Assessment of patients in ophthalmology typically involves taking a history and an examination.  History taking is important in the evaluation of patients as it provides information that can lead to the identification and treatment of the ophthalmic condition. For example, identifying systemic conditions that the patient may suffer from, medications that the patient uses and family history. Ophthalmologists typically ask the patient to describe their vision and the visual symptoms that they may suffer from. Whilst having a subjective understanding of a patient’s vision is important, testing it using objective means as well as assessing the eye is also necessary especially when monitoring in chronic conditions.

Ophthalmic Specialist Training (OST) is a seven-year surgical training programme. The Royal College of Ophthalmologists (RCOphth) have created a curriculum that will lead to certificate of completed training (CCT). Year on year, the competition for OST training spots is increasing, with the latest figures from 2023 showing the ratio of applicants to places was approximately 10:1. Due to the increased competition, medical students may start feeling the need to decide about their specialty of choice during medical school in order to prepare an adequate portfolio and become competitive at the application process.

Senile or degenerative retinoschisis is an uncommon condition usually seen in persons over the age of forty years. Retinal breaks involving the outer or inner layers of a retinoschisis cavity may occur during the natural history of the condition. We describe a patient, who developed retinal breaks at the inner and outer layers of the schisis cavity following trauma, resulting in an unusual appearance of dialysis at edges of retinoschisis, requiring laser photocoagulation to prevent retinal detachment. No previous report describing such features has been reported in the literature.

Abdullah A. Cheema1, Connor Qiu2, Mohamed Ahmed Roshdy Khalil3 1Royal Glamorgan Hospital, Llantrisant, Wales 2Royal Free London NHS Foundation Trust, London 3Glangwili Hospital, Carmarthen, Wales Abstract Phototoxic retinopathy may occur…

An 11-year old boy presented to his optometrist with a 2-week history of intermittent flashing lights and blurred vision in his right eye. His medical background included amblyopia secondary to strabismus and a port-wine stain (naevus flammeus) above his right eye, both of which were corrected in early childhood with patching and laser treatment, respectively. Whilst at the optometrist, fundoscopy was performed which highlighted an ambiguous lesion in his right eye temporal to the optic disc that could not be characterised. He was referred urgently to the acute eye clinic, where a B-scan and fundus fluorescein angiography (FFA) were performed. These investigations, along with slit lamp examination, were highly suggestive of a choroidal haemangioma. Given his history of a port-wine stain, he was referred to a specialist centre to explore the possibility of a diagnosis of Sturge-Weber syndrome. This article aims to shed light on this rare neurocutaneous disorder, and the ocular manifestations associated with these affected individuals.

Ophthalmology is a very niche and highly competitive specialty, with most recommending that you should start working on your portfolio as early as medical school if possible. However, not everyone knows what they want early on. I , for one, have many interests and did not fully know what I wanted until my FY2 year. It was vital that I rotated in different specialties to determine which was and was not for me. Ophthalmology portfolio-building demands time, commitment and dedication given the 10:1 competition ratio in 2023. Nonetheless, it is possible to get into even if you start late with a proper strategy in place. As what the other ophthalmology trainees I’ve met said, “someone will get that training number and why can’t it be you”. Here are my tips to starting your ophthalmology portfolio from scratch in FY2

A 38 year old white male patient presented to his community optometrist complaining of a four day history of painless blurred vision in the right eye that he described as “like looking through a glazed-bathroom window”. He had noted one similar episode two weeks previously that self-resolved within 2 hours. The patient was otherwise well and symptom free; he denied any pain or antecedent trauma and there was no history of recent surgery, travel or illness.

Foundation Year (FY) placements are there for you to primarily fulfil the competencies of a Foundation Year Doctor (FYD). They are there for you to develop into a well-rounded Doctor. However, with a competition ratio of almost 10:1 many who plan to apply to Ophthalmology will undoubtedly need to keep an eye on the prize also (1). Here we will focus on the benefits of certain foundation year rotations and how you can maximise your time in each specialty towards your application.

There was a great deal of upset in my year group when it came to electives. I was not in the year group where the idea of going abroad was completely out the question. Instead, for us it was a touch and go situation, dependent on country policies and the ever-fluctuating situation of the COVID pandemic. Many of those who did plan to go abroad had to cancel their electives and opt for a local department, few managed to fulfil placements abroad at the time. In a time of great uncertainty, I opted to arrange an elective with my local department through my university. Here I explain how staying local benefitted me.

Keratoconus is a bilateral asymmetric chronic disease process characterised by progressive corneal thinning that results in irregular astigmatism and decreased visual acuity. The pathophysiology of keratoconus begins with a reduction in collagen lamellae within Bowman’s membrane (the second outermost of the five corneal layers, between the outer corneal epithelium and middle stromal layers). Progression of disease then affects the deepest corneal endothelial layer, distorting the morphology and tessellation of normal hexagonal shaped corneal endothelial cells (reduced pleomorphism), increasing the variation in cell size (polymegathism), but without affecting the overall number of corneal endothelial cells. In the UK, keratoconus has been shown to have a marked ethnicity split, with incidence in Caucasian British populations (3.3-4.5/100,000 population/year) significantly lower than in British Asian populations (19.6-25/100,000 population/year). Its onset and progression is usually in the second and third decades of life, with subsequent stabilisation thereafter, although progression may also occur in older affected individuals. Keratoconus management is usually conservative through monitoring and refractive correction, with complications such as corneal hydrops dealt with separately, and surgical treatment such as corneal collagen cross-linking, deep anterior lamellar keratoplasty (DALK), and penetrating keratoplasty (PK) usually reserved for those with more severe disease.