The Ophthalmic Physician Newsletter

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The line between therapeutic vigilance and financial over-treatment is becoming increasingly blurred. Honesty is at the heart of medicine. Yet, in modern ophthalmic practice honesty is increasingly competing with profit - and too often profit is winning. Patients automatically told they need int...

by John R Martinelli MD OD FAAO — Nov 19, 2025

Painful Diplopia. What Will You Do?

Patient in Your Chair... 64yo gentleman, your 1st px of the day, called your answering service overnight. Left a message describing intense pain around his left eye, blurred vision, and difficulty opening that eye. You have him come in immediately. Slight ptosis OS with limited adduction + diplo...

by John R Martinelli MD OD FAAO — Nov 13, 2025

Are We Diagnosing More & Understanding Less?

A recent opinion piece in JAMA "The Impact of Definitions of Disease on Overdiagnosis" describes our culture in which expanded diagnoses and commercially driven health models have led to too much medicine - for which more tests, more diagnostic labels, and more prescriptions does not equate to b...

by John R Martinelli MD OD FAAO — Oct 10, 2025

Systematic Failure - Can The Ophthalmic Physician Wait?

A 78-year-old lady with sudden diplopia in my chair a week ago... Painful acute VIn palsy, pain & temple tenderness, family history of aneurysm. I send her to the ED with clear instructions including ESR, CRP, CT. She’s told by the ED doc: “It’s your eye, not your head.” Then: “You need to see a...

by John R Martinelli MD OD FAAO — Oct 03, 2025

Did you know Gin & Tonic was medicine?

In the 1700s, Scottish physician George Cleghorn discovered quinine (from cinchona bark) could fight malaria. British soldiers in India began drinking quinine water (“tonic water”), but the bitter taste led them to add gin, lime, and lemon — the birth of Gin & Tonic. Fast forward: quinine deriva...

by John R Martinelli MD OD FAAO — Sep 24, 2025

OMD Pathway Explained: 6 Questions I Keep Getting

Over the past few weeks, the concept to create a pathway towards a new medical specialty, the Doctor of Ophthalmic Medicine (OMD), has been met with overwhelming support. It's very exciting and the need is too obvious. This model introduces a two-year general medicine residency for Doctors of Op...

by John R Martinelli MD OD FAAO — Sep 17, 2025

Will You Get The Call?...

Imagine this... A 67-year-old lady with a history of diabetes, hypertension, atrial fibrillation, and prior coronary artery bypass graft (CABG) wakes up one morning to sudden total vision loss in one eye. Her panic is immediate. Her heart races. She stumbles for her phone, gripped by the fear of...

by John R Martinelli MD OD FAAO — Sep 09, 2025

The Quiet Truth of Medicine

The journey to becoming a physician is not glamorous. It is grueling. Acceptance into medical school requires sacrifice. Surviving medical school requires total sacrifice and endurance. Practicing daily requires an even deeper strength - the strength to forget yourself. Very quickly you learn it...

by John R Martinelli MD OD FAAO — Sep 03, 2025

Breaking Continuity...What's Your Story?

The other day, a longtime patient came in — and I can’t stop thinking about her. She’s 57, with idiopathic intracranial hypertension (pseudotumor cerebri). For years, she’s been managed successfully by myself and her longtime neurologist with Diamox, OCT, imaging, weight management, and close fo...

by John R Martinelli MD OD FAAO — Aug 27, 2025

Herpes Simplex Keratitis

Do You Know The Trigger?... Recents findings studying herpes simplex virus type-1 (HSV-1) keratitis may give us greater insight when we manage these individuals in daily practice. At least in this study (porcine), it appears HSV-1 infectious keratitis is primarily restricted to the corneal e...

by John R Martinelli MD OD FAAO — May 28, 2025

Nystagmus In Daily Practice

Do You Know Where To Start?... Whether congenital or acquired, nystagmus can be a difficult to understand and often mysterious complex ocular movement disorder. It is characterized by involuntary rhythmic eye movements, negatively impacting visual function and therefore quality of life. In d...

by John R Martinelli MD OD FAAO — May 21, 2025

Implantable IOP Sensors vs Tonometry

Will This Change How You Manage Glaucoma?... Intraocular pressure (IOP) is usually our primary concern in managing glaucoma - assuming we also understand and always consider additional pathophysiologic dynamics in glaucomatous optic neuropathy. For example, factors involved in glaucomatous prog...

by John R Martinelli MD OD FAAO — May 14, 2025

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The Ophthalmic Physician Newsletter

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