So to start us off, how do we even define blepharitis? How do you think about it or break it down conceptually in your mind for our residents and fellows out there?

Yeah, well, to start, all of these symptoms are not mutually exclusive, right? They have a lot of overlap between disease entity.

So blepharitis, if I had to define it, is kind of a chronic inflammatory disease of the eyelid margin.

It's really a spectrum.

It involves the lashes, the lid margin, the mebumian glands, and then ultimately the ocular surface, which is how they find me, right? Yes.

I guess if you're going to be rigid about definitions, you can talk about anterior blepharitis, which is more of like the eyelashes, or you can talk about posterior blepharitis.

I don't really divide them because...

What are some of the biggest mistakes you see clinicians making when managing blepharitis or ocular surface disease? And what's some of the advice that you would give to residents and fellows?

I guess, requirements or categorizations where you might say this type of patient should do more of an eat-off lens versus the multifocal? Do you ever discuss custom match, which is, you know, multifocal in one eye and eat-off in another? You know, how do you approach that? And again, you don't have a lot of time with the patient in the exam room, right? It's really just a few minutes,

kind of like on this podcast.

So, you know, when I'm doing an exam and we're having this conversation, it takes about, eight minutes for me to really ask those very specific questions and get the data that I need.

So I already have an idea of have they ever used monovision? Have they ever had refractive surgery? Those are like the two big things I really want to know.

Or have they ever had any kind of retina pathology, retina surgery, eye surgery, whatever, eye trauma? That's all taken and put in the chart before I even get in the room.

I ask every single patient, what do you do for fun? how do you spend your time? How do you spend your day? You know, how do you use your eyes the most? And every patient's going to say something different.

And so when they give me an answer, so let's, for example, say I've got a guy who's a former army ranger and he likes to shoot guns a lot, or, you know, he likes to go fishing or he's a pilot or she sews every day.

So it's, it's not only about the money, but you could still be upfront and honest about the money, right? Like the

Just to get started on our first topic, which we're going to title the Stepwise Workflow, how do we identify the most important steps in the process and how do we really summarize this for our audience? So in other words, what should be happening in the patient evaluation stage for someone who might be a candidate for an advanced technology or presbyopic correcting IOL? What are your thoughts?

Well, I agree.

This is a very important thing to discuss.

It's kind of a mystery in our field.

Why is there such low adoption of these amazing lenses that give a lot of spectacle independence and, in my opinion, are the best option if the patient's a good candidate? So in my office, we do a lot of diagnostics for every patient.

I'm always doing a topography, tomography.

I'm doing an OCT MAC.

And I know it's a lot to do in just a few minutes, but if you could like a high level overview, kind of almost like a summary, maybe what