Between 2021 and 2022, over 6.7 million CT scans were performed in England, most of which contained the orbit within the imaging (1). Emergency CT head and facial trauma radiographs are among the most frequently requested studies in acute medicine, often ordered to exclude intracranial haemorrhage or infarction. In these scans, the orbit is often also imaged but remains a bystander as the focus lies on the intracerebral contents. The orbital contents are consistently included and just as consistently underexamined.

For international medical graduates (IMGs), US clinical experience (USCE) is often a prerequisite when applying to competitive specialties such as ophthalmology. It enables applicants to obtain letters of recommendation, build professional networks, and demonstrate familiarity with the US healthcare system. These elements are critical components of a successful residency application.

Hydroxychloroquine (HCQ) is widely prescribed in the United Kingdom for autoimmune conditions such as systemic lupus erythematosus and rheumatoid arthritis. Although generally safe, long-term use is associated with a risk of retinal toxicity, which may result in irreversible visual impairment. Hydroxychloroquine retinopathy (HCR) is often asymptomatic in its early stages, making structured screening programmes essential. In response to emerging evidence of higher-than-previously recognised prevalence, the Royal College of Ophthalmologists has developed national guidelines for monitoring. This article reviews the pathophysiology, risk factors, clinical features, UK-based screening recommendations, and management strategies for HCR, with emphasis on prevention and early detection.