"Huh, Huh, so what's new today?"

Blog vol 3. 17 "Huh, Huh, so what's new today?"


He had just retired as head of the University of Bern’s Eye Clinic, where he presided from 1935 to 1968, when in 1969 he spent a year sabbatical at Washington University’s Eye Clinic in St. Louis Missouri. Dr. Hans Goldmann, who was born in 1899 in Bohemia, would appear in the mornings and greet the faculty and students with, "Huh, Huh, so what's new today?" 


His work in glaucoma research and in developing new eye testing techniques are lauded to this day. We still use the Goldmann tonometer, which is the gold standard in measuring eye pressure, and the Goldmann field perimeter, which measures visual field. 


I have written several articles on bioptic driving and telescopes. Many of my patients who have presented for possible bioptic use have an eye condition called nystagmus, where the eyes weave back and forth searching for a better reference point. 


In the 1970s automatic perimeters replaced the manual Goldmann variety. Problem is that the automatic variety cannot account for the eye movement of my nystagmus patients, and that is real trouble when a reliable and accurate measure of a potential driver’s peripheral vision is required. 


Dr. Tabone, who practices with us, suggested that we look into getting a Goldmann perimeter for these patients. That was early July, and I found one that, originally made and designed in Switzerland, was sitting on a hospital bed in Vernon Hills, Illinois, and not in a museum for ophthalmology. I purchased it and had it shipped to a family friend in East Aurora, New York because the supplier could not ship outside the USA. It then sat in a warehouse, for about a month as I figured out how to get it across the border to my office in Burlington. It was with much elation when, on an August morn, I received my Goldmann perimeter and have been working on getting it operational since. 


As the emperor in Star Wars says, “Now witness the firepower of this fully armed and operational battle station!” 


It feels like that, now that we have the Goldmann perimeter operational.  It has been a long process but much needed. The bioptic telescope makes it possible to see at least the 20/50 line on the eye chart, but that is not the most important visual task when it comes to getting around. It is your peripheral vision, and unless the driver has at least 120 degrees of visual field in the horizontal, they cannot responsibly drive a motor vehicle. The Goldmann perimeter measures the degree of field definitively for all patients.


So as Dr. Goldmann, used to say when he was doing his rounds at Wash U, "Huh, Huh, so what's new today?"


The answer is something that has been brought back and made new once again, the Goldmann perimeter for the patients and potential bioptic drivers that make it to Burlington Eyecare.




til next week,

 

 

the good doctor



By Dr. Mark Germain May 1, 2026
The good doctor discusses how the eye is a window to the heart with the help of the OCT.
The good doctor take a deeper look at how gut health is connected to eye tissues.
By Dr. Mark Germain April 29, 2026
Blog vol 6.40. The Gut and the Eyes. One of my biggest jobs is to keep abreast of new research and advances in eye health. Most recently, we have seen new stem cell research, gene therapies, as well as new drugs for dry and wet macular degeneration. In January of this year, there was an article in the journal, Cell Death and Disease, that looked at cell apoptosis, specifically with the photoreceptors of the eye. (Read the article here ). Apoptosis is the genetic programming of deliberate and constructive cell death, allowing for the maintenance of healthy structures and systems in the body. Some estimates have the body replacing 50 to 70 billion cells daily by this process. Necrosis, on the other hand, is unplanned cell death caused by injury, toxins, or other negative outside factors; this causes inflammation and disrupts the body’s balance of things. There are stressors that speed up cell turnover. The study looked at photoreceptors in the retina and were able to demonstrate cellular recovery, even in late stages of apoptosis, recovery not breakdown. When certain stressors were reduced, by working with the mitochondria, there was recovery of the photoreceptor cells. How? Mitophagy, the mitochondria’s own process of programmed breaking down and then repurposing the recycled components for new ones. This mitochondrial repair helps to reverse the sequence of apoptosis for the photoreceptors. Mitochondria, how cool. How is this helpful for our eyes? Conditions like retinitis pigmentosa or macular degeneration directly involve the photoreceptors and may be slowed or reversed by helping the mitochondria. So, let’s take care of those mitochondria. There is some evidence for nutritional support for the mitochondrial system. The nutrient, Urolithin A (UA), which is a compound made in our gut from fiber found in pomegranates, berries, and nuts is the only clinically proven substance known to trigger mitophagy, made in the gut no less. Vitamin B3 is critical for mitochondria function, however vitamin B3 based supplements are still to be clinically tested for their support of cell recovery. Nutrients Coenzyme Q10 and L-carnitine are known to help the mitochondria generate energy, and interestingly, infrared light therapy has also been shown to benefit mitochondrial function. Again, food for thought. The gut and its function needs a lot of research. How do probiotics and nutrient precursors affect eye tissues? It is so interesting that the gut can be a factor in eye health. Maybe adding Urolithin A as a supplement is wise, along with the antioxidants in Lutein and Zeaxanthin we use to combat photoreceptor degeneration. Will keep you posted on any new developments.  The good doctor
By Dr. Mark Germain April 16, 2026
The good doctor focuses in on visual processing. Why do we miss things that are right in front of our eyes?
By Dr. Mark Germain April 10, 2026
The good doctor discusses the Artemis II mission, space travels affects on the eyes, and "the dark side of the moon"
By Dr. Mark Germain April 3, 2026
The good doctor discusses exciting new and emerging options to treat nystagmus.
By Dr. Mark Germain March 27, 2026
The good doctor reflects on The Country of the Blind, a book by Andrew Leland which gives insight into the experience of vision loss.
More Posts