Electives in ophthalmology are incredibly useful for 2 main reasons. The first being that ophthalmology is sparsely covered in medical school, and it is a relative unknown to most medical students, therefore an elective is a great opportunity for any student interested in ophthalmology to gain a better understanding of the speciality and understand the core principles of ophthalmology.
Advances in surgical techniques, intraocular lens calculations, infection prevention protocols, and patient selection mean reduced risks when performing bilateral cataract surgery on the same day. Advantages include faster visual rehabilitation, improved patient convenience, potential economic benefits through reduced healthcare costs and fewer hospital visits. There needs to be strict adherence to established safety guidelines however, including complete aseptic separation of procedures for each eye to minimise the risk of rare but potentially sight-threatening complications. It is likely that evidence supporting ISBCS will increase over time and with the anticipated rise in cataract surgery demand the adoption of ISBCS is likely to increase.
Ptosis is a common eyelid complaint, encountered across a range of specialties, including general practice, emergency medicine and neurology, and whilst often benign, ptosis may be the presenting feature of underlying neurological disease. This article provides a comprehensive overview of ptosis, including anatomy, assessment, key differentials, red flags and management principles.
Intraocular pressure (IOP) is the only modifiable risk factor in the development and progression of glaucoma and thus lowering IOP is the main goal of glaucoma care. SLT was first introduced in 1995. Prior to this ALT (argon laser trabeculoplasty) was used. ALT uses thermal energy to cause scar formation which leads to mechanical stretching of the surrounding untreated regions of the trabecular meshwork, subsequently leading to a reduction in IOP. In contrast to this SLT selectively targets pigmented cells without damaging adjacent healthy tissue.
Ophthalmology training already has a strong apprenticeship-based culture, but increasing outpatient demand can limit opportunities for trainees to lead consultations with immediate senior feedback. A shared-list, consultant-supervised clinic model may provide a simple and practical way to increase trainee autonomy, strengthen clinical reasoning and improve feedback while maintaining patient safety. Further evaluation through trainee feedback, consultant feedback and service impact measures would help determine whether this model could be usefully adapted within ophthalmology outpatient training.
Attending the Yorkshire Retina Society Meeting in Sheffield was a valuable opportunity to gain further exposure to the specialty. With relatively limited ophthalmology experience so far, I was initially unsure how accessible a retinal meeting would be. However, I found the programme engaging, easy to follow and highly relevant, offering a broad insight into medical retina, glaucoma, vitreoretinal surgery, uveitis and multidisciplinary ophthalmic care.
The variant of CHRPE which is related to Familial Adenomatous Polyposis (FAP) is the atypical type. FAP consists of numerous adenomatous polyps of the colon and rectum. Untreated individuals with FAP almost always develop colorectal cancer by middle age. Atypical CHRPE is also associated with Gardner syndrome, a variant of FAP characterised by a constellation of colonic polyps, osteomas, soft tissue tumours and dental abnormalities.
The BOPSS held their annual meeting in Sheffield this year, a multi-day event including an oncology themed ‘update day’ and the latter scientific meeting days housed within the over-century-old, neo-classical City Hall. A varied selection of speakers from around the globe, wet-labs for different grades, a nurses-specific programme and a pre-BOPSS Trauma and Aesthetics workshop promised a fulfilling trip.