There are so many subtle clues in cataract surgery that can easily be missed, particularly when less experienced surgeons are … More
Category: Quiz
Cataract Quiz: First eye predicts the next
This patient had cataract surgery in the first eye a few years ago and when we look at the undilated … More
Cataract Quiz: Zonular Dehiscence
Our guest surgeon is Dr Willie Kan from Malaysia and he presents a very tough case: a traumatic white cataract … More
Cataract Quiz: Why did this happen?
Looking at this picture, the pupil dilation went from 5 mm in diameter to 10 mm in diameter in just … More
Cataract Quiz: Why did the trypan do this?
Cataract Quiz: Why did the trypan blue dye do this? Why is the staining so odd looking? Why is the … More
Cataract Quiz: Where is the hidden piece?
Time for another cataract quiz — look carefully at the photo above. Where is the nuclear fragment hiding? And how … More
Cataract Quiz: When did the break happen?
This patient has a relatively dense cataract and requires a toric IOL for 2 diopters of regular corneal astigmatism. When … More
Cataract Quiz: What should you do?
What are these dark spots seen in the red reflex as you are about to start cataract surgery? What do … More
Cataract Quiz: What happened here?
Our quiz features a video from Gustavo Hüning, MD, MBA from Brazil and it shows an unusual situation that happens … More
Cataract Quiz: Trapped Air Bubble
We have a great learning case from Dr. Xiaogang Wang from Taiyuan, China with a surgical challenge. This patient has … More
Cataract Quiz: many small opacities
Quiz time! You are doing what seemed like a routine cataract case and then you see many small opacities in … More
Cataract Quiz: slight peak of pupil
This is a very subtle sign — look carefully at the picture. In the sub-incisional area, there is a slight … More
Cataract Quiz: Why did the capsule rip?
This resident surgeon recently experienced quite a surprise: when he injected viscoelastic at the beginning of the surgery, the anterior … More
Cataract Quiz: Why is the cornea cloudy?
This is a routine cataract surgery case. It is very efficient and a minimal amount of ultrasound energy is used … More
Cataract Quiz: What’s wrong with the IOL?
Time for a Cataract Quiz, featuring guest surgeon Dr. Sourabh D. Patwardhan from India, featuring a complication with an IOL. … More
Cataract Quiz: Argentinian Flag Sign
Cataract Quiz: How can you prevent the dreaded Argentinian flag sign now? White cataracts can pose a challenge when performing … More
Quiz: Why are there two main incisions?
Cataract Quiz: Why are there two phaco incisions in this eye? This is a routine cataract surgery and the case … More
Quiz: What is different about this cataract?
Look carefully at the picture above and you will see something that is different about this white cataract. It is … More
Cataract Quiz: Why shift the capsulorhexis?
Looking at the picture above it seems like the capsulorhexis has been shifted nasally: it is much closer to the … More
Anterior Capsule Rips Uncontrollably
Quiz time: What do you do when the anterior capsule rips uncontrollably in a young patient who is scheduled to … More
Quiz: Should I have used a pupil ring?
This is a tough case and the pupil is smaller than I expected. Should I have used a pupil expansion … More
Cataract Quiz: IOL with capsule tear
Cataract Quiz time: you have removed the lens nucleus and the cortex and you see that the anterior capsular rim … More
Cataract Quiz: Which direction for capsulorhexis?
In this Cataract Quiz we have a patient with a white cataract and as we start to tear the capsulorhexis, … More
Cataract Quiz: Chopper breaks zonules
The resident surgeon has good hands and is talented, but like all new surgeons, he is lacking in experience. The … More
Cataract Quiz: Rescue this Rhexis!
For this Cataract Quiz we have guest surgeon Dr. Naveen Gopal from Bangalore, India showing us a tough case that … More
Cataract Quiz: Why did this IOL decenter?
The patient underwent a combined cataract surgery with pars plana vitrectomy. The cataract surgery went well and even today, 1 … More
Cataract Quiz: When did the bag break?
In this anonymously submitted resident video, there is a break in the posterior capsule during cataract surgery. With the assistance … More
Cataract Quiz: Where should you make the incision?
Our phaco incisions will induce an astigmatic change in the cornea and we can use that to help achieve a … More
Cataract Quiz: What happened here?
Look carefully at this picture: what do you see? There is a three-piece IOL in the sulcus and there is … More
Cataract Quiz: What is hidden in this pic?
Look carefully! There is something that needs to be addressed in this picture — it is not easy to see, … More
Cataract Quiz: Optic-Iris Capture
Happy New Year! It’s Quiz Time: how do you approach this case with optic-iris capture and a dense fibrotic membrane? … More
Cataract Quiz: The chop failed. Now what?
Even for expert cataract surgeons, sometimes the attempt at phaco chop fails. This can be due to many reasons and … More
Cataract Quiz: What is the problem here?
Time for another Cataract Quiz. Look carefully at the photo — the IOL has just been implanted and now it … More
Cataract Quiz: Why is there a capsular wrinkle?
This surgery seemed quite routine. A nice capsulorhexis, easy nucleus removal, and complete cortex clean-up. The three-piece IOL was placed … More
Cataract Quiz: Why is this cortex so adherent?
This seemed like a completely normal case… until it came time for removal of the last bit of cortex, which … More
Cataract Quiz: Why did we get bleeding here?
In this resident case, the IOL is in the capsular bag, the capsulorhexis is intact, the viscoelastic has been removed … More
Cataract Quiz: What complication will happen next?
Cataract Quiz: look carefully at the IOL in the injector cartridge. Now it’s time to implant the IOL into the … More
Cataract Quiz: What is this white plume?
