Attendance at the Introduction to Ophthalmic Surgery course at the Royal College of Ophthalmologists was a highly formative experience. Although the course contributes one point to the ST1 portfolio, its real value lies in the early exposure it provides to microsurgical skills and the expectations of ophthalmic training. The enthusiasm and clarity of the teaching team, who shared practical insights into both technique and training pathways, were a particular highlight.

Most of what we learn as resident doctors comes from clinics, ward rounds, and the occasional on call referral. Ophthalmology often feels like a distant world unless you actively chase opportunities. Conferences were my way of stepping into that world. I didn’t realise how much they would shape my early interest in the specialty until I attended my first few.

Entry into ST1 Ophthalmology is highly competitive, demanding that applicants demonstrate not only high clinical competence but also significant engagement with the non-clinical pillars of medicine. The Education and Teaching domain is critical in the national application portfolio, offering up to 5 cumulative portfolio points based on a tiered scoring system. Given that small point differences often decide successful candidacy, strategically maximising this section is paramount. This article provides a comprehensive analysis of the ST1 scoring matrix requirements and offers high-yield, actionable strategies derived from experience to systematically achieve the maximum available points through securing formal teaching qualifications, delivering sustained teaching programs, and engaging with structured educational initiatives.

A hordeolum (or also stye) is an acute, localized bacterial infection of the sebaceous glands of the eyelid, either of the glands of Zeis (external hordeolum) or the meibomian glands (internal hordeolum). The condition presents as a painful, localized purulent infection of the sebaceous glands of the eyelid of either gland of Zeis (external hordeolum) or the meibomian glands (internal hordeolum). Conversely, an infected chalazion is a chronic, non-infectious, lipogranulomatous inflammatory lesion caused by ductal blockage of the meibomian gland, which changes an otherwise painless, firm lesion into an acute, painful lesion, which is tender, warm, and swollen, and which clinically simulates an internal hordeolum.

Filamentary keratitis is a condition characterised by the presence of filaments on the corneal surface. First described in 1882 by Leber, these filaments comprise of mucus, epithelium and cellular debris. Although relatively uncommon, filamentary keratitis has strong associations with several ocular surface diseases and systemic conditions, making it a condition frequently encountered in clinical practice. Corneal filaments can cause significant morbidity, with the chronicity of the condition and debilitating symptoms significantly impacting quality of life. This review provides an overview of the pathophysiology, clinical features, diagnosis and management of filamentary keratitis.

Anti-vascular endothelial growth factor (anti-VEGF) therapy has transformed the management of several retinal conditions that once led to significant and irreversible vision loss. Prior to its introduction, diseases such as neovascular age-related macular degeneration (nAMD) frequently resulted in rapid, irreversible central vision decline. The advent of intravitreal anti-VEGF injections now allows most patients to maintain vision, and many experience meaningful improvement. This article aims to provide a foundational understanding of the therapeutic mechanism, primary clinical indications, current treatment paradigms, and the future trajectory of anti-VEGF agents, highlighting developments focused on maximizing efficacy and reducing patient burden.

The annual Royal Australian and New Zealand College of Ophthalmologists (RANZCO) Congress is the flagship ophthalmology meeting for Australia and New Zealand. An energetic mix of clinical updates, global health discussions and rapidly evolving technologies. I attended day two of this year’s meeting in Melbourne, which offered a fascinating opportunity to compare approaches across two healthcare systems as a UK-trained doctor currently working in Australia. For UK trainees spending time abroad, RANZCO delivers value: fresh perspectives, high-quality teaching and insight into subspecialty priorities across the region.

Pellucid marginal degeneration (PMD) is a rare, bilateral, non-inflammatory corneal ectasia characterised by a peripheral band of inferior thinning with relative central sparing. Patients usually present in early to mid-adulthood with progressive visual distortion from high against-the-rule and irregular astigmatism. Clinical examination typically reveals a clear, quiet eye with a crescentic band of thinning located 1–2 mm from the inferior limbus. Corneal topography and tomography are essential for diagnosis and commonly show a “crab-claw” pattern of inferior steepening with corresponding thinning on pachymetry. PMD may be misdiagnosed as keratoconus, particularly when only anterior curvature maps are reviewed. Non-surgical management focuses on optical rehabilitation with spectacles in early disease and rigid, corneoscleral or scleral contact lenses in more advanced cases. Corneal collagen cross-linking (CXL) has emerged as a strategy to stabilise progression, although evidence is largely limited to small series and requires modification of protocols for thin peripheral corneas. Intracorneal ring segments (ICRS) can regularise corneal shape in selected patients, while lamellar or penetrating keratoplasty is reserved for advanced disease, scarring or contact lens intolerance. Overall prognosis is favourable with early recognition, judicious use of contact lenses and targeted surgical intervention, although keratoplasty in PMD can be more challenging than in keratoconus with a higher risk of residual astigmatism.

Ocular lymphoma comprises a spectrum of lymphoid malignancies affecting the ocular adnexa and intraocular compartments. The most frequent form is ocular adnexal lymphoma (OAL), usually extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), which typically presents with painless periocular swelling or a salmon-coloured conjunctival mass. Primary vitreoretinal lymphoma (PVRL), in contrast, is an aggressive diffuse large B-cell lymphoma that often mimics chronic uveitis and is closely linked to central nervous system (CNS) lymphoma. Diagnosis relies on high clinical suspicion, targeted imaging, and timely biopsy with immunohistochemistry and molecular studies. Localised OAL is highly radiosensitive, with excellent local control and survival, whereas advanced or high-grade disease requires systemic chemo-immunotherapy. In selected regions, Chlamydia psittaci-directed antibiotic therapy may be considered as an adjunct in MALT-type OAL. This overview summarises current understanding of the epidemiology, pathophysiology, clinical features, diagnostic work-up, and management principles for ocular lymphoma.

The advent of gene augmentation therapy for inherited retinal dystrophies (IRDs) marks one of the most significant therapeutic shifts in paediatric ophthalmology. The approval of voretigene neparvovec for RPE65-mediated retinal dystrophy demonstrated for the first time that genetic diseases causing childhood blindness could be treated rather than merely supported. The pivotal phase 3 trial provided robust evidence of functional visual improvement, particularly in low-luminance mobility, with sustained benefit over several years of follow-up. Real-world paediatric data further corroborated meaningful visual gains after treatment. These results influenced regulatory frameworks, such as the National Institute for Health and Care Excellence (NICE) HST11 guidance, which underlined the importance of sufficient viable retinal cells before gene therapy can be effective.