Episcleritis is a benign inflammatory condition affecting the episcleral layer, the outermost layer of the sclera of the eye. There are two main types of episcleritis, nodular and simple. Nodular episcleritis accounts for 30% of cases and presents with a discrete elevated area of inflamed tissue (nodule) in the episcleral layer surrounded by dilated blood vessels. Simple episcleritis also presents with a red eye and dilated blood vessels but not an elevated area of inflamed tissue. It is subdivided into two groups; diffuse simple episcleritis, where the inflammation is generalised, and sectoral simple episcleritis, where the inflammation is restricted to one region.

Leber Congenital Amaurosis (LCA) is a rare genetic eye disorder that is the most common cause of inherited sight loss in children. It is estimated to affect 1 in 40,000 newborns and leads to severe, irreversible loss of vision by affecting the retina. LCA was named in 1957 after it was first described by Theodor Karl Gustav von Leber in 1869. He was responsible for the first description of Leber’s hereditary optic neuropathy, a completely different condition that is easy to confuse LCA with. In current literature, LCA is thought to represent 5% of all retinal dystrophies and accounts for 20% of visual impairment amongst children in special schools.

A cataract is a clouding of the lens which can lead to gradual reduction in vision and disturb every day activities such as driving and reading (1). The main symptoms include clouding or blurring of vision, glare, reduced night vision that is noticed when driving, haloes around lights and fading of colours. There are various risk factors of which increasing age is the most significant one. Others include lifestyle factors such as diabetes, smoking and hypertension, previous ocular trauma or surgery and iatrogenic causes such as use of long-term corticosteroids (which can typically lead to a posterior subcapsular cataract).

Glaucoma is a common eye condition which involves optic nerve damage, resulting in progressive peripheral vision loss. It is most commonly caused by raised intraocular pressure (IOP), therefore most medical and surgical treatments aim to lower the IOP by either reducing production or increasing drainage of aqueous humour in the anterior chamber of the eye. It is important to note that glaucoma management is centred around prevention of further vision loss rather than restoration of vision that has already been lost, and thus early diagnosis and management are paramount.

Sympathetic ophthalmia (SO) is a bilateral granulomatous uveitis following penetrating ocular trauma or surgery. It is a rare but important cause of irreversible visual loss in trauma. Early identification and intervention is therefore vital in mitigating the long term effects of this potentially sight threatening disease.

There comes a daunting time in every foundation doctor’s life when they are expected to make a life-changing decision about applying to a specialty training programme. A simple click of a button can open doors, paving the way for a whole new journey of self-learning and clinical challenges. Choosing a specialty requires careful consideration and is a task that many struggle with. A number of foundation trainees are uncertain about their career choice between medical and surgical sub-specialities due to limited exposure, lack of insight into professional satisfaction and sense of career achievement. Additionally, there is fierce competition for entry into most specialist training programmes. Ophthalmology is unique with regards to its immensely intricate practical skills but also provides scope for diagnosis, treatment and prevention of diseases - arousing the “medical” mind.

The direct ophthalmoscope was invented in 1851 and ophthalmologists were first able to visualize retinal detachment through it in 1853. Subsequently, the first viewings of central retinal artery occlusion and papilloedema were obtained in 1855 and 1860, respectively. Despite being around for more than a century, today’s medical students still lack the confidence and competence to perform it well. Concerningly, this lack of confidence is not exclusive to medical students. Amongst junior doctors, only one in five foundation year doctors felt confident identifying papilloedema by the end of foundation year. Amongst more senior doctors, up to 43% of General Practitioners admitted to lacking confidence in performing direct ophthalmoscopy.