 Okay. Well, he's getting set up. I'm going to introduce our next speaker. This is James Tucker. He's currently a third year medical student. I met James a few years ago as he's part of the MD-PhD program here. He's done very well. I think we overlap maybe a little bit. He was just beginning right when I was finishing up. Something that you may not know about James is he is an avid paraglider and gets down to the point of the mountain as often as he can. He has an orange paraglider. He says it's 28 square meters. Now, we know James needs to be careful. Like, just on Sunday there was an accident where a guy got pretty seriously hurt for about 50 feet. But James is very skilled at paragliding. Much more careful than that guy. Thank you for coming this morning. If you had a chance to see the patient this morning by all means please speak up. We don't have any imagery of him yet. We've only seen him at the Redstone Clinic in Park City. We're hoping to get some imagery taken of him today in clinic. He lives back east. He just winters here in Park City. The patient has a very complex, ocular history. Forgive me, I reversed the sides here. But when you're working on a He was 12 years old. He had a... So he was born very high myopic. At the age of 12, trauma led to a massive retinal detachment. Reattachment failed. He lost all vision in his left eye at the age of 12. So he's been completely blind. No light perception from that time on on the left side. On the right side he began developing glaucoma with interocular pressures on the high teens when he was about 15 years old. He was well controlled. His pressures have been well controlled on Timelaw for the majority of the population. He did develop a cataract which he had removed. Subsequent to becoming a phakik, he developed a significant retinal detachment on the right side this time. Fortunately, as Clarrell Buckle was successful this time and returned his vision right back to where it had been prior to the detachment. But being a phakik for that long, his interocular pressures began to rise mostly into the 20s but spiking and fluctuating up into the high 30s refractory to very significant medical therapies. In his late 30s developed some central field loss with a major scotoma from about 9 o'clock to 12 o'clock. He had a canaloplasty at the age of 52. A couple of revisions on it and it is now successfully controlling his interocular pressures usually around 5 to 6 at most 8. But at this point his best corrected visual acuity tested in clinic is about 2600. Though he subjectively states that it's significantly better than that particularly in the morning. We'll talk about that in just a minute. Most recently and what bothers him most of anything at this point is extremely severe dry eye in both sides. So at this time on the left he has no light perception on the right. He's quantitatively measured at 2600 though he says that his vision is significantly better than that when he wakes up in the morning. And that it slowly declines over the course of the day. He also finds that if he dilates his pupils his vision is better. And then he just told me this morning that if he lays down for an hour or two but even with his eyes open if he lays down flat and sits back up that his vision improves dramatically for a very short period of time and then once again decays as the day goes on. And Dr. Tabin and I were not able to necessarily make any sense of these things. At this point our major questions are what's behind his sort of diurnal variations in his visual acuity. What causes his vision to be significantly better in the morning and then decline throughout the day. He says it's not associated with a change in the discomfort for his dry eye. His dry eye hurts him significantly throughout the day from when he wakes up to when he goes to sleep. So he doesn't think that his eyes are moist in the morning and then drying out over the course of the day. And then second of course we can't come up with a good theory as to why dilating his pupils would result in a significant change except to say perhaps there's an additional light getting his damaged retina. His cup to disc ratio at this point is approximately .95 or worse. I'll open it up to questions. He can see the difference with his vision whether or not it's for him. He will see a 2600 in which he sees as a dramatic change. Dr. Moshevar could you comment on the appearance of this cornea that you saw? It has an appearance that Dr. Tabin described as cracked concrete. Thank you very much. So our last talk is going to be from one of our cornea fellows, Jason Edmonds. Something that you may not know about Jason is he was a high jumper and actually competed at the division one level for Mizzou, right? Jason has gotten his whole body here over a bar that was seven feet tall. That's his best jump. So that's very impressive and he can dunk.