Guest Editorial

Millennial innovators

1983 was a year of innovation: Motorola made history by producing the world’s first commercially available mobile phone. ARPA-NET migrated to TCP/IP, which signaled the true beginning of the internet. McDonald’s even introduced the “McNugget.”

1983 was also the year I was born, which makes me one of the first members of the millennial generation.

“Millennials” is perhaps one of the most polarizing organizational terms one can use when discussing business and management, eliciting strongly held opinions, bias and emotion from most people. This is especially prevalent in the health-care landscape when discussing this generation of doctors and surgeons. According to the Pew Research Center in Washington D.C., 2019 is the year that millennials are expected to overtake baby boomers as the largest living generation in the United States, to the tune of 73 million people.


Countless hours and dollars have been spent researching how millennials think and behave. With this issue of Ophthalmology Management, I thought it would be interesting to see how leading surgeons from the largest living generation approach the two largest causes of blindness: cataract and glaucoma.

I have family, friends and mentors in this field who are younger than me as well as some who are more than twice my age. The way in which different generations of ophthalmologists approach patient care in the cataract and glaucoma space can be very different. From our willingness to become early adopters of minimally invasive glaucoma surgery (MIGS) technologies to our receptivity on the value of femtosecond laser-assisted cataract surgery and premium IOLs and even the cultural identity one should have when running a refractive cataract practice, millennials often have a totally different mindset than those one and two generations ahead. This should come as no surprise — the innovation cycle has gotten shorter, while the technology keeps getting better.


This issue explores many thematic concerns surrounding modern cataract and glaucoma surgery, as approached from the millennial mindset.

How do you successfully launch a femtosecond laser program when there’s never been one within 100 miles of your practice? What solutions do you have for the post-RK patient who wants spectacle freedom after cataract surgery? When do you go to bat against the insurance companies for a MIGS device you’ve selected for your patient that isn’t covered? Where do you start when a patient with multiple co-morbidities is in need of DMEK, MIGS and phacoemulsification? These questions and more will be addressed by some of the future leaders of ophthalmology who are poised to make a big impact at an early age.

It was an honor to be guest editor for this important issue, as I learned that the only thing more impressive than the passion my millennial peers have for innovation is the respect and admiration we have for those generations who innovated before us. And while millennials have been called many things, one thing is for sure: We are here to stay — just like the internet, mobile phones and McNuggets. OM