Professional, ethical, and effective expert witness services.


Posts in Vitreoretinal Disease
Central Retinal Vein Occlusion

CRVO is a frequently encountered retinal disease. Risk factors include age, glaucoma, or vascular diseases including hypertension, hyperlipidemia, and diabetes. Furthermore, smoking and taking oral contraceptives increase the risk in otherwise healthy individuals. When no underlying risk factor is present, a workup searching for a hypercoagulable disorder may be performed.

Read More
Branch Retinal Vein Occlusion

BRVO is a disease of retinal circulation which may affect a patient’s vision. Macular ischemia, edema, vitreous hemorrhage, or neovascular glaucoma all may occur. The disease is more common with increasing age and in patients with hypertension, diabetes, or hypercholesterolemia.

Read More
Role of the Expert Witness

The medical expert witness provides several important functions.  First and foremost, the expert must be able to interpret and analyze complex clinical scenarios.  Then the expert determines the appropriate standard of care to be applied to the specific facts.  It is then necessary to decide if the care given represents a breach from the applicable standard of care.  If a breach has occurred, an assessment of any injury the patient has experienced is done.  Finally, establishing causation between the breach and the injury is necessary for the case to have merit.

Read More
Macular Hole

During my career, macular holes have gone from an untreatable disease to one which is almost always repairable. Surgical success has improved over time with advancements in surgical techniques and equipment. In my opinion, peeling the ILM, achievable with the use of intraocular dye, has greatly increased the rate of successful hole closure.

Read More
Epiretinal Membrane

Epiretinal membranes are a very common ocular disease, affecting as many as 30 million Americans. The majority of patients experience minimal visual disturbance. In about 20% of patients, the pucker worsens and causes progressive vision loss.

Surgery is recommended when the condition interferes with the patient’s activities of daily living such as reading, driving, or watching television.

Read More
Paradigm Shift: Anti-VEGF Therapy in the Treatment of Diabetic Eye Disease

Vision loss from diabetic retinopathy is related to the severity of the disease. In mild NPDR, the risk for vision loss is low. As the disease worsens, the risk for loss of vision increases.

In recent years, anti-VEGF injections have been utilized to treat patients with diabetic macular edema. While treating diabetics for edema with anti-VEGF therapy, an improvement in the diabetic retinopathy is frequently observed.

Read More
Diabetic Retinopathy

The treatment for diabetic retinopathy has come a long way in the past forty years. Initially an untreatable, blinding disease, it is now quite responsive to therapy. 

Read More
Age-Related Macular Degeneration

Macular degeneration is a common disease in America’s aging population. While dry AMD is more common, wet AMD is associated with greater risk for vision loss.

Read More
Retinal Detachment

Retinal detachments are an ocular emergency. When the retina detaches from the eye wall, it no longer sees normally. Surgical repair is indicated. Vitrectomy, scleral buckle, or pneumatic retinopexy are the treatment modalities most frequently utilized.

Read More
Posterior Vitreous Detachment & Retinal Tear

One of the most frequent conditions ophthalmologists encounter is posterior vitreous detachment. While the condition is relatively common, complications such as vitreous hemorrhage, retinal tear, or retinal detachment are not. As the symptoms of PVD, retinal tear, and retinal detachment are similar, a complete examination including dilated fundoscopy, and sometimes retinal imaging or ultrasonography, should be performed in a timely manner.

Read More