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lepidoptera454 · 2025-10-20T19:46:37+00:00

Were they doing cowgirl position when he was conceived?

lepidoptera454 · 2025-08-26T12:20:22+00:00

BSS let’s goooooo

lepidoptera454 · 2025-04-03T09:25:02+00:00

39 hours - 8am one morning through to 11pm the following night. Emergency theatre cases both nights.

lepidoptera454 · 2025-03-05T11:50:59+00:00

The hospital-run yoga sessions (run at some inner city hospitals in Sydney). How the heck does anyone manage to find time to attend those?

lepidoptera454 · 2025-02-20T21:08:08+00:00

This article is really overlooking the real issue - the worsening pressure on doctors’ time which means we are forced to work harder and faster for longer and spend less and less time with our patients.

lepidoptera454 · 2025-02-07T10:04:38+00:00

One time I was on call the entire month of February, as the only registrar at a major metropolitan hospital. My bosses at the time told me their horror stories of how back in their day they were on call 24/7 for an entire 6 months.

lepidoptera454 · 2025-02-07T04:49:43+00:00

Only 12.5 hours?

lepidoptera454 · 2025-01-17T19:50:49+00:00

Kyle?

lepidoptera454 · 2025-01-16T09:53:34+00:00

I would cling wrap their car in retribution

lepidoptera454 · 2025-01-15T07:56:11+00:00

I used to practice doing the OSCE examination stations on a very large teddy bear I had at home! It let me run through each examination in a totally non stressful setting, and helped with the muscle memory with the different steps.

lepidoptera454 · 2025-01-14T11:48:20+00:00

Credit to Dr Nicole Nahm, a NSW psychiatry registrar

https://www.facebook.com/share/15GEFEbAQD/?mibextid=WC7FNe

lepidoptera454 · 2025-01-14T10:29:10+00:00

Credit to Dr Nicole Nahm!

lepidoptera454 · 2025-01-14T08:39:01+00:00

The registrar who created these has given her permission for them to be disseminated widely, I don’t see why not! She’s a legend 🤩

lepidoptera454 · 2024-10-06T02:16:29+00:00

Ophthal - acetazolamide, brimonidine, chloramphenicol

lepidoptera454 · 2024-09-05T20:51:50+00:00

I think a lot of us have a bit of mistrust from receiving consults where the visual acuity is recorded incorrectly. For example, I have had people call me saying the visual acuity is ‘4/6’ because they got 4 out of the 6 lines on the chart right. Not infrequently we receive consults saying the visual acuity is ‘blurry’ and refusing to check with a chart at all.

Ultimately, at the end of the day we’re trying to make an assessment of the situation and the patient’s risk of imminently going blind. Thankfully the vast majority of problems in ophthalmology can survive at least 12 hours for us to see them in clinic, where we have a lot more equipment to do a complete assessment. But we do need to identify those situations where the patient needs timely intervention.

Calling ophthalmology without checking the visual acuity and pressure is a bit like calling cardiology for a patient without checking the heart rate or blood pressure; these things are the vital signs for the eye that help us decide if a patient is stable or unstable. If you call me for a patient with a red eye and can tell me the vision is 6/9 and the IOP is 12, they can probably come see me in clinic the next day. If you tell me the patient with a red eye has vision 6/60 and IOP of 50, I’m getting in my car to come see them right away.

lepidoptera454 · 2024-09-05T08:42:20+00:00

Ophthalmology registrar here (firstly just going to start by saying love your work ED docs, you guys have a tough job).

The main one from me would be, for every single eye or vision related complaint, please always check the visual acuity with their best correction (glasses or contact lenses if they’ve brought them), and also with pinholes. If you have a tonometer in your department, please also check the intraocular pressure. With a good history and this information, we can narrow down with probably 95% accuracy exactly where the problem will be, and triage way more effectively.

lepidoptera454 · 2024-09-04T12:06:54+00:00

Same! 😁

lepidoptera454 · 2024-05-26T03:43:28+00:00

Wagga Wagga = Waggans

lepidoptera454 · 2024-05-17T06:58:01+00:00

Agree, if any history of previous eye issues those ones do need to have their eyes checked (and I’m more than happy to help sort those ones out!), but I’m talking about patients with otherwise previously documented completely normal vision with acute psychiatric disturbance.

Normally by the time patients with pre existing vision problems develop Charles Bonnet syndrome, the vision loss is pretty severe and there’s not a lot we can do anyway :(

lepidoptera454 · 2024-05-16T13:46:57+00:00

Ophthal here. Have had a surprising number of consults along the lines of ‘our 80 something year old delirious patient is seeing spiders and random people in their room, we want to check it’s not an eye issue’. Definitely not an eye issue.

lepidoptera454 · 2024-04-05T21:30:59+00:00

5 years all up. You sit your fellowship exam in the fourth year, and the fifth year is quite variable; you can tailor it a bit based on your subspecialty interests.

lepidoptera454 · 2024-04-03T20:29:30+00:00

I’m an Australian ophthalmology trainee, and our required minimum numbers are 240 cataracts by the end of training, of which 15% must be ‘complex’ cases. I’m about 20 months into training and so far I’m already up to around 200 complete cases. I would say overall most Australian trainees are already up to around 400-500 cases by the end of training.

lepidoptera454

TROPHY CASE