OCT was first introduced in 1991, it is a non invasive imaging technology which uses low-coherence interferometry. It is effectively an optical version of ultrasound imaging. In 1996 it first became available in clinic practice. OCT allows the quantitative evaluation of the RNFL, the optic nerve head (ONH), and the macula. OCT has made a large improvement in the detection and management of glaucoma by taking it from a mainly subjective based assessment to a mainly objective based assessment.

Purtscher retinopathy is an uncommon occlusive retinal microangiopathy that many clinicians will rarely encounter, but it is important because of what it can represent. It was first described by Otmar Purtscher in 1910 in patients who developed retinal haemorrhages and retinal whitening after head trauma. Since then, similar retinal findings have been reported in several non-traumatic systemic illnesses. These cases are usually described as Purtscher-like retinopathy.

Artificial intelligence (AI) has redefined the diagnosis and early detection of multiple ocular conditions in the realm of ophthalmology. Artificial intelligence was initially focused on retinal conditions, such as the grading and early detection of diabetic retinopathy and age related macular degeneration through the use of optical coherence tomography (OCT) and retinal databases. Systems such as IDx-DR achieved FDA approval for the detection of diabetic retinopathy, and based on a set of protocols was able to determine those that required further follow up. This paved the way for further systems being introduced for screening and now for anterior segment conditions such as keratoconus, becoming the focal point of its expansion.

Artificial intelligence (AI) is increasingly being integrated into ophthalmology, from automated screening tools, such as those for diabetic retinopathy, to newer AI models and research aimed at individualising patient care, patient education and improving surgical accuracy. Understanding patients’ attitudes is crucial for the successful integration of AI in ophthalmology; however, their perspective has seldom been studied. This article aims to explore this gap by reviewing the literature on patient-reported outcomes.

The Royal College of Ophthalmologists annual congress is often a window into the speciality’s collective mind and direction. The city hosting this year’s conference was Manchester, where on and off rain and sun, and rich history of industry and innovation set in red brick mirrored some of the congress’s key themes. For juniors, congress is a motivator. Learning can be arduous at times, and congress is a moment that widens the lens. Below are reflections and learning points from some sessions. They include presidential handover, an important moment for the Royal college’s identity, high volume care, the impact of systemic medicines entering ophthalmic conversations and reflective, interactive vitreoretinal surgeon sessions.

Transient monocular vision loss (TMVL) is a common but diagnostically challenging presentation in Ophthalmology and emergency medicine. Two clinically important causes include retinal migraine and amaurosis fugax, which differ significantly in underlying pathology, systemic risk, and management. To provide a practical and clinically focused approach to differentiating retinal migraine from amaurosis fugax in patients presenting with TMVL. Narrative clinical review of key diagnostic features, risk factors, and investigation strategies relevant to TMVL, with emphasis on bedside differentiation. Amaurosis fugax is most commonly embolic in origin and is strongly associated with carotid atherosclerosis and cardiovascular risk factors, requiring urgent stroke pathway assessment. Retinal migraine is rare, diagnosis of exclusion condition, typically seen in younger patients with a history of migraine and reversible vasospasm. Duration of symptoms, symptom character and vascular risk profile and associated systemic features are key differentiators. Accurate distinction between retinal migraine and amaurosis fugax is essential to prevent missed cerebrovascular disease and avoid unnecessary investigations in benign cases. A structured clinical approach improved diagnostic accuracy and patient safety.

Ophthalmology requires long term dedication and passion for the specialty and this is reflected in the competition ratios in entering the specialty with recent competition ratios in 2025 being 21.5:1 with 2,197 applications for 102 posts (1). The competitive nature of the specialty is displayed through the application process including the portfolio requirements. The breadth of domains to cover include previous posts and experience, quality improvement audit, research and teaching with extra points awarded to awards/prizes dedicated at an undergraduate level (2). The limited exposure to the specialty during foundation years in addition to medical school years can make it difficult to obtain the vital points to enhance your portfolio, hence the desirability of posts such as the Clinical Teaching Fellow (CTF) posts (3). This article will explore the benefits of the post and how it improves the chances of obtaining a training number in ophthalmology.

The amniotic membrane (AM) is the innermost layer of the placenta, comprising a thick basement membrane and an avascular stromal matrix. It has been used in ophthalmology since the early twentieth century, with renewed interest following the work of Kim and Tseng in the 1990s, who demonstrated its efficacy in ocular surface reconstruction (1). Its unique biological properties, including anti-inflammatory, anti-fibrotic, anti- angiogenic, and pro-epithelialisation effects, make it a versatile adjunct in the management of a wide range of ocular surface conditions (1,2). Amniotic membrane transplantation (AMT) is now an established surgical technique in corneal and anterior segment practice, and familiarity with its indications and applications is essential for ophthalmic trainees.

Five generations of IOL power calculation formulas trace a progression from empirical regression to data-driven prediction. Accurate prediction of the effective lens position (ELP), the postoperative anterior-posterior location of the implanted IOL, remains the central, persistent technical challenge.

Cystoid macular oedema (CMO) is one of the leading causes of visual loss in non-infectious uveitis (NIU) and frequently resists conventional treatment, including corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and tumour necrosis factor-alpha (TNF-α) inhibitors.