Trainees
The treachery of images – making sense of OCT imaging
In 1929 Belgian surrealist Rene Magritte produced his painting La Trahison des Images. It depicted an old fashioned pipe for smoking tobacco and underneath were the words “ceci n’est pas une pipe”, this is not a pipe. You may wonder...
Take this waltz
My last weekend on-call was the busiest I can remember for a very long time. We were just completely swamped with patients. The weather was not too good that Saturday and it felt like every second inhabitant of our ocean...
The medical student syndrome
It is often said that “a little learning is a dangerous thing,” but being super savvy can’t put us at the brink of harm, can it? Each year as thousands of students commence their medical degrees, they begin a journey...
Unravelling ocular motility
Ocular motility can often be a slightly abstract concept during the earlier years of ophthalmology training. A large variance on what embodies normality; mythical concepts like fusion and binocular vision, examination techniques that can be fiddly, and complex neuroanatomy all...
The ‘art’ of refraction – designing a refraction course
Learning how to refract requires theoretical knowledge, practice and determination. Refraction is a notoriously challenging skill to acquire and the competing demands on junior ophthalmologists can often be restrictive of the development of this core skill. To consolidate theory learnt...
Embryology in clinical practice
The fascinating world of embryology is both beautiful and practical. It is a home video of our evolutionary history through the ages from the single cell through to the life aquatic, the development of gut, limbs and brain, and most...
A tale of two membranes
It was the best of times, it was the worst of times... It was the season of Light, it was the season of Darkness... I am fortunate to work on a vitreoretinal firm at the moment and only a few...
The embryology of the eye
Nobody claims to like embryology. At least nobody I know. It has been a neglected part of the curriculum since time immemorial and a vicious cycle occurs in which those with an incomplete understanding fail to appreciate the inherent beauty...
Principles of contact lens fitting in keratoconus
Keratoconus is an ectatic condition of the cornea characterised by progressive conical distortion with irregular astigmatism, myopia and apical protrusion. Most cases progress slowly resulting in varying degrees of myopic astigmatism. Management of keratoconus includes spectacles, soft contact lenses, a...
The assessment of pupils and pupillary reactions
Understanding pupillary reactions is vital in understanding basic neuro-opthalmology. It is a skill required in eye casualty, clinics and perhaps most importantly, exams. To start at the beginning, the pupil is the central aperture of the iris, its size controlling...
Preventing refractive surprises by real time biometry during cataract surgery
A few months ago a retired lady presented for second eye cataract surgery. I noted on the pre-op ward round that the outcome of her first eye’s surgery looked like a refractive surprise as her spherical equivalent in that eye...
White dot syndromes
It is fair to say that trainees and consultants who are not medical retina specialists are a bit scared of the so called retinal ‘white dot syndromes’. It is easy to understand why this is the case, as almost every...
