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My Top Five: Preparing for the Duke Elder examination: My tips for success

The Duke Elder Examination is a prestigious ophthalmology exam, open to all medical undergraduates. It is a prize examination, consisting of 90 multiple-choice questions in two hours, testing students on ophthalmology content beyond the undergraduate curriculum. With notoriously tough questions,...

Making sense of the orthoptic assessment

Following the Specialty Trainee article on this topic in the February/March 2020 issue, Joe Smith provides a more detailed breakdown of the orthoptic report. Orthoptists investigate, diagnose and manage a wide variety of patients with varying problems. In this article,...

The use of toxin in paediatric strabismus

Strabismus is a common condition that affects up to 5% children and can be associated with abnormal visual development, double vision, loss of depth perception and impaired binocularity [1]. It can also cause cosmetic concerns, negatively impact psychosocial wellbeing and...

Refined glaucoma referral practice offers prospect of improved capacity and expanded role for primary eye care professionals

Glaucoma is the most frequent cause of irreversible blindness worldwide and the second leading cause of blindness in the UK [1,2]. The global prevalence of glaucoma in 2010 was approximately 3.5% for people aged 40-80 years, according to Jonas et...

Surgical treatment of high myopia

Although several excellent modalities are available for correcting high myopia, the surgical treatment of this condition remains one of the biggest challenges for refractive surgeons; this group of patients is often very dependent on contact lenses. If these patients become...

Neovascular AMD: fresh recommendations underline standards of best practice

The management of neovascular age-related macular degeneration (nAMD) has advanced dramatically over the past seven years, with the introduction of targeted new therapies that successfully maintain or improve vision in a majority of affected individuals. It’s a fast moving field,...

Paediatric ptosis

Manoj Parulekar and colleagues provide a comprehensive overview of the diagnosis, assessment and management of childhood ptosis. Blepharoptosis (commonly referred to as ptosis – Greek, πτῶσις, ‘to fall’) is a condition where the upper eyelid is in an abnormally low...

Progress in retinal disease management: Highlights of the Retina Day, RCOphth 2025 Annual Congress

The Retina Day meeting at the Royal College of Ophthalmologists (RCOphth) 2025 Annual Congress in Liverpool was held on 22 May 2025. This report highlights 10 selected topics of interest to subspecialists and general ophthalmologists. Decarbonising anti-VEGF clinics (or making...

Postgraduate training for ophthalmic practitioners

The UK currently spends £25 billion per year on ocular disease, and there is expected to be a 40% increase in those affected by visual impairment by 2050 [1]. To manage this demand, 82% of ophthalmology units across the UK...

Ultrasound imaging of the eyes

Since its initial use in the eyes fifty years ago, ultrasound has established itself as a common diagnostic technique in ophthalmology. Sonographers, engineers and clinicians from all around the world have contributed to the development of ocular ultrasonography. As a...

Aqueous misdirection: a case series of unexpected surgical complications

Aqueous misdirection (AM), also known as malignant glaucoma, is a form of secondary glaucoma that typically presents with shallowing of the anterior chamber (AC), raised intraocular pressure (IOP), and reduced visual acuity (VA) in the presence of patent peripheral iridotomies...

‘The Way Forward’ champions clinicians as architects of patient-centred service redesign

The demographic time bomb poses the dilemma of how more healthcare can be delivered to the UK’s ageing population without commensurate growth in resources. The Way Forward Project provides a robust resource for clinical centres to better identify and implement...