I was never that person who came into medical school knowing exactly what sort of specialist I wanted to be. I began this journey knowing that the feeling I got in knowing exactly what to do during someone’s time of illness, was something I could chase all my life. On first entering medical university, I was overwhelmed by the sheer number of specialties to which one could dedicate their entire life. This concern of mine had to take a backseat though, as the demands of basic sciences studies took over my entire time soon thereafter. At my university, the first 2 years were dedicated to covering Basic Medical Sciences like Anatomy, Physiology, and Pharmacology, among others. Even though these 2 years did give me a good idea about what sort of basic sciences are involved in specialties like Cardiology, Neurology, or Pulmonology, I did not find myself gravitating towards any specialty.
Glaucoma-filtering procedures (e.g., trabeculectomy) is a standard surgical procedure commonly done when maximally tolerated medical therapy or laser trabeculoplasty fails to adequately control intraocular pressure (IOP). The filtering procedure creates a fistula between the anterior chamber and the subconjunctival space, covered with thin sclera and conjunctiva that allows excess aqueous humour to be absorbed into the systemic circulation. Thus, the presence of a filtering bleb poses an enduring risk of a bleb related infection (BRI) over the patient’s lifetime (1). To improve the success of these procedures, it has now become routine to use intraoperative antifibrotic agents (e.g., mitomycin and fluorouracil) as an adjunct to standard trabeculectomy (2). Although these agents have improved the chances of long-term IOP control they have further predisposed to an increased incidence of postoperative complications including late-onset filtering bleb-related infections (1).
Having fortunately passed the FRCOphth part 1 in my first attempt, the aim herein is to detail exactly how I used one of the main foundational texts- ‘Clinical Optics’ by Elkington and Frank. Out of 174 multiple choice questions in the April 2022 FRCOphth Part 1 exam, 47 questions were dedicated to Optics; comprising the most number of questions of any topic. Optics generally has formed the majority of questions in previous sittings too, although since its conversion to a pure MCQ exam, there appears to be increasing emphasis in this area.
Retinopathy of prematurity (ROP) is an ophthalmic disorder that arises in premature infants, particularly those born before 32 weeks gestation, or who weigh less than 1,500 grams at birth. In many children, it is mild and presents no problems, but can also be severe and lead to blindness. In the 1940s, it was the leading cause of blindness in children in the US and, unfortunately, it still remains a leading cause of blindness in children worldwide.