Dr. Lander’s Eye Manual for Residents

I would like to thank Jeffrey R. Lander, MD from the Leader Heights Eye Center for agreeing to share his awesome Eye Manual for Residents with the world.

In Dr. Lander’s words:

“If you are an internist or family practice doctor, you do need to know a few things about ophthalmology. Fortunately for you, you don’t need to know much! But the stuff you do need to know, you need to know well.”

The 50-page manual covers all the important ophthalmology topics really well. For example, here is Dr. Lander’s approach to temporal arteritis:

“If you are only going to remember only one thing from this manual, this would be it. Elderly people with the following need attention ASAP!!!

• Transient visual loss: Amaurosis fugax is a black-out of vision in one eye, lasting 10 to 30 minutes. If it lasts seconds, it’s not it.
• Sudden black-out or dimming of vision in one eye (without recovery). This can be from ischemic optic neuropathy or, less commonly, central retinal artery occlusion. Both of these can be from giant cell arteritis.
• Sudden onset of diplopia in an elderly person

In an older patient (over 60), proceed as follows: Get the patient in to your office or mine now. If yours, give them three or four 20 milligram prednisone tablets in a pill envelope and a lab slip to take now to the nearest lab, do not pass Go. You will be ordering a sedimentation rate, quantitative CRP and complete blood count. The patient must take all the prednisone there at the lab, as soon as the blood is drawn. The patient can go suddenly blind from this disease, if untreated, and the prednisone is usually very effective in preventing this disastrous complication. Then, and only then, do they see the ophthalmologist (if the ophthalmologist wasn’t the first person to see them). This is a good test for your ophthalmologist—he should drop everything to take care of this patient immediately, if he is to be the first physician seeing the patient.” (Lander, 2013).

You can download the manual free here.

On a personal note, I would like to thank Dr. Lander for the opportunity, privilege really, to work with him during my residency at York hospital. He is an excellent, dedicated teacher and clinician who raises the bar of clinician-ship for everyone who has the opportunity to work with him.