How I overcame the hurdle that is the FRCOphth Part 1

The FRCOphth Part 1 is one of the most difficult exams in ophthalmology training, with an exam pass rate of 39.6% over the last 12 months (compared to 60.8% for FRCOphth Part 2 oral [60.8%] and written [68.7%]). Stack the...

Light in darkness – manual small incision cataract surgery in India

Cataract has been documented to be the most significant cause of bilateral blindness in India, where vision <20/200 in the better eye on presentation is defined as blindness [1,2]. Estimation of blindness in India by the World Health Organization (WHO)...

Simulation in ophthalmology: a pedagogic viewpoint

The advent of simulation technology has enhanced modern medical training. The first utilisation of simulation was in 1929 where Edward Link used this concept to develop a mechanical flight simulator [1]. Industries such as aviation, nuclear power and the military...

An arm and a leg

“It cost me an arm and a leg.” – Mr B told me. An arm and a leg to be seen by the famous Russian eye surgeon who said that everybody can be spectacle-free. He took Mr B’s money (roughly...

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...

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...

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...

On the wrong track

A 65-year-old very high myope lady presented with sudden blurred vision down to count fingers to her right eye after a short and sharp pain. She also described seeing a black swirly line and as all these symptoms were exactly...

Anisometropia following cataract surgery and its non-surgical treatment

The desired result of cataract surgery is improved visual acuity without the use of spectacles. In practice most patients following initial cataract extraction are likely to be symptomatic of anisometropia giving rise to prismatic effects (anisophoria) and unequal retinal image...

A European ophthalmology perspective

Europe: from the Greek eurus: broad, wide, and ops: eye, face, sight. Thus Europe = the far-sighted (lady). For my first contribution to this column – as the successor of Jonathan Park, whose witty observations and entertaining style many of...