Knock Knock Eye: Why This Nobel Prize Could Change How We Treat Blindness
Knock Knock, Hi! with the GlaucomfleckensShow Notes
The weight of the healthcare system has been sitting heavy. Our practice officially dropped UnitedHealthcare after they offered a 0.8% rate increase, and I’m feeling genuine empathy fatigue for the first time since I came back to clinic after my cardiac arrest. I talk about what that feeling actually is, how to spot it, and what finally helped me through it last time. Also, Dr. Oz is pushing to eliminate modifier 25, which would effectively end same-day procedures in private practice.Then some actual good news: the 2026 Nobel Prize in Physiology or Medicine went to Peter Hegemann, George Nagel, and Karl Deisseroth for optogenetics. I walk through the 2021 Nature Medicine case of a man with 40 years of retinitis pigmentosa who regained the ability to locate and touch objects after an AAV-delivered opsin was injected into his retinal ganglion cells. It’s mutation-agnostic, it’s low-resolution, and it’s one of the most exciting developments in vision science in a long time.
Takeaways:
After years of negotiation, Will’s practice has fully dropped UnitedHealthcare over a 0.8% rate increase offer against a 3% request.
Empathy fatigue is real, often follows personal medical trauma, and requires time off, honest conversations, and self-awareness to work through.
Dr. Oz and CMS are pushing to eliminate modifier 25, which would effectively end same-day E&M visits combined with procedures and devastate private practice.
The 2026 Nobel Prize in Physiology or Medicine went to the discoverers and developers of optogenetics, which has already shown promise restoring partial vision in retinitis pigmentosa.
Optogenetics is mutation-agnostic because it installs light sensitivity in surviving ganglion and bipolar cells rather than repairing dead photoreceptors.
—
To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live
We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! [email protected]
Can’t get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken
Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/
If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken
If you want more information on models I use:
Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact. For more information go to Anatomy Warehouse DOT com. Link: https://anatomywarehouse.com/?aff=14 Plus for 15% off use code: Glaucomflecken15
As a proud FIGS Ambassador, visit https://WearFIGS.com and use code DrGFIRSTFIGS to shop, stay updated on new launches, and learn more about FIGS advocacy projects.
Check out FIGS on social platforms: @wearfigs
To learn more about Microsoft Dragon Copilot, visit:
http://aka.ms/knockknockhi
--
A friendly reminder from the G’s and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit http://www.EyelidCheck.com for more information.
Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices
More from Knock Knock, Hi! with the Glaucomfleckens
This week I get into the No Surprises Act, starting with my own $20,000 out-of-network bill after my cardiac arrest and the nine-month fight to resolve it. The law was supposed to prevent exactly that, and from the patient side it works. But the arbitration system behind it is now processing millions of claims per year (not the 22,000 the feds expected), doctors are winning about 85% of the time, and insurance companies are lobbying hard to rewrite the rules.
Dr. Lindsey Fitzharris is back and she brought her best book yet. Sleuth Hound: The Case of the Real Sherlock Holmes, out October 20th, which tells the story of Joseph Bell, the Edinburgh surgeon who was the actual inspiration for Sherlock Holmes.
We did back-to-school night for our ninth grader and I came away wanting to re-enroll myself. The CS teacher (28 years in the classroom) convinced me that what computer programming really teaches is attention to detail, one misplaced space breaks the whole thing, and the Spanish teacher, who grew up under Franco with his left hand literally tied to his chair for writing right-handed, had a philosophy so good I almost asked if I could come on Monday. After the break, I get into the AI mathematics controversy. OpenAI announced their agents solved the Navier-Stokes equations using 10,000 agents over 88 hours on a problem humans have worked on for 60 years, but an NYU mathematician and an Anthropic researcher claim OpenAI trained on their ongoing unpublished work without attribution, which is a more acute version of the IP argument that's followed AI from the start, and it bugs me in a way I don't have a clean answer for.
The Blue Cross Blue Shield Association put out a truly hilarious study complaining that AI tools drove nearly $1 billion in extra costs for their insurers over two years, blaming hospitals and doctors for using AI to code more accurately. This from the industry that pioneered using AI to deny claims. It's an arms race now, and the only people who actually lose are patients, premiums keep going up regardless of who wins.
This week Kristin and I sat down with Dr. Sasha Hamdani, a board-certified psychiatrist, ADHD expert, and author of the new book Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply. Sasha breaks down the actual neuroscience behind why some of us feel emotions so intensely, and gave us some genuinely useful tools for dealing with it. We also got a proper medical explanation for hangxiety, which, as someone who has experienced it, I found extremely validating.