Time for introspection.

Sir,

The well-written report by Chaurasia calls for introspection from our community.[1] The report highlights our nadir, concerning not so much the devastating complications of the procedure but the indication of the procedure itself.

A doctor and more so a surgeon has been placed in a privileged position in society, and episodes like this are responsible for the public gradually losing faith in us. Patients often have unreasonable expectations based on information received from the internet or advertisements from the industry, and it is unfortunate that instead of correcting them, we further misguide them for our gains. It is understandable that decisions are not often black and white but shades of gray, but if we remember the Hippocratic Oath and err on the side of “not doing harm” we would usually be correct.[23]

This report is just the tip of the iceberg and many of us are guilty of letting finances dictate our decisions. However, one should be exceptionally cautious when dealing with a normal eye as in the report. Trying to improve on the creation of nature is to be foolish and is an action that is bound to be punished. We have seen the following when literature and logic both are against them: (a) refractive lens exchange being done for low myopia or incidental finding of trace cortical cataract, (b) Injudicious advice of multifocal intraocular lenses and intravitreal injections, (c) exaggeration of the benefits of femto-assisted cataract surgery.[456] Some of these may be debatable, but then, many similar conditions may be added.

Only way forward is to keep the interest of the patient central and all other issues secondary. It is also the only way in which we can restore our lost glory. When facing a difficult decision one should do a clear risk benefit analysis and ask oneself if one would advise the same management to a family member. The answer should be loud and clear. All the best.

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Nil.

Conflicts of interest

There are no conflicts of interest.