Orbital varices are characterized by thin-walled, distensible venous channels that communicate with the normal orbital venous system. These rare venous malformations account for approximately 1.3% of all orbital masses. Varices can be classified as primary or secondary; primary varices are congenital, while secondary orbital varices are acquired, often resulting from arteriovenous malformations or arteriovenous fistulas. Due to their rarity, orbital varices present diagnostic and management challenges. However, timely identification is crucial, as they can lead to significant complications, including thrombosis and haemorrhage.

Ichthyosis is a group of inherited skin disorders characterised by skin thickness and dry scale formation. There are many forms of Ichthyosis which range in appearance, severity and mode of inheritance. Ichthyosis can also present with ocular manifestations which are primarily due to abnormalities in the eyelid and tear film. This can lead to development of exposure keratopathy. In more severe forms of Ichthyosis, such as harlequin ichthyosis, the skin around the eyelids can become tight and inflexible leading to cicatricial ectropion.

Dupilumab is a biologic agent licensed in the treatment of multiple atopic conditions such as atopic dermatitis, asthma and rhinosinusitis with nasal polyps. However, with continued use, reports of ocular side-effects associated with dupilumab use seem to be increasing. Ocular side effects range from mild eye disease such as conjunctivitis and blepharitis, to more severe ocular manifestations such as ulcerative keratitis.

Uveitis glaucoma hyphema syndrome also known as Ellingson Syndrome is a complication that occurs due to intraocular chafing and rubbing of intraocular lens against uveal tissue in the eye that leads to iris trans illumination defect, micro hyphema (red blood cells in anterior chamber), gross hyphema, pigment dispersion, raised intraocular pressure (glaucoma) and intraocular inflammation of uveal tissue (uveitis).  It can present with symptoms such as decrease in vision, redness, pain, and sensitivity to light. Clinical signs include raised intraocular pressure, anterior chamber inflammatory activity (red blood cell and inflammatory cells), cystoid macular oedema and optic nerve cupping if persistent for long term. Symptoms can be controlled with topical medication like steroids and pressure lowering drops but surgical intervention like repositioning, removal and exchange of intraocular lens is definitive surgical treatment.

Glaucoma is one of the leading causes of global blindness, responsible for approximately 8.4% of all blindness cases worldwide in 2020. Medical treatment of glaucoma, ocular hypertension and glaucoma suspect involves use of long-term topical medications to lower intraocular pressure and thereby minimise optic nerve damage and sight loss. However, adherence to topical glaucoma medication is often poor, with reported rates of non-adherence varying from 30% to 80%. Poor adherence can be attributed to a range of factors, including patient beliefs, potential or perceived side effects of medications, forgetfulness, difficulty with eye drop administration and insufficient patient education. It is important to educate patients about the importance of medication adherence and attending glaucoma clinic appointments for monitoring of the disease, given that glaucoma is irreversible, and the more chronic forms are usually asymptomatic until the later stages. Whilst glaucoma is typically diagnosed and monitored in secondary care settings, GPs and other primary care professionals can play an important role in providing patients with long-term support, coordinating care, and promoting compliance with medication.

Teaching and placement opportunities within ophthalmology vary across UK medical schools and the foundation programme. Ophthalmic pathology can present in various settings, such as acutely in the emergency department, in general practice, and among inpatients where patients may develop an ocular complaint or an ophthalmic manifestation of systemic disease. It is therefore important to develop a strong foundational knowledge of this speciality.

Osteo-Odonto-Keratoprosthesis (OOKP), also known as "tooth-in-eye surgery," is a highly specialized surgical procedure designed to restore vision in patients with severe corneal blindness who are not candidates for traditional corneal transplantation. It was first pioneered by Professor Benedetto Strampelli in the 1960s in Italy and established in the United Kingdom by Professor Christopher Liu. OOKP involves the use of the patient's tooth and surrounding bone as a support structure for a prosthetic optical cylinder, making it one of the most intricate and unique ophthalmological procedures.

Acute Retinal Necrosis (ARN) and Progressive Outer Retinal Necrosis (PORN) are two major clinical entities of necrotising herpetic retinitis, a severe and vision-threatening condition caused by herpes viruses. Both conditions lead to rapid retinal necrosis, but they differ significantly in their affected populations, clinical presentations, inflammatory responses, and prognoses. Understanding these differences is crucial for early diagnosis, appropriate treatment, and vision preservation.

North Carolina Macular Dystrophy (NCMD) is a rare autosomal dominant disorder characterised by congenital macular abnormalities. It was first described in a large cohort of patients from North Carolina, USA in the 1970s. Despite its name, NCMD has been reported globally, with considerable phenotypic variability, ranging from subtle drusen-like deposits to severe coloboma-like macular lesions. The condition is linked to non-coding variants upstream of the PRDM13 gene on chromosome 6. This variant leads to disruption of retinal development and gene expression. Early diagnosis is important to inform genetic counselling and monitoring for secondary complications, e.g. choroidal neovascularisation.

Autosomal Dominant Drusen (ADD), also known as Doyne Honeycomb Retinal Dystrophy, Malattia Leventinese and Familial Dominant Drusen is an inherited retinal disease characterised by early-onset drusen deposits in the macula and peripapillary region. First described in 1899, ADD is caused by pathogenic variants in the EFEMP1 gene, which encodes fibulin-3, an integral extracellular matrix protein. The aforementioned variant leads to a disruption in protein secretion; consequently, there is drusen accumulation beneath the retinal pigment epithelium (RPE) and within Bruch’s membrane. Unlike age-related macular degeneration (AMD), ADD manifests earlier, often within the first four decades of life, with a distinct radial drusen pattern and a significant risk of choroidal neovascularisation (CNV). As such, early diagnosis is crucial in order to initiate treatment against CNV.