Vision is central to the apprenticeship of ophthalmology residency training. As clinicians who diagnose and treat diseases of the eye, ophthalmologists build their professional identities around the mission of safeguarding their patients’ sight. At the same time, ophthalmologists rely on their own vision as they peer into the eye to detect subtle signs of disease. Based on an extended ethnography of an ophthalmology residency programme, as well as autoethnographic analysis of ophthalmology training, this article explores how novice trainees learn to view the eye by considering two fundamental examination techniques. The first is slit lamp biomicroscopy, where a table-mounted microscope is used to view ocular structures in fine detail. The second is binocular indirect ophthalmoscopy, where examiners view the retina using a head-mounted instrument in conjunction with handheld lenses. Rather than framing visual interpretation as a cognitive exercise in identifying pathology, I instead consider these techniques as embodied practices where trainees must discipline their movement, attention, and use of instrumentation to make the eye visible. This process of embodiment, in turn, unfolds within a broader terrain of affects as trainees marvel at what they behold, yearn to see more, and fear the limitations of their own vision while they learn to perform challenging examination manoeuvres. Situating the ophthalmic examination in its embodied and affective contexts illustrates the sensibilities that ophthalmology residents come to inhabit during their apprenticeship and which undergird the visual expertise of ophthalmologists.

A 5-year-old girl was referred for evaluation of blepharoptosis of the left eye present since birth (Figure). Her mother reported that, since infancy, the child's left eye has twitched during feeding and mealtimes. The patient was born at term; had an unremarkable delivery; and had no history of developmental delay, trauma, or systemic illness. Her ocular history was significant only for bilateral mixed astigmatism (−0.25 + 0.75 × 145 OD and −0.25 + 1.00 × 005 OS). There was no family history of strabismus, amblyopia, or congenital ptosis. Her best-corrected visual acuity was 20/30 OD and 20/40 OS. Pupils were reactive to light bilaterally, and there was neither an afferent pupillary defect nor anisocoria. Extraocular motility was full. There was notable asymmetry in the following eyelid measurements: palpebral fissure height (10 mm OD; 5-6 mm OS) and margin reflex distance 1 (3.5 mm OD; 0.5-1.5 mm OS). In addition, elevation of the left upper eyelid was observed with lateral jaw thrust but not with anterior-posterior jaw movements or with mouth opening and closing. The levator function was 14 mm OU, and the margin crease distances were 5 mm OD and 6 mm OS. The remainder of the anterior and posterior segment slitlamp examination was unremarkable.

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