Katie Winstone

Your first years of work as a junior doctor are generally highly anticipated, exciting but also daunting. The learning curve is steep, responsibility is thrust upon you and there often feels like there is a lot to remember.

Most doctors will have spent between 5 to 6 years training to become a doctor, usually going on to Foundation training if in the UK. Many will have also completed additional degrees or other qualifications prior to or during this medical training. International doctors may have had a similarly challenging journey to graduation.

During medical school, we study ophthalmology, learning about the eye and its numerous potential pathologies. However, not all students are fortunate enough to attend an ophthalmology rotation or hands-on experience as part of their training. For those that do, it is often short, approximately 1 or 2 weeks at most. They may get the chance to develop skills using a direct ophthalmoscope or examining the external eye.

For budding ophthalmologists, there is an opportunity to pursue additional placements or electives, though this is not a common choice for the majority of students.

In my experience, ophthalmological issues are often underestimated, in many situations considered comparably less important than other ongoing medical issues. Despite this, newly qualified foundation doctors must be able to recognise some of the most serious, most urgent and most common ophthalmological problems, at a minimum.

It is important to remember that patients on the wards may have pre-existing ophthalmological conditions or may develop acute issues whilst admitted. They may have significant additional needs due to their ophthalmological condition, or be dependent upon medication to manage their condition/s.

Below is a compilation of useful resources for medical students and junior doctors that may help provide you with useful ophthalmology information, to help with your clinical practice.

The more detailed resources will also provide additional information to further build your knowledge if you already have an established understanding.

EyeWiki (1)

A fantastic resource which is easy to read, clearly laid out and will cover every ophthalmological problem you may face as a junior doctor.

It is very detailed and at times may be more information than you need. However, it is great for reference.

https://eyewiki.org/Main_Page (1)

GeekyMedics (2)

The examination and history guides for ophthalmology are useful when you have to assess your patient. They cover important red flags and also explain some of the key pathologies you may encounter.

https://geekymedics.com/eye-examination-osce-guide/ (2) https://geekymedics.com/ophthalmic-history-taking-osce-guide/ (2)

Tim Root (3)

The ‘Virtual Eye Professor’, Dr Tim Root is a well-known American Ophthalmologist who has free online videos to explain even the trickiest concepts.

He also has videos of common ophthalmological problems, allowing you to see how they appear clinically, as well as Ophthobook lectures, flashcards and questions to help with learning.

If you are a visual learner (no pun intended), then you may find this helpful. https://timroot.com/ (3)

Oxford Handbook of Ophthalmology (4)

A part of the ‘Oxford Handbook’ series, the book is relatively compact. It covers the basics as well as detailed information about important ophthalmological conditions.

If you prefer a book over an internet resource, this may be for you.

Ophthalmology Journals – British Journal of Ophthalmology (5), Eye (6) and others

The budding researcher, or those keen on the latest evidence-based medicine may enjoy reading one of the many ophthalmology journals. The British Journal of Ophthalmology is included with BMA membership, if you choose to join them, which is a great way to explore an interest in ophthalmology you may have.

https://bjo.bmj.com/ (5) https://www.nature.com/eye/ (6)

Mind the Bleep (7)

Mind the Bleep has a great section on ophthalmology, focusing on the fundamentals, pitched at a level appropriate for junior doctors.

They cover some of the core pathologies, eye drops, examination technique, how to use an ophthalmoscope, amongst other articles.

https://mindthebleep.com/ophthalmology/ (7)

In summary

1. Remember that, as a junior doctor, you are rarely alone. Don’t be afraid of asking for help. Some conditions can be sight-threatening therefore it is important you assess them thoroughly or seek the help of a senior who can, if you are not confident. You are mostly certainly not expected to be an ophthalmologist.
2. Discuss cases with your seniors, you can learn a lot from those who are more experienced.
3. Never underestimate the importance of regular eye care and medications. Eye drops can be crucial in the control of chronic conditions.
4. If you are concerned about a patient, always escalate it and discuss with a senior if a specialist ophthalmology opinion is needed.
5. The resources above are some of my favourites, but are the tip of an iceberg. There is a vast array of resources you can explore and see which you find most helpful, as we all learn differently.

References

1. American Academy of Ophthalmology. EyeWiki [Internet]; 2023 [accessed 19 July 2023]. Available from: https://eyewiki.org/Main_Page
2. Geeky Medics [Internet]; 2023 [accessed 19 July 2023]. Available from https: https://geekymedics.com/
3. Root, T. Tim Root: Virtual Eye Professor [Internet]; 2023 [accessed 19 July 2023]. Available from: https://timroot.com/
4. Denniston, A, Murray, P. Oxford Handbook of Ophthalmology. Fourth Edition. Oxford University Press; 2018.
5. BMJ journals. British Journal of Ophthalmology [Internet]; 2023 [accessed 19 July 2023]. Available from: https://bjo.bmj.com/
6. Royal College of Ophthalmologists. Eye [Internet]; 2023 [accessed 19 July 2023]. Available from: https://www.nature.com/eye/
7. Mind The Bleep [Internet]; 2023 [accessed 19 July 2023]. Available from: https://mindthebleep.com/contribute/