On the clinical end, some surprising cultural differences in clinical approaches have emerged. In Japan, not only are all patients insured, but all costs are covered. The residents are also able to observe surgeries they may never see in the US due to differential treatment approaches. In the US, only pediatric glaucoma is treated with trabeculotomies; but in Japan, open-angle glaucoma among adults is treated with trabeculotomy. Because some approaches are different, the residents experience patient complications that they may never see in the US (for example, corneal decompensation post laser surgery due to the argon laser).
The approach to training residents differs in some interesting ways as well. Notably, when using teaching scopes to examine dry eyes in patients, the doctors are able to show patients and residents videos of what happens in the eye that causes dry eye. Because the scopes are connected to video equipment, the physicians are able to rewind the tape and show patients what happens in their own eyes.