Hi everyone! I’m an ophthalmology resident in Spain, and I’ve developed a cataract surgery training simulator called CataTrain!
A while ago, I shared a video of one of my first cataract surgeries here. Since then, I’ve performed over 200 in a year! Alongside supervised surgical experience, practising with this device at home and in the operating room has helped me improve much faster.
I built it because I wanted a simple, affordable way to practise more often. Other simulators are waaay to expensive and only incluye a few capsulorrhexis and exercices. In this model I include 100+ capsulorrhexis and multiple free exercises that have helped me develop my surgical skills. Now I’m making it available to other residents around the world who might find it useful too for an afordable 59.90€ price.
I’m sharing a video showing the exercises you can do with it. Happy to answer questions or hear your feedback here, by email at hello@catatrain.com, or on Instagram @cata.train!
http://www.catatrain.com
Instagram Cata.train

Hi everyone, I recently secured an interview for a Medical Retina fellowship at a Canadian program. As an (IMG) without prior experience in the Canadian/American interview process, I would love some insight into what to expect.

​Will the interview focus heavily on clinical/case-based questions, or is it primarily behavioral and fit-focused? Any advice on how best to prepare would be greatly appreciated. Thank you

I saved this Ocular 90D lens from being thrown away by our clinic the other day. In its present state it's quite unusable due to the deep scratches on the user side. Do you guys know if there is a way to somehow polish it and bring it back into work? I'm a resident.

Hello , I would like some guidance on how to prep for FRCOopth part 2 written and frcs part 2 written
What are the best books to read ? The most useful questions banks ? And how to prepare for the exam ! Any guidance will be helpful thank you

Is there anybody out here that tested the Zumax microscope?

**Ophthalmology resident**

For anyone interviewing for cornea/refractive/anterior segment fellowships this cycle, here's a shared spreadsheet to compare actual fellowship impressions, interview dates, case volume, etc. across programs:

https://docs.google.com/spreadsheets/d/1GNyu9Nostz0KNEvi41hAqvMsHvzoe0OvbaR_t9E_YXs/edit?usp=sharing

If you've received surgical case numbers during an interview or presentation, please add them! Even partial data are helpful.

A few things to keep in mind:

• Enter actual reported numbers rather than estimates.
• Include the reporting year/source whenever possible.
• Leave unreported procedures blank rather than entering zero.
• No names or identifying information about contributors are needed.

Hopefully we can get enough programs represented to make this useful for everyone before rank lists are due, then have those interviewing next year add tabs for their season.

I’m a final-year medical student from Greece, planning to pursue ophthalmology in the UK.

However, after reading about the difficulties IMGs face when applying for specialty training, I’m starting to feel quite discouraged.

What are the realistic pathways for an IMG to enter ophthalmology training in the UK in 2026? Is it possible to secure an ST1 training number directly, or is it more realistic to start with a non-training post, such as a clinical fellow position

I’d really appreciate hearing from IMGs who have gone through this process, or from people familiar with the current UK ophthalmology recruitment system.

Hello fellow eye nerds,

Whilst working in the eye clinic, I’ve found most patients are unaware of the various refractive targets that they can choose from which makes it difficult in a public clinic to pick the right IOL in 5 minutes (even though it’s just single focal IOLs +/- torics) for them.!

I tend to go for emmetropia OU as it’s the most safe but what’s everyone’s thoughts on this?

There’s also monovision, mini monovision, myopic aim. If it’s monovision/mini - my advice is to get a contact lens trial with their Optom to ensure they’re not anisometrooic and they actually like it - which is not doable if they have a dense cataract (as is the case in the public system).

Some ophthalmologists I’ve talked to state that monovision essentially takes away your stereopsis? But some ophthalmologists (that have had R emme and L -0.75 post phaco/IOL) simply adjust their microscope power for each eye and operate completely fine - is that because they “regain” their stereopsis by doing so?

Is the new thought to make previous myopes emmetropic? So that they are more glasses independent and less likely to fall over as they age?

And what about torics? Usually I try to pick a toric if the IOL master + Pentacam + Glasses matches up nicely. But some consultants won’t put a toric in for <1.5D of cyl especially if it is ATR astigmatism as they believe that the main wound incision will flatten out that meridian and reduce their toricity.

How do you best optimise a pre-op patient for cataract surgery? I find sometimes they will have a bit of dry eye or blepharitis/MGD and so their pentacam is irregular appearing but still kinda matches with their IOL master and glasses. But because it’s irregular, a lot of my seniors will opt for a spherical lens and then they come back with an unaided VA of 6/12-6/9. Idk - that would piss me off as a patient so I wonder how do you guys optimise the cornea before hand? And is there anything else to optimise?

