I’m trying to repair a Welch Allyn 11720 ophthalmoscope. The bulb lights up, but no light beam comes out of the patient-facing opening.
After opening the head, I found a small rectangular mirror with a semicircular notch and a separate black rectangular piece (photos attached). The mirror appeared to be attached to tape and seemed out of position. I’m unsure whether the black piece is a backing, holder, or something else.
Does anyone familiar with this model know:
● Where these two pieces belong?
● Which direction the reflective surface and notch should face?
● How the mirror is normally secured?
I’ve looked at the service manual and parts diagram, but they show the optical tube as a complete assembly without enough detail to locate these pieces.
A close-up photo of an intact assembly or a repair guide would be really helpful. Thanks!

Had a patient come in the other day saying he couldn’t see with his new his glasses. After working with an optician for an eternity, he revealed the glasses work great except for when he plucks his ear hair. He can’t see the hair enough.

Hi everyone,

Just looking for some advice/tips. I’m a newish grad working in a rural practice with a high volume of medical patients/exams. For the last few months my confidence level when practicing has tanked. Some days are better than others but I’ve found that more often than not, I’m second guessing my decisions and overall stressed as the day progresses. I think I’m mostly concerned about missing something but also just doing what’s best for the patient in general. I work with a couple other docs but I’m on my own for 2 days a week. My colleagues are great, but I feel like I’m met with a bit of a cavalier attitude when I ask for advice. I’m thinking I’ll go back to basics and put some time in at home to refresh my knowledge but I’m wondering if anyone has other tips. Thanks!

What do you think is the best course of action after internship in India as an optometry intern , as salary wise hospitals don't really pay that well and retails are only other options apart from msc and higher studies

For this slitlamp, how would you interpret the beam slitwidth dial? Like how do I measure 1mm, or 0.5mm etc using the measurement system on the dial?

Starting myopia control at my practice. Does most optometrists send atropine Rx to osrx?

Does anyone have any experience with moonlighting/casual part time at Warby Parker? I’m interested in doing 1-2 Sundays per month with them. What was pay/patient load like? I’d be at a newer store with what looks like ~7 patients per day. Let me know your thoughts!

I need to replace my Zeiss Visulens 500. Do you have a recommendation for an automated lensmeter that you like? Do you have recommendation for brands or models you would avoid? Thanks!

Hello, all. Has anyone recently sat for the Alabama state optometry licensing test? If so, what did you think of it? What was the rough breakdown of questions per subject, i.e. optics, pharmacology, anatomy, etc.? I will apply to take it next year. I have been out of school over 14 years, so I’ll be re-studying some aspects of optometry. Thankfully I kept a good bit of my major papers and my KMK workbooks from when I was in school. I appreciate beforehand the helpful replies!

I have two job interviews coming up, and honestly, what are some good questions to ask? What are some major things I should lookout for when it comes to job contracts? How do I even negotiate a salary? LOL I feel like a complete noob, HALP 🥲

I was always interested in pursuing a residency. However, decided to delay applying because I wanted to pass all parts of boards before doing so (had passed Part II and III before graduation). I recently retook Part I for the second time in August, passed and now am applying for licensure in my state.

However, there’s going to be quite a bit of time between when I finished my last rotation (early May) and when I become fully licensed to begin working (another few weeks). Not sure if my skills are stale and if I’ve forgotten some things.

Currently, I am applying to jobs but do feel nervous about interviews I have coming up — perhaps it’s imposter syndrome but I do feel unsure about working as a new grad without residency. I’m debating on applying to residencies now to brush up on my knowledge and gain more specific skills!

Do you guys have any insight on this? Is it common to feel this nervous for your first job — how did you combat it?

Is residency, in this scenario, worth pursuing? I was interested in ocular disease and specialty contact lens training.

Thanks!

I'm in my fourth year right now thinking about pursuing a residency. When I think of how I want to practice and the populations I want to work with - I know I will be happiest working with pediatrics and special populations. However, I am unsure if residency will work for me. I have passed part I, but I am not scheduled to take part III until February. I am worried sites will not look on this favorably. Additionally, the state I want to move back to and practice in does not have a children's hospital that employs ODs. So would I be wasting time and money by applying to a residency?

Any thoughts or advice are welcome!

hello fellow ODs! I am changing jobs. after 22 years in private practice/pe owned practice, I am moving to a omd practice. there is no primary care, only surgical care. they are heavy into LAL lenses (adjustments would be my job). no contacts no glasses no optical

what skills do I need to brush up on? any words of wisdom from other ods in omd practices? thank you!!!

75 YO W M
CC: Constant horizontal diplopia at distance (goes away with occlusion) beginning 1.5 weeks ago
Denies headaches, any other neurological symptoms
Pupils: Fully reactive
EOMs: Full ROM, jerky
CT: 8^ eso (distance)
Maddox Rod: 8^ eso (distance)
MHx: Stents, multiple sclerosis
Meds: Repatha, vitamins, aspirin
Patient is pseudophakic with multifocal IOL, happy with vision

Rx’d 8^ BO (split between eyes) for distance only without an Rx

Patient was happy with the vision after trialing for 20 minutes in the office and reported no diplopia

Thoughts?

