One concern of the theory of evolution is how a highly complex organ such as the eye might develop if there are not intermediate forms of rudimentary eyes that confer a survival advantage to the organism. An intermediate life form recently has been discovered, and Ophthalmology Times Chief Medical Editor Dr. McDonnell hypothesizes that it may have implications for patient care.

Ophthalmic resident and fellowship education programs in the United States are responding to the changing requirements of working in a modern health-care delivery system and new incentives have been created for transforming the "apprenticeship model" to a "competency-based" model of education.

Changing demographics in the United States will require ophthalmology practices to adopt strategies to deliver care to large numbers of diabetic and elderly patients. Possible steps could include more effective use of support staff and increasingly efficient practice patterns.

When it comes to LASIK, much like elected officials, physicians should never promise too much and make sure the patient is aware of all risks.

There is an inherent tension between the appeal of maintaining a successful, secure business and the desire to expand the business. According to Dr. McDonnell it is much more common for practices and departments to wait too long before beginning the process of adding excellent people to build upon a successful and vibrant operation.

There may be a great unease among ophthalmologists when it comes to the current relationship between industry and professional meetings including conflict of interest among speakers at ophthalmology meetings, disclosures of such conflicts by speakers, and concern about the "integrity" of these meetings.

Children and adults alike are sometimes disgusted by the thought of eating vegetables. Peter J. McDonnell, MD, explains his remedy, a grilled vegetable recipe that pleases the eyes and distracts the taste buds.

Volunteer faculty instructors can add to the experience of ophthalmology residents, sharing the skills and perspectives gained over decades in their busy practices. In public universities and Veteran's Administration hospitals, self-insurance with the deep pockets of a state or federal government can make liability insurance for teachers a non-issue. But for private institutions the costs of taking out policies on an entire volunteer faculty would immediately bankrupt most medical schools.

Meetings and other travel commitments can keep a department chair quite busy. The necessity of their obvious function to provide idea sharing and educational opportunities is important, but also the relations and connections made with people along the way.