I’ve seen some consultants do warm compress + low dose topical steroids (FML BD) + lubes + gel/ointment for a month then bring back the patient. What about oral azithromycin for 3 days or novatears with omega3 or oral omega 3 supps?

Just a junior doctor wanting to get better and do better for my patients 😎

Any experience with using thermal cautery (endolaser/ecp) to tamponade a hemorrhage after a goniotomy procedure?

I have a patient with an 8 ball hyphema after MIGS. POW1 he continues to have brisk bleeding from the angle and will require a washout secondary to high IOP.

I have seen articles reference the use of cautery for bleeds brisker than the slow leak of a collector channel but have not found any case reports with actual examples.

Any advice appreciated

Hi guys, I need to make a difficult decision and all the people that I know are pretty biased toward one of my options. I recently took a difficult test (it was horrible) in order to qualify for a medical residency (USMLE type thing). In my country, this works like this: You take a 6-hours test and you get your score immediately. Most of us know how much we need in order to select our first choice. About 60,000 physicians took the test, so even though you know how you did, it’s not certain that you’ll get what you want, because it depends on how well everyone else performed. Then you have to wait 3-4 weeks until the results are published and you’re assigned to a block of 100 people who will be able to choose the specialty and place for residency. There are nearly 500 blocks. Once you choose your desired specialty you can begin to meet all the requirements of the specific institution you selected. If the hospital doesn’t accept you or you don’t find the specialty of your interest in the first choosing round you can wait for the second round where maybe some spaces free up because rejection can happen. There are 4 rounds. For specialties like the one that I want (ophthalmology) it’s rare, if not impossible, that you can find a spot in the second choosing round. 

Back to the problem, I scored really great in the test and its very likely that I'm going to be in the first block or at least in the second one, so I can choose any specialty and hospital. The problem comes here, I have two options: doing my ophthalmology residency at a public hospital or at a private one. Both are pretty good but with some key differences:

The public one: for what I heard from some residents there, the workload is heavy, especially in your first year, so attending rarely have time to teach you. It’s mostly the senior residents the ones that do the teaching. In this hospital you don’t have lectures everyday because of the workload so you need to study on your own. One of the positive things and the main reason for wanting this hospital is that your surgical curve will be much larger (you will perform more phaco surgeries by your own) than it would be in private hospitals. It is not only an ophthalmology hospital so we can get consultations from other specialties. (I’m interested in internal medicine so it sounds nice to be able to be in touch with other disciplines and also learn from them in their specific fields). In this hospital once you choose it its almost impossible to get rejected.

The private one: everyone in my country (those who know something about ophthalmology) consider this the best hospital to be as a resident if you want to be an ophthalmologist. It’s a hospital exclusively dedicated to ophthalmology (this can be a good or a bad thing). It has several fellows so the majority of surgeries are going to be performed by them making the surgical curve shorter than the public hospital. Everybody says that in order to be a good surgeon you need to do a fellowship after your 3 years as resident (You can do that in the same hospital). The academia is exceptional, they have lectures everyday and have test regularly. This gives you the urge to study and perform well but it feels like being back in university once again (again, this can be a good or a bad thing). For you to be in this hospital you don’t only need to choose it, you also need to do an admission process where you need to gather some requirements, take an ophthalmology test and do an interview. All of this opens the door to get rejected and be in the need to repeat everything next year and be able to get a good score. 

I think I have a pretty strong case to be accepted in the private one but you never know. I’m also pretty unsure if it is worth to take the risk. So I wanted to know what would you do? Would you prioritize strong academics or a large surgical volume? I’m from México.

Hey!

I'm soon in the market for both a new OR microscope as well as a phaco machine and wondering what my options are before I start contacting reps and start shopping around.

Like many, I'm entirely trained on Alcon's Centurion platform and have used it extensively, but would really like to hear about your experience on other platforms, such as Bausch & Lomb Stellaris, Zeiss Quatera 700, J&J Veritas and other that I'm not even thinking about.

Positive and horror stories about servicing and such are also welcome!

When it comes to microscopes I've tried a few, mostly used to Leica scopes and a Zeiss Lumera, have no problem with these. Didn't really love Alcon's microscope. Have any of you tried out the Haag-Streit Metis or any other "workhorse" OR scopes you would recommend?

Any pearls & pitfalls I should keep in mind? Anyone that has bought "blindly" into a new phaco machine without having been trained on it?

Thanks in advance!

