well, i'd not call them ridiculous b/c each person has different views on money, life, and priorities. some people find the most happiness in money and being able to provide for one's family well, and some find happiness in impact factor, power, professorship, and some in voluntarism and serving the indigent and money means nothing to them - important thing is recognizing this is do not automatically bring down someone else just b/c they dont share the same visions/goals in life as u do.
anyway, back to your q.. derm will surely let u surpass 500k/yr, but ophthy should also, if ophthy is what makes your blood boil. I can think of 3 ways - get the best training in ophthy residency and do retina fellowship, and do nothing but retina surgeries; do cornea/LASIK(or new upcoming laser vision correction procedures) fellowship and become a LASIK machine; lastly u could also become a general private practice 'eye' and work LONG hours, but this can be more fun b/c u get to see more wide variety of pts instead of lasik after lasik after lasik.....