A minimally invasive cosmetic treatment also known as a non-surgical procedure (NSP) refers to a procedure which involves small incisions or skin punctures intended to produce an aesthetic change with ‘minimal risk and downtime’. Dermal filler is used in multiple NSP, for example in the glabella region to “treat” deep-frown lines, in non-surgical rhinoplasty, in the tear-trough region to reduce hollowness of the tear trough and reduce under-eye circles and in the forehead for brow lifts. NSP in these areas have associated complications related to the eye including blindness and optic neuropathy.

Postoperative visual loss (POVL) is a rare complication of surgery. The spectrum of disability from POVL can range between transient blurring of vision, to permanent visual loss. Permanent POVL are most commonly attributed to central retinal artery occlusion, ischemic optic neuropathy, and cerebral vision loss, whilst other postoperative ocular injury can include corneal abrasion, which may or may not be associated with visual loss. The underlying mechanisms of POVL (postoperative visual loss) are not always fully understood, but it can arise from damage at any point along the visual pathway, from the cornea to the occipital lobe. The incidence for temporary POVL and permanent POVL of non-ocular procedures are 5.4 per 10,000 and 0.16 per 10,000 respectively, with the most prevalent cases occurring post cardiac surgery and spinal fusion.

Asteroid hyalosis (AH) is a benign vitreous opacification in which calcium-lipid complexes are suspended throughout the collagen fibrils inside the vitreous cavity. These complexes are named asteroid bodies due to their reflective appearance that resemble the stars (asteroids) in the night sky.

Open globe injuries (OGI) are defined as a full thickness wound of the eyewall, which can be due to either a rupture or a laceration. They can be characterised by mechanism, namely rupture injuries and laceration injuries, and then by anatomic site, which is categorised as zones.

Abusive Head Trauma (AHT) in young children refers to repeated acceleration-deceleration abusive injury with or without blunt head impact. Abnormal eye findings are frequently observed in children with AHT, for example retinal haemorrhages, vitreous haemorrhages, or optic nerve sheath (the latter visible only on autopsy) and less commonly, retinoschisis or peri-macular retinal folding.

Ophthalmology is one of the most competitive specialties to enter with the latest figures for competition ratios showing 1,383 applications for 96 posts, in other words, 1 in 14 applicants are successful. This is a staggering increase from 1 in 3 in 2019. The main domains to prepare for is the MSRA (20% weightage), evidence folder (50% weightage) and interview (30% weightage). While it’s possible for IMGs to excel in the MSRA and interview with good preparation in the days leading up to the application, the evidence folder needs planning ahead, and this is where most IMGs lose out on.

Common clinical manifestations of NS include craniofacial dysmorphism, congenital heart disease, ocular abnormalities, short stature, skeletal and neurodevelopment abnormalities, and other comorbidities (3). Other systemic manifestations of NS have been extensively studied, whereas limited reports focus on the ophthalmologic manifestations of NS.

This article highlights the key differences between the 2024 and 2025 scoring criteria for the portfolio evidence section, which remains a critical component of the Ophthalmology ST1 application. Applicants typically begin assembling their portfolios based on the previous year’s criteria, available on the Severn Deanery website, until the updated 2025 criteria are released in mid-October, shortly before applications open.

Visual hallucinations, in the absence of psychopathology, remains a challenge for diagnosis in clinicians. Charles Bonnet Syndrome (CBS) is a condition whereby a patient experiences visual hallucinations, with clear insight into their nature; this often occurs in people with varying degrees of vision loss. While acknowledging that these phenomena are illusory, they may still cause significant distress to the patient. As a result, prompt awareness and understanding of the condition is essential. However, CBS remains difficult to diagnose through a lack of an accepted set of criteria; this article will briefly address the concept of visual acuity in its diagnosis, alongside some future recommendations to clinicians.

Junior doctors manage patients with eye symptoms in the Accident & Emergency (A&E) department. However, a systematic review published by Tolley et al. in 2023 revealed there is decreased confidence in managing ophthalmic emergencies among A&E junior doctors in the UK. Baylis et al. conducted a survey in 2011 about ophthalmology education delivered across different UK medical schools which found that ophthalmology education varies in terms of standards, methods used and assessments done, with some students receiving no ophthalmology education at all.  This article aims to serve as a guide for ophthalmic assessment in the A&E.