Basic and Clinical Sciences Applied to Ophthalmology
Core concepts
Integrate pharmacology (drug classes, mechanisms, side effects), microbiology (common pathogens, culture, antibiotics), genetics (inherited retinal dystrophies, retinoblastoma), and evidence-based practice (study design, sensitivity/specificity, number needed to treat).
Know the key drugs: prostaglandins, beta-blockers, steroids, antibiotics, and anti-VEGF agents. Understand the principles of antibiotic selection and resistance. Learn the genetics of common conditions (e.g., RB1 in retinoblastoma, ABCA4 in Stargardt).
Traps
- Confusing sensitivity and specificity.
- Overlooking drug side effects (e.g., beta-blocker-induced bronchospasm).
- Not considering genetic testing in inherited disease.
- Misinterpreting study results without considering bias.
Rule of thumb
Sensitivity rules out disease; specificity rules in; and always consider the pretest probability when interpreting tests.
Worked example
A screening test with high sensitivity is useful for ruling out disease; a high-specificity test is useful for confirming it. In a low-prevalence population, even a specific test can have a low positive predictive value.