Veatriki Athanasiou
Introduction
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.
Course Overview and Practical Skills Acquired
Microsurgical Techniques and Instrument Handling
The day was structured almost entirely around hands-on learning, with minimal didactic teaching. This practical approach allowed us to engage directly with the microsurgical techniques used in cataract, oculoplastic, strabismus and corneal surgery (1). We began by identifying commonly used instruments, understanding their subtle differences, and practising the fine motor control required for safe manipulation under magnification.
Suturing and Knot-Tying Practice
A detailed introduction to sutures and needles followed. Appreciating the variations in needle design, where to hold them for stability, and how each behaves within tissue laid an essential foundation for the practical suturing stations (1). Knot-tying practice followed, during which we refined both reef and surgeon’s knots, skills that became progressively more intuitive with repetition. This early exposure reinforced the need for regular practice in developing confiedence with delicate microsurgical techniques.
Eyelid Suturing Workshop
One of the most enjoyable parts of the morning was the eyelid suturing workshop. Using techniques demonstrated in the recommended oculoplastic video tutorials, we practised eyelid margin repair on a porcine eye model, gaining a realistic sense of the precision and tissue-handling skills required in oculoplastic surgery (1).
Strabismus Model Practice
Later in the day, the strabismus models provided a structured introduction to scleral and rectus muscle suturing. These exercises required careful depth control to avoid scleral perforation and highlighted the distinct tactile feedback associated with engaging the rectus tendon insertion (1).
Corneal Session and Phacoemulsification Incision
The corneal session brought together several themes from earlier in the course. Constructing a self-sealing phacoemulsification incision illustrated how incision architecture directly affects surgically induced astigmatism. We then progressed to corneal suturing using 10-0 nylon under the operating microscope, an exercise that highlighted the importance of depth control, even spacing and appropriate suture tension (1).
A Proper Introduction to the EyeSi Simulator
Although brief, the EyeSi simulation session was one of the most valuable components of the day. Foundation doctors must be able to set up and safely operate the simulator before booking independent sessions, and trainees are expected to engage in regular EyeSi practice as part of their early surgical development and progression towards cataract surgery. This guided introduction made subsequent EyeSi sessions feel far more approachable and clarified the simulator’s role within the OST curriculum.
Impact and Personal Reflection
The immersive nature of the course prompted meaningful reflection on my readiness for surgical training. The repeated emphasis on fine visuomotor skills encouraged me to undergo a formal stereopsis assessment shortly afterwards, something I might not otherwise have considered at this early stage. The experience reaffirmed that while the course provides an excellent grounding in essential microsurgical principles, long-term progression depends on consistent, deliberate practice.
The Introduction to Ophthalmic Surgery course is an valuable starting point for anyone considering a career in ophthalmology. It offers a realistic first immersion into the microsurgical environment, builds early confidence with tools such as the EyeSi simulator and helps clarify whether this demanding yet rewarding specialty feels like the right fit. While the portfolio point is a welcome addition, it is the hands-on learning, expert guidance and personal insight gained throughout the day that truly make the course invaluable.
References
- Royal College of Ophthalmologists. Introduction to Ophthalmic Surgery Course Handbook. London: RCOphth; 2019.