We read with interest the paper by Scantling-Birch et al. [1] Core clinical skills are imparted to medical students during undergraduate training to enable them to function as a junior doctor: triaging, differential diagnoses, referral and management planning of patients. The authors argue that the gradual phasing out of ophthalmology teaching from medical schools has led to decline in the clinical confidence amongst medical students [1].

Most referral requests originated from medical specialties (62%; n = 129), neurosurgery (17%; n = 35), and intensive/critical care (14%; n = 30). 55% (n = 115) offered a differential diagnosis at referral. Most frequent diagnostic categories found on clinic review were ocular findings associated with systemic disease (31%; n = 50), of which (23%; n = 38) were acute cranial neuropathy, anterior segment pathology (20%; n = 33), and 29% (n = 48) had no acute ocular pathology.

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