Ophthalmology is a rapidly growing specialty, with huge opportunities to improve the quality of
people’s lives. Our sight is our most precious sense, and the goal of preservation – or restoration of sight makes ophthalmology a hugely rewarding choice of career.
A day in ophthalmology begins like most surgical specialties - with a ward round. This does not take long, as we tend to have very few inpatients. Almost all elective surgery is day-case surgery, leaving only patient’s with severe ocular disease – such as acute corneal abscesses – as inpatients. We examine them at the slit-lamp, make appropriate changes to their treatment plan, and then it’s off to department teaching activity which usually held in the department meeting room. The teaching round is for an hour and we start our clinic after that.
Today, I’m in a general ophthalmology outpatient clinic. On other days there are more specialist
clinics, and sessions in the busy emergency eye clinic. The general E linic will see a wide variety of eye conditions present. A mixture of new and review patients will be seen, with a wide age range.
Glaucoma stands out as the most common condition requiring continued follow-up. I check the patient’s eye pressures, and their optic discs. I also ask about compliance and understanding of the treatment. The clinics are busy, but still allow me time to talk with the patients; explore their ideas and concerns, and hopefully impart some helpful information, at the same time as managing their eye condition. There is an important team-based approach in the clinic, as we utilise the skills of the ophthalmic nurses, orthoptists and low vision support workers in the care of patients. We see several elderly patients with poor vision, who need support and practical help. Blind or partially-sighted registration is one way of accessing the support they need.
After a lunch-time, it’s off to theatre for the afternoon. Cataract surgery forms the bulk of the surgical workload in ophthalmology, for all ophthalmologists, regardless of sub-specialty. It is therefore taught to ophthalmology trainees from the beginning of our training and requires excellent hand-eye coordination and stereoscopic vision. Cataract surgery has advanced rapidly over the past decade or so, and is now a day-case local anaesthetic procedure, taking under thirty minutes to perform. Visual rehabilitation is fast, and success rate is at least 97%. I have a list of five to perform, with the consultant supervising. They go well. Theatre sessions are my favourite part of the week.
I feel quite privileged to be working in ophthalmology. The majority of our patients do very well, with a high rate of symptom control or cure, compared with other specialties. Therefore, personal and professional job satisfaction is very high. The life-changing impact of performing cataract surgery on a patient, restoring sight to someone who has gone without, is profound. There are of course negative aspects of the specialty – we spend the majority of our time in a dark room, with blackout blinds preventing us from seeing daylight. Focusing exclusively on the eye and the visual system can also lead to some loss of general medical skills. But it’s a happy specialty, combining medicine and surgery, challenging and demanding at times, but rewarding and an excellent career choice.