The phaco probe is placed in the eye at the beginning of the cataract surgery and when ultrasonic energy was … More
Quiz: What will happen next? Look carefully
This picture tells me that there is going to be an issue during this case. As soon as the incision … More
Quiz: Cataract & Penetrating Corneal Injury
This patient had a penetrating corneal injury many years ago. When we look at the eye we can see evidence … More
Quiz: Why is this phaco chop going to fail?
Look at this photo carefully. We can tell that this phaco chop will fail and the nucleus will not be … More
Quiz: What is happening in this eye?
Look carefully at this photo taken at the slit-lamp microscope. What is happening in this eye? Describe what you see … More
Quiz: Why is the vision 20/200?
This patient has a pre-op visual acuity of just 20/200 but the cataract does not look that bad. Also, we … More
Quiz: What is this focal lens opacity?
What is this focal lens opacity that is seen during cataract surgery? And how do we remove it? What likely … More
Quiz: What are these spots seen during surgery?
During cataract surgery for this patient, everything seemed relatively routine. The patient is elderly with some zonular laxity, but even … More
Quiz: Why does this pupil look irregular?
This patient is undergoing a combined cataract surgery with a pars plana vitrectomy. Two novice surgeons are operating: a senior … More
Quiz: What is going on with this IOL haptic?
The surgery has gone very smoothly and the senior resident is doing a great job. The incisions are good, the … More
Quiz: What is the huge danger seen in this photo?
This surgery is being performed by a senior resident and it starts off great. It is a dense white cataract … More
Quiz: What size is this Capsulorhexis?
We want a capsulorhexis to be just large enough to overlap the optic of the IOL in order to hold … More
Quiz: Why won’t this nucleus rotate?
This patient has a relatively opaque cataract with a pre-operative vision of only counting fingers. When we go to perform … More
Quiz: What is this large central opacity?
Quiz time: What is this large central opacity seen in the anterior chamber? The patient is scheduled for cataract surgery … More
Quiz: Why is the posterior capsule wrinkled?
This seemed like a totally routine case. Good incision, good capsulorhexis, efficient nucleus removal, and complete cortex removal. There was … More
Quiz: Cataract Surgery in Fuchs’ Corneal Dystrophy
Look carefully at the picture and tell me what you would do differently for this cataract surgery. This patient has … More
Quiz: Why does the red reflex change during surgery?
This is a routine cataract surgery, but there is a limited red reflex during the surgery. This is sometimes due … More
Quiz: It’s a good incision so why did the AC collapse?
Quiz time! Watch this brief video carefully and figure out why the anterior chamber collapsed after this resident surgeon made … More
Quiz: What is the problem here? Look Carefully!
This case seemed like a routine cataract surgery. Everything went smoothly. A good incision, a nice round capsulorhexis, easy removal … More
Quiz: What is this dark spot and what is the danger?
This is a complicated case sent to us for review by an anonymous surgeon. You can also submit a video … More
Quiz: Why won’t this IOL stay centered?
This case seemed 100% normal. Reasonable dilation, good zonular support, 5-mm round capsulorhexis, phaco chop, and a normal capsular bag. … More
I just cannot chop this cataract – you’ll never guess why!
This seemed like a routine cataract surgery, but I was wrong. I just could not seem to chop this cataract … More
Quiz: Why did we miss the post-op target of plano?
There are many methods of IOL calculations and with every generation, these get more refined and more accurate. Most surgeons … More
What IOL Power do you choose for this patient?
This 60 year old patient is seeing you in consultation for cataract surgery. He has a significant posterior subcapsular cataract … More
Quiz: Which ACIOL is in the correct orientation?
An anterior chamber IOL (ACIOL) is rarely used, but in cases with no capsular support, it can be very helpful … More
Learning from the IOL Calcs of the First Eye
Even with the best methods of IOL calculations (new generation formulae, artificial intelligence methods, and more), there will still be … More
IOL Calc Quiz: hitting plano in a high hyperope
Here is your challenge. You’re operating on a patient who is highly hyperopic (wearing +6.50 OD and +7.00 OS for … More
Quiz: Can you spot the potential complication?
In this case, everything seemed routine and it progressed quite smoothly. A nice incision, an accurate capsulorhexis, efficient nucleus removal, … More
IOL Calc Quiz: Why are the eyes so different?
This patient has similar cataracts in both eyes and is preparing for cataract surgery with you. The biometry has been … More
Quiz: Why does the IOL optic look cloudy?
This patient had cataract surgery with the same IOL about 18 years ago and she did very well for many … More
Quiz: Should you implant a Toric IOL in this eye?
The patient is 70 years old and the corneal scar of the left eye is about 80% depth within the … More
Why is the pupil peaked during this cataract surgery?
The iris is a fluid tissue that moves within the eye in response to the fluidic changes of cataract surgery. … More
Routine case, but what’s this line on the capsule?
This is a perfectly routine cataract case and it goes beautifully. But then, at the end of the case with … More
Wait! Is the Posterior Capsule Ruptured?
In this video which was submitted anonymously, the guest surgeon had a routine case with an intact capsulorhexis. But then … More
Traumatic Cataract: What is your surgical approach?
This 42 year old patient sustained an airbag injury to his face a few months ago. He noted cloudy vision … More
Quiz: Persistent Corneal Edema – Why?
This 70 year old patient had successful cataract surgery about one month ago. There were no complications. The patient has … More
White Cataracts: Can you pass the Quiz?
Only a true cataract expert will pass this 2 minute test! The past five articles and videos have all been … More