BSAVA Ophthalmology Certificate with Andrew - First steps

On 6th May 2025, I attended the first module, delivered by Dr David Williams MA VetMD PhD CertVOphthal CertWEL FHEA FSB FRCVS, focused on the structure and function of the eye — laying a solid foundation for both accurate diagnosis and effective treatment in small animal ophthalmology.

I found the session incredibly relevant, combining core knowledge with clinically applicable detail — and it reminded me that even the most subtle ocular changes can signal deeper issues. Below are some of the key insights I took from the day.

Ocular Anatomy: Beyond the Globe

This first session covered a thorough review of the eye’s anatomy — not just the globe, but also the adnexa, which are often just as important in clinical practice.

• Eyelids – The eyelids play a crucial role in tear film distribution, corneal protection, and drainage via the lacrimal puncta. We discussed common lid disorders including entropion, ectropion, lagophthalmos, and neoplasia — conditions we frequently encounter in practice.
• Cornea – A closer look at the cornea’s four layers highlighted how structural integrity and clarity are maintained, and why full-thickness defects (down to Descemet’s membrane) are emergencies.
• Uveal tract – The iris, ciliary body, and choroid were explored in the context of inflammation, immune response, and intraocular pressure regulation.
• Lens and Retina – A refresher on lens anatomy helped clarify the development of cataracts and lens luxation. The structure of the retina and its blood supply were linked with practical discussions on pathology such as retinal detachment (often seen in cats with hypertension).

Function in Focus: Ocular Physiology in Action

Structure is only half the story — understanding how the eye functions adds depth to our interpretation of clinical signs.

• Aqueous humour dynamics – Vital for glaucoma diagnosis and treatment, we reviewed how aqueous humour is produced by the ciliary body and drained through the iridocorneal angle.
• Tear film – Emphasis was placed on the three-layer tear film (lipid, aqueous, mucin), and how dysfunction in any layer can lead to dry eye (KCS), discomfort, and secondary infection.
• Neurological pathways – We covered the reflex arcs of the PLR, menace response, and dazzle reflex — invaluable tools when distinguishing ocular from neurological causes of visual deficits.

Clinical Pearls for the First-Opinion Vet

Even in a foundational session, there were several practical takeaways directly applicable to general practice:

• Always examine both eyes — even if the client reports an issue in just one. Subtle asymmetries can be diagnostically significant.
• Don’t ignore eyelid conformation — Always try to examine the eyelids hands off at a distance first, as subtle entropion can be easily masked by even gentle pulling of the lids during closer exam.  Also, try to assess the lid margin carefully under magnification for distichia as these are easily missed and are often contributing to those stubborn non healing ulcers.
• Maximise your tools — Use your ophthalmoscope to assess anterior chamber clarity and lens opacity, not just the retina.

Why This Knowledge Matters in General Practice

Ophthalmic cases are common in small animal practice — and being confident in our basic examination and understanding of the eye can drastically improve outcomes. Knowing when a case is medical vs. surgical, or when to refer, starts with recognising normal anatomy and function.

This session highlighted how important it is to go beyond surface-level signs, and to integrate anatomical and physiological knowledge into every ocular exam.

The first module of the BSAVA’s Certificate in Veterinary Ophthalmology, was an excellent start to the programme. Revisiting core ocular anatomy — including often-overlooked structures like the eyelids — alongside essential physiological processes has already made a difference in how I approach eye cases in general practice.

For anyone with a developing interest in ophthalmology, I can highly recommend this course. I’m looking forward to building on this foundation in the modules to come.