Confidence at the Slit Lamp: The Case for Accessible, Low-Cost Training

Effective use of the slit lamp is a fundamental skill for ophthalmologists. However, ophthalmology teaching plays a diminishing role in many medical school curricula, with limited or no slit-lamp training. As a result, many residents begin specialty training without formal prior experience. A 90-minute introductory course was delivered to first-year ophthalmology residents across the deanery. The session comprised four short talks covering slit-lamp components, corneal examination, posterior segment examination, and gonioscopy with Goldmann applanation tonometry. Three of the four talks were delivered by second-year ophthalmology residents, with fourth-year ophthalmology residents providing senior oversight and addressing more complex queries. This was followed by a practical session in which residents practiced gonioscopy, direct and indirect fundoscopy, and corneal examination using SimulEYE and Reti Eye models. Pre- and post-course feedback was collected using a 7-point Likert scale. Nine residents attended the session, and eight completed post-course feedback. All reported no prior formal ophthalmology experience. Mean confidence scores improved across all domains: slit-lamp knowledge (2.9→5.1), corneal and anterior chamber examination (3.0→4.75), posterior segment examination (1.9→4.5), indirect ophthalmoscopy (1.3→3.9), and intraocular pressure measurement (2.0→4.38). All respondents found the session helpful in building their confidence with basic slit-lamp skills and recommended that it be included in the ST1 educational programme. The course significantly improved confidence in core slit-lamp and examination skills. Our model was non-paid, centralised, and resource sustainable, using reusable equipment and a peer-to-near-peer teaching structure with senior oversight. This format promoted open dialogue, reduced hierarchy, and improved engagement. Given its accessibility and the positive feedback received, we support its incorporation into trainee educational programmes and its replication across other regions.