Time To Go Get Beat Up Again!

Ophthalmology for Delta Gamma Sorority

November 11, 2026

INTRO

Good evening. I’m Dr. Mary Côté.  Geri Lopker invited me to speak about ophthalmology.  I will tell you a little about myself and ophthalmology, and then briefly discuss some common problems you might need to address.  We’ll leave time at the end to answer any questions you might have.

I graduated from Loma Linda University in 1979 on an Army Health Professions scholarship.  At that time, you couldn’t borrow enough money to pay for school, and you couldn’t work while you studied.  After completing one year of a Categorical Surgical internship (rotating through Ear, Nose & Throat, Chest Surgery, Orthopedics, & Ophthalmology), I decided that advancing technology and the option of a balanced lifestyle made ophthalmology a good choice for me. Especially after I had four children.   HOWEVER, the Army decided that, despite telling me I could complete my specialty training, they needed me immediately.  So, one year out of medical school, I became a General Medical Officer in Germany (basically a family practice doctor).

Thankfully, about 4 years later, I got into ophthalmology residency training at White Memorial in Los Angeles, followed by a fellowship in ocular pathology at USC/Doheny Eye Institute. Ocular pathology is the examination of eye tissue after surgery to determine what tumor it is and whether they got all of it.   My USC Faculty appointment went hand in hand with my next job as Chief of the downtown Veterans Affairs clinic in LA, which I did 50% of the time, and 50% in a private general ophthalmology practice.  I maintained this 50/50 pattern throughout my career.  Moving to Orange County brought me to UCI, where I held a faculty appointment in both Ophthalmology and Pathology and eventually became an Associate Clinical Professor.  I became Assistant Chief of Ophthalmology for the VA in Long Beach in 1993 and retired from there in 2020, after 30 years of service.

Now, what is an ophthalmologist?  I completed 14 years of training to become an ophthalmologist and ocular pathologist.  And it doesn’t stop there.  We must complete 50 hours of continuing medical education every 2 years to maintain our license.  This contrasts with an optometrist, who specializes in optics and glasses. They complete 4 years of college, then 4 years of optometry school, and perhaps 1 additional year of residency for a specialty. About 19,000 ophthalmologists practice in the US, and twice that many optometrists.  This is why they have such a strong political voice and are pushing to do surgery and handle many medical issues.  In some places, they are succeeding.

How often should you see an ophthalmologist?  Children are screened at birth and later by their pediatrician.  Eyes continue to grow and change, so yearly exams are sometimes necessary.  If a child has crossed eyes, a pediatric ophthalmologist should investigate it.  Once you are an adult, your eyes will generally stabilize, and exams every two years are usually adequate.  However, if there is a family history of eye disease, yearly exams are advisable.  Once diagnosed with something such as glaucoma, every 3-4 months is best.  Cataracts require yearly monitoring.  Diabetes requires yearly checks, or more often, depending on the disease’s severity and whether it affects the eyes.

I’m going to tell you about four of the most common eye conditions. I’ll talk about cataracts, glaucoma, macular degeneration, and diabetic retinopathy. 

First, we’ll talk about Cataracts.  This is the yellowing and clouding of the eye’s lens, an age-related change almost everyone experiences. It’s like grey hair: most people get it, but not everyone.  Cataracts aren’t harmful, and the changes are so gradual that people sometimes don’t notice them.  The surgery is elective, which means it is not an emergency and can be done at any time.  There is no advantage to “doing it early” unless you want to help your ophthalmologist buy a new Mercedes.  People generally have cataract surgery when they have difficulty reading or driving.  It isn’t mandatory unless a white, enlarged lens is causing eye pressure.   When you look at the pupil,l it is white because the lens is no longer clear.   My husband had cataract surgery and said things were no longer yellowish.  One of my first patients said, “Oh, what have you done?  My house is so dirty!”

Second is Glaucoma, which is increased eye pressure and a blinding disease.  About 3-4% of people worldwide, aged 40-80, have glaucoma.  These statistics go up with age.  You gradually lose peripheral vision.  Sometimes it isn’t noticeable until people have “tunnel” vision.  Try making a tunnel with your hand to see what it is like.  It is treated with medication, laser, and surgery.

Third, macular degeneration is a serious disease that can limit central vision.   In the US, 20 million people over the age of 40 have some form of AMD. (age-related macular degeneration).  !.5 million are severely affected. You never get to the point of black blindness, but loss of central vision means that you would be unable to read or drive.  Dry macular degeneration is treated with nutritional support, and new drugs can help.  You cannot cure it; you can only slow it down.  Wet macular degeneration means it is bleeding, and injections can now slow or halt this process.  However, constant monitoring is necessary, as it can flare up again at any time.  Also, it is hereditary.

Finally, and fourth on our list is diabetes.  1 in 9 people in the US are diabetic.  It can also affect the eyes and cause blindness.  The best treatment is prevention by maintaining a low Hemoglobin A1c.  It measures average blood sugar over a couple of months and is more reliable than an isolated glucose reading.  That is one of the reasons I retired.  Partly because I lost my filter.  All of the “pre-diabetics” are really diabetic, but not so bad yet. They are just in denial about their disease.  I would say to those without a controlled Hemoglobin A1c, “So, you really want to eat whatever you want?  You are going to go blind from diabetic retinopathy, so how is that working out for you?”

In conclusion, you heard about me, ophthalmology, and some common problems in ophthalmology.  With that, I’ll wrap up and open the floor to any questions you might have.