I’m trying to repair a Welch Allyn 11720 ophthalmoscope. The bulb lights up, but no light beam comes out of the patient-facing opening.
After opening the head, I found a small rectangular mirror with a semicircular notch and a separate black rectangular piece (photos attached). The mirror appeared to be attached to tape and seemed out of position. I’m unsure whether the black piece is a backing, holder, or something else.
Does anyone familiar with this model know:
● Where these two pieces belong?
● Which direction the reflective surface and notch should face?
● How the mirror is normally secured?
I’ve looked at the service manual and parts diagram, but they show the optical tube as a complete assembly without enough detail to locate these pieces.
A close-up photo of an intact assembly or a repair guide would be really helpful. Thanks!

Learning Neuro-ophthalmology can be difficult at times, and teaching it, I see students and trainees struggle with the same things:

• Static images can't show movement. Nystagmus, saccadic intrusions or an INO only really make sense when you see them move.
• YouTube is patchy. Quality varies, you can sit through minutes of video for a few seconds of the actual sign, and some are labelled wrong (I've seen a right INO called a left INO more than once, or mislabelling a saccadic dyskinesia).

So I built Eyemo: 50+ conditions animated with accurate, clearly labelled eyes in every relevant gaze position, plus 200+ quiz questions. It covers INOs, 3rd/4th/6th nerve palsies, vertical gaze palsies, nystagmus, saccadic intrusions and pupil disorders.

Before launch, 14 testers (students, residents, fellows and a neuro-ophthalmologist) rated it 5.0/5 for accuracy and 4.87/5 for recommending it to novice learners.

Full disclosure: I made it. The beginner level is free. That's 12 core conditions (INO, 3rd/4th/6th nerve palsies, Horner, RAPD, upbeat/downbeat nystagmus and a few others) plus 20 quiz questions. The intermediate conditions, e.g. one-and-a-half, opsoclonus, seesaw nystagmus) and advanced (e.g. Duane, Bruns, aberrant 3rd nerve regeneration) levels are a one-off in-app purchase, alongside 200 quiz questions. https://eyemo.app

Which neuro-ophth sign did you find hardest to learn? I'm always looking for what to animate next, and happy to answer any questions.

Hi everyone! 😊
Is anyone else taking the EBO exam next Friday?
I was wondering if anyone has any last-minute tips, recommendations for question banks, or knows of any study groups where we could share experiences and help each other prepare.
I’d be incredibly grateful for any advice or resources, especially from those who have already taken the exam!
Thanks so much in advance, and good luck to everyone preparing! 🤞

Hi everyone, I’m a second-year ophthalmology resident and I started learning cataract surgery about a month ago.
I actually completed my first full cataract surgery last week, which went quite well, but I’m still having some difficulties in the cases after that.
The capsulorhexis is going well for me, as well as the other steps such as cortical aspiration and IOL implantation. The most difficult part for me at the moment is hydrodissection and especially cracking the nucleus.
With hydrodissection, I enter under the capsule, lift the edge of the rhexis slightly and inject, but I often have difficulty seeing a clear wave passing through the nucleus. I usually see small “pseudo-waves” or little waves, but rarely a clear wave that travels all the way across the nucleus.
I usually try again from the other side, at 6 and 12 o’clock, and eventually the fluid passes through, but sometimes I feel like I’m filling the space too much between the posterior capsule and the nucleus.

I’ve watched many videos from Cataract Coach and other cataract surgeons on YouTube, but despite that, my hydrodissection only works occasionally.
All my colleagues tell me that it mainly comes with experience, but since we are many residents we need to improve as much as possible with every case.
For those of you who have more experience, what do you think are the most common mistakes that make hydrodissection difficult? Do you have any practical tips for getting a good hydrodissection wave and improving nucleus cracking?
Any advice would be really appreciated. Thanks!

Idk what is the situation in other countries, but in Ukraine residents often have to buy their own instruments, lenses, ophthalmoscope to be able to diagnose/treat. Can you give some advise on where to buy cheap (used) but quality instruments, lenses and so on. Some kind of auction or marketplace.

Hey everyone, how are you?
Basically, just what the title says. I’m currently doing my residency at a hospital that I won’t name because I don’t want to dox myself, but I’m not really happy there.
I was pretty disappointed that I didn’t get into Clínicas, Rivadavia, Lagleyze, or Santa Lucía. So I keep having this thought in the back of my mind that I’m training at a mediocre place instead of one of those hospitals. It really gets me down, and I think about it pretty much every day.
I’ve considered taking the residency entrance exam again, but ophthalmology is already very difficult to get into, so I’m not sure.
In case anyone is wondering what I don’t like about my current program:
Patient volume: It’s very low, and most of the patients are elderly.
Surgery: There isn’t much surgical volume.
Academics: We don’t really have case conferences or much academic activity within the department. We residents give classes to each other, but beyond that there isn’t much.
Few subspecialties: We have one attending who does orbit, one retina specialist, and two oculoplastics specialists. Other than that, there isn’t much.
Prestige: Being somewhere that isn’t particularly prestigious gets to my ego. I did my entire medical degree at Clínicas and was also a teaching assistant there, so it really bothers me that I’m not doing my residency there.
That’s pretty much it. I mainly wanted to vent and hear what you guys think.

