology residency and and fellowship, and I’m considering moving back to Toronto for family reasons.
Has anyone gone through the Ontario licensing process with CPSO?
Do you still need Royal College certification, or is American Board certification enough to practice independently? Also curious about how long licensing took, hospital privileges, OR access, and whether a U.S. fellowship is recognized.
Would really appreciate hearing from anyone who has made a similar move.

PI says I should consider a research year, hoping to get your thoughts.

254 Step Two (the average is 258 so I am not the strongest here)

2nd Quartile In Class (AOA pending); Issue is I HPd IM which I know is important :/. Surgery was Honors

1 first author paper, 3 1st author papers submitted but not published (thus why my PI says it may be best I take a year off, let these develop)

9 posters (7 I am listed as first author)

2 Ophthalmology Research Excellence Awards

Presented at Ophtho Grand Rounds x2, Ophtho NewsLetter Writer, VP of Ophtho Club

I do not think I will get a paper published from my waiting list hell in time (September is apps D:) so my PI is pushing for me to take a year off. That would be a heavy financial decision for me so Im really battling if its needed or not. Give it to me straight guys

RCA seems to be taking over pretty much every major retina practice across the entire US. While their 3 year salary contract is fairly standardized, what actually happens after year 3? What does partnership in their shares actually mean?
DMs welcome for those with insider knowledge

I’m a fellow

I am a recently appointed attending ophthalmologist and regularly perform cataract surgery independently. I feel comfortable managing routine cases and usually complete them without significant difficulty. Even small anterior chamber; PEX and dense catarats cases are fine for me. However, I still struggle to understand how I can improve my surgical technique, particularly when dealing with challenging cases such as brunescent cataracts with poor pupillary dilation.

Because I work in a setting where there is no more experienced surgeon available to supervise or mentor me, I often feel that I am learning entirely on my own. At the moment, my main educational resource is watching surgical videos online. Although these videos are helpful, they do not provide the feedback, guidance, or reassurance that direct mentorship would offer.

I genuinely want to become a better surgeon and, eventually, someone my colleagues can turn to for advice. However, almost every time I attempt a particularly difficult case, I struggle and sometimes end up with a posterior capsule rupture. These experiences are frustrating and have made me increasingly reluctant to take on complex cases.

This has led me to question how surgeons should define their own limits. Should every cataract surgeon aim to become highly skilled in the most complex cases, or is it reasonable to recognize that certain cases may be beyond one’s current level of experience?

I want to continue improving, but I am unsure how to do so safely without supervision or structured mentorship. How can I gradually develop the skills and confidence needed to manage more difficult cases while still protecting my patients and respecting my current limitations?

I just started residency and I’m looking for free websites with ophthalmology atlases and case quizzes. I want to expose myself to as many clinical images as possible so I can recognize diseases more quickly in clinic.
Looking for things like OCTs, fundus photos, slit lamp images, FAF, visual fields, and unknown cases with explanations.
Any recommendations?

I’m kind of panicking about not having a mentor in ophthalmology. There’s 4 people in my class interested in Optho as well and they all have mentors already.
Any suggestions on how to find someone? My school is in Ohio

It's been discontinued. Do you know why? The website says only that it was 1993-2026.

I am an M4 applying into ophthalmology this year. I’m interested in peds and was wondering what residencies on the east coast will give me the best training. Surgical training >>> location/prestige

Hey everybody,
These are 2 different cases which we found during strabism surgery. Both haven’t had surgery before. The dark spot is near the vortex vein. Do you think it is scleral melanocytosis?

Background: ophthalmologist from Germany. Kaukasian patients.
Thank you for your help!

They will probably say, well at least it wasn't a 4% rate cut, only a 1-2% rate cut.

With the current trend of rate cuts, do you see any changes in your practice management strategy going forward? When are the rates low enough where you plan to drop them and start making people pay out of pocket?

Why is it that if PCR occured ans vitreous prloapsed let's say into the capsular bag or AC.. anterior vitrectomy is a must?

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What would happen if this vitreous was left as it.. and during e.g. globe "scleral" rupture before closing the wound.. meticuluous scissoring vitrectomy is performed prior to wound closure??

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"Retina, you have no collaterals."