Nature of the work

Medical ophthalmology or ophthalmic medicine is a holistic specialty which provides specific expertise in the diagnosis and medical treatment of people with disorders of vision. More than 50% of new ophthalmic referrals present with a medical rather than a surgical problem so medicine comprises a large proportion of the workload of any eye department.

Working in medical ophthalmology

The workload of an ophthalmic physician is very varied and consists of the management of the main causes of permanent, but increasingly treatable, causes of visual impairment in the United Kingdom:

• inflammatory disorders affecting vision (e.g. uveitis, thyroid eye disease, systemic vasculitis)
• neurolological disorders affecting vision (e.g. multiple sclerosis, myasthenia gravis, pituitary tumours)
• retina-specific disorders affecting vision (e.g. age-related macular degeneration)
• vascular disorders affecting vision (e.g. diabetes, diabetic retinopathy screening, stroke, hypertension)
• genetic disorders affecting vision (e.g. retinitis pigmentosa)

Medical ophthalmology is an emerging medical specialty in the United Kingdom. In the future it is expected there will be one ophthalmic physician per 263,000 of the population. The Royal College of Ophthalmologists’ survey, Demand for Medical Ophthalmology, found that many units wished to have an ophthalmic physician to enable them to deliver effective care.

Common procedures/interventions

Therapeutic procedures performed by ophthalmic physicians include laser for diabetic retinopathy, intraocular injections of anti-vascular endothelial growth factor agents for age-related macular degeneration, diagnostics taps of the anterior segment and vitreous for ocular infection and botulinum injections for facial dystonias. Anti-vascular endothelial growth factor agents have revolutionised the treatment of age-related macular degeneration. They are likely to do the same for diabetic retinopathy and other vascular retinopathies.

Associated sub specialties

There are no associated sub-specialties of medical ophthalmology. However, ophthalmic physicians work closely with specialists in ophthalmology, dermatology, endocrinology and diabetes, infectious diseases, medical genetics, neurology, neurosurgery, rheumatology and stroke medicine.