Meet a Specialist: Scott H. Greenstein, MD, FACS

Greenstein CopyFor Dr. Greenstein, choosing a career in ophthalmology was an easy decision. While he enjoyed all of his clinical rotations during medical school, “ophthalmology was both fascinating and fun,” he said. 

His passion and excitement for the field has remained constant throughout his career. Today he is a member of the Comprehensive Ophthalmology and Cataract Consultation Service at Mass. Eye and Ear, where he specializes in routine and complex cataract surgery.

“Cataract surgery is unique because you can have a direct and immediate impact on people’s lives,” he said, noting that the recovery time is short and the benefits are significant. “The majority of cataract patients have their vision restored quickly and can see clearly for the first time in years.”

While Dr. Greenstein provides routine eye care and sees the full spectrum of eye conditions—ranging from diabetic eye disease and macular degeneration to glaucoma—many of his patients have cataracts ranging from routine to complex. These cases typically require careful surgical planning and adjustments to the surgical technique to maximize the benefits of surgery. 

For example, Dr. Greenstein recalls one particular case, in which a patient had cataracts along with a misaligned eye (known as exotropia). Although previous doctors had told the patient that nothing could be done to correct the misalignment, Dr. Greenstein was hopeful that surgery would be successful.  By six weeks after the cataract was removed, because of the much improved vision and the ability of the eye to fixate, the eye straightened itself out. “The surgery exceeded our expectations. It was a great success,” Dr. Greenstein said. 

Such success stories are common in the Comprehensive Ophthalmology and Cataract Consultation Service. The Service has consistently met or exceeded international benchmarks for successful cataract surgery. 

Dr. Greenstein also sees many patients who are seeking second opinions and recently conducted a study to find out why so many patients end up visiting two or three doctors. “Is it because they’re not satisfied with their diagnosis? Did their doctors make a mistake in their treatment? Do they trust their doctors?” questioned Dr. Greenstein. “I wanted to find out.” 

Over the course of a year, Dr. Greenstein reviewed all of the patients who came in for second or third opinions. He found that most patients (about 60 percent) wanted confirmation of the diagnosis or simply wanted more information. 

“Billions of healthcare dollars are being spent on people who go to multiple doctors for multiple opinions,” Dr. Greenstein said. “If we did a better job explaining things, we could eliminate a lot of these second opinions,” he said. 

That’s why Dr. Greenstein provides clear and detailed information to his patients, often using simple metaphors to explain complex procedures. For instance, Dr. Greenstein likens cataract surgery to “replacing a damaged windshield on a car.” He also says making personal connections with patients is critical. “I put myself in the place of the patient. A lot of the time, I’m just relieving their anxiety and providing reassurance. I treat every patient like they’re a family member,” he said. 

Dr. Greenstein is a clinical innovator who looks for ways to improve current procedures. For example, he improved the design of a surgical instrument called the “toric axis marker,” which improves the accuracy of toric intraocular lens implantations—a procedure used to treat cataracts and astigmatism. The instrument allows him to more accurately determine the proper orientation for the implant. 

In addition to his clinical responsibilities, Dr. Greenstein also trains Harvard Medical School students and residents in the clinic, operating room, surgical training facility, and classroom. “I really enjoy teaching. It’s a chance to share the enthusiasm I have for ophthalmology with the next generation.”

Contact Dr. Greenstein’s office at 617-573-3202. 

View Dr. Greenstein’s online bio for more information.