Despite its fearsome reputation among spelling bee contestants, ophthalmology is the crown jewel of medical specialties. Most ophthalmologists cite reasonable hours, good outcomes, generous compensation, quick and satisfying surgeries, and a good mix of clinical practice with operating as key aspects they love about their jobs. Indeed, ophthalmology has one of the lowest burnout rates of any field, and a shocking amount of ophthalmologists “pass on the speciality” to their children.
For many med students, ophthalmology is an unfamiliar, niche subject:
My favorite ophtho pimping question that 50% of med students can’t answer is “tell me something you know about the eye.”
— Dr. Glaucomflecken (@DGlaucomflecken) May 16, 2017
Whether you’re new to ophtho or you’ve already realized that it’s the greatest speciality, you’ll need some good resources on deck to help master the basics. Even if you don’t want to go into ophthalmology, mastering the basic eye exam will help you diagnose neurologic disease, deal with common ocular complaints, and assess the progression of diabetes. Far from being an isolated organ, the eye gives you the only means of viewing the CNS noninvasively, and the retinal vasculature closely parallels that of the kidneys.
- Practicing the retina exam
- If you can get access to an indirect and a condensing lens (20 D), the little eye cube that comes with Welch-Allyn direct ophthalmoscopes is a good model for practicing. Unlike (non-comatose) patients, models don’t care if you shine bright lights at them for an hour!
- Suggested books
- If new, start with OphthoBook (https://timroot.com/ophthobook/). You can read PDFs of each chapter for free online, but I prefer the print copy. I highly recommend reading it before starting any ophtho clerkship.
- Start OphthoBook Questions towards the end of OphthoBook.
- Helpful books I found in my library:
- Slit Lamp: Examination and Photography B5 .M37 2007 (oversized). You can skim the historical and photographic discussions, but the beautiful images will help you start recognizing patterns. This book does a great job of breaking down how experienced ophthalmic healthcare workers control lighting with the slit lamp for viewing various ocular structures and pathology.
- Practical Ophthalmology: A Manual for Beginning Residents RE75 .M36 2005 is good for starting to appreciate the techniques.
- Wills Eye Manual is a good reference for tagging along with residents; you’ll find concise information for dealing with nearly anything that comes into the ER.
- Ophthalmology Made Ridiculously Simple RE56 G56 1987 is worth a skim if you need to brush up on the basics. It’s concise and a decent example of an MRS book; you’ll find the other titles in this series useful for micro and for the boards.
- Vitreoretinal Surgery RE501 .W55 2008 is a good way to get oriented if you are spending a morning in the OR with a vitreoretinal (VR) surgeon.
- Basic Ophthalmology is good; an old edition is fine.
In the words of my attending, “Basic Ophthamology is too basic; Practical Ophthalmology would be practical.
- EyeGuru.org is good for learning the exam, interpreting fields and OCTs, etc.
- Tim Root’s videos are really funny and entertaining. He also has some good slit lamp findings up on there. See https://timroot.com/videos/.
- https://www.pre-ophtho.com has good links to books and resources.
- Ophthalmologist, cancer survivor, and comedian “Dr. Glaucomflecken” has been writing up hilarious blog posts like this one on OTC eye drops and this one on chalazia that are well worth a read!
- Tim Root has two podcasts covering the basics (the eye exam and anatomy): https://timroot.com/extras/.
- Dr. J. Lawton Smith recorded some really good neuro-ophtho lectures in the 1970’s. They’re really funny since he uses wacky South Carolina idioms (“happier than a dead hog in the sun,” “Marcus-Gunn pupil wide enough to drive a Mack truck through it,” “enough Mydriacyl to float the Queen Mary,” “MMM-mmmmm!” “rare as hen’s teeth,” “more hypermetropia than you can shake a stick at,” etc.). Find them at https://novel.utah.edu/Smith/outline.php They are a bit dated, however. The first ten or so are more boring, but then Dr. Smith starts drinking more coffee and using weirder idioms, so they get much more “high energy” and exciting. He has some really “knock-out” patient interviews on some of the tapes.
- Straight from the Cutter’s Mouth: A Retina Podcast (http://www.retinapodcast.com/)—Lots of episodes; very hit-or-miss and way too much sports talk on some of them! I recommend the ones where they interview Dr. Matthew Weed about inherited retinopathies (Ep. 76, 62, 56, 23). The matched MS4 panels (Ep. 89 and 21) are also quite good.
- Eyetube.net podcasts
- New Retina Radio—Great content but the most annoying transitions possible. Definitely check out the anti-VEGF biographies!
- Ophthalmology off the Grid—Excellent content! I wish it came out more often. Often focused on cataract surgery and innovations. Ep. 29, “From Engineering to Vitrectomy” is pretty inspiring; the interviewee is a machine and a standout in the field.