For most of us, our environment can have a strong influence on our attitudes and outlook, both for good and ill. For instance, it’s easy to have a bright and sunny disposition on a beautiful day in June, but it’s a lot harder in winter when it’s already dark at 4:45 p.m., and you’re trudging through an ice storm. 

It’s ironic, then, that the period of the year that’s filled with the most darkness and cold weather (at least here in the Northeast) is often home to the warmest, most friendly feelings. Seasonal songs exhort everyone to be of good cheer and celebrate “good will toward men.” Families and friends gather to spend valuable time with each other, and maybe exchange gifts. There’s a general air of optimism and hope, despite the weather and lack of sun.

This line of thinking is interesting when you consider some of the sentiment expressed in our article on in-office cataract surgery, part of our cover focus on novel techniques and technologies ophthalmology practices may incorporate in the coming years. At one point in the article, Omaha surgeon Lance Kugler notes how, in past decades, when surgeons’ approach to cataract surgery changed, it was a crisis that made people wonder how the profession would emerge from it. 

“[Cataract surgery in the early 80s] was a big deal and required general anesthesia,” says Dr. Kugler. “When surgeons started to perform outpatient cataract surgery, people thought it was crazy. People were actually disciplined by hospital boards for sending patients home after cataract surgery. But, after a while, everyone realized that it made sense and that it was good for payers, patients and surgeons, so they continued to do outpatient surgery in the hospital.” In fact, after the initial wave of concern over outpatient cataracts, the Health Care Financing Commission actually ruled that all cataracts should be removed in an outpatient facility, save for those patients with “exceptional circumstances.”

Please note that this isn’t a call for in-office surgery, since it’s not without its issues (also noted in the article). Instead, I’m illustrating how, even in trying times, ophthalmologists have found ways to make new approaches work for both their profession and their patients. They’ve found some hope when things appeared dark.

Likewise, during this period of declining reimbursements, hopeful signs may be appearing from an unexpected quarter: Recent estimates put refractive surgery on pace for a 16-percent increase in volume compared to last year.¹ Though this increase will need to be sustained, of course, this renewed interest in refractive surgery might also signify the renewal of a potentially significant income stream for ophthalmology practices scrambling after each fresh reimbursement cut. 

With these hopeful thoughts in mind, the staff here at Review would like to wish you and yours a happy and healthy holiday season.

— Walter Bethke
Editor in Chief

^{1. Demand for Laser Vision Correction Procedures Increases During COVID-19 Pandemic. https://americanrefractivesurgerycouncil.org/press-room/demand-for-laser-vision-correction-procedures-increases-during-covid-19-pandemic/. Accessed November 29, 2021.}