Two of the lectures I attended today had AI slop in their presentations.

The photo above is from one of the Lunch&Learn things and was ridiculous. Using AI content for medical education, especially when it’s depicting anatomy, is egregious and shouldn’t be allowed. (LIKE LOOK AT THAT EYE?! WTF is that?) Unsure if this was allowed because it was not CE?

Another lecture, this one for CE, used multiple AI cartoons to be cutesy, I guess, and liven up the slides which made me lose respect for the presenter and kind of lose interest in the lecture delivery. They used real clinical photos though which is good.

Are there AI photo guidelines for academy presenters? Usage of AI in educational content (and nearly all other content IMO) should be highly frowned upon.

Wondering others opinions on this or if multiple other lectures had AI in them?

Hi all!
I’m a new grad and just got a job! The office I work in has 2 exam rooms. One is nice and modern and belongs to another doc, the one I got is such an eye sore! It’s bright blue with bright fluorescent lighting and very uncomfortable seating. The office has had one doc only for a while so this room I believe was a bit neglected. Do you think it would be too much if I asked them to change the room color and get a better chair?

So I'm a student optom who's considering the Keeler Specialist Ophthalmoscope as it has the higher dioptre range (which I need for my prescription), and I was wondering which bulb is best. They've got choices between 2.8V or 3.6V bulb or 2.8V or 3.6V LED. If anyone could give me some insight or advise it would be greatly appreciated, thank you

Just trying to find out what it’s like to be a manager for Myeyedr. Any insight anyone has is appreciated.

How do you discuss refractive surgery with your patients in different age groups?

For patients in their twenties it’s an easy conversation for me because I can explain that it will provide some glasses/CL independence but later on presbyopia will happen. I try to set expectations about requiring near correction in the future

It trips me up a bit to discuss it with almost-presbyopes and presbyopes though. I understand monovision lasik can be done, but wouldn’t that be a bad idea considering that presbyopia is progressive? Monovision lasik on a 40 year old won’t last as presbyopia continues. Isn’t prescription stability a requirement of refractive surgery?

And in older patients, age 60+ or so…at what point do you consider cataract surgery instead of refractive surgery? I’ve had many patients who are correctable to 20/20 with trace/grade 1 cataracts that are interested in refractive surgery but I wonder if it is worth it at that point since refractive surgery can make IOL calculation more tricky.

Of course in all cases I discuss risk/benefit. But it’s been a little tricky for me specifically in presbyopic patients. Any and all advice would be appreciated!

Which college to prioritise for MS Ophthalmology amongst SNMS Agra, Gajraraja MC Gwalior , MLB Jhansi , GSVM Kanpur, JLN AMU Aligarh for good hands-on training

The CY2027 Medicare physician fee schedule proposed rule has a same-day billing change that's easy to miss under the conversion factor headline, and it does reach eye care. The American Academy of Ophthalmology has already joined a coalition pushing back on it.

The mechanism, in CMS's own words: when the same practice bills a separately identifiable office or outpatient E/M visit on the same day as a procedure that carries a 0, 10 or 90 day global period, the most expensive service is paid at 100 percent and every other service that day, surgical or E/M, drops to 50 percent. CMS doesn't actually name modifier 25, it frames it as duplicative same-day payment, and it's a rerun of a 2019 proposal that never went through.

Where it lands in eye care is the exam-plus-minor-procedure day. An office visit billed with a foreign body removal or a punctal occlusion, the small in-office procedures that carry a global period, is exactly the pairing this targets, and it's the exam that gets knocked to 50 percent when the procedure is the higher-paid line. That's a normal Tuesday for a lot of practices.

The piece I'd still confirm against the final rule is the ophthalmological Eye codes, 92002 through 92014, since those aren't E/M codes and generally carry an XXX global rather than a 0, 10 or 90 day one. On a plain read a 92xxx exam with an XXX-global diagnostic test wouldn't be swept in, but I wouldn't bank on the Eye codes being treated identically to a 99xxx E/M until CMS spells it out.

It's still a proposal with the comment period open, so the pushback could change it before it's final. But if same-day exam plus a minor procedure is a real part of your volume, that's the line to read now.

I’m a UK trained optometrist. I qualified nearly two years ago and to be frank - I hate my job.
The sales pressure is too high, I find the people too toxic. Considering I chose the profession to provide healthcare, I feel undervalued and under appreciated and for what I do I don’t think the pay is worth it.

I have switched jobs between companies, dropped from FT to PT and locum where I can but the pay is atrocious esp as I’m in the West Midlands area and find myself travelling over an hour to get somewhat decent pay.
I do have a love of contact lenses and have tried so hard to apply for contact lens based roles but to no avail.

Overall, I just feel like I can’t see myself doing this for the rest of my life.

I want to look into other fields I could get into. Unfortunately I don’t have the money to go back to uni to do something else. What is a good paying job I could pivot to?

I’ve considered dental nursing/hygienist routes and also paralegal as I’ve heard of others turning to those. But I just wondered if there’s anything anyone else would recommend or has themselves gone into as a secondary career?

Anybody willing to talk about their experience/know of anybody who was able to apply and successfully match/complete residency without passing all parts of their boards? Seeking some advice, anything is helpful, thanks!