How to Present Cases to Your Ophthalmology Consultants
- Atanas Bogoev M.D. and Maria Bogoeva
- 5 days ago
- 5 min read
Sounding smart won't gain the trust of your ophthalmology consultants. You need to present cases in a manner that's clear, structured, and clinically reliable. A good case presentation shows that you can think, prioritize and take responsibility. A poor one signals uncertainty, even if you are very knowledgeable.
Case Presentation Matters More Than You Think
Consultants listen for problems, not stories. They want to know why the patient matters now and what needs to happen next.
Presentations should not turn into long stories. Not because details are unimportant but because too much information can mask the key issue. Before you speak, you should already know what the general problem is and what decision it requires. Be straightforward and show confidence in what you present.
If you are unsure what you are asking from the consultant, the case presentation will feel incomplete.
Presenting Cases in Ophthalmology
Start Strong and Set the Frame Early
The first sentence matters more than most trainees realize. It frames the entire discussion.
A strong opening tells the consultant who the patient is, what stage they are in, and why they are being discussed. This allows the listener to orient themselves and focus on the relevant information.
If the consultant has to ask basic clarifying questions in the first seconds, confidence in the presentation drops.
“Umm… this is a patient with… decreased vision… maybe AMD, I think…” “This is a 82-year-old peseudophacic patient with progressive painless vision loss in the right eye over 1 year, metamorphopsia, with history of dry macular degeneration.”
Present Information With Purpose
Every detail you include should serve a reason. Either it explains the problem, supports your assessment, or influences management.
Listing normal findings or unrelated history weakens your message. Do not do it. If the finding is normal, you do not need to mention it. Consultants assume you have checked the basics. What they need is the information that changes thinking or action. But if there is a mismatch of the expected normal finding, then it is a good idea to emphasise on it.
"A 36 year old patient with history reaccuring of ideopathic uveitis anterior of the right eye presents with decreased vision, conunciva is not injection, no corneal precipitates, no AC cells."
If you mention a value, examination finding, or test result, you should understand what it means. Reporting numbers without interpretation signals insecurity.
"In the OCT of the optic nerve all of the parameter are aousude of the normal value range… ”
Interpretation Builds Trust
Consultants trust trainees who interpret findings, even if their conclusions are not perfect.
Saying what you think is happening shows that you care about the case. It tells the consultant you aren't just good at gathering the data, but processing it. You don't need to sound confident. You need to sound thoughtful and interested.
Always connect findings to meaning.
This is a 68-year-old patient. Visual acuity is 0.3. OCT shows central thickness 520 microns. There are some changes in the macula.” “This is a 68-year-old patient with reduced vision to 0.3. OCT shows central thickness of 520 microns consistent with macular edema, which likely explains the visual loss.”
Show That You Have Thought Ahead
Consultants love to see you thinking one step further. And you don't have to propose complex plans. Show awareness of possible next steps and risks.
Even simple reasoning is taken as maturity. Consultants are far more comfortable correcting your plan than building one from nothing.
“This is a 71-year-old glaucoma patient. IOP is 28 and 31 mmHg on 3 medications. Here are the Perimetry and the OCT of the ONH. He presented in our clinic 2 weeks ago and had a corneal foreign body which was extracted with topical anesthesia. He sais that he still has foreign body sensation sometimes after he puts his drops, and they feel like they are burning. ”This is a 71-year-old glaucoma patient with open angle, IOP of 28 (OD) and 31 (OS) mmHg despite maximal topical therapy (3 medications) and signs of progression (shows the disgnostic tests). I’m concerned this is uncontrolled glaucoma. I would consider recommending microinvasisve glaucoma surgery and saw that we hav availability to operate the patient next week. I would suggest to start with the left eye first.
Be Honest About What You Don't Know
Nothing damages trust faster than pretending.
Consultants expect uncertainty, especially from junior doctors. What they want is honesty paired with initiative. If something is unclear, say so. Then explain what you have already checked and what you plan to do next. This shows responsibility rather than weakness.
(Resident presents): “This is a patient with tractive retinal detachment due to proliferative diabetic retinopathy planned for pars plana vitrectomy. No relevant systemic issues.” (Consultant asks): “Did you specifically ask about anticoagulants or antiplatelet therapy?” - - (Resident): “Yes… I mean… I think so… he said no.” (Later discovered: patient is on Apixaban)
(Resident presents): “This is a patient with tractional retinal detachment due to proliferative diabetic retinopathy planned for pars plana vitrectomy." (Consultant asks):“Did you specifically ask about anticoagulants?” (Resident): “No, I realize I didn’t ask specifically about anticoagulation - that’s my oversight. I ask the patient again and if it is not clear, I will contact his family doctor to confirm current medications before proceeding.”
Know Your Patient Thoroughly
A clear presentation cannot compensate for poor preparation. You should know the patient’s key details without hesitation. Age, reason for admission, procedure performed, timeline, and current status must be immediately accessible.
Confusing laterality, dates, or basic facts signals a lack of ownership and undermines confidence quickly.
“This is a patient with a corneal ulcer… I think in the left eye… or right… I’m not sure. Vision is reduced. He had some symptoms for a few days… I believe since Thursday... don’t remember exactly when it started. I will check in the file once again...” “This is a 54-year-old patient with a 3-day history of pain, redness, and reduced vision in the right eye. Examination shows a central corneal ulcer with stromal infiltration and overlying epithelial defect. Vision is 0.1. I’m concerned about infectious keratitis requiring urgent treatment.”
End With a Clear Plan or Question
Never end a case presentation passively. A consultant expects either a proposed plan or a clear question. This shows that you understand the decision point and are ready to act.
Silence at the end of a presentation forces the consultant to take control and reduces your perceived autonomy.
“This is a 68-year-old patient with cataract and reduced vision. Biometry has been done. Axial length is 24.5 mm. Keratometry is normal. The patient wants surgery.” “This is a 68-year-old patient with visually significant cataract of both eyes. Biometry shows axial length of 24.5 mm with regular astigmatism of 1.25 D. I would consider a monofocal toric IOL targeting emmetropia (the patient wishes emetropia). Would you agree with this plan or suggest something different?”
Bonus Video from Learn About Eyes
Before you go back to presenting patients to your attending, check out this video by Dr. Lorenz Kuske on how to present a case over the phone.
In Summary...
Consistent, clear case presentations change how consultants interact with you.
You will be trusted with more responsibility, receive better teaching, and be included earlier in decision-making. Good presentation skills need to be practiced and do not come from talent alone.
Consultants don't expect perfection, but clarity, honesty, and clinical thinking.
ABOUT THE AUTHORS
Atanas Bogoev, M.D., FEBO is a consultant ophthalmologist, eye surgeon, and co-founder of Ophthalmology24. Atanas has trained internationally, attending courses at Harvard Medical School, Oftalmo University, and completing observerships such as the GAASS program in Toronto. He combines surgical experience with a passion for education, translating surgical best practices and clinical learning into accessible resources.
Maria Bogoeva is a medical writer with over 11 years of experience in copywriting and content strategy. She’s the founder of Ophthalmology24, where she leads the creation of clear, practical, and medically accurate content for ophthalmologists and patients. Her mission: make ophthalmology education more accessible and engaging worldwide.
