Iris My Case

Dr. Raja's blog



Putting the “Trip” in “Tryptophan”

FYI, tryptophan is the stuff in turkey that makes people sleepy…

So it’s been a busy long weekend!

It was my birthday on Wednesday. Nothing special, turned 41 which is as nondescript of an age as you’ll ever find. Aging is always a funny thing–I see it all the time in my patients. In fact, most of my patients would be considered elderly. I see people who have parents or spouses pass away and others who are having new additions to the family–children, grandchildren, or maybe pets! Such is the circle of life, I guess.

On Thursday, of course, was Thanksgiving. We were in South FL for the weekend, which was really nice but strange. Strange because it was the sunniest, warmest Thanksgiving I can ever remember. Even the turkey looked a little tanner than usual! It was good to spend some time with the family. The kids loved the beach and pool and the food was excellent over the weekend. The traffic on the way back was another story entirely. Took forever to come back home. I’m glad to be back home, however! Nothing like a trip away to make you appreciate what you have here at home. I’m excited to see what the new week brings!



The Wonderful Wizard of Odd

Judging from the the post-op week one results, the RoboMarker seems to having its desired effect! I’m very excited by this little gadget moving forwards. Makes me want to tinker around and invent something of my own…

Speaking of which, the family all decided to go to the Maker Faire 2018 at the Central Florida Fairgrounds this past weekend. The kids (and adults) all had a blast! There were robots of all sorts–dogs, walking robots like these:

final (1)

Always been a fan of ingenuity in all its forms! I was a biomedical/electrical engineering major in college, after all, so I can appreciate what goes into it. The kids had a lot of fun running in hamster wheels to get snow cones, making and racing cars made out of recycled materials, and playing a giant version of pinball. My personal favorite was the combat robots, as seen on the show BattleBots. My son and I enjoy watching that (my daughter…not so much!). After a lot of metallic bashing, the favorite lifted the challenger to presumably suplex him into submission. He did–by throwing him upside-down– but the champion flew out of the arena in the process! It was a double-knockout! It was probably more exciting to see, moreso than read about. We’ll definitely be attending next time, but I think I may bring carrots or something so we don’t have to deal with the inevitable sugar high of fair snacks. And by “we” I mean “me.” That stuff will keep you going for hours!



Back from the Windy City

Sorry, been a while! We had our American Academy of Ophthalmology meeting recently in Chicago. It was a quick trip but still eventful! Learned about some new procedures that we’re hoping to offer soon. One is the XEN gel stent for glaucoma. This can be offered in conjunction with cataract surgery or on its own. This appears to be a more controlled and easier procedure to recover from than other treatments for moderate to severe glaucoma like tube shunts and trabeculectomies. I’m excited to have another tool in the armamentarium to try to get people off glaucoma drops! That’s always been one of my goals (or at least to minimize it). Another is a refractive procedure called SMILE. A lenticule is cut in the patient’s cornea along with a small pocket. The lenticule is carefully dissected and removed, giving rapid improvement in vision, akin to LASIK. The idea here is hopefully there is less dry eye postoperatively along with no risk of the flap becoming loose from trauma. Additionally, evidence seems to show it does a better job for severely nearsighted people, in terms of it not regressing as much. Lastly, I did get something called the RoboMarker. As far as I know, I’m the only one in the area with it. It is an auto-leveling marker which allows us to mark the eye before cataract surgery to better assist us during laser-assisted cataract surgery and implantation of astigmatism-correcting toric IOLs. Little known fact: the eye cyclorotates when a person lays flat as opposed to when they are standing up. Therefore, we like to mark the eye prior to surgery (when the person is laying flat). Otherwise, our axis of astigmatism can be off. Marking it by hand is notoriously variable. Funny thing, we can have all these fancy toys, but sometimes it comes down to simply making proper marks on the eye! At any rate, I used it this past Monday and it worked wonderfully! I’ll definitely be using this step for my PersonalEYES cataract surgery patients!


But it wasn’t all work! Dr. Parbhu was there too, so we ate at some good restaurants and did some shopping. I got an authentic leather jacket, which I’ve always wanted. Only problem is its just not that cold down here in Florida…in Chicago, though, that was a different story and I put it to the test! I’m hoping that one day, one of the kids will see it in the closet and will want it and it could be an heirloom item. I think that’d be pretty cool! Speaking of heirloom items, I’m also very slowly working on building a dollhouse for my little girl. There’s a lot of painting involved before the actual gluing, which is awfully confusing since all these pieces look the same! Oh well, I’ll just hope for the best!



I’ve often been described as…energetic.

I’ve often been described as…energetic. Funny, when I was in elementary school, they just called it being hyperactive! These days, I have a lot of interests, though it is hard to find time to allot for each one, especially with work and being a family man. If only I could clone myself! Alas, I don’t think the world is ready for that…

The underlying theme is I enjoy things that let me express my creativity and allow me to build. For instance, I play, sing, and write songs in a band, draw, and do some occasional woodworking (not at the same time, of course!). Currently, I’m working on a concrete and wooden bench for my front patio. I’ll keep you updated on the progress.


I’d like to think those same skills translate to my being a better doctor. For instance, not everything is cut and dry—sometimes you have to think outside the box and come up with creative solutions. It’s impossible to be static in medicine because it is so dynamic, so fluid! And this requires fluid solutions, at least in my humble opinion.



It was the worst of times, it was the best of times.

