A common objective structured clinical examination (OSCE) station for medical students is an ophthalmology station where students are required to examine the eye and communicate their findings. In many medical schools in the United Kingdom (UK), a mannequin is used where pictures can be inserted in the mannequin’s eye of fundus images with pathologies. It is often an area of anxiety for students as they have little practice examining patients’ eyes. Below the steps involved in examining the eye and communicating findings, in a 10-minute OSCE station, are examined.

Cataract is a condition of clouding of the natural lens that resides within the eye. Its normal function is to focus the incident light beams entering the eye through the cornea onto the fovea of the retina, where specialised photoreceptors reside and, through geometric isomerisation of the retinal chromophore, send information about the incident light intensity and frequency to the brain for further processing. When the lens  clouds, the incoming light is both decreased in intensity and distorted leading to the distorted perception of the external world by the patient.

Artificial Intelligence in the last 5 years, seems to have become a buzzword across all industries in the pursuit of increased efficiency. Its use has transcended cultural and industrial boundaries, an represents a new frontier within technology that can allow for seemingly impossible tasks or problems to now be solved with a fraction of the manpower. There is no generally accepted definition of the concept of AI, however John McCarthy, a computer scientist who coined the term artificial intelligence in the famous Dartmouth Conference in 1956, regarded AI as ‘the science and engineering of making machines that are smart.’ Without taking part in the philosophical argument of what constituted true intelligence, it can be broadly defined as the development and simulation of computer systems that mimic human learning, comprehension, problem solving and, potentially, autonomy.

Tuberculosis is an infection caused by Mycobacterium tuberculosis, which can manifest in multiple organs, most commonly the lungs, but can also affect the eye. The unique aspect of infection by M. tuberculosis is the complex interplay that occurs with the host immune system, leading to chronicity of the infection. When initial infection occurs, it promotes a type IV hypersensitivity reaction leading to the recruitment of alveolar macrophages that attempt to phagocytose and destroy the bacilli. However, when they fail, the bacteria multiplies within the intracellular matrix and bursts out, leading to the recruitment of more macrophages and a domino effect ensues. Lymphocytes are then recruited and form a granuloma to contain the infection. In immunocompetent individuals, this can lead to resolution of infection or indefinite latency. In the setting of immunocompromised patients, the disease can progress to active TB.

Morning Glory Syndrome (MGS) is a rare congenital optic disc anomaly, first described by Pedler in 1961 and later widely recognised by Kindler in 1970. The condition is named for the resemblance of the optic disc to the trumpet-shaped morning glory flower. MGS is characterised by a funnel-shaped optic disc with a central glial mass and surrounding retinal pigmentary changes. It is typically unilateral and can lead to variable visual impairment, ranging from normal acuity to legal blindness.

Multiple evanescent white dot syndrome, or MEWDs, was first described by Jampol and colleagues in 1984. It is categorised as a white dot syndrome (WDS), a group of inflammatory chorioretinopathies which clinically present as numerous, discrete white lesions affecting multiple layers of the retina including the retinal pigment epithelium (RPE), choroid and choriocapillaris. Other white dot syndromes include acute retinal pigment epitheliopathy (ARPE), acute posterior multifocal placoid pigment epitheliopathy (APMPPE), multifocal choroiditis and panuveitis (MCP) acute zonal occult outer retinopathy (AZOOR), punctate inner choroidopathy (PIC), serpiginous choroidopathy and birdshot chorioretinopathy. MEWDs is a unilateral condition which typically presents in women aged 20-50 years with a viral prodrome and has a benign and self-limiting course. The white dot syndromes are a rare entity with one multi-centre study calculating the incidence of WDS as 0.45 cases per 100,000, whilst other studies have reported the incidence of MEWDs as 0.22 per 100,000 population annually. We will provide an overview of this rare condition characterising its clinical presentation, clinical course and findings on ophthalmic imaging.

Bosch-Boonstra-Schaaf Optic Atrophy Syndrome (BBSOAS) is a rare genetic disorder resulting from mutations in the NR2F1 gene, known for its role in brain and ocular development. The syndrome, initially described by Bosch, Boonstra, and Schaaf, presents a spectrum of symptoms, with significant ophthalmologic involvement being central to its clinical picture. Visual impairment is often among the first indicators and a major contributor to the overall impact of the condition on affected individuals.

Comorbidity among ophthalmology patients is under recognised. Patients often need to see multiple sub-specialists for multiple conditions, and this can be overwhelming and often leads to appointments being missed. This is because currently there is a mismatch between the capacity and demand that current NHS Ophthalmology departments can offer. It was reported that 630,000 patients were waiting for an ophthalmology appointment in 2023 in comparison to 260,000 in 2011.

In medical school, I wasn’t always sure which path I wanted to pursue. Surgery seemed like a natural choice, especially given my family’s influence—my uncles and grandfather were all surgeons, specialising in general, paediatric, and orthopaedic surgery. They had built meaningful careers, and I felt the weight of their legacy as I considered my future. Nevertheless, nothing quite resonated with me, and for a while, I felt adrift, unsure of where I truly belonged. I always wanted to be different, envisioning a path that was uniquely my own.

Canaliculitis is an uncommon condition caused by chronic infection of the lacrimal canaliculus, a key part of the lacrimal drainage system. It is typically a unilateral condition and is associated with a variety of signs including discharge, epiphora, swelling of the eyelid and punctum pouting. Primary lacrimal canaliculitis (PLC) occurs mainly secondary to infection, most commonly due to actinomyces, staphylococcus, and streptococcus. Secondary canaliculitis, on the other hand, occurs as a complication of inter-canalicular or punctal plug insertion for the treatment of dry eye. Management can be conservative, with warm compress, topical and systemic antibiotics, irrigation, and syringing, or surgical, including punctoplasty, canaliculotomy, canalicular curettage, and silicone tube intubation.