Brown syndrome, which is also referred to as superior oblique tendon sheath syndrome, describes a rare presentation of vertical strabismus in which there is restricted ability to elevate the affected eye when it is adducted. This article aims to highlight the pathophysiology, clinical features, associations, diagnosis and management of this visual phenomenon which was initially reported in 1949 by Dr Harold Whaley Brown.
When I began as a foundation doctor, I assumed ophthalmology would sit at the edge of my training. I expected the occasional red eye in A&E, but little more. Instead, ophthalmic problems kept appearing on the wards — often quietly, sometimes urgently — and each encounter reminded me that vision wasn’t a minor detail — it often sat at the heart of patient safety.
Doing an ophthalmology rotation can teach you to diagnose and manage common eye conditions, perform key examinations, and observe surgical procedures such as cataract removal. It will also provide you with the opportunity to gain insight into the clinical work environment, exploring its benefits and challenges.
First described by Wiethe in 1882, optic disc pits are cavitary abnormalities of the optic nerve head, which may be congenital or acquired. The main complication is optic disc pit maculopathy (ODPM), characterised by the accumulation of intraretinal and subretinal fluid. Timely identification is crucial as ODPM results in a deterioration in vision, and if left untreated, is associated with serous macular detachment with central vision loss.
This personal reflection explores how webinar-based learning through Cybersight contributed to my professional development in ophthalmology between June 2024 and May 2025. Covering clinical topics such as keratoconus, refraction, glaucoma diagnostics, and dry eye disease, these sessions offered not only exam-aligned knowledge but also broader insights into how ophthalmology is practised globally. As a doctor preparing for specialty training, I found this form of self-directed learning instrumental in shaping my understanding, clinical reasoning, and subspecialty interests.
The UCL Institute of Ophthalmology Summer School, run in collaboration with Moorfields Eye Hospital, is a five-day programme designed to introduce participants to the breadth of ophthalmology as both a clinical specialty and an academic discipline. It is held annually in London and attracts medical students and junior doctors from a wide range of backgrounds, including participants travelling from overseas. The course is intended for those considering ophthalmology as a future career, offering a structured overview that combines teaching, practical skills, and professional development.
The Arclight is an innovative, low-cost ophthalmoscope and otoscope designed to improve access to diagnostic eye and ear care worldwide. Traditional ophthalmoscopes are expensive, fragile, and require battery changes, making them impractical in many low-resource settings. The Arclight addresses these barriers while offering a practical solution for both clinicians in the UK and healthcare workers globally.
A gentleman in his 40s presented to eye casualty following trauma from shattered eyeglasses, which caused a full-thickness corneal laceration in his left eye. Slit-lamp examination revealed an approximate 7 mm paracentral wound, 3 mm from the visual axis. There was associated mild vitreous haemorrhage and reduced vision. Seidel test was negative, indicating spontaneous self-sealing of the wound. However, this resulted in significant irregular astigmatism and refractive error, compromising visual acuity. Lens structure was intact, with the presence of fibrin strand from the anterior lens capsule. Urgent surgical repair was performed with interrupted 10-0 nylon sutures to restore anatomical integrity and regularise the corneal contour. The anterior chamber was reformed, and a bandage contact lens was placed. Postoperative management included topical antibiotics, corticosteroids, and lubricants. The early postoperative course was uncomplicated, with a stable wound and maintained visual acuity. This case highlights the importance of recognising self-sealed corneal lacerations, where irregular healing can cause optical distortion, and demonstrates the role of surgical repair in optimising both structural and visual outcomes.