Guests: Marion Munk, MD – Medical Retina & Uveitis Specialist, Gutblick Group (Switzerland) Oliver Hvidt – Co-Founder & CEO, Norlase

Show Summary

The episode opens with a brief discussion on optometric scope expansion in Kansas, where John explains why fears surrounding expanded procedural scope may be overblown based on real-world experience from states where similar changes have already taken effect.

Marion Munk, MD, then shares her extensive real-world experience using the Valeda Light Delivery System (Alcon) for photobiomodulation in AMD, drawing on over 300 treated patients to discuss patient selection, treatment protocols, and functional outcomes — including why improvements don't always show up on structural imaging.

The episode closes with Oliver Hvidt, co-founder and CEO of Norlase, who traces his path from economics to ophthalmic device engineering and explains how next-generation portable laser systems are being designed around workflow efficiency as much as clinical performance.

Hosts: John Kitchens, MD, and Scott Krzywonos

Topics Covered

Scope Expansion in Optometry

• Kansas legislation expanding optometric procedural scope

• Real-world experience from Kentucky following similar changes

• Why expanded scope has had limited impact on retina practice

• The evolving role of optometry as general ophthalmology declines

Photobiomodulation in AMD (Marion Munk, MD)

• Differences between general "red light therapy" and medical PBM

• The Valeda Light Delivery System and evidence from LIGHTSITE trials

• Real-world outcomes from 300+ treated patients

• Ideal patient profiles (drusen-predominant AMD, non–center-involving GA)

• Reported benefits: improved dark adaptation, contrast, and daily function

• ~50–60% of patients reporting subjective improvement

• Challenges in correlating functional gains with OCT or structural changes

• Implementation strategies: standardized imaging, AI-assisted analysis, and patient tracking

• When to continue vs. discontinue treatment in non-responders

Norlase and the Future of Laser Technology (Oliver Hvidt)

• Founding story: from engineering collaboration to ophthalmic application

• Redesigning laser architecture using semiconductor technology

• Miniaturization and portability (headset-based indirect laser systems)

• MEMS-based pattern scanning vs. traditional galvanometer systems

• Designing equipment around workflow efficiency, not just performance

• Addressing increasing patient volume with limited clinical resources

• Funding challenges in a post-COVID, AI-dominated investment landscape

• Future roadmap: software-driven upgrades and multi-specialty applications

Key Takeaways

Photobiomodulation is gaining traction, but patient selection and expectation-setting are critical. Functional improvements in AMD may not always correlate with structural imaging. Device innovation in retina is increasingly focused on efficiency, portability, and workflow integration. The future of ophthalmic technology will depend as much on practice economics as clinical performance.

Sponsor Acknowledgment

This episode includes a segment made possible with support from Alcon, featuring technologies like UNITY VCS designed to enhance surgical performance and efficiency.