As the year draws to a close, many clinicians are taking stock of the moments that shaped their practice in 2025. For Neda Shamie, MD—a cataract, LASIK, and corneal surgeon at the Maloney-Shamie-Hura Vision Institute in Los Angeles, California—one patient in particular left a lasting impact. The Eye Care Network caught up with Shamie to reflect on the most challenging case she managed this past year and the lessons it continues to carry forward.

Note: Transcript edited for clarity and length.

What was the most difficult patient case you handled in 2025?

Neda Shamie, MD: The hardest patient case I handled in 2025 involved a monocular woman who had lost vision in her first eye after complications from cataract surgery performed elsewhere. Understandably, she avoided surgery on her only seeing eye for years. When she finally came to me, her cataract was brunescent with significant pseudoexfoliation and zonulopathy, a poorly dilating pupil, and a very shallow chamber. The surgical complexity was considerable, but the greater challenge was the level of fear and anxiety she carried into every visit.

Ultimately, this case strengthened my belief that caring for patients is as much about guiding them through their fears as it is about performing a complex surgery.

Her appointments were often emotional, and she struggled to get through even routine examinations. My staff and I felt the weight of her previous trauma in every interaction. Guiding her through the process required patience, clear communication, and steady reassurance, an approach I have always taken with vulnerable or high-risk patients, but one that this case brought into sharper focus.

What lessons from this case have changed the way you practice today?

Shamie: This case did not change the way I practice, but it reaffirmed the importance of meeting patients where they are emotionally, especially when they are making decisions under fear. It strengthened my commitment to slowing down when needed, giving patients space to process information, and ensuring my staff feels supported when working with individuals who require more time and care.

How did this case impact you personally or professionally?

Shamie: On a personal level, the experience reminded me how much trust patients place in us, particularly when their past experiences have made that trust difficult. Professionally, it reinforced the value of consistent communication and a calm, steady presence in high-stakes situations.

What resources or support might have made managing this case easier?

Shamie: Looking back, additional psychological support for patients with medical trauma and more structured resources for staff navigating emotionally intense encounters would have been helpful. Extra time in the schedule for cases like this would also have eased some of the pressure.

Ultimately, this case strengthened my belief that caring for patients is as much about guiding them through their fears as it is about performing a complex surgery.

Neda Shamie, MD
E: [email protected]
Shamie is a cataract, LASIK, and corneal surgeon with Maloney-Shamie-Hura Vision Institute in Los Angeles, California.