I finally finished another week of Orlando Health trauma call last Friday. I’ve taken a lot of call over the years. I think of it as the “jury duty” of ophthalmology–I try to do it for a few weeks per year to help shoulder the city’s burden. I feel it’s my civic responsibility…plus I used to be the Ophthalmology Department Chair a few years ago, so it is something near and dear to me. It’s busier than you’d think–you’d be surprised how many eye emergencies show up in the ED. This past week there were two ruptured globes–eye injuries so severe they were cut open during the initial injury (a car accident and a twig to the eye, respectively). It’s always a unique experience, because you are catching people at their most vulnerable. It is a tremendous responsibility to take care of these patients in their hour of most urgent need, and I am grateful for the opportunity to hopefully help save the eye and restore vision. You never know how bad the injury will be until the operation begins so there is a good bit of improvising.

The things that hit me the hardest are when I have to see child abuse cases. As a father myself, it upsets me to see children mistreated in such a fashion. Many of them are less than a year old. My role is to look for retinal hemorrhages in both eyes. Hemorrhages, in conjunction with other findings, could indicate that the child is being shaken vigorously. Thankfully, most times I look, it is negative. But when it is positive, it’s an emotionally draining experience. I have to remind myself that this is the exception, and not the norm.

Needless to say, I was glad to have a free weekend come around. The missus and I went to the Jazz’n Blues Concert at Leu Gardens on Saturday night. It was a great experience! We ate crackers with assorted cheeses and meats with some red wine and listened to “The Betty Fox Band.” She had an incredible voice, by the way. It was incredibly relaxing and judging from the vast amounts of people there, it’s a popular annual attraction. We’ll definitely be going next year. You know what they say, “work hard, play hard!”



It’s that time of year again–no, not Halloween (that’s the topic of a different blog).

Flu season! I’ve had the flu before, in college actually. Bombed a math test while having a fever, then got hospitalized for a few days afterwards. I vowed never to go through that again, so I’ve been pretty faithful about getting my vaccines. Every year we offer the vaccine to our OEI staff because the statistics are pretty staggering. Over 80,000 people died from the flu last year, and over 900,000 were hospitalized. Sure, there’s no guarantee it’ll be 100% effective, but I’d just as soon take my chances. You know what they say –“an ounce of prevention is worth a pound of cure.”

I decided to go to Publix to get my vaccine. It’s near the office and I can always try to score a free cookie from the bakery afterwards (just kidding). As I was waiting patiently for my turn, I decided to roll up my sleeve so I could leave my deltoid muscle ready for the shot. Much to my horror, I realized that I had decided to wear a trendy, tight-fitting dress shirt. Once I hit the elbow, there was no way it was going to roll up any further–it was acting like a tourniquet! I don’t work out so it must have been the shirt. So I had to unbutton my shirt and put my arm through the front. It was…incredibly awkward. Let this be a lesson to the rest of you! Make sure you wear loose fitting clothing and short sleeves when you are getting your flu shot! Trust me on this one.

This was also an important week because it was OEI’s 8-year anniversary! I can’t believe we’ve been around for eight years…I don’t know where the time has gone. I’m extremely grateful to our patients and referring providers for all our success. I’m also especially indebted to my wife, Dr. Parbhu, for all of her help. We couldn’t have done it without ya! I’d like to get the office a present in commemoration but I wasn’t sure what to get. A quick internet search reveals that the classic 8th anniversary gift is made of copper. I’ll have to keep this in mind moving forward.

Till next time, Cu2+ later! (get it? that’s elemental sign for copper…oh nevermind)



Well, now I’ve gone and done it.

I’ve decided to write a blog.

Yes, I know I’m probably a decade or two behind, but hey, better late than never! After much thought, I’ve decided that I’ll use this platform to talk about frequently asked questions and interesting topics that come up on a daily basis. Hopefully, over time, any readers will have a better feel of who I am as a person. There are many things we can figure out online–what insurances we take, my education, ratings etc. But that never gives an idea of who your doctor is on a personal level. Perhaps this will be my way to change that.

“Why did you go into ophthalmology?” I get asked that a lot. There are a number of reasons actually. First, my parents are doctors (surprising as an Indian, right?!) so that was always a field I was interested in. Second, I LOVE technology–always have and ophthalmology is loaded with it! Last but not least, when I was young I used to go to the ophthalmologist for a few reasons. I have eyes of two different colors (heterochromia) and I was watched closely to make sure my iris freckle (nevus) was not a melanoma. It wasn’t (whew!), so I was able to avoid the eye doctor for a time. I then began getting nearsighted. I hated wearing glasses in school. They were ugly and I felt embarrassed to wear them. Unfortunately, school was difficult because I just couldn’t see. I was eventually fit in contact lenses and that helped tremendously! Still, I hated my annual eye exams much like people fear going to the dentist. Every year, my prescription would get worse and worse and there was no end in sight. Was I going to end up -30.00 D or something!? Was I going to be functionally blind? Short answer–no and no. My prescription stabilized to -6.00 and after medical school, I got LASIK done. It was wonderful–I could see everything so clearly! Even things I didn’t want to see, like how dirty my bathtub was–blech!

I will never forget what it was to be sitting in the patient’s chair. There is a lot of fear that comes with not having the knowledge that I presently have. That’s why I try to make it a point to explain a situation as clearly as possible to patients. That way, if they have some understanding of their condition and the comfort of having some plan in place, their fear may be lessened. After all, at any moment, I could be sitting in the patient’s chair again and I would want someone to do that for me.


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