Btw : I’m not from the states, I’m from Argentina.

3rd year (PGY-4) resident here.

I would like to some tips and demonstrative videos of how to safety take out the last quadrant.

I've broken bag twice so far, but both times, its been the same story.

White cataract with brunescent center, taking up the last quadrant, and there is a post-occlusion surge and the capsule comes up to the phaco tip.

I have been pushing the capsule back with my connor wand and I've been told that I am phaco-ing too close to the endothelium if anything...

Other things I've tried was to try epinucleus setting to slowly eat up the quadrant but it didn't really work for very dense cataracts like these.

Also I am trying to get partial occlusion of the tip rather than full occlusion, but its been kind of difficult to actually achieve this consistently.

If there are any tips or videos to avoid this post-occlusion surge causing capsule rupture, It would be immensely helpful.

Low key everytime I see a dense cataract, I feel like I will go into the surgery scared unless I have a good way of preventing this from happening.

Thank you in advance.

I finished my residency a little over a year ago and I’m now working at a different hospital. We also use the Alcon Centurion for cataract surgery, but here the handpiece heats up very quickly, making it very easy to burn the main incision.
To avoid burning the incision, I’ve found that I have to press the foot pedal only halfway and use short bursts, because if I press it all the way down, the handpiece gets extremely hot.
Has anyone else experienced this? Personally, I never had this problem when using the Centurion before, but I’m having it consistently at this hospital.
Any advice on how to troubleshoot or fix this problem would be greatly appreciated. Thanks!

I am having trouble finding the right power for sculpting. Sometime, the attending says I use too much power and other times not enough. I also keep moving the eye away from the me. Any tips? - a PGY3 struggling in surgery 😑

Had this came in yesterday (36F). She has no visual complain other than needing new spectacle

Spread of competence

Ultra-widefield (UWF) pseudocolor fundus imaging of a 15-year-old girl with CHARGE syndrome shows large, dysplastic optic nerve head colobomas extending inferiorly in both eyes (A, B). Corresponding UWF swept-source OCT (DREAM OCT, Intalight) B-scans reveal multilobulated, deeply excavated colobomatous discs with an aborted inferior coloboma, marked chorioretinal atrophy, and intrachoroidal cavitations. In the right eye, subretinal fluid is adjacent to the colobomatous complex, possibly arising from microdefects within the coloboma permitting aberrant communication between the intrachoroidal and subretinal spaces (C). The left eye shows a similar colobomatous excavation with local separation of the posterior hyaloid (D).

From “Choroidal Cavitations within Optic Nerve Colobomas in CHARGE Syndrome” by Alberto Quarta, MD, Monica Khitri, MD, Srinivas R. Sadda, MD. Published by Ophthalmology Retina online on February 11, 2026.

Read: https://www.ophthalmologyretina.org/article/S2468-6530(26)00020-5/fulltext00020-5/fulltext)

Hi! I’m currently studying for the EBO exam. Does anyone know of any Telegram, Discord, or WhatsApp groups where candidates share or discuss questions from previous EBO exams?
Also, if you’ve already taken the EBO, I’d really appreciate any tips, tricks, recommended resources, or advice on what to focus on while preparing. Thanks! :)

I don't think residents are exposed nearly enough or early enough to refractive surgery or premium cataract surgery and rightly so given that as physicians, our training should be focused on identifying and managing pathology and disease. However, I think it's a career field that often gets overlooked or downplayed in academic residencies so many residents don't get the exposure unless one actively seeks it.

Given the yearly discussion of falling cataract reimbursements and the decline in rates of laser vision correction surgery such as LASIK, I was curious if there were any lurkers on this sub who are highly refractive/premium lens surgeons in private practice who can briefly talk about their thoughts on things like job satisfaction, future-proof/predictions on if the field will continue to expand, lifestyle, if you recommend more residents take a serious look into it, or if it's a very competitive field that requires savvy marketing and business acumen to thrive?

Unfortunately I don't think I'll be able to go to AAO or ASCRS this year so some online discussions would be very insightful! thank you