SURGERY - CLINICAL UPDATE - Behind the Scenes: 3 Eye Surgeons on How They Prep for the OR

Sep 27, 2026

Clinical Update Surgery profiles how three eye surgeons prepare for the OR, emphasizing preoperative planning, coordination, and precise clinical routines. The glaucoma surgeon describes scheduling logistics, emergency preparedness, EHR-based case timing, and brief connection practices with patients before anesthesia. Glaucoma readiness is supported by sleep, nutrition, daily prayer, music to keep the team upbeat, and peer support. The article also introduces oculoplastic preparation through practice growth and consistent Friday OR scheduling.

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CategoryHealthcare

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Reading Time8 min

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Behind the Scenes: 3 Eye Surgeons on How They Prep for the OR

What happens before an eye surgeon steps into the OR

Focus, Flexibility, and Collaboration in Glaucoma Surgery

Connecting with patients in the OR

Music keeps the team upbeat

Translating Details Into Precision in Oculoplastic Surgery

Leon W . He rndon, Jr, MD SURGERY CLINICAL UPDATE Behind the Scenes: 3 Eye Surgeons on How They Prep for the OR What happens before an eye surgeon steps into the OR is witnessed by few and often underestimated. From days to weeks of planning logistics to the quiet mental prep before the first incision, getting ready for surgery is a process that blends coordination, communication, clinical precision, and personal routine. Eye surgeons from 3 different subspecialties shared a peek behind the curtain at how they prime for surgery to ensure the best possible outcome for their patients. Focus, Flexibility, and Collaboration in Glaucoma Surgery Leon W. Herndon Jr, MD, has a busy clinical practice, seeing 130 150 patients each week. He is in the OR on Mondaysand Wednesdays, performing 8 12 procedures each day, typically of an advanced nature, including trabeculectomies, tube shunts and revisions, and phacoemulsifications, said Herndon, Professor of Ophthalmology and Chief of the Glaucoma Division at Duke Eye Center at Duke University School of Medicine in Durham, North Carolina. Planning for emergencies. Maintaining his weekly surgical schedule requires careful planning and coordination, said Herndon, who has 30 years of experience as a glaucoma surgeon. Typically, he plans surgeries 1 to 2 weeks in advance.“Because of the nature of my work, we need to accommodate those patients who have urgent needs,” so his staff knows to keep some slots open for emergency surgeries, he said. These can include patients with severe glaucoma with markedly elevated pressures needing urgent IOP control. Scheduling is fairly seamless through the EHR system, Herndon said, where he posts each case with the estimated procedural time and any special needs that might require specific devices or instruments. The scheduling staff and nurses arrange specific times for surgery and times to reach out to patients to provide preoperative instructions. A QUIET MOMENT TO CONNECT. Glaucoma surgeon Leon W. Herndon Jr, MD, conducts a slit-lamp exam athis Duke Eye clinical practice in Durham, North Carolina. On surgery days, just before his patient is given anesthesia, Herndon takes a few moments to connect with them. It “grounds me,” he said. Surgery day practices. Getting a good night’s sleep before surgery is paramount, said Herndon. He is usually in bed by 9:30 pm and up by 5:00 am. On surgery days, he eats a healthy breakfast—oatmeal and blueberries.“For a good outcome, I have a good breakfast,” he said. He also prays each day. Connecting with patients in the OR. On operating day, Herndon makes sure he personally sees each patient before their surgery so he can answer any final questions they might have and to make sure they are comfortable. Just before the patient is given anesthesia, he takes a few moments for what he’s come to view as a small but meaningful practice that helps him connect with the person he’s about to operate on. It seems to help them, too, he said.“I put my handson their temples” or he may also place a hand on the eye that he plans to operate on.“It helps me to become fine tunedon the task at hand and kind of grounds me. It feels like a sort of spiritual gesture.” Music keeps the team upbeat. During surgeries, Herndon likes to keep the atmosphere positive and will play music from a variety of genres, includ BY ASHLEY WELCH, INTERVIEWING USIWOMA E. ABUGO, MD; LEON W. HERNDON JR, MD; AND EVAN SILVERSTEIN, MD. ing funk, rhythm and blues, old school hip hop, and Bollywood tunes.“I try tobe mindful of what everyone likes,” he E Y E N E T M A G A Z I N E • 25 said, adding that research shows some surgeons perform better when they’re listening to music they enjoy.1,2 Being there for colleagues. Some days, Herndon is called on to help colleagues in the OR, so prep time maybe a bit shorter than when he’s making plans for his own patients’ surgeries.“I’ve had colleagues who haven’t felt mentally prepared for

FAQs

How do these surgeons plan for operations before patients enter the OR?

They emphasize logistics planning from days to weeks, coordinated scheduling through systems such as the EHR, and clear communication with patients and staff for preoperative instructions and device needs.

What specific practices does the glaucoma surgeon use to connect with patients before anesthesia?

Before anesthesia, he personally checks on each patient, answers final questions, and uses a grounding, meaningful touch practice—such as placing a hand on the patient’s temples or the eye—to help them feel comfortable.

How does the glaucoma surgeon handle emergencies and maintain his weekly surgical schedule?

He plans cases 1 to 2 weeks ahead but keeps some OR slots open for urgent needs, coordinating with staff so emergency surgeries can be accommodated when severe glaucoma requires urgent IOP control.

Sep 27, 2026

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