Smartphone-based fundus imaging (SBFI) has emerged as a portable, user-friendly, and low-cost alternative. These devices leverage the high-resolution sensors and processing power of modern smartphones, often costing a fraction of traditional equipment—sometimes under $700 for basic adapters.

In the UK, over two million people live with sight loss, 59% of whom are aged 75 or over. It is estimated that by 2050, the number of people with sight loss in the UK will double, reaching over four million (2). Notably, nearly 60% of these cases are attributed to cataracts and uncorrected refractive errors – both of which are readily treated through corrective lenses or cataract surgery. Despite this, visual assessments are often overlooked in the management of older adults presenting with falls. This article explores the reasons behind this oversight, outlines a practical approach to assessing vision, and highlights the benefits of integrating visual assessments into routine clinical care.

Many commonly prescribed medications doctors can adversely affect the eye. These effects range from mild and reversible symptoms, such as dryness and blurred vision, to severe and potentially irreversible conditions including optic neuropathy and retinopathies. Early recognition of medication-related ocular pathology is essential for healthcare professionals, as timely intervention can mitigate vision loss. This review outlines frequently prescribed medications and their associated ocular adverse effects.

Wearables and consumer-grade devices are shifting “monitoring” from episodic clinic snapshots to higher-frequency, patient-driven data. The opportunity is real - but the evidence base is uneven, and implementation succeeds or fails on workflow: what triggers review, how false alarms are handled, and whether the pathway can deliver timely confirmation and treatment.

Cancer-associated retinopathy (CAR) is a paraneoplastic autoimmune retinopathy in which an immune response generated against tumour antigens cross-reacts with retinal antigens, resulting in subacute retinal dysfunction that is often bilateral and may occur with minimal intraocular inflammation (or a clinically quiet eye). In a clinically meaningful proportion of patients, visual symptoms can precede the diagnosis of the underlying malignancy, making CAR a potential ophthalmic “sentinel” presentation of occult cancer.

Glaucoma is the subspecialty where “patient voice platforms” arguably deliver the greatest real-world impact because the clinical challenge is less about short-term decisional points and more about sustained behaviour over years: attending lifelong monitoring, instilling drops correctly, persisting with treatment despite limited symptoms, and navigating escalation to laser or surgery. Those are precisely the domains where organised patient communities, education hubs, and adherence support add value. This is particularly relevant in the context of persistent global vision impairment burden and health system emphasis on people-centred eye care, which explicitly positions community engagement and empowerment as part of delivery, not an optional adjunct.

The global ophthalmology community is not short of effective interventions; it is short of equitable delivery. The Lancet Global Health Commission on Global Eye Health positioned eye health as integral to universal health coverage (UHC), arguing that progress depends on shifting from vertical, disease-specific activity to health-system strengthening with explicit attention to equity and quality. The WHO World report on vision similarly frames the challenge as one of access, affordability, quality, and people-centred systems rather than a lack of clinical solutions.

Preparing for the Duke Elder exposes you to the full breadth of ophthalmology, far beyond clinic taster weeks. Many students only realise during revision whether they genuinely enjoy areas such as optics, neuro-ophthalmology, and visual science. For both of us, Duke Elder preparation was pivotal in confirming that ophthalmology was the right career choice.

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) represent a rare but potentially life-threatening immune-complex-mediated hypersensitivity reaction that predominantly affects the skin and mucous membranes. Characterized by widespread epidermal necrosis and detachment, these syndromes also involve significant mucosal inflammation, including oral, ophthalmic, and urological surfaces. Initial symptoms often mimic a viral prodrome, presenting as flu-like malaise and fever, which rapidly progress to painful blistering and erosions. Given the acute and systemic nature of SJS/TEN, early recognition and urgent multidisciplinary intervention are crucial to mitigate morbidity and mortality.

A plasmacytoma is a localized tumour composed of monoclonal plasma cells, which are antibody-producing cells derived from B lymphocytes. It represents a focal form of plasma cell dyscrasia and occurs either as a solitary bone plasmacytoma or as an extramedullary plasmacytoma arising in soft tissues. Extramedullary plasma tumours are rare and account for roughly 3–5 % of all plasma cell neoplasms. Unlike multiple myeloma, plasmacytoma lacks diffuse bone marrow involvement and systemic features, although it carries a risk of progression to multiple myeloma over time. It often presents diagnostic challenges due to its varied and site-specific clinical manifestations.